key: cord-0830285-cmnjy5q1 authors: Evangelista, H.; Goncalves, S. J.; Sodre, E. D.; Nogueira, J.; Barbosa, R. G.; Magalhaes, N.; dos Santos, A. M. G.; Godoi, R. H. M.; Amaral, C.; Cataldo, M.; de Oliveira, D. A. J.; Porto, L. C. title: Combining science and social engagement againstCovid-19 in a Brazilian Slum date: 2021-01-09 journal: nan DOI: 10.1101/2021.01.06.21249243 sha: d13339d507eb26a899d6f5eb0193a614060eb2d4 doc_id: 830285 cord_uid: cmnjy5q1 Vaccine is the only way out towards an effective action against Covid-19. Nevertheless, for many underdeveloped countries, ordinary people's access will occur late within or even after the second disease wave. In this context, strategies implemented by social communities allied to the scientific knowledge may attenuate the rapid spread of cases and allow access of treatments at health care services to the population. Here, we present results of coordinate actions combining the aerosol SARS-Cov-2 virus monitoring and sanitization at Santa Marta slum in Rio de Janeiro city, where profits were significantly achieved. ABSTRACT. Vaccine is the only way out towards an effective action against Covid-19. Nevertheless, for many underdeveloped countries, ordinary people's access will occur late within or even after the second disease wave. In this context, strategies implemented by social communities allied to the scientific knowledge may attenuate the rapid spread of cases and allow access of treatments at health care services to the population. Here, we present results of coordinate actions combining the aerosol SARS-Cov-2 virus monitoring and sanitization at Santa Marta slum in Rio de Janeiro city, where profits were significantly achieved. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 9, 2021. ; https://doi.org/10.1101/2021.01.06.21249243 doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. Around 13.6 million people, which represents 6% of the population, live in slums or similar agglomeration households in Brazil, according to the latest official 2019 census by the Brazilian Institute of Geography and Statistics (IBGE). More than 13 thousand slums were identified throughout Brazil, in 734 of the 5,570 Brazilian municipalities. According to the World Health Organization (WHO), 1 billion people live in such conditions worldwide. It is estimated that nearly 89% of people living in slums are concentrated in Brazil's capitals and metropolitan regions. In these places, health is impacted by factors arising from the shared physical and social environment, despite poverty alone. One of these factors is the sewage treatment network that currently left attended 43% of the Brazilian cities' population. In the north of the country, this number climbs to 90%. Among the diseases of highest incidence associated with this lack of sewage treatment network are leptospirosis, schistosomiasis, parasitoids, and worsening of epidemics dengue, chikungunya, and zika. Presently, in several countries of Europe, USA, Australia, and Brazil (1-5), one important finding related to the environmental issue of the Covid-19 pandemic is the detection of the SARS-CoV-2 virus in sewage samples. Diarrhea has been described as a symptom of Covid-19 disease, and human excreta may contain important viral loads derived by infected people. Additionally, most SARS-CoV-2 carriers exhibit none or mild non-specific symptoms, and therefore they represent a group of mostly silent contributors to the virus's environmental release. In Brazil, especially in the City of Rio de Janeiro, slums were historically . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted January 9, 2021. In parallel and aiming to investigate airborne contamination's potential due to sewage spraying and living in agglomeration, we conducted atmospheric samplings at slum alleys where sewage aerosolization and habitants' passage are constant, Fig.1 . . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 9, 2021. ; https://doi.org/10.1101/2021.01.06.21249243 doi: medRxiv preprint . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 9, 2021. ; https://doi.org/10.1101/2021.01.06.21249243 doi: medRxiv preprint therefore be able to be deposited as more profound as the bronchiolar lung compartment according to several lung deposition models (8) . As illustrated in Fig. 3 , along the year 2020, the Santa Marta slum sanitization passed through different communitarian support stages. Along with the first Covid-19 wave from April to August, sanitizations took place two times in a week with great social engagement (100% activity), between September and November activities halved (50% activity) and during December, a combination of fatigue, relaxation of social distances and reduced, or lack, of investments in the project, lead to a break down in the activities (0% activity). It . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 9, 2021. ; https://doi.org/10.1101/2021.01.06.21249243 doi: medRxiv preprint 6 is also interesting to observe that the second wave of accumulated death presented two peaks. The second one in early December coincided with the official release of the discovery of the new variant of SARS-CoV-2, named B.1.1.7 (9) , which was first detected in Brazil in mid-December. Based on England's available preliminary statistical data, it is estimated that the new variant could be 50% to 74 % more transmissible. Comparing these stages with the statistics of accumulated death for both locally and the Rio de Janeiro municipality depicts a picture of high social engagement interference in lowering death numbers. While the city of Rio de Janeiro was under a high number of deaths and cases in May and June (first Covid-19 wave), mortality at Santa Marta slum was maintained at very low levels (Fig. 3) . Although death in Rio de Janeiro city stabilized during August-September-October, death at Santa Marta increased significantly 1 order of magnitude, reaching a peak when none social action is under course. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 9, 2021. ; https://doi.org/10.1101/2021.01.06.21249243 doi: medRxiv preprint To many underdeveloped countries, Covid-19 highlighted unsolved long term sanitary problems. The sanitary issue enclosing the Covid-19 is part of a problem that governments have been neglecting for decades or even centuries in the countries. The Santa Marta case study exhibits evidence that sanitization, and other social activities that accompany such activity, maybe a solution to break contamination routes (not only for SARS-CoV-2 but many other viral pathologies). A partial socio-epidemiological bulletin for Covid-19 specific for slums ("favelas"), 01/2020, edited by the Oswaldo Cruz Foundation/FIOCRUZ (an institution from the Brazilian Ministry of Health), showed that Covid-19 lethality during the first wave in non-slum neighborhoods was estimated to be 9,23% until June 2020, while the neighborhoods with high slum concentrations . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 9, 2021. into three compartments: collector spout, the central part of "microorganism trapping," and air outlet (11) . The collector nozzle is a moving part that functions as an "inlet" through which atmospheric air passes. This compartment is fitted over a central part, which contains tangential nozzles designed to form a vortex inside the sampler itself. A liquid solution (e.g., glycerol) is placed in this compartment where viruses and microorganisms can be fixed. 1.3. MAS100 sampler, this sampler uses the same principle as the Andersen sampler. It is a compact and integrated suction system in which air is forced through a flat cover with 400 equally spaced holes, which acts as an "inlet" (12). The diameter of each hole is 0.7 mm. Just below the holes, a Petri dish containing a solid culture medium (e.g., agar) is arranged so that the bioaerosols captured by the suction of the air directly impact the surface of the medium that holds them. Impactor, is a selective instrumentation for airborne particles. It collects particles according to their aerodynamic diameter. In this work, we used a PIXE impactor that allowed discriminate bioaerosols according to the following fractions under a constant airflow of 1.5 Lpm for 24 hours of integration: 16 µm . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted January 9, 2021. ; https://doi.org/10.1101/2021.01.06.21249243 doi: medRxiv preprint 9 to 8 µm; 8 µm to 4 µm; 4 µm to 2 µm; 2 µm to 1 µm; 1 µm to 0,5 µm; 0,5 µm to 0,25 µm; 0,25 µm to 0,12 µm; 0,12 µm to 0,06 µm and < 0,06 µm. We did not receive any financial funding for the development of the present work. First confirmed detection of SARS-CoV-2 in untreated wastewater in Australia: a proof of concept for the wastewater surveillance of COVID-19 in the community Presence of SARS-Coronavirus-2 in sewage and correlation with reported COVID-19 prevalence in the early stage of the epidemic in the Netherlands SARSCov-2 titers in wastewater are higher than expected from clinically confirmed cases. medRxiv Time course quantitative detection of SARS-CoV-2 in Parisian wastewaters correlates with COVID-19 confirmed cases Preliminary results of SARS-CoV-2 detection in sewerage system in Niterói municipality International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals. 2020 Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1 Deposition distribution of the new coronavirus (SARS-CoV-2) in the human airways upon exposure to cough-generated aerossol Fast-spreading U.K. virus variant raises alarms Enhancing Bioaerosol Sampling by Andersen Impactors Using Mineral-Oil-Spread Agar Plate Comparison of the Results of Studies of Air Pollution Fungi Using the SAS Super 100, MAS 100, and Air IDEAL We greatly thank Mr. Thiago Firmino and Mr. Thandy Firmino and the Santa Marta sanitization team for logistics and discussion on routine life and work at slums in Rio de Janeiro City. We greatly thank IAEA -International Atomic Energy Agency for the experimental support based on donation of materials and equipment. The authors declare that the research was conducted in the absence of any commercial or financial frameworks that could be construed as a potential conflict of interest. All authors contributed equally to the development of the project and the writing is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 9, 2021. ; https://doi.org/10.1101/2021.01.06.21249243 doi: medRxiv preprint It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 9, 2021. ; https://doi.org/10.1101/2021.01.06.21249243 doi: medRxiv preprint