Health overview

The pandemic caused by the COVID-19 virus arose in the Americas region during a time when there were significant social disparities and it created harmful synergy with other epidemics that were already in existence.

There is a greater rate of mortality among those who live in places with larger concentrations of poverty, as well as among indigenous populations and people of African heritage, according to research that was conducted in a number of nations within the Region (12-15). There have been deaths, a decrease in life expectancy, and a simultaneous and synchronized impact on physical, mental, and social health as a result of the pandemic (to a higher extent within social groups that are in vulnerable situations).

Since the first cases of COVID-19 were reported in the Region, there have been five waves of the epidemic that have been documented (figures 3.1 and 3.2). These waves will continue until August 31, 2022 respectively. In each wave, the disease exhibited varying degrees of virulence and fatality, which served as distinguishing characteristics. The most recent wave was brought under control as a result of vaccination coverage against COVID 19, which contributed to a considerable reduction in mortality (16,17).

In spite of having just 13% of the world’s population, the Americas Region has been one of the regions that has been affected the worst by the pandemic. Two-nine percent of confirmed cases and forty-four percent of deaths have occurred in this region. The Region has a total of 175,771,144 cases of COVID-19 as of the 31st of August, 2022, with 52% of those cases being women and 48% being men. In addition, although North America was responsible for 55% of all cases in the Americas Region, Latin America and the Caribbean were responsible for 62% of the total deaths that occurred (figures 4 and 5).

Following the Southern Cone (21,212.17 cases per 100,000 population) and the non-Latin Caribbean (11,418.30 cases per 100,000 population) as the subregions that reported the highest number of cases per 100,000 population during the pandemic, the North America subregion recorded the highest number of cases per 100,000 population (figure 6). There is a possibility that this result is a reflection of improved management of the information that is created as well as increased speed of monitoring, detection, and diagnostic systems.

The North America sub-Region also experienced the highest proportion of deaths reported throughout the pandemic (Figure 7), with a total of 1,079,383 cumulative deaths reported as of August 31, 2022. This constitutes the highest number of deaths reported among all regions. Nevertheless, when the cumulative mortality rate per million inhabitants was compared, Brazil had the highest rate (3199), followed by the Andean area (2938) and the Southern Cone (2900). Brazil was the country with the highest rate.

Data from around the world that has been broken down by gender reveals that the number of confirmed cases is higher among females than it is among males (Figure 8). This is according to the World Health Organization (WHO). On the other hand, the situation is reversed when it comes to deaths: females account for 42 percent of the overall number of deaths, while males account for 58 percent (18,19).

According to the most current study from the World Health Organization (WHO) on the excess mortality caused by COVID-19, it is estimated that there was an excess mortality of 3.23 million fatalities in the Americas region, which is equivalent to 430,000 more deaths than were recorded (20). There was a concentration of 83.5% of the excess mortality in five countries: Brazil, Colombia, the United States of America, Mexico, and Peru. COVID 19 has emerged as a leading cause of death in the years 2020 and 2021 as a result of its exceedingly high mortality rate.

According to the data that is currently available on a global scale and broken down by age group, the total number of instances is disproportionately concentrated in the population that is between the ages of 20 and 50. As indicated in Figure 9, the population aged 70 and older is anticipated to account for 9.1% of the total cumulative cases in the Americas region. Furthermore, this age group is responsible for 51% of the deaths that have occurred collectively. To add insult to injury, the lethality of COVID-19 in the Region increases at an exponential rate with increasing age. There is little doubt that vaccination has decreased the risk of death in general, while the number of deaths that occur among the elderly continues to be higher.

A higher lethality of COVID 19 has been recorded in population groups that are in vulnerable conditions, including those who live in places with a higher concentration of people, according to research that were carried out in different countries within the Region. These studies were conducted in order to investigate the socio-economic disparities that exist. Both indigenous peoples and poverty are mentioned.

In North America, life expectancy decreased from 79.5 years in 2019 to 77.7 years in 2021 (1.8 years less), and in Latin America and the Caribbean, life expectancy decreased from 75.1 years in 2019 to 72.2 years in 2021 (2.9 years less). This decrease was primarily caused by the impact of COVID-19 (21), with the greatest loss of life expectancy being recorded in Latin America and the Caribbean. When compared to the life expectancy in 2004, the life expectancy in 2021 for Latin America and the Caribbean and North America is comparable. When compared to women, men saw a greater decrease in life expectancy during this time period, and this trend was observed in both Latin America and the Caribbean as well as in North America (Table 2).

In spite of the fact that there are some notable exceptions, the health care systems in the Americas Region have been characterized by underfinancing, segmentation, and fragmentation. The progress that has been made in the nations of the Region has not been able to safeguard the countries from the pressures that have been caused by the epidemic, despite the fact that reform and strengthening procedures of the health sector are currently happening in those countries. The average amount of money spent by the government on health care is just 3.8% of gross domestic product, which is a significant distance from the aim of 6%. Because of this, there are gaps in both the physical infrastructure and the human resources that are available for health care.

One of the primary causes of inequality in access to health services is the lack of financial protection for the most vulnerable people, who are more likely to incur catastrophic expenses if they become ill. The level of out-of-pocket health expenditures in the Region is high, which increases the risk of household impoverishment and constitutes one of the main sources of inequality in access to health services.

There have been long-standing gaps in universal health that have been exposed once again as a result of the huge pressure that the pandemic has placed on the health systems of nations in the Americas Region. Additionally, there have been widened inequalities in access to health services that are both effective and comprehensive (22,23). When it comes to combating a new and deadly disease that has fast converted into a global public health, social, and economic crisis, health services have been confronted with an extraordinary surge in demand against the backdrop of restricted resources.

The epidemic has also brought to light the difficulties that health care systems encounter when attempting to provide universal health coverage and access to medical care for all people. Due to the adaptation and reconversion of services in order to boost treatment capacity, it has been able to provide additional services to individuals who are afflicted with this newly discovered disease. However, this has also resulted in a reduction in the provision of other services, notably in peri-urban and rural areas. in addition to native people.

The initial level of care has been strengthened in a variety of different ways across countries. Therefore, one of the most important actions that has been recommended in the COVID 19 response in the area of health service delivery has been to reorganize and strengthen the capacity to care for the first level of care in order to participate in the processes of containing the spread of the disease, early detection of SARS-CoV-2, monitoring and initial treatment of cases, as well as prioritizing service delivery in all areas, while maintaining essential services (24). This has been achieved by reorganizing and strengthening the capacity to care for the first level of care.

Both the degree of effectiveness of these efforts and the pre-existing public health capacities in countries were a significant factor in determining the degree of effectiveness. There have been several instances in which capacity gaps have prevented a full and integrated response from being implemented. This has resulted in the late adoption of response measures, interruptions in the continuity of key services, an increase in the severity of barriers to access, and low vaccination rates for COVID 19. Even if they are not yet functioning at full capacity, around twenty countries have already incorporated primary health care services into the COVID 19 response as of the month of May during the year 2020. Services related to mental health, communicable diseases, and sexual, reproductive, maternity, newborn, child, and adolescent health were the ones that were most negatively impacted (Table 3).

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