Social distancing measures to control the COVID-19 pandemic: potential impacts and challenges in Brazil

doi:10.1590/1413-81232020256.1.10502020

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ARTICLE • Ciênc. saúde coletiva 25 (suppl 1) • June 2020 • https://doi.org/10.1590/1413-81232020256.1.10502020 copy

Social distancing measures to control the COVID-19 pandemic: potential impacts and challenges in Brazil

About the SCIMAGO INSTITUTIONS RANKINGS

Abstract

The COVID-19 pandemic has challenged researchers and policy makers to identify public safety measures forpreventing the collapse of healthcare systems and reducingdeaths. This narrative review summarizes the available evidence on the impact of social distancing measures on the epidemic and discusses the implementation of these measures in Brazil. Articles on the effect of social distancing on COVID-19 were selected from the PubMed, medRXiv and bioRvix databases. Federal and state legislation was analyzed to summarize the strategies implemented in Brazil. Social distancing measures adopted by the population appear effective, particularly when implemented in conjunction with the isolation of cases and quarantining of contacts. Therefore, social distancing measures, and social protection policies to guarantee the sustainability of these measures, should be implemented. To control COVID-19 in Brazil, it is also crucial that epidemiological monitoring is strengthened at all three levels of the Brazilian National Health System (SUS). This includes evaluating and usingsupplementary indicators to monitor the progression of the pandemic and the effect of the control measures, increasing testing capacity, and making disaggregated notificationsand testing resultstransparentand broadly available.

Key words
COVID-19; Pandemics; Social distancing; Epidemiological surveillance

Country	Date of the 1st and the 50th confirmed cases	Type of Measurement (date of the start of implementation)					Time between the 50th case and the start of social distancing
		Isolation of suspected/confirmed cases	Social Distancing
		Isolation of suspected/confirmed cases	Closure of schools and universities	Social distancing encouraged	Mass gatherings banned	Total lockdown decreed
Germany	1^st:One case (local transmission) 27/01/2020 50^th: 29/02/2020	Individuals with symptoms should undergo testing and then self-isolate (06/03/2020)	Nationwide (14/03/2020)	The Prime Minister recommended avoiding social interaction whenever possible (12/03/2020)	No gatherings of >1,000 people. Otherwise, regional restrictions (only until lockdown) (08/03/2020)	Meeting of more than 2 people forbidden; 1.5 meters of distance between individuals (22/03/2020)	8 days
Spain	1^st:One case (imported) 31/01/2020 50^th:01/03/2020	Self-isolation for 7 days if symptoms of cough or fever are present (17/03/2020)	Nationwide (13/03/2020)	Social distancing and working from home recommended (09/03/2020)	All public events banned (14/03/2020)	Nationwide lockdown (14/03/2020)	8 days
France	1^st: Three cases (imported) 24/01/2020 50^th: 29/02/2020	Recommended from lockdown (16/03/2020)	Nationwide (14/03/2020)	Recommended from lockdown (16/03/2020)	Events involving more than 100 people banned (13/03/2020)	The population must stay at home. Allowed out for maximum of 1 hour with a self-declaration form (17/03/2020)	13 days
Italy	1^st: Two cases (imported) 31/01/2020 50^th: 22/02/2020	Recommendation to self-isolate if symptoms are present and to quarantine if test is positive (09/03/2020)	Nationwide (05/03/2020)	People must keep at least one meter from each other and all gatherings are banned (09/03/2020)	Government bans all public events (09/03/2020)	The government closed all public venues. People should stay at home except for essential travel (11/03/2020)	12 days
United Kingdom	1^st: Two cases (imported) 31/01/2020 50^th: 04/03/2020	Self-isolation for 7 days if symptoms of cough and fever are present (12/03/2020)	Nationwide. Kindergartens and nurseries instructed to follow guidance to close (21/03/2020)	Warnings to avoid pubs, clubs, theaters and other public institutions (16/03/2020)	Implemented with lockdown (24/03/2020)	Meetings of more than 2 people not from the same household banned and police authorized to break them up. (24/03/2020)	12 days

Intervention analyzed	Resulting impact	Referência
Reducing mobility	The peak of the epidemic was delayed; there was a reduction in the number of cases within cities, and in transmission to other locations	¹⁰10 Kraemer MU, Yang CH, Gutierrez B, Wu CH, Klein B, Pigott DM, du Plessis L, Faria NR, Li R, Hanage WP, Brownstein JS. The effect of human mobility and control measures on the COVID-19 epidemic in China. Science 2020; pii:eabb4218. ^, ²³23 Chinazzi M, Davis JT, Ajelli M, Gioannini C, Litvinova M, Merler S, Piontti AP, Mu K, Rossi L, Sun K, Viboud C. The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak. Science 2020; pii:eaba9757. ^, ³³33 Boldog P, Tekeli T, Vizi Z, Denes A, Bartha FA, Rost G. Risk Assessment of Novel Coronavirus COVID-19 Outbreaks Outside China. J Clin Med 2020; 9:2. ^, ³⁴34 Lau H, Khosrawipour V, Kocbach P, Mikolajczyk A, Schubert J, Bania J, Khosrawipour T. The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China. J Travel Med 2020; pii:taaa037.
Travel restrictions, quarantining and distancing	A reduction in R0 and an increase in doubling time	³⁴34 Lau H, Khosrawipour V, Kocbach P, Mikolajczyk A, Schubert J, Bania J, Khosrawipour T. The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China. J Travel Med 2020; pii:taaa037.
Travel restrictions	A reduction in transmission and in the number of cases in the country and abroad	²³23 Chinazzi M, Davis JT, Ajelli M, Gioannini C, Litvinova M, Merler S, Piontti AP, Mu K, Rossi L, Sun K, Viboud C. The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak. Science 2020; pii:eaba9757. ^, ³⁵35 Kucharski AJ, Russell TW, Diamond C, Liu Y, Edmunds J, Funk S, Eggo RM, Sun F, Jit M, Munday JD, Davies N. Early dynamics of transmission and control of COVID-19: a mathematical modelling study. Lancet Infect Dis 2020; S1473-3099(20)30144-4.
Social distancing	A reduction in social interaction A reduction in the demand for hospital care and in the number of deaths	³⁶36 Pepe E, Bajardi P, Gauvin L, Privitera F, Lake B, Cattuto C, Tizzoni M. COVID-19 outbreak response: a first assessment of mobility changes in Italy following national lockdown. medRxiv 2020; 2020.03.22.20039933. ³⁷37 Flaxman S, Mishra S, Gandy A. Estimating the number of infections and the impact of non-pharmaceutical interventions on COVID-19 in 11 European countries. United Kingdom: Imperial College COVID-19 Response Team; 2020. ³⁸38 Ganem F, Mendes FM, Oliveira SB, Porto VB, Araujo W, Nakaya H, Diaz-Quijano FA, Croda J. The impact of early social distancing at COVID-19 Outbreak in the largest Metropolitan Area of Brazil. medRxiv 2020; 2020.04.06.20055103. ^, ³⁹39 Canabarro A, Tenorio E, Martins R, Martins L, Brito S, Chaves R. Data-Driven Study of the COVID-19 Pandemic via Age-Structured Modelling and Prediction of the Health System Failure in Brazil amid Diverse Intervention Strategies. medRxiv 2020; 2020.04.03.20052498. ^* * Brazilian studies.R0: basic reproduction number.

Location (Notified cases/100,000 inhabitants)	Category of social distancing	Measure (government act)	Effective date
Brazil (14.51)	Social distancing	Remote working for vulnerable civil servants in at-risk groups (Administrative Act19 - Ministryof Economy)	17/03
Brazil (14.51)	Social distancing	Remote working, anticipation of individual and collective statutory leave, compensation of time and anticipation of public holidays (Provisional Act927)	22/03
Amapá (39.69)	Events	Mass gatherings banned (Judicialdecision)	29/03
	Education	Closure of all teaching establishments(Decree 1377)	17/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups(Decree 1377)	17/03
		Mass gatherings banned (Decree 1414)	20/03
		Non-essential businesses and services closed except for deliveries (Decree 1414)	20/03
		All river transport stopped (Decree 1415)	23/03
Amazonas (36.93)	Events	Public gatherings and gatherings in public facilitiesbanned (Decree 42,061)	16/03
	Events	Events involving more than 100 people banned (Decree 42,063)	17/03
	Education	Partial closure of state schools (Decree 42,061)	16/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups and those with mild symptoms (Decree 42,061)	16/03
		All river transport stopped (Decree 42,087)	19/03
		Gyms and similar establishments closed (Decree 42,087)	19/03
		Circulation of all intercity bus services and tourist coaches stopped (Decree 42,098)	20/03
		All establishments involved in serving food directly to customers, as well as the leisure events industry, closed (Decree 42,099)	21/03
		Remote working for all civil servants (Decree 42,101)	23/03
		All non-essential businesses and services closed (Decree 42,101)	23/03
		Circulation of interstate bus services stopped (Decree 42,158)	04/04
Bahia (5.92)	Events	Events involving more than 50 people banned in cities in which there is community transmission (Decree 19,529)	17/03
	Events	Events involving more than 50 people banned in the entire state (Decree 19,586)	28/03
	Education	Partial closure of teaching establishments (Decree 19,529)	17/03
	Education	Complete closure of teaching establishments (Decree 19,586)	28/03
	Circulation of people	Obligatory self-isolation at home for people with symptoms of the disease (Decree 19,529)	17/03
		Docking of large vessels banned (Decree 19,529)	17/03
		Remote working for vulnerable civil servants in at-risk groups (Decree 19,528)	17/03
		Circulation of interstate buses stopped (Decree 19,528)	19/03
		Circulation of intercity transport stopped in locations in which there is community transmission - except for professional activity (Decree 19,549)	19/03
Ceará (24.95)	Events	No licenses granted for events involving more than 100 people (Decree 33,510)	16/03
	Events	Collective activities using public facilitiesbanned (Decree 33,510)	16/03
	Education	Total closure of all teaching establishments (Decree 33,510)	19/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups (Decree 33,510)	16/03
		Discretionary leave for civil servants (Decree 33,519)	19/03
		Non-essential industrial activities and non-essential on-site activities in the commercial and service sectors closed (Decree 33,519)	19/03
		All beaches, rivers, lakes and swimming pools closed for visitation (Decree 33,519)	19/03
		Circulation of intercity and municipal public road transport, and subways stopped (Decree 33,519)	19/03
		Obligatory self-isolation at home for people with symptoms of the disease (Decree 33,519)	19/03
		Circulation of interstate buses stopped (Decree 33,519)	19/03
		Remote working for all civil servants able to work from home (Decree 33,536)	05/04
Federal District (22.80)	Events	No licenses granted for events involving more than 100 people (Decree 40,509)	11/03
	Events	No licenses issued for any events (Decree 40,538)	19/03
	Education	Complete closure of all teaching establishments (Decree 40,509)	11/03
	Circulation of people	Quarantining of suspected cases and obligatory self-isolation at home for individuals with symptoms of the disease (Decree 40,475)	28/02
		Remote working for civil servants with mild symptoms (Decree 40,526)	17/03
		Non-essential on-site activities in the commercial and services sectors closed (Decree 40,538)	19/03
		Remote working for all civil servants (Decree 40.546)	23/03
Espírito Santo (18.55)	Events	All events banned except for places of worship (Decree 4599-R)	18/03
	Education	All teaching establishments closed (Decree 4597-R)	23/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups (Decree 4599-R)	18/03
		Self-isolation for civil servants with mild flu-likesymptoms (Decree 4599-R)	18/03
		All gyms and shopping mallswith on-site activities closed (Decree 4600-R)	19/03
		On-site activities at bank branches stopped (Decree 4604-R)	20/03
		All commercial establishments and restaurants with on-site activities closed (Decree 4605-R)	20/03
Rio de Janeiro (21.55)	Events	Mass gatherings banned (Decree 46,970)	13/03
	Education	All teaching establishments closed (Decree 46,970)	13/03
	Circulation of peolple	Remote working for vulnerable civil servants in at-risk groups (Decree 46,970)	13/03
		Circulation of interstate buses with journeys originating in a state with community transmission banned (Decree 46,973)	17/03
		Free student travelpass cancelled (Decree 46,973)	17/03
		Intercity public road transport between the state capital and other cities banned (Decree 46,980)	19/03
		Air transport and docking of cruise ships coming from areas in which there is community transmission stopped (Decree 46,980)	19/03
		All beaches, rivers, lakes and pools closed for visitation (Decree 46,980)	19/03
Roraima (22.50)	Events	All events banned (Decree 28,587-E)	16/03
	Education	Partial closure of teaching establishments (Decree 28,587-E)	16/03
	Circulation of people	Circulation of intercity transport stopped (Decree 28,635-E)	23/03
		All non-essential business and service activities stopped except for deliveries (Decree 28,635-E)	23/03
		Remote working for all civil servants (Decree 28,635-E)	23/03
São Paulo (23.86)	Events	Events involving more than 500 people banned (Decree 64,862)	14/03
	Events	Mass gatherings banned (Decree 64,864)	17/03
	Education	Partial closure of teaching establishments (Decree 64,862)	14/03
	Circulação de pessoas	Remote working for vulnerable civil servants in at-risk groups (Decree 64,864)	17/03
		Parks closed for visitation (Decree 64,879)	21/03
		All non-essential business and service activities closed except for deliveries (Decree 64,881)	24/03

Area (Notified cases/100,000 inhabitants)	Social distancing category	Measure (Government Act)	Effective date
Brazil (14.51)	Social distancing	Remote working for vulnerable civil servants in at-risk groups (Administrative Act19 - Ministry of Economy)	17/03
Brazil (14.51)	Social distancing	Remote working, anticipation of individual and collective statutory leave, compensation of time and anticipation of public holidays (Provisional Act927)	22/03
Acre (11.29)	Events	Events involving more than 100 peoplebanned (Decree 5,465)	17/03
	Education	Partial closure of teaching establishments (OrdinanceSEE 764)	20/03
	Circulation of people	Non-essential businesses and services closed except for deliveries (Decree 5,496)	20/03
	Circulation of people	International and interstate transport stopped (Decree 5,496)	20/03
Alagoas (2.48)	Events	Open-air events involving more than 500 people and indoor events involving more that 100 people banned (Decree 69,501)	16/03
		Activities using public cultural facilitiesbanned (Decree 69,501)	16/03
		Total ban on any events (Decree 69,541)	20/03
	Education	Complete closure of all teaching establishments (Decree 69,501)	23/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups (Decree 69,502)	16/03
		Non-essential businesses, industries and services closed except for deliveries (Decree 69,502)	20/03
		Intercity road transport and subways stopped (Decree 69,502)	20/03
		All beaches and parks closed for visitation (Decree 69,502)	20/03
		Self-isolation obligatory for individuals with any flu-like symptoms(Decree 69,502)	20/03
		Discretionary leave for civil servants (Decree 69,502)	23/03
		Remote working for all civil servants able to work from home (Decree 69,577)	30/03
Amapá (39.69)	Events	Mass gatherings banned (Judicial decision)	29/03
	Education	Total closure of all teaching establishments(Decree 1,377)	17/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups (Decree 1,377)	17/03
		Gatherings in public places banned (Decree 1,414)	20/03
		All non-essential businesses and services closed except for deliveries (Decree 1,414)	20/03
		River transport stopped (Decree 1,415)	23/03
Amazonas (36.93)	Events	Public events and those using public facilitiesbanned (Decree 42,061)	16/03
	Events	Events involving more than 100 people banned (Decree 42,063)	17/03
	Education	Partial closure of state teaching establishments (Decree 42,061)	16/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups and for those with mild symptoms (Decree 42,061)	16/03
		River transport stopped (Decree 42,087)	19/03
		Gyms and similar establishments closed (Decree 42,087)	19/03
		Circulation of intercity buses and tourist coaches stopped (Decree 42,098)	20/03
		On-site food sector closed and leisure events banned (Decree 42,099)	21/03
		Remote working for all civil servants (Decree 42,101)	23/03
		All non-essential businesses and services closed (Decree 42,101)	23/03
		Circulation of interstate public road transport stopped (Decree 42,158)	04/04
Bahia (5.92)	Events	Events involving more than 50 people banned in municipalities in which there is community transmission (Decree 19,529)	17/03
	Events	Events involving more than 50 people banned throughout the entire state (Decree 19,586)	28/03
	Education	Partial closure of teaching establishments (Decree 19,529)	17/03
	Education	Total closure of teaching establishments (Decree 19,586)	28/03
	Circulation of people	Obligatory self-isolation at home for people with symptoms of the disease (Decree 19,529)	17/03
		Docking of large vessels banned (Decree 19,529)	17/03
		Remote working for vulnerable civil servants in at-risk groups (Decree 19,528)	17/03
		Circulation of interstate buses stopped (Decree 19,528)	19/03
		Intercity bus transport from cities in which there is community transmission stopped except for professional activity (Decree 19,549)	19/03
Ceará (24.95)	Events	No licenses granted for events involving more than 100 people (Decree 33,510)	16/03
	Events	Gatherings in public spaces banned (Decree 33,510)	16/03
	Education	Complete closure of teaching establishments (Decree 33,510)	19/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups (Decree 33,510)	16/03
		Discretionary leave for civil servants (Decree 33,519)	19/03
		All non-essential industriesand non-essential on-site commercial establishments and services closed (Decree 33,519)	19/03
		All beaches, rivers, lakes and swimming pools closed for visitation (Decree 33,519)	19/03
		Intercity and metropolitan road transport and subways stopped (Decree 33,519)	19/03
		Self-isolation at home obligatory for anyone with symptoms of the disease (Decree 33,519)	19/03
		Circulation of interstate buses stopped (Decree 33,519)	19/03
		Remote working for all civil servants able to work from home (Decree 33,536)	05/04
Federal District (22.80)	Events	No licenses granted for events involving more than 100 people (Decree 40,509)	11/03
	Events	No licenses for events granted (Decree 40,538)	19/03
	Education	Complete closure of all teaching establishments (Decree 40,509)	11/03
	Circulation of people	Quarantining of suspected cases and obligatory self-isolation at home for individuals with symptoms of the disease (Decree 40,475)	28/02
		Remote working for civil servants with mild symptoms (Decree 40,526)	17/03
		All on-site non-essential businesses and services banned (Decree 40,538)	19/03
		Remote working for all civil servants (Decree 40,546)	23/03
Espírito Santo (18.55)	Events	All events banned except for places of worship (Decree 4,599-R)	18/03
	Education	Complete closure of all teaching establishments (Decree 4,597-R)	23/03
	Circulation of people	Remote working for all vulnerable civil servants in at-risk groups (Decree 4,599-R)	18/03
		Self-isolation at home for civil servants with flu-likesymptoms (Decree 4,599-R)	18/03
		Gyms and shopping mallswith on-site service closed (Decree 4,600-R)	19/03
		On-site service at banks stopped (Decree 4,604-R)	20/03
		Retail businesses and restaurants with on-site service closed (Decree 4,605-R)	20/03
Goiás (4.27)	Events	All events banned (Decree 9,633)	13/03
	Education	Complete closure of all teaching establishments (Technical note 1/2020 - SES/GO)	18/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups and alternating schedules for the remainder (Decree 9,634)	17/03
		Non-essential commercial establishments and services closed except for deliveries (Decree 9,637)	19/03
		Road and air transport from regions where the virus is in circulation stopped (Decree 9,638)	24/03
		Non-essential businesses closed (Decree 9,644)	25/03
Maranhão (9.77)	Events	No licenses granted for events (Decree 35,660)	16/03
	Events	Activities involving mass gatherings banned (Decree 35,677)	21/03
	Education	Partial closure of teaching establishments (Decree 35,662)	17/03
	Circulation of people	Self-isolation at home for civil servants with mild symptoms (Decree 35,660)	16/03
		Interstate transport stopped (Decree 35,672)	21/03
		Non-essential commercial establishments and services closed except for deliveries (Decree 35,677)	21/03
		Docking of large vessels from countries in which the disease is in circulation banned (Decree 35,677)	21/03
Mato Grosso (4.28)	Events	All events banned except for those guaranteeing at least 1.5 meters between each individual present (Decree 419)	20/03
	Events	All events banned (Decree 425)	26/03
	Education	Complete closure of all teaching establishments (Decree 425)	26/03
	Circulation of people	Remote working and alternating schedules authorized for civil servants (Decree 407)	16/03
		Bars, convenience stores, bakeries and restaurants closed except for deliveries (Decree 421)	23/03
		Intercity road transport stopped (Decree 421)	23/03
		Leisure spaces, places of worship, sports and cultural venues closed for visitation (Decree 425)	26/03
		"Vertical" isolation of infected individuals in cities with community transmission (Decree 432)	02/04
		Restrictions imposed on non-essential activities in cities with community transmission (Decree 432)	02/04
Mato Grosso do Sul (4.31)	Events	No licenses for events granted (Decree 15,396)	20/03
	Education	Partial closure of teaching establishments (Decree 15,393)	23/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups and who have any symptom (Decree 15,391)	16/03
		Remote working for all civil servants able to work from home, with alternating schedules being an option (Decree 15,393)	20/03
		All state-run parks and sports facilities closed (Decree 15,393)	20/03
		Discretionary leave for civil servants (Decree E 29)	03/04
Minas Gerais (4.24)	Events	Events involving more than 30 people banned (Decision 17 of theExtraordinary Covid-19 Committee)	22/03
	Education	Partial closure of all teaching establishments (Decision 01)	18/03
	Education	Complete closure of all teaching establishments (Decision 15)	21/03
	Circulation of people	Priority given to remote working for all civil servants and/or measures to reduce the number of employees present (Decision 02)	17/03
		Remote working for all vulnerable civil servants in at-risk groups (Decision 04)	18/03
		All interstate road, riverand rail transport stopped (Decision 11)	21/03
		Remote working for all civil servants (Decision 12)	21/03
		All municipalities ordered to close businesses and services (Decision 17)	22/03
Pará (5.60)	Events	No licenses issued for events involving more than 500 people (Decree 607)	16/03
	Events	Events involving more than 10 people banned (Decree 609)	07/04
	Education	Total closure of all state teaching establishments (Decree 607)	16/03
	Circulation of people	Possibility of remote working, particularly for vulnerable civil servants in at-risk groups (Decree 607)	16/03
		All beaches, riversides, bathing resorts, clubs, etc. closed for visitation (Decree 607)	16/03
		Gyms, bars, restaurants, nightclubs and similar types of establishment closed except for deliveries (Decree 607)	16/03
		On-site religious gatherings banned (Decree 607)	16/03
		Interstate road, sea and river transport stopped (Decree 607)	23/03
		Intercity road and sea/river transport stopped during April extended public holidays (Decree 607)	08/04
Paraíba (4.08)	Events	State-run events cancelled (Decree 40,128)	19/03
	Events	Events in cities in which there are cases of the disease banned (Decree 40,173)	04/04
	Education	Partial closure of teaching establishments (Decree 40,128)	19/03
	Circulation of people	Alternating schedules for all civil servants and remote working for all those in at-risk groups (Decree 40,128)	19/03
		All crews from cargo ships banned from disembarking (Decree 40,135)	21/03
		All non-essential businesses and services closed except for deliveries (Decree 40,135)	21/03
		Intercity transport from major cities stopped (Decree 40,135)	21/03
		Remote working for all civil servants able to work from home (Decree 40,136)	21/03
		Reduction in service of the main ferry routes (Decree 40,135)	22/03
Paraná (7.09)	Events	Events involving more than 50 people banned (Decree 4,230)	16/03
	Education	Complete closure of all teaching establishments (Decree 4,230)	20/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups and a reduction in working hours, alternating schedules and remote working for the remainder (Decree 4,230)	16/03
		All state road transport stopped (Decree 4,263)	20/03
		Access of non-residents to an isolated community (Ilha do Mel) banned (Decree 4,230)	21/03
Pernambuco (15.43)	Events	Events involving more than 500 people banned (Decree 48,809)	14/03
		Events involving more than 50 people banned (Decree 48,822)	18/03
		Activities in cultural facilitiesand gyms banned (Decree 48,822)	18/03
		All events banned (Decree 48,837)	24/03
	Education	Complete closure of all teaching establishments (Decree 48,810)	18/03
	Circulation of people	Docking of large vessels banned (Decree 48,809)	14/03
		Remote working for all vulnerable civil servants in at-risk groups (Decree 48,810)	17/03
		Obligatory self-isolation at home for individuals arriving from countries in which there are cases of the disease (Decree 48,822)	18/03
		All travel to an isolated community (Fernando de Noronha) and tourism there stopped (Decree 48,822)	18/03
		All crews of cargo ships banned from disembarking (Decree 48,830)	19/03
		All non-essential businesses and services closed except for deliveries (Decree 48,833)	21/03
		All access to an isolated community (Fernando de Noronha) stopped except for essential activities (Decree 48,878)	03/04
		All beaches and parks closed for visitation (Decree 48,881)	04/04
Piauí (2.77)	Events	Open-air events involving more than 100 people and indoor events for more than 50 people banned (Decree 18,884)	16/03
	Education	Partial closure of teaching establishments (Decree 18,884)	16/03
	Education	Complete closure of all teaching establishments (Decree 18,913)	30/03
	Circulation of people	All non-essential businesses and services closed except for deliveries (Decree 18,901)	21/03
		Reduction of 50% in the flow of personnel involved in essential activities (Decree 18,902)	23/03
		Reduction in working hours for the industrialsector (Decree 18,902)	23/03
		All intercity road transport stopped (Decree 18,924)	03/04
Rio de Janeiro (21.55)	Events	Mass gatherings banned (Decree 46,970)	13/03
	Education	Complete closure of all teaching establishments (Decree 46,970)	13/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups (Decree 46,970)	13/03
		The circulation of all interstate buses coming from states in which there is community transmission of the disease banned (Decree 46,973)	17/03
		Free student travel pass cancelled (Decree 46,973)	17/03
		All intercity road transport between the state capital and other cities cancelled (Decree 46,980)	19/03
		Air transport and docking of cruise ships from areas with community transmission of the virus stopped (Decree 46,980)	19/03
		Beaches, rivers, lakes and swimming pools closed for visitation (Decree 46,980)	19/03
Rio Grande do Norte (11.29)	Events	Events involving more than 100 people banned (Decree 29,524)	18/03
		Events involving more than 50 people banned (Decree 29,541)	21/03
		Events involving more than 20 people banned (Decree 29,583)	02/04
	Education	Complete closure of all teaching establishments (Decree 29,524)	18/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups (Decree 29,512)	14/03
		All non-essential businesses and services closed except for deliveries and for open-air shopping malls(Decree 29,541)	21/03
		Any establishment with artificial air circulation system closed (Decree 29,583)	02/04
Rio Grande do Sul (6.67)	Events	All events banned (Decree 55,128)	19/03
	Education	Partial closure of all teaching establishments (Decree 55,118)	17/03
	Education	Complete closure of all teaching establishments (Decree 55,154)	01/04
	Circulation of people	Remote working for all civil servants able to work from home and alternating schedules for the remainder (Decree 55,118)	17/03
		Remote working for all vulnerable civil servants in at-risk groups (Decree 55,118)	17/03
		Interstate transport banned (Decree 55,128)	19/03
		Alternating schedules and remote working for all civil servants (Decree 55,128)	19/03
		All interstate and international road transport stopped (Decree 55,130)	21/03
		Beaches closed for visitation (Decree 55,130)	21/03
		All non-essential businesses and services stopped except for deliveries (Decree 55,128)	01/04
Rondônia (4.06)	Events	All events involving more than 5 people banned (Decree 24,887)	25/03
	Education	Complete closure of all teaching establishments (Decree 24,871)	17/03
	Circulation of people	Remote working for all civil servants able to work from home (Decree 24,871)	17/03
		Circulation of all motorcycle taxis banned (Decree 24,887)	25/03
		All flights from out of state banned (Decree 24,887)	25/03
		All non-essential businesses and services closed except for deliveries (Decree 24,887)	25/03
		The entry of all vehicles from other countries banned (Decree 24,887)	25/03
		The circulation of personnel for essential activities to be obligatorily reduced (Decree 24,887)	25/03
Roraima (22.50)	Events	All events banned (Decree 28,587-E)	16/03
	Education	Partial closure of all teaching establishments (Decree 28,587-E)	16/03
	Circulation of people	All intercity transport stopped (Decree 28,635-E)	23/03
		All non-essential businesses and services closed except for deliveries (Decree 28,635-E)	23/03
		Remote working for all civil servants (Decree 28,635-E)	23/03
Santa Catarina (12.29)	Events	All events banned (Decree 515)	17/03
	Education	Complete closure of all teaching establishments (Decree 509)	17/03
	Circulation of people	Remote working for all vulnerable civil servants in at-risk groups (Decree 507)	16/03
		Public spaces closed for gatherings and visitation (Decree 521)	19/03
		Municipal, intercity and interstate public road transport stopped (Decree 521)	19/03
		River and sea transport for pedestrians and cyclists stopped (Decree 525)	23/03
		All non-essential businesses and services closed except for deliveries (Decree 525)	23/03
		Reduction of 50% in number of customers for essential activities (Decree 525)	23/03
		Reduction of 50% in the size of the workforce in the industrialsector - prioritizing remote working for personnel in at-risk groups and administrative staff, without affecting salaries. Charter transportation service to run at no more than 50% of capacity (Decree 525)	23/03
São Paulo (23.86)	Events	Events involving more than 500 people banned (Decree 64,862)	14/03
	Events	Mass gatherings banned (Decree 64,864)	17/03
	Education	Partial closure of teaching establishments (Decree 64,862)	14/03
	Circulation of people	Remote working for vulnerable civil servants in at-risk groups (Decree 64,864)	17/03
		Parks closed for visitation (Decree 64,879)	21/03
		All non-essential businesses and services closed except for deliveries (Decree 64,881)	24/03
Sergipe (2.07)	Events	Open-air events involving more than 100 people and indoor events involving more than 50 people banned (Decree 40,560)	17/03
	Events	All events banned (Decree 40,563)	20/03
	Education	Complete closure of all teaching establishments (Decree 40,560)	17/03
	Circulation of people	Cinemas, theaters and similar establishments closed (Decree 40,560)	17/03
		Remote working for all vulnerable civil servants in at-risk groups (Decree 40,560)	17/03
		All non-essential businesses and services closed except for deliveries (Decree 40,563)	20/03
		Docking of ships coming from regions where the virus is in circulation banned (Decree 40,563)	23/03
		Interstate buses from states in which the virus is in circulation stopped (Decree 40,563)	23/03
		Alternating schedules for the workforce in the commercialand industrial sectors (Decree 40,563)	20/03
		Alternating schedules and remote working for all civil servants, as well as a reduction in working hours (Decree 40,563)	20/03
		Remote working for all civil servants able to work from home (Decree 40,567)	25/03
Tocantins (1.82)	Events	All events banned (Decree 6,072)	21/03
	Education	Partial closure of all teaching establishments (Decree 6,065)	18/03
	Education	Total closure of all teaching establishments (Decree 6,071)	19/03
	Circulation of people	Reduction in working hours and alternating schedules for civil servants (Decree 6,066)	16/03
		Nature parks closed for visitation (Decree 6,067)	17/03
		The practice of sports in state-owned venues banned (Decree 6,071)	19/03
		Remote working for vulnerable civil servants in at-risk groups (Decree 6,072)	21/03

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Collaborations

EML Aquino, JM Pescarini, IH Silveira, R Aquino idealized the study, participated in data collection, research and wrote the manuscript, having also contributed as the first authors in this manuscript; JA de Souza-Filho participated in data collection and research and collaborated in writing the article. The other authors, AS Rocha, A Ferreira, A Victor, C Teixeira, DB Machado, E Paixão, FJ Oliveira Alves, F Pilecco, G Menezes, L Gabrielli, MCC Almeida, N Ortelan, QHRF Fernandes, RJF Ortiz, RN Palmeira, EP Pinto Junior, E Aragão, LEPF de Souza, M Barral-Netto, MG Teixeira, ML Barreto, MY Ichihara and RTRS Lima participated in the data collection and critical review of this manuscript.