How is Latin America preparing for the coronavirus (Covid-19)?
As of this writing (March 3, 2020), cases of Covid-19 (coronavirus 2019) have been reported in 76 countries, according to information on the website of the Center for Science and Engineering Systems (CSSE) at Johns Hopkins University. The number of cases worldwide is 92,132. China accounts for 86.9% of the cases (80,151). The countries with the highest number of cases after China are South Korea (5,186), Iran (2,336), Italy (2,036), and Japan (283). In Latin America, cases have been registered in Ecuador (7), Mexico (5) Brazil (2), and the Dominican Republic (1).
Although the calculation of the case fatality rate at this time is not reliable, because there may be unreported cases in significant numbers, it at least provides a sample of the differences in manifestations across countries. The fatality rate expresses the proportion of deaths over total cases. In China the case fatality rate is 3.6%, i.e. just under four deaths per 100 patients. However, in South Korea the fatality rate is 0.5%, while in Iran it is 3.2%. These differences, especially between South Korea and Iran, indicate the peculiar characteristics of the health systems and their unequal capacities for early diagnosis and effective treatment. In the case of China, given the magnitude of the number of cases, time must pass to know more precisely how many people suffered from the disease in a mild form without being reported.
The magnitude of the presence of Covid-19 on all continents is indicative that it is only a matter of time before cases are reported in a greater number of countries. So the question is rather how to prepare to effectively deal with the Covid-19 epidemic. The experience in managing the disease that the Chinese health system has developed is a reference for the organization of preparedness, especially in Latin America. To date, according to a report by the World Health Organization (WHO), the Chinese authorities have developed at least six protocols or guidelines to control the epidemic and treat patients. These protocols have been updated according to new knowledge acquired since the end of last year. It is likely that these protocols will be further updated in the coming weeks or months.
A good way to find out how prepared Latin American countries are with respect to Covid-19 is to find out if these protocols have been developed, and if they have been made available for the knowledge of the general population and for the teams in charge of control and treatment. In this era of massive use of the Internet, it would be desirable for all ministries of health in the region to have posted general information on Covid-19 on their respective websites, especially the protocols for case detection and clinical and epidemiological treatment. Reference to the countries that are facing the greatest number of cases is particularly useful. It is also desirable that national technical teams have been formed, with the participation of clinical, public health, and information science specialists, among other areas, to provide advice as the circumstances in each country evolve.
When exploring the websites of the countries of the Region (20 in total), it was found that the care protocols have been put in place by nine countries. In another nine countries (Bolivia, Chile, El Salvador, Guatemala. Haiti, Honduras, Nicaragua, Panama and Peru) no protocols for Covid-19 care were found on the respective websites. In two countries (Cuba and the Dominican Republic), the websites were not active at the time of the review.
It is imperative that in the coming days all ministries post these protocols for use by the population and specialists. This step is especially valuable because it allows for harmonizing guidelines and avoiding delays in the diagnosis and management of Covid-19 cases that may arise. Of course, the mere development of protocols is no guarantee of success against the epidemic. It also requires that resources (human, inputs, transportation, diagnostic, among others) are available and functioning. But as in any demanding task, the design of the plan and the routines of action are the first steps in achieving the goal. The demonstration will be that Covid-19 cases are detected quickly, treated effectively, and that the spread of the disease is minimized. Testing for the region’s ministries of health is underway.
Published in Spanish on March 4, 2020 in TalCualDigital.com. See the article in: https://marinojgonzalez.blogspot.com/2020/03/como-se-prepara-america-latina-contra.html
