Adherence to physical contact restriction measures and the spread of COVID-19 in Brazil

Szwarcwald, Célia Landmann; Souza Júnior, Paulo Roberto Borges de; Malta, Deborah Carvalho; Barros, Marilisa Berti de Azevedo; Magalhães, Mônica de Avelar Figueiredo Mafra; Xavier, Diego Ricardo; Saldanha, Raphael de Freitas; Damacena, Giseli Nogueira; Azevedo, Luiz Otávio; Lima, Margareth Guimarães; Romero, Dália; Machado, Ísis Eloah; Gomes, Crizian Saar; Werneck, André de Oliveira; Silva, Danilo Rodrigues Pereira da; Gracie, Renata; Pina, Maria de Fátima de

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Epidemiologia e Serviços de Saúde

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Original Article • Epidemiol. Serv. Saúde 29 (5) • 2020 • https://doi.org/10.1590/S1679-49742020000500018 copy

Adherence to physical contact restriction measures and the spread of COVID-19 in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To analyze the adherence of the population to physical contact restriction measures and the spread of COVID-19 in Brazil.

Methods:

This was a web-based health survey carried out from April 24 to May 24 2020 using a chain sampling procedure. Intensity of adherence to physical contact restriction measures was analyzed according to sociodemographic characteristics, using logistic regression models to investigate associations with ‘No/little adherence’.

Results:

Of the 45,161 participants, 74.2% (73.8;74.6%) reported intense adherence to the measures. The group that did not adhere to the measures was characterized by men (31.7%), those aged 30 to 49 (36.4%), those with low education levels (33.0%), those who worked during the pandemic (81.3%), those resident in the North (28.1%) and Midwest (28.5%) regions of the country. In Brazil as a whole, there was a decrease in COVID-19 daily growth rates, from 45.4% to 5.0%.

Conclusion:

A large part of the Brazilian population adhered to physical contact restriction measures, which possibly contributed to decreasing the spread of COVID-19.

Keywords:
Coronavirus; Quarantine; Pandemic; Epidemiology; Brazil

Sex	Age group (in years)	n	Intensity of physical contact restriction (%)
Sex	Age group (in years)	n	No restriction^a a) No restriction: changed nothing, led life as usual.	Little restriction^b b) Little restriction: sought to take care, to keep distance from people, reduced contact a little, sought not to visit elderly people, but continued to go out.	Intense restriction^c c) Intense restriction: stayed at home, only going out to shop at the supermarket or drugstore.	Total restriction^d d) Total restriction: stayed strictly at home, only going out if needed health care.
Total of the sample		44,914	1.5	24.2	59.2	15.1
Male	18-29	5,511	2.8	19.5	64.8	12.9
	30-39	4,383	2.8	40.0	49.0	8.2
	40-49	3,782	1.7	43.2	46.5	8.6
	50-59	3,207	2.0	30.8	57.3	9.9
	≥60	3,960	2.8	16.2	60.7	20.3
Female	18-29	5,601	0.4	16.3	71.3	12.0
	30-39	5,006	0.4	30.5	59.8	9.3
	40-49	4,373	1.3	27.6	60.2	10.9
	50-59	3,950	0.9	21.0	62.0	16.1
	≥60	5,142	0.8	6.1	54.0	39.1
Total	18-29	11,112	1.6	17.9	68.1	12.4
	30-39	9,389	1.5	34.9	54.8	8.8
	40-49	8,154	1.5	34.8	53.9	9.8
	50-59	7,157	1.4	25.4	59.9	13.3
	≥60	9,102	1.7	10.5	56.9	30.9

Macro-region	n	Intensity of physical contact restriction (%)
Macro-region	n	No restriction^a a) No restriction: changed nothing, led life as usual.	Little restriction^b b) Little restriction: sought to take care, to keep distance from people, reduced contact a little, sought not to visit elderly people, but continued to go out.	Intense restriction^c c) Intense restriction: stayed at home, only going out to shop at the supermarket or drugstore.	Total restriction^d d) Total restriction: stayed strictly at home, only going out if needed health care.
Total of the sample	44,914	1.5	24.2	59.2	15.1
North	3,431	0.6	27.5	57.0	15.0
Northeast	11,205	1.5	24.7	58.5	15.2
Southeast	20,494	1.5	22.8	60.1	15.7
South	6,752	1.6	25.7	58.5	14.2
Midwest	3,032	3.3	25.2	59.2	12.3

Sociodemographic characteristics	Category	N^a a) Excluded or cases with missing values.	%	No/little adherence (%)	OR^b b) OR: odds ratio.	95%CI^c c) 95%CI: 95% confidence interval.	p-value^d d) Statistical test of odds ratio (OR) being significantly greater than 1.00.
Total of the sample		44,914	–	25.8	–	–	–
Sex	Male	20,842	46.4	31.7	1.79	1.69;1.85	<0.001
Sex	Female	24,072	53.6	20.6	1.00	–	–
Age group	18-29	11,112	24.7	19.5	1.74	1.61;1.88	<0.001
	30-39	9,389	20.9	36.4	4.12	3.82;4.45	<0.001
	40-49	8,154	18.2	36.3	4.01	3.79;4.43	<0.001
	50-59	7,157	15.9	26.8	2.63	2.43;2.86	<0.001
	≥60	9,102	20.3	12.2	1.00	–	–
Race/skin color	White	20,408	45.4	23.6	0.81	0.78;0.85	<0.001
Race/skin color	Non-White	24,506	54.6	27.6	1.00	–	–
Level of schooling	Incomplete high school education	4,909	11.0	33.0	1.91	1.76;2.08	<0.001
	Complete high school education	32,574	72.5	25.9	1.36	1.28;1.44	<0.001
	Complete higher education	7,431	16.5	20.5	1.00	–	–
Work situation during the pandemic	Did not work	24,121	54.3	10.4	1.00	–	–
	Worked	9,269	20.8	81.3	37.17	34.78;39.73	<0.001
	Word from home	11,047	24.9	13.1	1.29	1.21;1.39	<0.001
Macro-region	North	3,431	7.7	28.1	1.22	1.13;1.33	<0.001
	Northeast	11,205	24.9	26.2	1.11	1.05;1.17	<0.001
	Southeast	20,494	45.6	24.2	1.00	–	–
	South	6,752	15.0	27.3	1.17	1.10;1.25	<0.001
	Midwest	3,032	6.8	28.5	1.24	1.15;1.36	<0.001

Week	Period		Brazil	Rates (%) of daily growth
Week	Start	End	Brazil	North	Northeast	Southeast	South	Midwest
2	4/Mar	10/Mar	45.4	–	29.7	40.7	–	–
3	11/Mar	27/Mar	33.6	–	31.8	31.3	38.0	62.0
4	18/Mar	24/Mar	31.5	92.9	42.7	28.0	35.2	30.8
5	25/Mar	31/Mar	14.1	19.3	14.6	14.0	12.6	12.9
6	1/Apr	7/Apr	11.9	19.6	16.0	10.6	11.3	7.9
7	8/Apr	14/Apr	7.6	11.6	10.4	6.4	6.5	5.8
8	15/Apr	21/Apr	7.3	9.3	11.2	6.1	3.8	5.0
9	22/Apr	28/Apr	7.8	10.1	9.6	6.9	4.4	5.3
10	29/Apr	5/May	6.3	10.2	8.0	4.6	4.1	4.9
11	6/May	12/May	5.9	7.7	7.2	4.5	4.1	5.5
12	13/May	19/May	6.0	6.6	7.0	5.0	4.6	7.3
13	20/May	26/May	5.0	6.3	5.1	4.0	4.7	5.9

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
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[1] Correspondence: Célia Landmann Szwarcwald – Fundação Instituto Oswaldo Cruz, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT/Fiocruz), Av. Brasil, n° 4635, Pavilhão Haity Moussatché, Sala 225, Manguinhos, Rio de Janeiro, RJ, Brazil. Postcode: 21045-360. E-mail: celia_ls@hotmail.com