Title : Dengue and SARS Cov2 co-circulation early warning according to climate variations in Cuba

Abstract:

Co-circulation Dengue and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a reality that is more dangerous in endemic regions of arboviruses. The circulation of both viruses continues to spread, mainly in tropical environments, causing a high impact on the health systems of the countries due to the high morbidity caused by each virus. Knowing in advance the areas where they circulate the most at the same time, allows decision makers to take effective measures to reduce the risk of both epidemics that can lead to the collapse of health systems. Therefore, forecasting the circulation of the SARS-CoV-2 and dengue virus based on the transmission mechanisms of each virus and the influence of climate variability on a temporal and spatial scale makes it possible to improve the alert system and provides a tool for decision-makers in the health system take the necessary control measures. Methods: Ecological study with retrospective-prospective analysis of the SARS-CoV-2 virus series, dengue, as well as Aedes focus with its index and climatic anomalies described by the Bulto complex climatic index (BI_{1, r, t} ). The interpolation method was generated for the spatial structure with continuous information of 1200 nodes (Raster format). The kriging method combined with the inverse distance method (IDM) with a resolution of 10 km² was implemented. The Multivariate Moran Index was used to determine the spatial correlation. Models were developed for each indicator according to their transmission mechanisms and the influence of the environment on each one. For the prediction, the Simultaneous Autoregressive Models and the Spatial Autoregressive Conditional Models were used.  Temporal modelling was performed using the Autoregressive Conditional Heteroscedastic Model and the Autoregressive Model, both with exogenous variables. To obtain the forecast maps with co-circulation risk areas, a stratification of the predicted circulation of both viruses is performed and map algebra is applied. Results: The moments of greatest risk of Dengue and SARS-CoV-2 co-circulation are the months corresponding to the second quarter of the rainy period August-October with conditions of high humidity, very high temperatures, high volume of precipitation, high cloudiness, being potential predictors. The areas with the highest viral co-circulation were the Central-Eastern region of the country. All these results led to the creation of the alert system for dengue and co-circulation with SARS-CoV-2 based on the observation and forecast of climatic factors. Conclusions: An Early Warning System for infectious diseases and their causal agents was created. This system strengthens the health sector's surveillance system for decision-making. It is evident that the climate is an important determinant for the health sector, and in particular to understand the behaviour and co-circulation of Dengue and SARS-CoV-2, which strengthens the active health surveillance system. For the implementation of this system, it is necessary to form a transdisciplinary team, guarantee georeferenced information (climatic, virological and epidemiological date), which are the input in models on ArcGis and obtaining the forecast maps based on impact, and can be generalized to other regions, as well as have the information.

Keywords: Climate; co-circulation; Dengue; SARS-CoV-2; Early Warning System

Biography:

Yazenia Linares Vega, meteorologist in Meteorology Institute of Cuba, researcher on climate and health, specifically models of spatial prediction of infectious diseases from climate conditions. Has given countless conferences, workshops, Professor on topic of infectious diseases and climate variability and change. She is a PhD student in topic: Effect of climate on dynamics and circulation of viruses, as well as prediction of viral spread. Has several publications in the theme. She collaborates and cconducts research with several institutes (e.g. Tropical Medicine IPK, Institute of Hygiene, Epidemiology and Microbiology) both Environmental and Health in Cuba as well as in different countries.