The novel coronavirus (SARS-CoV-2) has continued to cause significant and unprecedented changes in the world since it was first reported in China in December 2019 (PAHO/WHO, 2020).

The extent of the COVID-19 pandemic continues to raise public health concerns regarding its impact on the physical and mental health of individuals and entire societies due to socioeconomic effects, fear of contracting the virus, and the stressful challenges of adapting everyday activities (UN, 2020).

In the Region of the Americas, several countries with high vac- cination coverage as of 8 August 2021 are reporting a rise in cases and hospitalizations with the appearance of the Delta variant of con- cern (VOC) (PAHO/WHO, 2021). The emergence of the Delta VOC in the Region makes it necessary for Member States to be aware of the importance of preparing to expand their capacity for care, given the potential increase in alcohol, tobacco, and other substance use.

Alcohol, tobacco, and other substances are often used in socializing and coping with negative emotions. Since anxiety, fear, depression, boredom, and uncertainty were commonly reported during the initial phase of the pandemic and are expected to increase as the countries of the Region prepare to respond to the Delta VOC, the use of these substances is expected to increase as well.

Use of these substances (alcohol, for example) gives rise to many acute and chronic health risks. It is identified as a causal factor in more than 200 diseases, resulting in 5.1% of the global burden of dis- ease and injuries, measured in disability-adjusted life years (DALY) (PAHO/WHO, 2020). Heavy drinking is associated with a higher risk of a weakened immune system, increasing an individual’s suscepti- bility to various infectious diseases, including COVID-19, and the severity of the diseases (PAHO/WHO, 2020). Continuing analysis of the data on substance use during the pandemic and the harm it causes has shown that prolonged use of these substances (i.e., alcohol and tobacco products) increases the risk of acute respiratory distress syn- drome (ARDS). One of the most severe complications experienced by patients diagnosed with COVID-19 (PAHO/WHO, 2020), ARDS puts individuals with a history of prolonged heavy drinking at higher risk of death if they contract the infection.

In its 2020 publication, PAHO reported that heavy drinking is a significant risk factor for mortality and morbidity in the Region of the Americas. Alcohol consumption levels in the Region are higher than the world average, and male and female abstinence rates are systematically lower. With regard to the burden of disease, it was reported that heavy drinking is the secondary cause of approximately 379,000 deaths (6.5% of all deaths) and more than 18.9 million DALYs in the Region of the Americas (PAHO/WHO, 2020). The findings presented in this publication also showed that men in the Region consumed more alcohol than women did, although the alcohol consumption rate among women in the Region now exceeds that of men (Rodrigo García-Cerde, 2021).

Since many people in the Region continue to exhibit symptoms of psychosocial stress (tension, sleep disorders, and anxiety) stemming from the pandemic, many may take to drinking or heavy drinking to cope with the situation (PAHO/WHO, 2021). It is therefore vital for Member States to be aware that certain groups may be at higher risk of developing a drinking problem. Special groups, such as older persons, essential workers, parents with children, people closely connected with someone critically ill with COVID-19, and people with major depression, anxiety, or positive emergency impulsivity, may need additional monitoring while the world continues to fight this pandemic.

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