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\begin{document}

\title{Evolving Drivers of Brazilian SARS-CoV-2 Transmission: A
Spatiotemporally Disaggregated Time Series Analysis of Meteorology,
Policy, and Human Mobility}



\author[1]{Gaige Hunter Kerr}%
\author[2]{Hamada S. Badr}%
\author[3]{Alisson Barbieri}%
\author[4]{Josh M Colston}%
\author[2]{Lauren M. Gardner}%
\author[5]{Margaret N Kosek}%
\author[6]{Benjamin F Zaitchik}%
\affil[1]{The George Washington University}%
\affil[2]{Johns Hopkins University}%
\affil[3]{Federal University of Minas Gerais}%
\affil[4]{University of Virginia School of Medicine}%
\affil[5]{Division of Infectious Diseases and International Health and Public Health Sciences, University of Virginia School of Medicine}%
\affil[6]{John Hopkins University}%


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  \date{June 14, 2024}


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\begin{abstract}
Brazil has been severely affected by the COVID-19 pandemic. Temperature
and humidity have been purported as drivers of SARS-CoV-2 transmission,
but no consensus has been reached in the literature regarding the
relative roles of meteorology, governmental policy, and mobility on
transmission in Brazil. We compiled data on meteorology, governmental
policy, and mobility in Brazil's 26 states and one federal district from
June 2020 to August 2021. Associations between these variables and the
time-varying reproductive number (R\textsubscript{t}) of SARS-CoV-2 were
examined using generalized additive models fit to data from the entire
fifteen-month period and several shorter, three-month periods.
Accumulated local effects and variable importance metrics were
calculated to analyze the relationship between input variables and
R\textsubscript{t}. We found that transmission is strongly influenced by
unmeasured sources of between-state heterogeneity and the near-recent
trajectory of the pandemic. Increased temperature generally was
associated with decreased transmission and specific humidity with
increased transmission. However, the impact of meteorology, policy, and
mobility on R\textsubscript{t} varied in direction, magnitude, and
significance across our study period. This time variance could explain
inconsistencies in the published literature to date. While meteorology
weakly modulates SARS-CoV-2 transmission, daily or seasonal weather
variations alone will not stave off future surges in COVID-19 cases in
Brazil. Investigating how the roles of environmental factors and disease
control interventions may vary with time should be a deliberate
consideration of future research on the drivers of SARS-CoV-2
transmission.%
\end{abstract}%



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