The Pandemic We Have to Endure. Reflections in December 2021

The consequences of the pandemic, in terms of mortality and disability after COVID-19, cannot yet be measured in their real magnitude, since it is still ongoing, but it is undoubtedly several times higher than official records.

In some countries in the region, excess mortality for specific periods during the first months of 2021 was 250% higher than the deaths of the same period of previous years—before the pandemic—and the vast majority of these deaths are directly attributed to COVID-19.

The pandemic has indirectly caused an enormous impact on essential public health programs aimed at children, women and people at risk or with prevalent diseases, whether infectious or not: for example, diabetes, dengue, malaria, tuberculosis, cancer, and a long etcetera.

Many of these programs, for example, immunization, generally a good performer in terms of coverage and the result of enormous technical and financial efforts over decades, collapsed alarmingly. In the Americas, for instance, this decline could reach 10 percentage points, taking the DPT3 vaccine as a reference.

At this point in late 2021, the world is experiencing an alarming uptick in the number of cases, fortunately in this case with no equivalent rise in mortality rates. This surge in cases was caused by several factors, including the emergence of new variants of the virus (e.g. Omicron) that can evade the immune response created by existing vaccines or by previous infection by other variants; low vaccination coverage, intense social mobilization and lack of compliance with health measures; declining immune response some time after the last dose of the vaccine, among other factors.

It is understandable, to some extent, that many people are fed up with using of facemasks, reject distancing and other non-pharmacological measures and, this is precisely one of the weakest points of our strategy to address the pandemic. Non-use of facemasks, for example, is often a very harmful and dangerous act of rebellion and, when it is part of the “demands” of anti-vax movements that unfortunately seem to be expanding, it forms a nefarious, even criminal combo.

In terms of nutrition, a significant effect of the pandemic and containment measures is the alarming rise in the number of people facing food insecurity. According to the latest report on the state of food security in the world (FAO 2021), the Latin American and Caribbean region saw an increase by 2020 of 67.2 million people facing moderate or severe food insecurity, compared to 2019. In other words, a little more than 40% of the region’s population has seen a decline in the quality or quantity of food or, in the worst case, have gone entire days without eating.

This short summary describes only some direct or indirect effects of the pandemic, but they are useful to understand the situation and gain insight of the most pressing issues ahead of the coming year.

In this context, we need to strengthen and support the resilience of health systems, particularly in their capacity for epidemiological surveillance and comprehensive response to health crises of great magnitude, and leverage technological advantages.

In this connection, a relevant aspect is the need to reduce the gaps in biotechnology of the countries of the region, both material and human talent gaps. More advanced countries could, for instance, transfer technology for the production of vaccines, medicines, viral genomic sequencing, etc. All countries should have best prepared to face a future crisis. This is an urgent task.

Strengthening communication of risk and general communication to the population, strategically and appropriately in the different contexts, is of utmost importance and must be taken seriously and responsibly. This requires specific strategies to counteract the effect of messages with false content, and reinforce appropriate and evidence-based messages, in a systematic and sustained manner.

In this sense, political and social actors at all levels should avoid promoting public agglomerations and seek other ways to connect with their followers or make demands.

In the light of experience gained and assimilated, countries need to review and update their policies, plans, programs, projects, strategies, which have implications for public health and nutrition, and to update them, considering the value of evidence of interventions.

Financing the health sector or actions in other sectors related to health and nutrition, which is traditionally insufficient, needs to be analyzed and adjusted with a short, medium and long-term vision, in order to ensure sufficient funding.

Sparing expenses on public health is definitely NOT a good idea.

Through contingent credit lines and technical cooperation, CAF supports countries in the acquisition of COVID-19 vaccines recommended by the WHO, as well as other actions to strengthen and underpin the health sector. Through its health and nutrition agenda, it aims to have an increasingly direct impact on improving the health and nutrition of the people of Latin America and the Caribbean, particularly the most vulnerable groups.