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Covid-19: Countries in the Americas are warned not to lower their guard

BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o664 (Published 14 March 2022) Cite this as: BMJ 2022;376:o664
  1. Luke Taylor
  1. Bogotá

Covid-19 is on the retreat across the American continents but it is too early for the region to let its guard down, warned the Pan American Health Organisation, the World Health Organization’s regional office for the Americas, on 9 March.

Reported cases of covid-19 fell by 26% in the past week and deaths by nearly 19%, as the omicron wave of infections tailed off. But ongoing transmission and future variants could expose the region’s public health priorities once more, said PAHO’s director, Carissa Etienne.

A total of 2.6 million people have died from covid-19 in the Americas, the highest number of any region of the world and almost half of the global total, despite being home to only 13% of its population. “This is a tragedy of enormous proportions, and its effects will be felt for years to come,” said Etienne on the second anniversary of the pandemic.

Patchy vaccination coverage has left countries vulnerable to current and future variants of SARS-CoV-2. Around 248 million people in Latin America and the Caribbean are yet to receive a single dose of a covid vaccine, with vaccination rates particularly low in hard-to-reach rural areas.

In the first two months of 2022 the Americas accounted for 63% of the world’s new cases. Despite a general fall in incidence across the region, new cases rose by 2.2% in the Caribbean, while Bolivia and Puerto Rico reported an increase in deaths in the past week.

Michael Touchton, head of the University of Miami’s covid-19 policy observatory for Latin America, said, “Latin America is perhaps the most vulnerable region in the world to the emergence of a new variant. Vaccine delays have a greater impact in Latin America due to concentrated urban populations, chronic disease burden, and low capacity health systems. Taken together, Latin America is likelier to fare worse than other similarly low and middle income regions.”

Some South American countries, such as Colombia and Venezuela, have begun to relax public health restrictions, such as mandatory mask wearing, in recent weeks as transmission rates fell. But Etienne warned that they must not act prematurely, as the apparent reduction in cases may be exaggerated as a result of less testing.

“We all want the pandemic to be over, but optimism alone will not control the virus,” Etienne told the press conference.

Senior PAHO officials advised governments to enact the lessons learnt in the past two years of the pandemic. They must continue to monitor transmission and to sequence variants, sharing the information quickly to help policymakers make decisions. Testing should be made readily available, even when transmission is low.

“Covid-19 is likely to be here to stay,” said Etienne. “We must learn to live with this virus and quickly adapt to new changes. We can do that by keeping our finger on the pulse of the pandemic and adjusting public health guidance any time there is a risk of increased transmission.”

The war in Ukraine has caused concern that the delivery of vaccines to Latin America could be delayed, but there is no obvious effect yet on supply chains, said PAHO’s assistant director, Jarbas Barbosa.

Manufacturers of Russia’s Sputnik vaccine are in the process of applying for emergency approval from WHO, but the country is unlikely to receive inspection, given the current situation in eastern Europe, which could hinder the vaccine’s rollout.

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