Latin America, epicenter of the pandemic, faces a crucial month to stop it

In recent weeks, Latin America has become the new epicentre of the COVID-19 pandemic, with more than a million cases, and June will be crucial for slowing the region's progress, Pan American Health Organization (PAHO) expert Marcos Espinal told Efe. 

The director of the Department of Communicable Diseases of PAHO (the World Health Organization's arm in the Americas) stressed that June "is going to be a critical month, in which the countries that implemented mitigation measures in time will be able to manage the overload of cases in their health systems a little better". The Dominican expert recalled that at the moment countries in the area such as Brazil, Chile or Mexico are experiencing daily increases of up to 4 and 5% in new infections, and others such as Bolivia or Venezuela are also increasing their relative numbers of daily cases. 

This is complicated by the region's economic problems, with large pockets of poverty and many informal workers without health coverage or means of subsisting in confinement, which is leading some countries to consider them de-escalating even though contagion has not yet been reduced. 

PAHO "has recommended that this is not the time to reopen, but each country is sovereign," says Espinal, who says the organization understands "that many people without permanent jobs have to seek support for their families. If they decide to reopen, "it should be in a gradual and analytical way," suggested the expert, encouraging each country to sit down and decide on these responsible economic and financial measures together with public health authorities and representatives of civil society. 

Espinal explained that Latin American countries on the one hand had a little more time than European countries to initiate prevention measures (social distancing, awareness campaigns) but on the other hand many of their health networks are not sufficiently financed for this type of emergency. 

"PAHO recommends that countries invest a minimum of six percent of their Gross Domestic Product in public health, but most of them don't reach that figure," laments the expert, who hopes that the pandemic will help countries in the area become more aware of this need. "The investment must be in quantity and quality, for years to come, because it's not just about tackling the COVID but also other diseases that are going to come in a region where we've already had zika or H1N1 flu," he said. 

Brazil, with almost 700,000 cases and 37,000 deaths - as of June 8 - is the second most affected country in the world by the coronavirus, although in the region the situation in Peru (almost 200,000 infections), Chile (134,000) or Mexico (almost 120,000 infections) is also of concern in absolute terms. PAHO and WHO have expressed concern about Haiti, which has one of the weakest health systems in the region, or Nicaragua, which according to Espinal "was de facto trying to adopt group immunity" that has already failed in European countries like Sweden or the United Kingdom. 

On the other hand, some governments in the region took preventive measures relatively early on, and Espinal gave the examples of Colombia and the Dominican Republic, although he said that even with maximum foresight it was difficult to have zero infections in any country. 

She also highlighted the "excellent testing programme" of countries such as Chile or Uruguay (with 30,000 and 14,000 tests per million inhabitants, respectively) or the good use of mobile health teams in Costa Rica to attend to people who are self-isolated in their homes. 

Regarding the initial attitude of some of the region's political leaders, like President Jair Bolsonaro, who denied the possibility of the pandemic coming to his country, the head of PAHO said he was neutral and that the organisation "respects all the opinions of the heads of state". "What we do ask is that the message be consistent, because when the messages are inconsistent the population gets confused," he added. 

Surprising in the region is the situation of Venezuela, which despite the serious economic difficulties that its hospitals have shown in previous years, seems to have been one of the least affected by the pandemic in Latin America, with only 2,300 confirmed cases. "It is a country where there were already very few flights before the arrival of the COVID," explained Espinal, who nevertheless pointed out that Venezuela is doing many rapid diagnostic tests for the disease that are "not very reliable" and few molecular tests, which are those recommended by the WHO and PAHO.