Insufficient social distancing may be related to COVID-19 outbreak: the case of Ijuí city in Brazil

The coronavirus disease initiated in 2019 (COVID-19) has proven to be highly contagious and quickly became a pandemic. Nowadays, it presents higher transmission rates worldwide, chiefly in small Brazilian cities, as Ijuí. Located in the northwestern of the State of Rio Grande do Sul (RS) with 83,475 inhabitants, Ijuí was selected to receive a population-based survey organized in five steps, involving 2,222 subjects. Subjects were tested for the presence of antibodies against coronavirus (SARS-CoV-2) and answered questions regarding social distance adherence (SDA), daily preventive routine (DPR), comorbidities, and sociodemographic characteristics. In parallel, the local government registered the official COVID-19 cases in Ijuí, and the mobile social distancing index (MSDI) was also registered. In this study, we demonstrate the decrease in the levels of SDA, DPR and MSDI before the beginning of COVID-19 community transmission in Ijuí. Also, we provide predictions for cases, hospitalization, and deaths in the city. We concluded that the insufficient social distancing, evidenced by different methods, might have a strong relationship with the rapid increase of COVID-19 cases in Ijuí. Our study predicts a closer outbreak of community infection of COVID-19, which could be avoided or attenuated if the levels of the social distancing in the population increase.