  While extensive literature exists on the COVID-19 pandemic at regional and
national levels, understanding its dynamics and consequences at the city level
remains limited. This study investigates the pandemic in Maring\'a, a
medium-sized city in Brazil's South Region, using data obtained by actively
monitoring the disease from March 2020 to June 2022. Despite prompt and robust
interventions, COVID-19 cases increased exponentially during the early spread
of COVID-19, with a reproduction number lower than that observed during the
initial outbreak in Wuhan. Our research demonstrates the remarkable impact of
non-pharmaceutical interventions on both mobility and pandemic indicators,
particularly during the onset and the most severe phases of the emergency.
However, our results suggest that the city's measures were primarily reactive
rather than proactive. Maring\'a faced six waves of cases, with the third and
fourth waves being the deadliest, responsible for over two-thirds of all deaths
and overwhelming the local healthcare system. Excess mortality during this
period exceeded deaths attributed to COVID-19, indicating that the burdened
healthcare system may have contributed to increased mortality from other
causes. By the end of the fourth wave, nearly three-quarters of the city's
population had received two vaccine doses, significantly decreasing deaths
despite the surge caused by the Omicron variant. Finally, we compare these
findings with the national context and other similarly sized cities,
highlighting substantial heterogeneities in the spread and impact of the
disease.
