As Covid-19 infections double, smart local measures needed to slow its spread

WASHINGTON D.C. - As cases of COVID-19 have more than doubled in the region of the Americas in the past weeks, reinforcing contact tracing and data management are key when many countries are reopening their activities.

The number of new COVID-19 infections reported in the Americas has more than doubled, rising from 5.3 million on July 1st to more than 12 million cases today

"Primary health care should be at the center of the response: identifying cases, acting to contain transmission and providing timely care in the community," the Director of the Pan American Health Organization, Dr. Carissa F. Etienne said during a press conference today. "Local health authorities have a central role to play in generating and analyzing data to adjust public health measures to the reality in each area".

Noting that in the past 6 weeks deaths in the region have doubled, Dr. Etienne said, "we can't stop all transmission, but if countries stay vigilant and expand testing and surveillance, they can better identify spikes in cases and act quickly to contain them before they spread out of control."

Despite the rise in cases, countries have gradually relaxed restrictions, resumed commerce and some are gearing up to head back to school. "In far too many places, there seems to be a disconnect between the policies being implemented and what the epidemiological curves tell us. This is not a good sign. Wishing the virus away will not work, it will only lead to more cases, as we've seen over these past 6 weeks," Etienne said.

"We have good tools today: data that show where the hot spots are, contact tracing protocols to slow onward transmission and public health measures that can reduce the risk of exposure. We'll have even better tools in the future: improved tests, more effective treatments and even vaccines. National and local governments need to be strategic about how they use these tools – old and new – to achieve the desired impact," she said.

Incidence of COVID-19 in younger people

Data from all over the Americas show that the majority of cases are reported in people between 20 and 59 years of age, but almost 70% of deaths are reported in people over 60.

"This indicates that younger people are primarily driving the spread of the disease in our region. Many young people who contract the virus may not become ill or require an ICU bed, but they can spread it to others who will. This is a stark reminder that defeating COVID-19 is a shared responsibility – not only among countries and regions, but between people, neighbors and communities," Etienne added.

"If you don't take the right steps to keep yourself safe, you're putting others in danger," she warned.

Concerns and encouraging signs

Dr. Etienne said she was concerned about new infections in the Caribbean as countries open their borders. While Caribbean islands have avoided major outbreaks thanks to strong political resolve and a smart mix of public health measures, "now that non-essential air travel is resuming across the region, several countries are reporting spikes in cases."

Two weeks ago, the Bahamas observed a 60 percent increase compared to the previous week, while Sint Maarten, Trinidad and Tobago and the US Virgin Islands all reported a 25 percent jump.

"This is not just driven by tourism, but also by citizens returning home after the lockdown. We know that countries that depend on tourism can't remain closed indefinitely, but as they reopen, they must use all the resources available to reduce risk for their people," she said.

Dr. Etienne said encouraging signs in the data from some countries show that countries have the tools to reduce the spread of COVID-19 and save lives.

"One of the most effective strategies we have is contact tracing," as shown in work to stop the chain of transmission by using it to track all new cases and limit the spread of the virus in Dominica, The Bahamas, Argentina, Guatemala and Suriname, she said.

"This bought them time to prepare their systems for this moment, and they've built the necessary capacity to identify cases and trace people who may have been exposed."

Dr. Etienne cited other examples of how the right strategies can bend the curve of the pandemic. "As recently as June, infections in Chile were rising rapidly. So national authorities looked at the data and tailored their approach: drastically expanding testing, isolating cases and deploying stay-at-home orders in the hardest hit areas. It worked. For six weeks now, Chile has seen COVID-19 lose steam, and is reporting fewer cases," she said.

Costa Rica had low transmission when they implemented stay-at-home orders and used the opportunity to prepare, by expanding testing and hospital capacity.

"Even though there are new cases now, their health services are coping well. These examples prove that if we employ evidence-based approaches, we can eventually overcome this crisis, even in places where cases are rising," she said.

"This virus is going to be with us for a while. Without a vaccine, it's going to be with us for years. This will not be a fight we win once – but one that will go several rounds. That's why we need to apply lessons from places that have controlled the virus and let data guide our actions," Etienne added.