WASHINGTON — The Pan-American Health Organization will deploy teams this week to countries in Latin America and the Caribbean that require extra support on their response to the outbreak of COVID-19, the novel coronavirus.
PAHO said on Friday it will assess the current status of country responses so far, review national response plans and surveillance systems, and help countries identify how and where they will isolate and quarantine identified cases of the disease.
“We need a multisectoral approach, and these discussions must start now … We must be able to determine the public measures that will be activated including school closures, cancellation of mass gatherings, teleworking.”— Dr. Carissa F. Etienne, PAHO director and WHO regional director for the Americas
“PAHO is working intensely with all the countries in our region with particular emphasis on those with the weakest health systems,” said Dr. Carissa F. Etienne, PAHO director and World Health Organization regional director for the Americas, at a briefing in Washington.
“What is very important is that we recognize that the countries with weaker health systems carry a higher risk, a higher risk not just for importation but for the ability to ensure strong surveillance … to manage cases to save lives, and to ensure infection prevention,” Etienne continued.
Countries where PAHO will send the additional support include Venezuela, Bolivia, Paraguay, Guyana, Nicaragua, Honduras, Guatemala, Haiti, and some small Caribbean island states.
Public health organizations in Latin America and the Caribbean are working with national health departments and other stakeholders to prepare the region for a potential outbreak.
PAHO is also expecting to release guidelines this week on how to protect migrant and internally displaced populations from COVID-19. Latin America and the Caribbean are currently experiencing mass migration from Venezuela across the region, as well as a movement of Central Americans north to Mexico and the U.S. border.
“We are in close contact with IOM, the International Organization for Migration, and also UNHCR, but most importantly with the member states also to address the migrant population,” said Ciro Ugarte, director of health emergencies at PAHO, noting that migrants often lack access to appropriate health care, which could mean cases to go undetected.
Etienne said it is likely Latin America and the Caribbean will experience a “mosaic” of cases, and that PAHO envisions three possible scenarios with varying degrees of severity for the future of COVID-19 in the region: one that sees no widespread transition; one where outbreaks occur in closed environments like nursing homes and prisons; and one where community transmission is widespread.
As of March 6 in the Americas and Caribbean, cases have been detected in the U.S., Canada, Brazil, Mexico, Ecuador, the Dominican Republic, St. Martin, St. Barts, Argentina, Chile, French Guiana, Peru, and Martinique.
PAHO is working with health departments across the region to strengthen response mechanisms in the event that critical cases elevate. It has developed a hospital readiness tool so health facilities can evaluate their level of preparedness, and PAHO trained and equipped 29 of the 32 available testing labs in the region so both travel and community cases can be quickly identified.
“We need a multisectoral approach, and these discussions must start now … We must be able to determine the public measures that will be activated including school closures, cancellation of mass gatherings, teleworking,” Etienne said. “The countries of Latin America and the Caribbean are better prepared than 10 years ago, as they have learned valuable lessons.”
These lessons come from the region’s past experience with disease outbreaks, from H1N1 and zika to yellow fever and dengue, Etienne said, and can be applied to the current COVID-19 response. She said PAHO has been encouraged by the strong political response seen so far from leaders in the region to protect their citizens by investing appropriately in the preparedness.
Ugarte said that the Americas have one of the strongest surveillance systems in the world to detect respiratory illnesses and have the strongest vaccine coverage for seasonal influenza. The region is home to several countries that will experience both the seasonal flu and coronavirus outbreak at the same time, which Ugarte said will require a balanced response to ensure the emergency response does not overshadow other health care needs.
“We've been working with all the countries on strengthening their laboratory capacities and their surveillance capacities so we are seeing that countries now are able to take the samples and confirm the cases very quickly,” Ugarte said. “The challenge is to find them as soon as possible.”
Etienne said that while the region must focus on containing the virus through early detection and isolation of COVID-19 cases, “it is important to avoid overreacting” and ensure health departments are disseminating accurate, timely information to their populations to help avoid transmission.