How prepared is Latin America for coronavirus?
A report from late 2019 demonstrated gaps in the region’s pandemic preparedness.
With the numbers of coronavirus (2019-nCoV) cases in China increasing daily, there are concerns over what happens if this disease spreads globally.
For Latin America and the Caribbean, the current challenge is prevention and detection. The best way to combat a pandemic is to not have it spread inside the region. For now, the region should monitor travelers who have recently been to China and try to isolate cases as they appear. The challenge will become much more severe if there is significant spread of the virus on the continent. At that point, the region will need to adapt its health systems quickly to help those who are ill and lessen the spread of the virus.
The Pan-American Health Organization has encouraged countries “to be prepared to detect early, isolate and care for patients infected with the new coronavirus.”
No country in the region is well prepared
Unfortunately, if the virus begins to spread to the Western Hemisphere, a report published late last year suggests much of the region will face difficulties and a few countries may face crises.
The Global Health Security Index published a ranking in October 2019 of 195 countries’ preparedness for a global health emergency.
The ranking used a comprehensive methodology focused on six areas:
Prevention
Detection and Reporting
Rapid Response
Health System
Compliance with International Norms
Risk Environment
Each area has its own score and criteria. The report provides more data for each country that may be valuable to those who want to research more in-depth.
Key takeaways from the report for the region
No country in Latin America is considered well prepared (and even the well prepared countries around the world have gaps in their pandemic preparations). Most of Latin America is in the middle category: somewhat prepared.
Five countries in Central and South America are of higher concern: Belize, Guatemala, Guyana, Honduras, and Venezuela. The key issues for Guatemala, Honduras and Venezuela are the combination of poor public health infrastructure, political tensions and the presence of gangs and other non-state armed actors, especially in urban areas.
The Caribbean’s ability to respond to a pandemic is far worse than most of Latin America’s. The Dominican Republic, with a score of 38.3 and a ranking of 91, is the highest ranking country in the Caribbean. Small island nations are particularly vulnerable if a significant contagious disease hits their shores and few have the resources to respond. While the isolation of the island nations make them less vulnerable initially, it also makes it more difficult to respond if the virus successfully begins human to human transmission on the island. These countries would benefit from a regionally coordinated response, potentially with PAHO in the lead, that pools their resources to detect, monitor and respond.
Few countries dedicate budget and personnel to pandemic preparation because they have limited government resources to spend on healthcare overall. For nearly all the countries in the region, there has been little effort to test systems that would be used in case of a disease outbreak such as this.
Many of the countries have challenges with their day-to-day public health infrastructure, meaning their preparation for and potential response to less common infectious disease outbreaks is lacking. Hospitals have been overwhelmed in China and would be similarly overextended in most of Latin America were a virus to spread in a major urban area.
The coronavirus is different than the region’s typical communicable disease challenges. Latin America has several communicable disease threats of its own that demonstrate the region’s ability (or lack thereof) to respond to a health crisis. In the past decade, the region has seen multiple outbreaks of mosquito-borne diseases such as chikungunya, dengue and malaria. There have also been challenges with cholera and other diseases that spread by water. However, the coronavirus is more similar to the common cold and would spread by a different vector than dengue, meaning less familiarity among local health officials and different regions including high altitude cities being hit.
The report highlights that many countries in Latin America face severe political challenges and citizen security risks that will hamper pandemic response. The region has countries that have high homicide and other violent crime rates, significant criminal organizations that replace the state in some areas, high levels of corruption, and political conflicts that pit large portions of the population against the government. All of those factors make responding to a health crisis much more difficult.
Communications are a key challenge. So far, rumors on social media of cases of coronavirus have been largely debunked. But if the virus began to spread in the hemisphere, government officials would have a hard time helping citizens sort rumor from fact. In places where citizens do not trust government statements, the information gap could be a problem.
There are regional and global political implications to any response. In 2009, China closed off trade to Mexico due to the outbreak of H1N1 (“swine flu”). While many countries placed brief restrictions on travelers from Mexico that year, China’s restrictions and quarantines were particularly harsh and did economic and reputational damage. AMLO is unlikely to retaliate with a ban on Chinese travel or trade right now, but any measure Mexico implements in this regard is going to be prepackaged with that history.
There is some good news. According to the ranking, many of the largest countries with the strongest ties to Asia are those that are most prepared in the region. That includes Brazil and Mexico, both of which receive high marks for their systems to detect and track diseases. Both countries also have strong public health infrastructure compared to many of the smaller countries in the region. Given that these two countries are among the most likely points for coronavirus to enter Latin America, that is one piece of positive news for the region in terms of its ability to detect and potentially halt the spread of the virus.
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