The World Health Organization's Americas office said this week it remains concerned about the rapid acceleration of coronavirus infections in Haiti, and worries that the country's ongoing political instability may have affected surveillance of the circulation of the deadly virus now leading to increased hospitalizations.
Haiti's spike in COVID-19 after more than a year of relatively low numbers of cases comes amid a worrying trend in Latin America and the Caribbean, where cases and death are at alarmingly high levels. The region does not have enough vaccines to fight the spread, and Haiti remains the only country in the Americas yet to administer any shots after expressing concerns about the AstraZeneca vaccine and shrugging off the urgency of vaccination.
Earlier this month the Haitian government finally agreed to permit the AstraZeneca vaccine after banning it. But when the first shipment will arrive from the U.N.-backed COVAX Facility, which gets vaccines to low and middle-income countries, remains unknown.
Dr. Jarbas Barbosa, assistant director for WHO's Pan American Health Organization, said the group is continuing to work with Haiti's government and health ministry "to finalize all of the administrative procedures that they need to adopt in order to receive the 130,000 doses that Haiti is entitled to receive as the first wave of deployment from COVAX."
"At this moment we cannot confirm exactly the date," Barbosa said. "But we are trying to get the vaccines in June. But we will only have a date when all of the procedures are finalized."
Earlier this week Haiti's government imposed a nightly curfew and other measures as part of an eight-day public health emergency to curb the spread of the virus following the detection of two highly contagious variants of concern — one from Brazil and the other from the United Kingdom — in the country.
Speaking to journalists earlier in the week, the country's health minister, Dr. Marie Greta Roy Clément, said at least 15 deaths had been confirmed in 72 hours and stressed they were known only because they had occurred in hospitals. She also noted that at least half of the country's COVID-19 infections were occurring in people younger than 50, another worrying trend in a country that thought it had escaped the worst of the pandemic because of its fairly young population.
"We are concerned about increasing trends in hospitalization in Haiti. Cases are rising especially in Port-au-Prince, hospitals are getting stretched," said Dr. Sylvain Aldighieri, incident manager for PAHO.
Aldighieri noted that Haiti's reporting, which is often delayed by days, did not truly reflect the epidemiological evolution of its coronavirus cases. For example, the ministry's most recent data was as of May 21 and confirmed 131 new cases and four additional deaths. As of the date, Haiti had registered a total 14,037 laboratory confirmed cases and 292 deaths.
Aldighieri said that in the past month, with PAHO's help, Haiti's health ministry and its national partners had dramatically expanded laboratory testing capacity. "However, the period of political instability and the low perception of risk in the population in the past month may have impacted negatively all control activities and also on the surveillance of SARS-CoV-2 circulation."
Dr. Carissa Etienne, the head of PAHO, said the vaccine doses destined for Haiti "are desperately needed" given the country's rapid spike in cases.
She noted that while public health officials are happy to see the arrival of more COVID-19 vaccines in the Americas, countries in Latin America and the Caribbean continue to face "a glaring gap in vaccines" even as they continue to report some of the highest case counts and deaths. Hospitals are full and many patients are not getting the care they desperately need, she said.
"In our region of nearly 700 million people, just 37 million have been fully vaccinated against COVID," Etienne said. "This is completely unacceptable and it demonstrates how long-standing inequities are being perpetuated by the slow COVID vaccine rollout. As wealthy countries expand vaccination, many of the most disproportionately impacted countries are being left behind."
In the past week, the Americas region, which includes the United States, Canada and Mexico, reported over 1.2 million new COVID-19 cases and 31,000 deaths.
"Last week, four out of five of the countries reporting the highest number of new infections were here in our region, and Latin American countries represented the top five highest mortality rates worldwide," Etienne said in opening remarks with journalists during her weekly press conference on the situation of COVID-19 in the Americas.
She noted that Trinidad and Tobago has also declared a national emergency following the recent COVID outbreak, Cuba continues to report significant new infections, and Saint Vincent and the Grenadines are still seeing spikes after recent volcanic eruptions resulted in people being moved to shelters.
Central American countries are also reporting spikes, including Costa Rica, Panama, Belize, and in Honduras, where intensive care beds are over 80% capacity. In South America, Chile, Peru and Paraguay have registered declines in new infections. However, Uruguay, Argentina and Brazil are once again seeing COVID-19 infections on the rise, after several weeks of progress. Bolivia is reporting a drastic increase in cases and deaths, and Guyana is experiencing the highest numbers of cases and deaths since the beginning of the pandemic.
"Despite persistently high infections, many people and places are no longer adhering to the public health measures we know are effective against COVID. And new figures suggest that we may not yet know the full impact of this pandemic," Etienne said.
