Weekly Press Briefing on COVID-19: Director's Opening Remarks, November 17, 2021

Good morning and thank you for joining today’s press briefing.

Last week there were nearly 760,000 new cases and 12,800 COVID-related deaths reported in the Americas.

We have seen a five percent decrease in new cases in the Region of the Americas over the previous week, and a 17 percent decrease in new deaths. Some of the most populous countries in the region like the United States, Brazil and Colombia are seeing a leveling of new infections after weeks of declining trends.

In North America, Canada cases and hospitalizations continue to drop.

In the Caribbean, the Dominican Republic and Barbados continue to report a steady rise in new infections. The Cayman Islands is experiencing its highest incidence of COVID infections to date – and two thirds of these cases are among the unvaccinated. Meanwhile Trinidad and Tobago is witnessing a sharp rise in COVID deaths as ICU beds fill with COVID patients.

But countries across Central and South America are seeing a decline in new infections, except for Bolivia, which continues to experience rising cases. As Uruguay and Chile have relaxed public health measures, they’re also witnessing a spike in COVID cases, even despite their high vaccination coverage.

It bears repeating that the COVID pandemic is still very active in our region.

As we near the holiday season, we remind everyone that it’s up to all of us to keep each other safe by getting vaccinated and following the public health measures that have proven effective against this virus, like social distancing and mask wearing.

Today, we have reached an important milestone: half of people in Latin America and the Caribbean have been fully vaccinated against COVID-19.

And nearly 3.5 million COVID vaccine doses are due to arrive in our region this week, helping us reach even more people.

But many countries remain far behind.

Less than 20% of people have been fully vaccinated in Guatemala, Jamaica and St. Vincent and the Grenadines—and vaccination coverage remains in the single digits in Nicaragua and Haiti.

As we continue to push to get the region immunized, today I wish to call your attention to a very important consequence of the COVID-19 pandemic, antimicrobial resistance, or as it is referred to, AMR.

Throughout this pandemic, we’ve seen the use of antimicrobials rise at unprecedented levels, with potentially serious consequences for years to come.

Data from hospital settings in the region shows that 90-100% of hospitalized patients were given an antimicrobial as part of their COVID treatment, while only 7% of these patients had a secondary infection that required the use of these drugs.

Antimicrobials are crucial life-saving drugs, but they must be used responsibly since bacteria can develop resistance and render these drugs ineffective over time.

In fact, that’s exactly what we’re seeing: thanks to the overuse and misuse of antibiotics and other anti-microbials, we risk losing the drugs we rely on to treat common infections. Our recent Epidemiological Alert noted the emergence of bacteria that are resistant to last-resource antimicrobials, with a magnitude and complexity that were not previously described.

Across our region, several countries, including Argentina, Uruguay, Ecuador, Guatemala, and Paraguay are reporting surges in detection of drug-resistant infections that have likely contributed to the rise in mortality we’ve seen during the pandemic in hospitalized patients.

Let’s not forget that health facilities have been overwhelmed by the COVID-19 pandemic. Many ICUs operated at 2-3 times their capacity. A rise in the use of invasive procedures such as intubation or ventilation, the use of antimicrobials and other drugs, overcrowding, and underlying conditions such as diabetes or obesity increased the risks for patients for bacterial and fungal infections. Limited availability of gloves and gowns, and changes in cleaning and disinfection practices were other factors that led to infections spreading more quickly.

Antimicrobials have also been misused outside of hospital settings. Drugs such as Ivermectin, Azithromycin and Chloroquine were broadly used as unproven treatments, even after we had strong evidence that they had no benefit to COVID patients.

Health professionals everywhere should practice responsible use of antimicrobials and prescribe antibiotics only when needed, because misusing these drugs is harmful to patients and also to public health. And countries should ensure that people can’t buy antimicrobials over the counter without a doctor’s prescription.

To help preserve the power of antimicrobials, we need better surveillance, better stewardship, and better drugs.

For over 25 years, PAHO has been helping countries track the spread of antimicrobial resistance and raise awareness of this serious challenge.

We’ve been pleased to see many countries maintain and expand their surveillance systems during the pandemic, and we want to encourage them to leverage these laboratory networks to track AMR for the foreseeable future.

Antimicrobials are still being misused to treat COVID infections, so countries must promote clear, evidence-based treatment guidelines so clinicians know when these drugs are recommended.

It’s only through better stewardship and infection prevention and control that we can prevent the spread of resistance.

And finally, we need to invest in new and better antimicrobial drugs. Today’s pipeline of new antimicrobials is very sparse, yet we rely on these drugs to treat a whole host of infections.

Just as we were able to channel our collective capacity to develop diagnostics and vaccines for COVID in record time, we need commitment and collaboration to develop new and affordable antimicrobials.

Any new drugs must be accessible to countries, regardless of income. That’s a core focus of PAHO’s Strategic Fund, which helps countries keep the costs of drugs, medicines and products under control and ensure adequate supply, so these tools are available when patients need them most.

Throughout this pandemic we have taken the power of antimicrobials for granted.

And while it may be months or even years until we see the full impact of their misuse and overuse, we cannot afford to wait to take action. Let’s start today, on the eve of World Antimicrobial Awareness Week, which is more relevant than ever in the context of the COVID-19 pandemic.

We need all countries—all countries— to work together now to control the rise in antimicrobial resistance so we can continue to rely on these drugs to treat diseases and prevent an unprecedented crisis.