Using demographic data to understand the distribution of H1N1 and COVID-19 pandemics cases among federal entities and municipalities of Mexico
Authors: Sarria-Guzmán Yohanna , Bernal Jaime , De Biase Michele , Muñoz-Arenas Ligia C. , González-Jiménez Francisco Erik , Mosso Clemente , De León-Lorenzana Arit , Fusaro Carmine 
Published: March 2021

Background
The novel coronavirus disease (COVID-19) pandemic is the second global health emergency the world has faced in less than two decades, after the H1N1 Influenza pandemic in 2009–2010. Spread of pandemics is frequently associated with increased population size and population density. The geographical scales (national, regional or local scale) are key elements in determining the correlation between demographic factors and the spread of outbreaks. The aims of this study were: (a) to collect the Mexican data related to the two pandemics; (b) to create thematic maps using federal and municipal geographic scales; (c) to investigate the correlations between the pandemics indicators (numbers of contagious and deaths) and demographic patterns (population size and density).

Methods
The demographic patterns of all Mexican Federal Entities and all municipalities were taken from the database of “Instituto Nacional de Estadística y Geografía” (INEGI). The data of “Centro Nacional de Programas Preventivos y Control de Enfermedades” (CENAPRECE) and the geoportal of Mexico Government were also used in our analysis. The results are presented by means of tables, graphs and thematic maps. A Spearman correlation was used to assess the associations between the pandemics indicators and the demographic patterns. Correlations with a p value < 0.05 were considered significant.

Results
The confirmed cases (ccH1N1) and deaths (dH1N1) registered during the H1N1 Influenza pandemic were 72.4 thousand and 1.2 thousand respectively. Mexico City (CDMX) was the most affected area by the pandemic with 8,502 ccH1N1 and 152 dH1N1. The ccH1N1 and dH1N1 were positively correlated to demographic patterns; p-values higher than the level of marginal significance were found analyzing the % ccH1N1 and the % dH1N1 vs the population density. The COVID-19 pandemic data indicated 75.0 million confirmed cases (ccCOVID-19) and 1.6 million deaths (dCOVID-19) worldwide, as of date. The CDMX, where 264,330 infections were recorded, is the national epicenter of the pandemic. The federal scale did not allow to observe the correlation between demographic data and pandemic indicators; hence the next step was to choose a more detailed geographical scale (municipal basis). The ccCOVID-19 and dCOVID-19 (municipal basis) were highly correlated with demographic patterns; also the % ccCOVID-19 and % dCOVID-19 were moderately correlated with demographic patterns.

Conclusion
The magnitude of COVID-19 pandemic is much greater than the H1N1 Influenza pandemic. The CDMX was the national epicenter in both pandemics. The federal scale did not allow to evaluate the correlation between exanimated demographic variables and the spread of infections, but the municipal basis allowed the identification of local variations and “red zones” such as the delegation of Iztapalapa and Gustavo A. Madero in CDMX.