Coronavirus disease 2019 (COVID-19) is the second pandemic of the twenty-first century, with over one-hundred million infections and over two million deaths to date. It is a novel strain from the Coronaviridae family, named Severe Acute Respiratory Distress Syndrome Coronavirus-2 (SARS-CoV-2); the 7th known member of the coronavirus family to cause disease in humans, notably following the Middle East Respiratory syndrome (MERS), and Severe Acute Respiratory Distress Syndrome (SARS). The most characteristic feature of this single-stranded RNA molecule includes the spike glycoprotein on its surface. Most patients with COVID-19, of which the elderly and immunocompromised are most at risk, complain of flu-like symptoms, including dry cough and headache. The most common complications include pneumonia, acute respiratory distress syndrome, septic shock, and cardiovascular manifestations. Transmission of SARS-CoV-2 is mainly via respiratory droplets, either directly from the air when an infected patient coughs or sneezes, or in the form of fomites on surfaces. Maintaining hand-hygiene, social distancing, and personal protective equipment (i.e., masks) remain the most effective precautions. Patient management includes supportive care and anticoagulative measures, with a focus on maintaining respiratory function. Therapy with dexamethasone, remdesivir, and tocilizumab appear to be most promising to date, with hydroxychloroquine, lopinavir, ritonavir, and interferons falling out of favour. Additionally, accelerated vaccination efforts have taken place internationally, with several promising vaccinations being mass deployed. In response to the COVID-19 pandemic, countries and stakeholders have taken varying precautions to combat and contain the spread of the virus and dampen its collateral economic damage. This review paper aims to synthesize the impact of the virus on a global, micro to macro scale.

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COVID-19: breaking down a global health crisis.

The delay or refusal of vaccination, which defines vaccine hesitancy, is a major challenge to successful control of COVID-19 epidemic. The huge number of publications addressing COVID-19 vaccine hesitancy necessitates periodic review to provide a concise summary of COVID-19 vaccine acceptance rates worldwide. In the current narrative review, data on COVID-19 vaccine acceptance rates were retrieved from surveys in 114 countries/territories. In East and Southern Africa (n = 9), the highest COVID-19 vaccine acceptance rate was reported in Ethiopia (92%), while the lowest rate was reported in Zimbabwe (50%). In West/Central Africa (n = 13), the highest rate was reported in Niger (93%), while the lowest rate was reported in Cameroon (15%). In Asia and the Pacific (n = 16), the highest rates were reported in Nepal and Vietnam (97%), while the lowest rate was reported in Hong Kong (42%). In Eastern Europe/Central Asia (n = 7), the highest rates were reported in Montenegro (69%) and Kazakhstan (64%), while the lowest rate was reported in Russia (30%). In Latin America and the Caribbean (n = 20), the highest rate was reported in Mexico (88%), while the lowest rate was reported in Haiti (43%). In the Middle East/North Africa (MENA, n = 22), the highest rate was reported in Tunisia (92%), while the lowest rate was reported in Iraq (13%). In Western/Central Europe and North America (n = 27), the highest rates were reported in Canada (91%) and Norway (89%), while the lowest rates were reported in Cyprus and Portugal (35%). COVID-19 vaccine acceptance rates ≥60% were seen in 72/114 countries/territories, compared to 42 countries/territories with rates between 13% and 59%. The phenomenon of COVID-19 vaccine hesitancy appeared more pronounced in the MENA, Europe and Central Asia, and Western/Central Africa. More studies are recommended in Africa, Eastern Europe and Central Asia to address intentions of the general public to get COVID-19 vaccination. 

A Global Map of COVID-19 Vaccine Acceptance Rates per Country: An Updated Concise Narrative Review

Abstract The delay or refusal of vaccination, which defines vaccine hesitancy, is a major challenge to successful control of COVID-19 epidemic. The huge number of publications addressing COVID-19 vaccine hesitancy necessitates periodic review to provide a concise summary of COVID-19 vaccine acceptance rates worldwide. In the current narrative review, data on COVID-19 vaccine acceptance rates were retrieved from surveys in 114 countries/territories. In East and Southern Africa (n = 9), the highest COVID-19 vaccine acceptance rate was reported in Ethiopia (92%), while the lowest rate was reported in Zimbabwe (50%). In West/Central Africa (n = 13), the highest rate was reported in Niger (93%), while the lowest rate was reported in Cameroon (15%). In Asia and the Pacific (n = 16), the highest rates were reported in Nepal and Vietnam (97%), while the lowest rate was reported in Hong Kong (42%). In Eastern Europe/Central Asia (n = 7), the highest rates were reported in Montenegro (69%) and Kazakhstan (64%), while the lowest rate was reported in Russia (30%). In Latin America and the Caribbean (n = 20), the highest rate was reported in Mexico (88%), while the lowest rate was reported in Haiti (43%). In the Middle East/North Africa (MENA, n = 22), the highest rate was reported in Tunisia (92%), while the lowest rate was reported in Iraq (13%). In Western/Central Europe and North America (n = 27), the highest rates were reported in Canada (91%) and Norway (89%), while the lowest rates were reported in Cyprus and Portugal (35%). COVID-19 vaccine acceptance rates ≥60% were seen in 72/114 countries/territories, compared to 42 countries/territories with rates between 13% and 59%. The phenomenon of COVID-19 vaccine hesitancy appeared more pronounced in the MENA, Europe and Central Asia, and Western/Central Africa. More studies are recommended in Africa, Eastern Europe and Central Asia to address intentions of the general public to get COVID-19 vaccination.

https://www.dovepress.com/getfile.php?fileID=77550

Early severity estimates of coronavirus disease 2019 (COVID-19) are critically needed to assess the potential impact of the ongoing pandemic in different demographic groups. Here we estimate the real-time delay-adjusted case fatality rate across nine age groups by gender in Chile, the country with the highest testing rate for COVID-19 in Latin America. We used a publicly available real-time daily series of age-stratified COVID-19 cases and deaths reported by the Ministry of Health in Chile from the beginning of the epidemic in March through August 31, 2020. We used a robust likelihood function and a delay distribution to estimate real-time delay-adjusted case-fatality risk and estimate model parameters using a Monte Carlo Markov Chain in a Bayesian framework. As of August 31, 2020, our estimates of the time-delay adjusted case fatality rate (CFR) for men and women are 4.16% [95% Credible Interval (CrI): 4.09–4.24%] and 3.26% (95% CrI: 3.19–3.34%), respectively, while the overall estimate is 3.72% (95% CrI: 3.67–3.78%). Seniors aged 80 years and over have an adjusted CFR of 56.82% (95% CrI: 55.25–58.34%) for men and 41.10% (95% CrI: 40.02–42.26%) for women. Results showed a peak in estimated CFR during the June peak of the epidemic. The peak possibly reflects insufficient laboratory capacity, as illustrated by high test positivity rates (33% positive 7-day average nationally in June), which may have resulted in lower reporting rates. Severity estimates from COVID-19 in Chile suggest that male seniors, especially among those aged ≥ 70 years, are being disproportionately affected by the pandemic, a finding consistent with other regions. The ongoing pandemic is imposing a high death toll in South America, and Chile has one of the highest reported mortality rates globally thus far. These real-time estimates may help inform public health officials' decisions in the region and underscore the need to implement more effective measures to ameliorate fatality.

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COVID-19 case fatality risk by age and gender in a high testing setting in Latin America: Chile, March-August 2020.

http://manuscript.elsevier.com/S1473309920308689/pdf/S1473309920308689.pdf

The urgent need for metallo-β-lactamase inhibitors: an unattended global threat

Effective management of a pandemic due to a respiratory virus requires public health capacity for a coordinated response for mandatory restrictions, large-scale testing to identify infected individuals, capacity to isolate infected cases and track and test contacts, and health services for those infected who require hospitalization. Because of contextual and socioeconomic factors, it has been hard for Latin America to confront this epidemic. In this article, we discuss the context and the initial responses of eight selected Latin American countries, including similarities and differences in public health, economic, and fiscal measures, and provide reflections on what worked and what did not work and what to expect moving forward.

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Rubén Torres

Papers

COVID-19 Response in Latin America.