Abstract
Intense SARS-CoV-2 transmission among affluent Manaus residents preceded the second wave of the epidemic in Brazil
Highlights
The sampling frame of the DETECTCoV-19 cohort is important to understand these results in the wider context of Manaus
As acknowledged in the Article, the results should not be generalised to the wider population of Manaus, but instead generalised to the affluent, profession ally employed subpopulation represented by the DETECTCoV-19 cohort
It is interesting that a high level of transmission persisted among this group, at a time (August to November, 2020) when populationlevel hospitalisations and deaths were low, presumably partly due to wide-spread population immunity,[1,4] which seemingly might not have extended to this more affluent group. These results accord with observations in the media of a relative uptick in private hospitalisations due to COVID-19 during this period.[6]
Summary
The sampling frame of the DETECTCoV-19 cohort is important to understand these results in the wider context of Manaus. As acknowledged in the Article, the results should not be generalised to the wider population of Manaus, but instead generalised to the affluent, profession ally employed subpopulation represented by the DETECTCoV-19 cohort. It is interesting that a high level of transmission persisted among this group, at a time (August to November, 2020) when populationlevel hospitalisations and deaths were low, presumably partly due to wide-spread population immunity,[1,4] which seemingly might not have extended to this more affluent group.
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