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As of May 16th, 2020, the number of confirmed cases and deaths in Brazil due to COVID-19 hit 233,142 and 15,633, respectively, making the country one of the most affected by the pandemic. The State of Sao Paulo (SSP) hosts the largest number of confirmed cases in Brazil, with over 60,000 cases to date. Here we investigate the spatial distribution and spreading patterns of COVID-19 in the SSP by mapping the spatial autocorrelation and the clustering patterns of the virus in relation to the population density and the number of hospital beds. Moran's I and LISA clustering analysis indicated that Sao Paulo City is a significant hotspot for both the confirmed cases and deaths, whereas other cities across the State could be considered colder spots. Bivariate Moran's I also showed that the population density is a key indicator for the number of deaths, whereas the number of hospital beds is less related, implying that the fatality depends substantially on the actual patient's condition. Social isolation measures throughout the SSP have been gradually increasing since early March, an action that helped to slow down the emergence of the new confirmed cases, highlighting the importance of the safe-distancing measures in mitigating the local transmission within and between cities in the SSP.
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