Neftali Eduardo Antonio-Villa1,2, Luisa Fernandez-Chirino1,2, Julio Pisanty-Alatorre3,4, Javier Mancilla-Galindo5, Ashuin Kammar-García6,7, Arsenio Vargas-Vázquez1,2, Armando González-Díaz8, Carlos A Fermín-Martínez1,2, Alejandro Márquez-Salinas1,2, Enrique C Guerra1,2, Jessica Paola Bahena-López1,2, Marco Villanueva-Reza9, Jessica Márquez-Sánchez10, Máximo Ernesto Jaramillo-Molina11, Luis Miguel Gutiérrez-Robledo1, Omar Yaxmehen Bello-Chavolla1. 1. Division de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico. 2. MD/PhD (PECEM) Program, National Autonomous University of Mexico, Mexico City, Mexico. 3. Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico. 4. Instituto Mexicano del Seguro Social, Mexico City, Mexico. 5. Unidad de Investigación UNAM-INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico. 6. Departamento de Atención Institucional Continua y Urgencias, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. 7. Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico. 8. Facultad de Ciencias Politicas Sociales y Sociales, National Autonomous University of Mexico, Mexico City, Mexico. 9. Departamento de Infectologia. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. 10. Departamento de Infectología, Instituto Nacional de Pediatría, Mexico City, Mexico. 11. International Inequalities Institute, London School of Economics, London, United Kingdom.
Abstract
BACKGROUND: The impact of the coronavirus disease 2019 (COVID-19) pandemic in Mexico City has been sharp, as several social inequalities at all levels coexist. Here we conducted an in-depth evaluation of the impact of individual and municipal-level social inequalities on the COVID-19 pandemic in Mexico City. METHODS: We analyzed suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases, from the Mexico City Epidemiological Surveillance System from 24 February 2020 to 31 March 2021. COVID-19 outcomes included rates of hospitalization, severe COVID-19, invasive mechanical ventilation, and mortality. We evaluated socioeconomic occupation as an individual risk, and social lag, which captures municipal-level social vulnerability, and urban population density as proxies of structural risk factors. Impact of reductions in vehicular mobility on COVID-19 rates and the influence of risk factors were also assessed. Finally, we assessed discrepancies in COVID-19 and non-COVID-19 excess mortality using death certificates from the general civil registry. RESULTS: We detected vulnerable groups who belonged to economically unfavored sectors and experienced increased risk of COVID-19 outcomes. Cases living in marginalized municipalities with high population density experienced greater risk for COVID-19 outcomes. Additionally, policies to reduce vehicular mobility had differential impacts modified by social lag and urban population density. Finally, we report an under-registry of COVID-19 deaths along with an excess mortality closely related to marginalized and densely populated communities in an ambulatory setting. This could be attributable to a negative impact of modified hospital admission criteria during the pandemic. CONCLUSIONS: Socioeconomic occupation and municipality-wide factors played a significant role in shaping the course of the COVID-19 pandemic in Mexico City.
BACKGROUND: The impact of the coronavirus disease 2019 (COVID-19) pandemic in Mexico City has been sharp, as several social inequalities at all levels coexist. Here we conducted an in-depth evaluation of the impact of individual and municipal-level social inequalities on the COVID-19 pandemic in Mexico City. METHODS: We analyzed suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases, from the Mexico City Epidemiological Surveillance System from 24 February 2020 to 31 March 2021. COVID-19 outcomes included rates of hospitalization, severe COVID-19, invasive mechanical ventilation, and mortality. We evaluated socioeconomic occupation as an individual risk, and social lag, which captures municipal-level social vulnerability, and urban population density as proxies of structural risk factors. Impact of reductions in vehicular mobility on COVID-19 rates and the influence of risk factors were also assessed. Finally, we assessed discrepancies in COVID-19 and non-COVID-19 excess mortality using death certificates from the general civil registry. RESULTS: We detected vulnerable groups who belonged to economically unfavored sectors and experienced increased risk of COVID-19 outcomes. Cases living in marginalized municipalities with high population density experienced greater risk for COVID-19 outcomes. Additionally, policies to reduce vehicular mobility had differential impacts modified by social lag and urban population density. Finally, we report an under-registry of COVID-19 deaths along with an excess mortality closely related to marginalized and densely populated communities in an ambulatory setting. This could be attributable to a negative impact of modified hospital admission criteria during the pandemic. CONCLUSIONS: Socioeconomic occupation and municipality-wide factors played a significant role in shaping the course of the COVID-19 pandemic in Mexico City.
Authors: Gustavo Olaiz-Fernández; Félix Jesús Vicuña de Anda; Jorge-Baruch Diaz-Ramirez; German E Fajardo Dolci; Patricia Bautista-Carbajal; Antonio Humberto Angel-Ambrocio; Miguel Leonardo García-León; Elena Gómez Peña; Jorge Alejandro Camacho Morales; Rosa Maria Wong-Chew Journal: Travel Med Infect Dis Date: 2022-05-29 Impact factor: 20.441
Authors: Eva O Arceo-Gomez; Raymundo M Campos-Vazquez; Gerardo Esquivel; Eduardo Alcaraz; Luis A Martinez; Norma G Lopez Journal: Lancet Reg Health Am Date: 2021-11-10