PAHO warns: Covid19 is still with us

Pan American Health Organization (PAHO) director Dr Jarbas Barbosa has warned against complacency over covid19, pointing out that the pandemic is still going on.

He said there have been more than 1.5 million cases and 17,000 deaths in the Americas over the last month.

“Covid19 is still with us, and the virus has yet to settle into a predictable pattern. We cannot be complacent. Testing rates have dropped, (but) it is crucial that countries maintain and continue to strengthen surveillance, as the virus can evolve and adapt quickly.”

He spoke at a virtual media conference on Wednesday marking three years of the covid19 pandemic in the Americas.

He called on countries to strengthen surveillance and increase vaccination coverage to end the covid19 emergency and better prepare for future health crises.

Barbosa said over the past three years, the Americas had over 190.3 million covid19 cases and over 2.9 million deaths, accounting for 25 per cent and 43 per cent of the global total respectively.

“The pandemic underscored that no country or organisation in the world was fully prepared for the impact of this pandemic, especially the Americas, which is a region marked by inequities.

"Today, incidence rates are 20-30 times lower than a year ago, but while we are not totally out of the woods, we are in a much better place.”

He said PAHO had implemented several strategies to assist countries throughout the pandemic, including building and strengthening the covid19 genomic surveillance regional network, mobilising over 160 million doses through COVAX and helping the countries of Latin America and the Caribbean roll out more than 1.3 billion vaccine doses in less than two years.

He said the network was key to tracking the evolution of the virus, as well as monitoring for other pathogens with pandemic potential, including avian flu.

Over the past three years, the network has facilitated the uploading of more than 580,000 sequences from Latin America and the Caribbean into global databases.

Barbosa said the key to preparing for any new wave of infection or variant of concern was reaching the 30 per cent of people who have yet to get their primary covid19 vaccinations.

“While the region has experienced a variety of setbacks throughout the pandemic that have revealed or exacerbated weaknesses in our health systems, including in the detection and treatment of diseases such as TB and HIV, in the testing and treatment of non-communicable diseases, and in declining rates for routine vaccination, we now have a unique opportunity to place health at the centreof the sustainable development agenda."

Communicable diseases director Dr Marcos Espinal said research continues into long covid, which can manifest as fatigue as well as neurological and pulmonary problems.

“Studies show that ten-20 per cent of people who get covid19 can develop long covid. The key to ending this is to vaccinate people with the primary vaccine series as well as booster shots.”

Epidemic response team head Dr Sylvain Aldighieri said a conservative estimate of those with long covid meant that millions had the syndrome after an acute infection.

“Some treatments have been effective for a set of symptoms. WHO has a definition of clinical cases in adults and children based on a global concensus, but in order to have updated evidence on treatment, PAHO has developed an updated site, which is live and presents new information as it becomes available.

"We’re also working with countries to have a clinical surveillance platform for long covid patients, which will have information about patients’ symptoms and how they’ve been treated. A March 2023 review includes 33 clinical trials.

“Diagnostic tools are still being developed, but many providers are implementing diagnostic recommendations and also specific tests based on clinical symptoms, eg orthostatic hypertension, detecting micro-clots, and looking at arrythmias, among others." He said many countries and institutions were working towards better understanding the pathogen and its diagnosis and treatment, but more large-scale studies were needed, as well as a comprehensive research agenda.”

Health emergencies director Dr Ciro Ugarte said in the Caribbean, countries are including covid19 surveillance in regular viral surveillance.

“The region and the world needs to maintain timely and up-to-date information on covid19 trends and the virus involved so appropriate control measures can be initiated early, to prevent a new surge of cases.

"PAHO is closely co-ordinating with member states on strengthening the surveillance capacity of the genomic network. We also regularly interact with the national authorities to update and review the information and the trends.”

Aldighieri said UWI has been invaluable in carrying out genomic testing in the region.

He said one of the main challenges has been vaccination coverage, which is lower in the Caribbean than other parts of the Americas region, even though vaccines are now more available.

Barbosa said countries should be reviewing the events of the pandemic to see what did or did not work and how to improve their capaciy to deal with a public health emergency.