Last 24 hours Region of the Americas

Pan American Health Organization / World Health Organization. Washington, D.C.: PAHO/WHO; 2021

www.paho.org | © PAHO/WHO, 2021

More information available at: https://paho-covid19-response-who.hub.arcgis.com/

1. On 21 September 2021, in Peru, as part of the multidisciplinary work deployed in the regions of Peru, the Ministry of Health (Minsa) and the Regional Health Management (Geresa) of La Libertad held meetings to agree on articulated strategies in order to strengthen the response capacity before the arrival of the third wave of COVID-19. This press release is available in Spanish at: https://bit.ly/39vfwhm

2. On 20 September 2021, in Chile, the Ministry of Health (MoH), called to reinforce self-care measures so as not to regress in the pandemic. As of Monday, September 27, isolation policies of confirmed and probable cases of COVID-19, and close contacts, will begin to be enforced. This press release is available in Spanish at: https://bit.ly/3Ez8KWt

127,765 Additional cases

2,241 Additional deaths

0.14% Relative increase in cases

0.10% Relative increase in deaths

41 Countries/territories reporting new cases

32 Countries/territories reporting new deaths

Cases (≥ 1,000) United States 91,194 Cuba 8,289 Brazil 7,884 Canada 3,852 Mexico 3,367 Argentina 2,162 Honduras 2,114 Costa Rica 1,514 Venezuela 1,201 Colombia 1,185

Deaths (≥ 100)

United States 1,326 Mexico 262 Brazil 203

Region of the Americas Update

COVID-19

Brazil 3 PM WDC. 21 September 2021

Region of the Americas

88,456,667 cases

2,178,593 deaths

56 countries/areas/territories affected

Highest numbers of cases & deaths in the last 24 hrs*

Total cases, deaths & CFR (%) among PAHO countries/territories with ≥ 150,000 cumulative cases.

Last 24 hours

Global

229,055,788 cases

4,700,376 deaths

236 countries/areas/territories affected

COVID-19 – Highlights

*Numbers may vary due to differences in reporting

Starting the weekend of 26 June 2021, the PAHO COVID-19 daily situation reports will no longer be published on Saturdays and Sundays. The reports will continue to be published during the workweek

– Monday through Friday – at the regularly scheduled time, with the exception of any official holidays observed by PAHO in Washington, DC

Country/Territory Cases Deaths CFR (%)United States of America 42,034,347 671,728 1.6%Brazil 21,247,667 590,955 2.8%Argentina 5,241,394 114,518 2.2%Colombia 4,942,249 125,924 2.5%Mexico 3,573,044 271,765 7.6%Peru 2,167,652 199036 9.2%Chile 1,648,026 37374 2.3%Canada 1,581,910 27434 1.7%Cuba 818,200 6919 0.8%Guatemala 530,026 13061 2.5%Costa Rica 510,653 6056 1.2%Ecuador 507,020 32661 6.4%Bolivia 497,386 18664 3.8%Panama 464,440 7176 1.5%Paraguay 459,665 16132 3.5%Uruguay 387,744 6048 1.6%Honduras 359,768 9537 2.7%Venezuela 356,262 4311 1.2%Dominican Republic 355,721 4029 1.1%Puerto Rico 179,232 3092 1.7%




Spotlight – Honduras – COVID-19 Daily PAHO CO Situation Report 21 September 2021 Current Situation: From the beginning of the COVID-19 pandemic as of 21 September 2021, a total of 359,768 cases of COVID-19 have been reported. Of these cases, 108,566 (30.18%) have recovered, and 9,537 (2.65%) have been reported dead. As of Epidemiological Week (EW) 36 Epidemiological Trends: Figure 1 illustrates the cumulative positivity rate data by department as of 13 September 2021. The national incidence rate (positivity) increased to 3,775 confirmed cases per 100,000 population, an increase of 2.19% in relation to EW-35 (3,694 confirmed cases per 100,000 inhabitants). The departments with the highest rates were: Francisco Morazán (6,494 cases per 100,000 population), La Paz (4,972 cases per 100,000 population), Cortés (4,506 cases per 100,000 population), Valle (4,183 cases per 100,000 population), El Paraíso (4,120 cases per 100,000 population) and Islas de la Bahía (3,929 cases per 100,000 population). The departments with the greatest percent increments in the number of confirmed COVID-19 cases between EW-35 and 36 were: Gracias a Dios (14.83%), Santa Bárbara (4.30%), Olancho (3.41%), Lempira (3.38%), Yoro (3.19%), Copán (2.53%) , Cortés (2.50%) and Atlántida (2.41%) Mortality: Figure 2 Illustrates cumulative mortality rate data by department as of 13 September 2021. During EW-

36, the national mortality rate increased to 100 deaths per 100,000 population, an increase of 3.09% with respect to the EW-35

mortality rate (97 deaths per 100,000 population). The departments with the highest rates were: Francisco Morazán (149 deaths per 100,000 population), Cortés (129 deaths per 100,000 population), Valle (103 deaths per 100,000 population), La Paz (102 deaths per 100,000 population) and Atlántida (99 deaths per 100,000 population). The departments with the greatest percent increase in COVID-19 related deaths between EW-35 and 36, were: Gracias a Dios (6.67%), Valle (6.56%), Yoro (5.35%),

Atlántida (4.58%), Choluteca (4.08%), Olancho (4.04%), Francisco Morazán (3.88%) and Cortés (3.70%). Hospitalizations: As of 13 September 2021, the public hospital network of Honduras reported a percentage occupancy of 63%. The occupation of hospital beds was 61% and of ICU beds 85%. However, regarding occupation in the country's specialty hospitals, the National Cardiopulmonary Institute of Tegucigalpa, reported 37% in the ward and 100% in the ICU, the Hospital Escuela Universitario de Tegucigalpa, reported 80% in the ward and 100% in the ICU , the María de Especialidades Pediátricas de Tegucigalpa hospital, reported 100% occupancy in the adult ward, 146% in the pediatric ward, 80% in the ICU and 150% in the PICU, the San Felipe de Tegucigalpa General Hospital, 75% in ward and 100% in the ICU, the Mario Catarino Rivas hospital in the city of San Pedro Sula, reported 81% occupancy in the ward, 83% in the ICU and 175% in the PICU and the Leonardo Martínez hospital, reported 93% room occupancy.

Figure 1: COVID-19 positivity rates – Cumulative data by departments as of 13 September 2021

Figure 2: COVID-19 mortality rates – Cumulative data by departments as of 13 September 2021




The highest rates in the region are seen in the US and Cuba. In North America, the US and Canada have the highest incidence. All states in the US have an incidence higher than 200 per 100,000 population, with Kentucky, West Virginia, Tennessee, South Carolina, Alaska, and Montana and its

surrounding states with a rate >500 per 100,000 people. In Canada, Alberta, Saskatchewan, and the Northwest Territories have a higher incidence than the rest of the country.

Map 1. Reported incidence rate of COVID-19 (per 100,000 population) in Epidemiological Week 36-37 by country/territory. As of 21 September 2021.




In Central America, Costa Rica has the highest incidence rate in the region, while Belize (Belize, Orange Walk, Stann Creek, Cayo), Guatemela (Zacapa, Sacatepequez), Panama (Colon), and El Salvador (San Salvador) have high rates as

well. In South America, there is an overall lower incidence rate, except in parts of Brazil (Roraima, Mato Grosso, Toncatins, Goias, Parana, Espirito Santo) and Argentina (Catamarca, La Pampa).

In the Caribbean, Cuba had the highest incidence, with its territories of Pinar del Rio, La Habana, Villa Clara, Sancti

Spiritus, Camaguey, Las Tunas had an incidence >500 per 100,000 population. Jamaica reported an increased incidence as well over the last 2 weeks, with all territories reporting >200, and some territories (Hanover, St

James, Trelawney, St Thomas) with >500 cases per 100,000 population. Guyana (Regions 8 & 7), as well as the French territories of French Guiana, and Guadeloupe also have a high incidence of cases in EW 36 and 37.






7 Day MA* Trend

Cummulative

7day % change

7 Day MA* Trend

Cummulative

7day % change

Canada 1,581,910 7% 27,434 -8% Community transmissionMexico 3,573,044 -31% 271,765 -16% Community transmission

42,034,347 -9% 671,728 18%

Subtotal 47,189,301 970,927Belize 18,902 39% 395 -28% Community transmissionCosta Rica 510,653 -11% 6,056 18% Community transmissionEl Salvador 102,024 -36% 3,125 24% Community transmissionGuatemala 530,026 -38% 13,061 -35% Community transmissionHonduras 359,768 -18% 9,537 -42% Community transmissionNicaragua 10,757 0% 203 0% Community transmissionPanama 464,440 -16% 7,176 -24% Community transmissionSubtotal 1,996,570 39,553Argentina 5,241,394 -24% 114,518 -9% Community transmission

497,386 -2% 18,664 -15%

Brazil 21,247,667 127% 590,955 19% Community transmissionChile 1,648,026 5% 37,374 -12% Community transmissionColombia 4,942,249 -9% 125,924 -33% Community transmissionEcuador 507,020 22% 32,661 121% Community transmissionParaguay 459,665 -22% 16,132 -78% Community transmissionPeru 2,167,652 8% 199,036 -14% Community transmissionUruguay 387,744 -20% 6,048 0% Community transmission

356,262 -2% 4,311 -2%

Subtotal 37,455,065 1,145,623Anguilla 340 0% 1 0% Clusters of casesAntigua and Barbuda 2,603 -9% 55 600% Clusters of casesAruba 15,274 -21% 159 0% Community transmissionBahamas (the) 20,288 -9% 512 221% Clusters of casesBarbados 6,631 14% 59 600% Community transmissionBermuda 4,632 19% 43 700% Clusters of casesBonaire 1,939 -54% 18 0% Community transmission

United States of America (the)

Community transmission

Bolivia (the Plurinational State of)


Venezuela (Bolivarian Republic of)


Caribbean and Atlantic Ocean Islands

South America

COVID-19 situation reported by countries and territories in the Americas,

as of 21 September 2021Updated as of 3 PM

North America

Central America

Cases Deaths Sub-Region Country/Territory Transmission Type




* 7 Day Moving AverageLegend >50% increase

10% to 50% increase10 to -10% change

10% to 50% decrease>50% decrease

Cayman Islands 782 23% 2 0% Imported/Sporadic casesCuba 818,200 1% 6,919 -17% Community transmissionCuracao 16,086 34% 158 -50% Community transmissionDominica 2,908 -18% 10 50% Community transmissionDominican Republic (the) 355,721 -2% 4,029 29% Community transmissionFalkland Islands (the) 67 0% 0 0% Imported/Sporadic casesFrench Guiana 38,965 22% 248 143% Community transmissionGrenada 4,213 34% 63 22% Community transmissionGuadeloupe 52,463 -50% 747 -42% Community transmissionGuyana 29,683 6% 733 15% Community transmissionHaiti 21,431 -28% 605 13% Community transmissionJamaica 80,780 -9% 1,800 -29% Community transmissionMartinique 40,572 -22% 600 -51% Community transmissionMontserrat 33 0% 1 0% Imported/Sporadic casesPuerto Rico 179,232 -22% 3,092 -36% Community transmissionSaba 11 0% 0 0% Imported/Sporadic casesSaint Barthelemy 1,624 83% 2 0% Clusters of casesSaint Kitts and Nevis 1,680 -26% 10 -33% Community transmissionSaint Lucia 10,624 -16% 150 29% Community transmissionSaint Martin 3,740 -30% 35 0% Community transmissionSaint Pierre and Miquelon 31 0% 0 0% No cases

2,848 140% 16 200% Community transmission

Sint Eustatius 24 0% 1 0% Imported/Sporadic casesSint Maarten 4,117 -21% 60 0% Community transmissionSuriname 37,590 21% 814 85% Community transmissionTrinidad and Tobago 48,629 3% 1,422 -9% Community transmissionTurks and Caicos 2,805 -23% 22 0% Clusters of casesVirgin Islands (UK) 2,676 1600% 37 0% Community transmissionVirgin Islands (US) 6,489 -16% 67 -75% Community transmissionSubtotal 1,815,731 22,490

Total 88,456,667 2,178,593

Saint Vincent and the Grenadines

Caribbean and Atlantic Ocean Islands




NOTES: -Case and death counts may include both confirmed and probable classifications depending on the reporting Member State. -Antibody tests, including rapid diagnostic tests (RDTs) based on antibody detection, are not recommended for use by PAHO/WHO in clinical diagnosis. Antigen-detecting RDTs may be used following the WHO 121 September 2020 Guidance, available at: https://bit.ly/2FxK2fs. -Data is updated on a weekly basis for Guadeloupe, Martinique, Nicaragua, Saint Barthelemy, Saint Martin, and Saint Pierre and Miquelon. -As of 11 November 2020, the previously aggregated Bonaire, Saba and Sint Eustatius are now being presented separately in the table. -*A dispute exists between the Governments of Argentina and the United Kingdom of Great Britain and Northern Ireland concerning sovereignty over the Falkland Islands (the) (Malvinas) Argentina: On 14 March 2021, due to daylight savings time observed in Eastern Standard Time zone, the Argentina data is no longer published by 3:00PM EST same day and is henceforth included in the following day table. Between 22 February and 14 March 2021, the data had corresponded to the same date. Bahamas: According to the latest Bahamas Ministry of Health (MoH) publication, there are a total of 30 additional deaths under investigation, available at: https://bit.ly/3wh84Aq, Ecuador: According to a 6 September Ecuador Ministry of Public Health press release, only cases confirmed by RT-PCR will be reported; previously, cases who tested positive by either RT-PCR or RDTs were reported, resulting in the exclusion of 8,956 cases. Available at: https://bit.ly/3h2EWEA ,,, El Salvador: Cumulative cases and deaths as published by the Government of El Salvador: https://covid19.gob.sv/. The government presents a retroactively adjusted epidemiological curve of daily cases on the same dashboard. Jamaica: According to the latest Jamaica Ministry of Health and Wellness press release, there are a total of 274 additional deaths under investigation, available at: https://bit.ly/3qAwIJo Mexico: On 1 June 2021, the Mexico Ministry of Health reported 4,272 deaths in 24 hours. Of these, 3,924 were reported in 2020 and the remaining were reported in 2021. Available at: https://bit.ly/3pfdMA8 Nicaragua: Please note there are discrepancies with the data published by the Citizen's Observatory COVID-19 Nicaragua as of 15 September 2021. Available at: https://bit.ly/3pw7ZVR Peru: Aggregated case total as reported by the Peru MoH; latest disaggregated data available is 642,985 by RT-PCR + 579,861 by antigen tests + 944,806 by other RDTs. Antibody tests, including RDTs based on antibody detection, are not recommended for use by PAHO/WHO in clinical diagnosis. Antigen-detecting RDTs may be used following the WHO 11 September 2020 Guidance, available at: https://bit.ly/3fJVKTM. On 31 May 2021, the Government of Peru announced that, after revision, the death toll was 180,764 deaths as of 22 May 2021, available at: https://bit.ly/3fYGj8V. The number of cumulative deaths reported prior to the revision, on 30 May, was 69,342, available at: https://bit.ly/3pkar2U. Puerto Rico: Aggregated case total as reported by the Puerto Rico Department of Health (DoH); 148,226 were positive by RT-PCR and 31,006 were positive by antigen tests; previously, cases who tested positive by either RT-PCR or serological RDTs were reported, resulting in the exclusion of 33,965 cases. Available at: https://bit.ly/3AXY7KU United States of America: Case and death counts include both confirmed and probable classifications, as published on the U.S. Centers for Disease Control and Prevention (US CDC) website on 21-September. Excludes American Samoa, Federated States of Micronesia, Guam, Commonwealth of the Northern Marianas, Puerto Rico, Palau, Republic of Marshall Islands and the United States Virgin Islands. Case and death counts may differ from other US CDC data sources because these are provisional counts which are subject to change, including updates to data reported previously, adjustments can occur. Sources: https://bit.ly/2RSpap5 and https://bit.ly/2RVI2n6. Uruguay: According to the latest Uruguay Ministry of Public Health report, the total notes 13 positive cases reported in the last 24 hours were excluded from the total. Available at: https://bit.ly/3EFEKbu. DATA ADJUSTMENTS: Differences in the total number of cases and/or deaths and respective % increases reflect the following adjustment(s): Bahamas: Cases were retrospectively adjusted for 20 September 2021 to align with the Bahamas Ministry of Health indicating 20,249 cases. Available at: https://bit.ly/3kqKJbR Guatemala: Cases and deaths were retrospectively adjusted for 20 September 2021 to align with the Guatemala Ministry of Health indicating 530,026 cases including 13,061 deaths. Available at: https://bit.ly/3hT2Mpo

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