Effect of social isolation in dengue cases in the state of Sao Paulo, Brazil: An analysis during the COVID-19 pandemic

BACKGROUND: Studies have shown that human mobility is an important factor in dengue epidemiology. Changes in mobility resulting from COVID-19 pandemic set up a real-life situation to test this hypothesis. Our objective was to evaluate the effect of reduced mobility due to this pandemic in the occurrence of dengue in the state of São Paulo, Brazil. METHOD: It is an ecological study of time series, developed between January and August 2020. We use the number of confirmed dengue cases and residential mobility, on a daily basis, from secondary information sources. Mobility was represented by the daily percentage variation of residential population isolation, obtained from the Google database. We modeled the relationship between dengue occurrence and social distancing by negative binomial regression, adjusted for seasonality. We represent the social distancing dichotomously (isolation versus no isolation) and consider lag for isolation from the dates of occurrence of dengue. RESULTS: The risk of dengue decreased around 9.1% (95% CI: 14.2 to 3.7) in the presence of isolation, considering a delay of 20 days between the degree of isolation and the dengue first symptoms. CONCLUSIONS: We have shown that mobility can play an important role in the epidemiology of dengue and should be considered in surveillance and control activities.