By Matías A. Loewy
BUENOS AIRES, ARG. The COVID-19 situation in the Americas region, where confirmed cases grew from 163,000 to nearly 3 million in the course of 10 weeks, "is terrible, but not hopeless," said Dr. Carissa Etienne, director of the Pan American Health Organization (PAHO), today.
Cases in the region already account for more than half of all those reported worldwide, he said, though he noted that there may be a way out of the crisis "to the extent that our approach to defeating the virus is based on solidarity. We must work together, share resources, and apply the proven strategies we learned along the way."
The official, who made those statements at the opening of the weekly briefing offered by the agency to the press, added that the impact of the pandemic in the region has been serious, but "it could have been worse" if the authorities had not taken the public health measures that managed to flatten the curve of cases.
However, he noted that a barrier to stopping the spread of COVID-19 is that it is a region with "massive inequalities," where people have to share public transportation in megacities or face various vulnerabilities, such as indigenous populations, migrants, or patients with other underlying chronic illnesses. And with "weak and underfunded" health systems that must also contend with other epidemics like malaria and dengue fever.
Three tips for dealing with the pandemic
Dr. Etienne noted that "the epidemiological curve continues to rise sharply in many places" and offered three pieces of advice to authorities for managing the coming weeks of the pandemic:
1. "We need to think twice before suspending social distancing measures"
The official explained: “We must be careful. We must not lift these measures too quickly, or we risk a resurgence of COVID-19 that could wipe out everything we have achieved in recent months.”
In this regard, Dr. Jarbas Barbosa, PAHO's deputy director, considered that "there is no magic formula (to exit confinement), but if transmission continues to grow, it is an indication that economic activity cannot be opened immediately because transmission could accelerate even more."
He added that social distancing measures must continue "until the curve is flattened and transmission is under control. The situation needs to be carefully monitored."
2. "Decisions should not be made blindly."
Dr. Etienne stressed that surveillance is the most valuable tool for guiding public health measures and tailoring responses. She emphasized that "we still have an urgent need to expand testing."
In that regard, Dr. Barbosa pointed out that there isn't a specific rate for how many tests a country should perform per million inhabitants, but indicated that there must be enough tests to analyze all suspected cases, their contacts, and healthcare personnel. "That's the bare minimum a country should have," he said.
Meanwhile, Dr. Marcos Espinal, director of the Department of Communicable Diseases at PAHO, described the situation in Brazil as "very delicate" and stressed that "it is imperative that the number of tests increases."
"Brazil has performed 4,000 to 4,300 tests per million inhabitants, but there are countries that are doing 25,000, 20,000 or 15,000 tests per million inhabitants," he compared.
3. "Strengthen health systems"
"These past few months should have allowed countries to strengthen their health infrastructure for the wave we knew was coming, especially to improve the capacity of hospitals," Dr. Etienne noted.
“As cases rise, we must continue these efforts. Many places are overwhelmed and operating at their limit, but we have always seen that health systems rise to the occasion,” he added. He also called for healthcare workers to be kept safe and healthy.
In his response regarding the situation in Brazil, Dr. Espinal addressed this issue. "The occupancy rate of intensive care beds is alarming in many states, for example, 80% in Ceará and Maranhão. It is important that Brazil take steps to make more beds available," he said.
Dr. Espinal concluded with a call to rethink and review the measures being taken. He said it's not enough to simply say "we're doing it," but rather the key question is: "What could we be doing better?"