Negative-Binomial and Quasi-Poisson regressions between COVID-19, mobility and environment in São Paulo, Brazil

Brazil, the country most impacted by the coronavirus disease 2019 (COVID-19) on the southern hemisphere, use intensive care admissions per day, mobility and other indices to monitor quarantines and prevent the transmissions of SARS-CoV-2. In this study we quantified the associations between residential mobility index (RMI), air pollution, meteorology, and daily cases and deaths of COVID-19 in São Paulo, Brazil. We applied a semiparametric generalized additive model (GAM) to estimate: 1) the association between RMI and COVID-19, accounting for ambient particulate matter (PM 2.5 ), ozone (O 3 ), relative humidity, temperature and delayed exposure between 3-21 days, and 2) the association between COVID-19 and exposure to for ambient particulate matter (PM 2.5 ), ozone (O 3 ), accounting for relative humidity, temperature and mobility. We found that an RMI of 45.28% results in 1,212 cases (95% CI: 1,189 to 1,235) and 44 deaths (95% CI: 40 to 47). Increasing the isolation from 45.28% to 50% would avoid 438 cases and 21 deaths. Also, we found that an increment of 10 μg·m -3 of PM 2.5 results in a risk of 1.140 (95% CI: 1.021 to 1.274) for cases and 1.086 (95% CI: 1.008 to 1.170) for deaths, while O 3 produces a relative risk of 1.075 (95% CI: 1.006 to 1.150) for cases and 1.063 (95% CI: 1.006 to 1.124) for deaths, respectively. We compared our results with observations and literature review, finding well agreement. Policymakers can use such mobility indices as tools to control social distance activities. Spatial distancing is an important factor to control COVID-19. Small increments of air pollution result in an increased number of COVID-19 cases and deaths.