In light of the increase in cases and deaths of COVID-19 among healthcare workers in the countries and territories in the Region of the Americas, the Pan American Health Organization / World Health Organization (PAHO/WHO) urges Member States to strengthen the capacity of healthcare services across all levels and to equip healthcare workers with the appropriate resources and training in order to ensure an adequate and timely response to the pandemic within the healthcare system.
The Region of the Americas is currently experiencing an accelerated increase in the number of reported cases of coronavirus disease 2019 (COVID-19). Between 1 January and 28 August 2020, the total number of COVID-19 cases reported in the Americas exceeded the number of cases reported in all the remaining five WHO Regions during the same period by 1.4 million cases.
As of 28 August 2020, a total of 13,005,995 cases of COVID-19, including 458,444 deaths, have been reported in the 54 countries/areas/territories in the Region of the Americas. The highest proportion of cases has been reported in the United States of America (45%) followed by Brazil (29%), while the highest case-fatality rates have been observed in Mexico (10.8%), Canada (7.2%), and Ecuador (5.8%).
During the previous 4 weeks, a 26% relative increase in cases and 20% relative increase in deaths has been observed. The highest proportions of new cases continue to be reported in the United States of America (36%) and Brazil (31%), while the highest proportions of new deaths were reported in the United States of America (27%), Brazil (26%), and Mexico (16%). A median of 132,322 new cases and 3,697 new deaths were reported every 24 hours over the past 2 weeks.
Furthermore, during the previous 4 weeks, the highest relative increases in cases and deaths were observed in the subregions of the Caribbean Atlantic ocean islands (33% in cases and 35% in deaths), Central America (33 % in cases and 28% in deaths), and South America (33% in cases and 27% in deaths).
Given the epidemiological situation in the Region, which has overwhelmed the current capacity of the healthcare systems and has the potential to continue, strengthening healthcare services is a priority.
Healthcare workers are crucial to maintaining healthcare services during the COVID-19 pandemic. Front-line staff conduct clinical assessments and administer treatment to COVID19 patients, patients presenting with non-COVID-19 emergencies, and patients requiring routine check-ups. One of the greatest risks to the healthcare system is the potentially high rate of infections due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), among healthcare workers. This could subsequently lead to a lack of availability of trained personnel to guarantee an adequate local and/or regional response to the pandemic. This risk has been augmented by a need to rapidly increase the capacity of intensive care units (ICUs), the redeployment of clinical staff to front-line positions (for example, ICU or COVID-19 patient care rooms), and the recruitment of less experienced personnel (e.g., recent graduates or healthcare workers from unrelated specialties) into the workforce to respond to the pandemic.
Sustained community-based human-to-human transmission of COVID-19 has been reported in most of the countries and territories in the Region of the Americas; in addition, transmission in the healthcare setting has also been reported. Transmission of COVID-19 includes direct contact and via droplets. Additionally, aerosol generating procedures (AGPs) also play an important role in the transmission of COVID-19 within the context of healthcare services.
Healthcare workers can be exposed to SARS-CoV-2 through unprotected contact with infected patients or through contact with other infected healthcare workers. Exposure in the healthcare services context could be due to non-compliance with infection prevention and control (IPC) standards, inappropriate use of personal protective equipment (PPE), lack of or inadequate PPE, insufficient training, stress, work pressure, working overtime, and limited availability of healthcare workers, amongst other reasons. However, this issue can be addressed not only through the implementation of IPC measures in healthcare services, but also through proper organization and management of healthcare services.
The Pan American Health Organization / World Health Organization (PAHO/WHO) is continuously monitoring the response capacities in the countries and territories in the Region of the Americas through the use of indicators in order to provide strategic support as needed during the pandemic response.
As of 19 August 2020, according to available information from 191 countries in the Region of the Americas, a total of 569,304 cases of COVID-19, including 2,506 deaths, have been reported among healthcare workers. Of these, 72% are female, and the age groups with the highest proportions of confirmed cases are 30-39 years and 40-49 years.
The following is a summary of the situation of COVID-19 among healthcare workers in countries for which information was available.