Perspectives on Battling COVID-19 in Countries of Latin America and the Caribbean

Andrus, Jon Kim; Evans-Gilbert, Tracy; Santos, José Ignacio; Guzmán, María G.; Rosenthal, Philip J.; Toscano, Cristiana M.; Valenzuela, Marı́a Teresa; Siqueira, Marilda M.; Etienne, Carissa F.; Breman, Joel G.

doi:10.4269/ajtmh.20-0571

Cited by 44 publications

(52 citation statements)

References 8 publications

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“…Although, co-infections with other respiratory viruses have been reported in other countries 40,42,43 , no difference in clinical disease severity between cases with and without viral co-infection has been observed thus far 44 . The co-circulation of other respiratory pathogens highlights the need to scale up laboratory and molecular screening of SARS-CoV-2 and other respiratory viruses in public laboratories across Brazil 15 . Continued molecular and genomic surveillance will be important to determine patterns of virus transmission and to guide public health measures in forthcoming phases of the epidemic 24,[45][46][47] .…”

Section: Discussionmentioning

confidence: 99%

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Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil

Buss²,

et al. 2020

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OVID-19 is a severe acute respiratory infection (SARI) that emerged in early December 2019 in Wuhan, China 1. The outbreak was declared a public health emergency of international concern by the World Health Organization on 30 January 2020. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an enveloped, single-stranded positive-sense RNA virus that belongs to the Betacoronavirus genus and Coronaviridae family 2. SARS-CoV-2 is closely related genetically to bat-derived SARS-like coronaviruses 3. Human-to-human transmission occurs primarily via respiratory droplets and direct contact, similar to human influenza viruses, SARS-CoV and Middle East respiratory syndrome coronavirus 4. The most commonly reported clinical symptoms are fever, dry cough, fatigue, dyspnoea, anosmia, ageusia, or some combination of these 1,4,5. As of 16 June 2020, more than 7.9 million cases have been confirmed worldwide, resulting in 434,796 deaths 6. Brazil declared COVID-19 a national public health emergency on 3 February 2020 7. After the development of a national emergency plan and the early establishment of molecular diagnostic facilities across Brazil's network of public health laboratories, the country reported its first confirmed COVID-19 case on 25 February 2020, in a traveller returning to São Paulo from northern Italy 8. São Paulo is the largest city in South America and no other Brazilian city receives a greater proportion of international flights 9. Currently, Brazil has one of the fastest-growing COVID-19 epidemics in the world, now accounting for 1,864,681 cases and 72,100 deaths, comprising over 55% of the total number of reported cases in Latin America and the Caribbean (as of 14 July 2020) 6. About 21% of Latin American and Caribbean populations are estimated to be at risk of severe COVID-19 illness 10. The region has been experiencing large outbreaks, with growing epidemics in Brazil,

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Section: Discussionmentioning

confidence: 99%

“…14 Boston Children's Hospital, Boston, MA, usA. 15 Departamento de genética, Ecologia e Evolução, Instituto de Ciências Biológicas, universidade Federal de Minas gerais, Belo Horizonte, Brazil. 16 MRC tropical Epidemiology group, Department of Infectious Disease Epidemiology, Faculty of Epidemiology…”

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Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil

Buss²,

et al. 2020

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“…Following the first report of SARS-CoV-2 in Brazil in late February 2020 ( Andrus et al, 2020 ; Rodriguez-Morales et al, 2020 ), SARS-CoV-2 has spread rapidly across the region, resulting in more than 7 million cases as of September 21st, 2020, with Brazil and Colombia reporting the highest burden of disease (“ Epidemic Diseases - Cumulative suspected and confirmed COVID-19 cases reported by countries and territories in the Americas, 2020 ”).…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 spread across the Colombian-Venezuelan border

Paniz‐Mondolfi

Muñoz

Flórez

et al. 2020

Infection, Genetics and Evolution

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Introduction Venezuela and Colombia both adopted measures of containment early in response to the COVID-19 pandemic. However, Venezuela's ongoing humanitarian crisis has decimated its health care system, and forced millions of Venezuelans to flee through its porous border with Colombia. The extensive shared border, and illegal cross-border transit through improvised trails between the two countries are major challenges for public health authorities. We report the first SARS-CoV-2 genomes from Venezuela, and present a snapshot of the SARS-CoV-2 epidemiologic landscape in the Colombian-Venezuelan border region. Methods We sequenced and assembled viral genomes from total RNA extracted from nasopharyngeal (NP) clinical specimens using a custom reference-based analysis pipeline. Three assemblies obtained were subjected to typing using the Phylogenetic Assignment of Named Global Outbreak LINeages ‘Pangolin’ tool. A total of 376 publicly available SARS-CoV-2 genomes from South America were obtained from the GISAID database to perform comparative genomic analyses. Additionally, the Wuhan-1 strain was used as reference. Results We found that two of the SARS-CoV-2 genomes from Venezuela belonged to the B1 lineage, and the third to the B.1.13 lineage. We observed a point mutation in the Spike protein gene (D614G substitution), previously reported to be associated with increased infectivity, in all three Venezuelan genomes. An additional three mutations (R203K/G204R substitution) were present in the nucleocapsid (N) gene of one Venezuelan genome. Conclusions Genomic sequencing demonstrates similarity between SARS-CoV-2 lineages from Venezuela and viruses collected from patients in bordering areas in Colombia and from Brazil, consistent with cross-border transit despite administrative measures including lockdowns. The presence of mutations associated with increased infectivity in the 3 Venezuelan genomes we report and Colombian SARS-CoV-2 genomes from neighboring borders areas may pose additional challenges for control of SARS-CoV-2 spread in the complex epidemiological landscape in Latin American countries. Public health authorities should carefully follow the progress of the pandemic and its impact on displaced populations within the region.

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“…Haiti offers one example, but other countries have experienced similar challenges with vulnerable populations, often leveraging unique solutions to add additional bed capacity for COVID-19 patients. 12,13 In March, the WHO released guidelines on the establishment of treatment centers for severe acute respiratory infections. 14 The document is a thorough and welcome guide, created as a response to the COVID-19 pandemic, but the infrastructure solutions proposed are likely to be out of reach for large portions of the global population living where health budgets are woefully inadequate to ensure safe delivery of health services in the midst of this pandemic.…”

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confidence: 99%

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Facility-Level Approaches for COVID-19 When Caseload Surpasses Surge Capacity

Walton

Ivers

2020

The American Journal of Tropical Medicine and Hygiene

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As COVID-19 cases continue to increase globally, fragile health systems already facing challenges with health system infrastructure, SARS-CoV-2 diagnostic capacity, and patient isolation capabilities may be left with few options to effectively care for acutely ill patients. Haiti-with only two laboratories that can perform reverse transcriptase PCR for SARS-CoV-2, a paucity of hospital beds, and an exponential increase in cases-provides an example that underpins the need for immediate infrastructure solutions for the crisis. We present two COVID-19 treatment center designs that leverage lessons learned from previous outbreaks of communicable infectious diseases and provide potential solutions when caseload exceeds existing capacity, with and without access to SARS-CoV-2 testing. These designs are intended for settings in which health facilities and testing resources for COVID-19 are surpassed during the pandemic, are adaptable to local conditions and constraints, and mitigate the likelihood of nosocomial transmission while offering an option to care for hospitalized patients.

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Perspectives on Battling COVID-19 in Countries of Latin America and the Caribbean

Abstract: This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 44 publications

References 8 publications

Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil

Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil

SARS-CoV-2 spread across the Colombian-Venezuelan border

Facility-Level Approaches for COVID-19 When Caseload Surpasses Surge Capacity

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