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The Risks of COVID-19 Spread Rapidly in Low- and Middle-Income Countries: The Brazilian Scenario

13 Pages Posted: 1 Feb 2021

See all articles by Diego Pacheco

Diego Pacheco

Centro Universitário Ritter dos Reis (UNIRITTER))



Background: At the end of 2019, a novel virus, the coronavirus (2019-nCoV), arose in Wuhan city in China. This virus was found to be the cause of the coronavirus disease 2019 (COVID-19). This grave illness is caused by the acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pandemic has spread strikingly fast affecting over 190 countries and territories. This rapid contagion is of great concern to global authorities, scientists, and society. However, despite the recent increasing number of publications on COVID-19, there has been little discussion about the impacts on vulnerable populations in low- and middle-income countries such as Brazil.

Method: This article combines findings from recent research on COVID-19 with multiple official national and international data for identifying the readiness, challenges, and vulnerability of populations, to an exponential spread of the pandemic in Brazil. Effective responses at both the regional and global level are immediately necessary for preparing the nations and their health systems worldwide according to their particularities and own contexts.

Findings: Findings indicate that the urgent Brazilian challenges with the pandemic include the combination of the following main risks: (i) the beginning of autumn and winter seasons, (ii) the heterogeneous distribution of the population in a continental country, (iii) the presence of 31 million elderly people, (iv) the historical gaps and ratios of basic sanitation, poverty, lack of availability of beds for ICU, lack of doctors and primary assistance. Moreover, mathematical models show that the beginning of the Brazilian epidemic curve is the same as in Italy and Spain. Some clues indicate that the epicentre of infection could conceivably move to South America in the next months. Findings also led to recommendations for a set of measures and priority actions - for authorities and society - for enhancing regional readiness. In sum, the scenario for Brazil and South America in the next weeks, considering all evidence discussed, can be defined as a complex and uncomfortable uncertainty.

Interpretation: This paper supports authorities and health specialists in providing suggestions on the importance of correctly prioritizing resources in the short-term to combat COVID-19 in Brazil. In addition, other low- and middle-income nations will also benefit from these insights.

Funding Statement: None.

Declaration of Interests: Authors declare no competing interests.

Keywords: COVID-19; SARS-CoV-2; 2019-nCoV; Brazil; South America; Low- and middleincome; Risks; Challenges; Countermeasures.

Suggested Citation

Pacheco, Diego, The Risks of COVID-19 Spread Rapidly in Low- and Middle-Income Countries: The Brazilian Scenario (3/25/2020). Available at SSRN: or

Diego Pacheco (Contact Author)

Centro Universitário Ritter dos Reis (UNIRITTER)) ( email )

Rua Orfanotrófio, 555
Porto Alegre, Rio Grande do Sul 90840-440

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