Abstract
The coronavirus disease 2019 (COVID-19) outbreak in North, Central, and South America has become the epicenter of the current pandemic. We have suggested previously that the infection rate of this virus might be lower in people living at high altitude (over 2,500 m) compared to that in the lowlands. Based on data from official sources, we performed a new epidemiological analysis of the development of the pandemic in 23 countries on the American continent as of May 23, 2020. Our results confirm our previous finding, further showing that the incidence of COVID-19 on the American continent decreases significantly starting at 1,000 m above sea level (masl). Moreover, epidemiological modeling indicates that the virus transmission rate is lower in the highlands (>1,000 masl) than in the lowlands (<1,000 masl). Finally, evaluating the differences in the recovery percentage of patients, the death-to-case ratio, and the theoretical fraction of undiagnosed cases, we found that the severity of COVID-19 is also decreased above 1,000 m. We conclude that the impact of the COVID-19 decreases significantly with altitude.
Highlights
On March 11, 2020, the coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization [1, 2]
Our results show that the incidence of COVID-19, the virus transmission rate, and the severity of COVID-19 decrease significantly above 1,000 masl
Since health policies in most countries in the American continent restricted the access to COVID-19 tests to people showing clear symptoms of infection or having a history of contact with infected people [32,33,34], in this study, we have made the reasonable assumption that the cases observed and reported officially include mainly symptomatic
Summary
On March 11, 2020, the coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization [1, 2]. Other densely populated metropolises with large slum areas, but located above 1,000 meters above sea level (masl), such as Mexico city (8 million people—26,000 people/km423 cases) [12], Bogota (7,4 million people—4,310 people/km554 cases) [13] and La Paz (2,3 million people—2,676 people/km413 cases) [14] (data as of July 7), seem to show lower incidences of COVID-19 This observation is of crucial importance since in American countries, more than 120 million people live at an altitude higher than 1,500 masl (defined as moderate altitude—MA), and more than 35 million people live at an altitude higher than 2,500 masl (defined as high altitude—HA) [15]. Our results show that the incidence of COVID-19, the virus transmission rate, and the severity of COVID-19 decrease significantly above 1,000 masl
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