Impact of COVID-19 in Latin America – Perspectives from 80 Latin American epidemiologistsSeminar Series on the Epidemiology of the COVID-19 Pandemic

Dr. Carlos Castillo-SalgadoProfesor de Epidemiología, BSPH/JHU

June 4, 2020

Department of Epidemiology and BiostatisticsUniversity of Maryland School of Public Health

Agenda:

-Background of LA Epi/Technical Chat -Lessons from Influenza Pandemic 1918-1919-Globalization and IHR-2005 - Epi LA Chat activities- Challenges for LA- Lessons Learned

Seminar Series on the Epidemiology of the COVID-19 PandemicDepartment of Epidemiology and BiostatisticsUniversity of Maryland School of Public Health

Background of LA-Epi/Technical Chat

• Development of the Advanced Epidemiology Program for Public Health Managers in Latin America and Spain. Overview

• The Online Professional Training in Epidemiology for Health Managers is an innovative online program that is designed for middle-level and senior epidemiologists from Latin America and Spain. 9-month program. The program is conducted entirely in Spanish.

• 13 cohorts with 419 professionals from 19 countries had completed this program.

• In April 2003, the BSPH signed an institutional agreement with the Director of the Pan American Health Organization (PAHO/WHO), to develop an internet-based professional training program in Epidemiology for Public Health Managers. The launching of this program was in response to the recommendations of the First Regional Meeting of National Directors of Epidemiology in 2000. The objective of the Program is to strengthen the capacity of middle level and senior epidemiologists in the management of public health functions.

https://www.jhsph.edu/academics/continuing-and-executive-education/professional-trainings/professional-training-in-epidemiology-for-health-managers/

Technical Chat for Monitoring COVID-19 in Latin America and Spain

• 80 Epidemiologists from 20 countries are participating in a real-time exchange of information in these areas:

• Case definitions: Suspected, Probable and Confirmed

• Protocols and guidelines• Surveillance approaches• Trends and Mapping • Research advances• Training materials• Epidemiologic Intelligence

What we learned about the measures used for prevention and control during the Influenza Pandemic of 1918-1919?

Why Epidemiology?The Science of Public Health

• Provides the concepts and metrics needed to recognize the frequency, distribution and the main public health problems and their determinants.

• Generates the Natural History of Diseases

• Provides the information about the Incubation and Latency Periods

• Offers the scientific evidence needed for prevention and control measures

• Identified vulnerable groups and areas of high risks and high levels of social inequalities in the access to health services and interventions

http://periodismoinvestigativo.com/category/actualidad/

1919: Frost's definition of epidemiology was "the natural history of the infectious diseases, with special reference to the circumstances and conditions which determine their occurrence in nature”

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Globalization: massive mobilization of people and goods.Takes only few hours to cross continents

Seguridad de la Salud Global (Global Health Security)

(PHEIC): “An extraordinary event which is determined, as provided in these Regulations:-to constitute a public health risk to other States through

the international spread of disease; and-to potentially require a coordinated international response”. “a situation that: is serious, unusual or unexpected; carries implications for public health beyond the affected State’s national border; and may require immediate international action”.

Development of the LA’s Epi Chat

In very few weeks, the members was expanded to cover first 3, 10, and then 30 countries and 80 epidemiologists

Exchange in real-time of Information about the confirmation of first cases in each LA country and of fake news and infographics

Sharing national and local Epi info in real-time

Type of testing in Brazil and First cases in Spain

Informing about data mistakes needing correction ASP(Comparison of Argentina and Chile was wrong)

Exchange of Important information about companies selling products, even without health registration (not approved for COVID-19)

Checking links with Economic Trends in the Region

https://www.statista.com/chart/21840/coronavirus-deaths-in-latin-america/

Identifying delays in moving the countries from phase 1 to phase 2

https://www.tableau.com/covid-19-coronavirus-data-resources

Mitigation Mechanisms in LAUse of Proxy Metrics for Mobility Trends

Evolución de Nuevos Casos (Globalmente y en LA)

New Recommendations

https://sites.google.com/udd.cl/consejocovid19chile/página-principal

Sharing Projections by the epidemiologists that did not approved the official trends

Market in Bolivia:Community Based Self-Social Distancing

“Discover fearless reporting, bold insights and thought-provoking features that spark national conversation”. NY Times

• When may open the economy and relax the containment measures:• 1) Identified infected population and their contacts (Dx (PCR) tests and their contacts (asymptomatics)

• 2) Massive Availability of Serologic Tests to know levels of antibodies and population immunity level• 3) Increment of health personnel for contact tracers (100,00-200,000) in USA with a cost of > 3 Billon Dollars• Keeping Social Distancing and Use of Face Masks

Current trends of COVID-19 in LAJune 01, 2020• Now is not the time for countries to ease

restrictions," Carissa Etienne, WHO director for the Americas and head of the Pan American Health Organization, said via videoconference.

• The Americas have registered more than 2.4 million cases of the new coronavirus and more than 143,000 deaths from the resulting COVID-19 respiratory disease. Latin America has passed Europe and the United States in daily infections, she said.

• "Our region has become the epicenter of the COVID-19 pandemic," Etienne said, as other PAHO directors warned there are "very tough" weeks ahead for the region and Brazil has a long way to go before it will see the pandemic end.

• Also of concern to WHO officials are accelerating outbreaks in Peru, Chile, El Salvador, Guatemala and Nicaragua.

COVID-19 Cases atJune 4/2020

Lessons Learned

Thank you.Questions?

• Carlos Castillo-Salgado, MD, JD, MPH, DrPH

• Professor of Epidemiology. Director of the Global Public Health Observatory. Director of the Certificate for Public Health Professionals

• Department of Epidemiology

• Johns Hopkins Bloomberg School of Public Health

• ccastil3@jhu.edu