Ricardo de Sampaio Dagnino

The present study analyzed how the economic, social and human mobility factors were responsible for dissemination of Covid -19 in Brazil and the Legal Amazon region. Human mobility was analyzed by four dimensions according to the network's hierarchies of: migration, pendular mobility, airlift, hydro and road routes and healthcare system. Manaus, capital of Amazon, was the first diffuser pole of cases; this may be explained by absence of public lockdown policies and restriction of mobility by river routes and airport system. In the face of the worsening of the pandemic, between March to May 2020, the previous migratory pattern of the urban population was accentuated to inland Amazonian cities that spread the virus towards remote areas of the Amazon. In addition, there was a pendular migratory movement to Manaus, which is the only center in the region with highly complex hospitals; this fact led to a strong migratory movement of populations seeking medical assistance. The analysis on migration revealed a close relation of the spatiotemporal behavior of Covid-19 spread and the migration network to Manaus. There were significant correlations related to fluvial or waterway transportation axis along the Amazon River which is the dominant route of the region. These pathways have long distances to be covered from one pole to another and were additional factors for the spread of the pandemic during the period studied and have long travel times that can be an important factor for COVID-19 further dissemination. We conclude that the wide dissemination of COVID-19 cases across the Legal Amazon was the result of multifactorial causes that include social inequities, vulnerability, high rate of mobility and migration, information failure and administrative and social management of the crisis.