Original Article
Virology/Public Health
Kasmera 48(1):e48106042020, Enero-Junio, 2020
P-ISSN 0075-5222 E-ISSN
2477-9628
https://doi.org/10.5281/zenodo.3830750
Progression of Coronavirus cases in Latin America:
Comparative analysis one week after the start of the pandemic in each country
Progresión de
casos de Coronavirus en Latinoamérica: Análisis comparativo a una semana de
iniciada la pandemia en cada país
Araujo-Banchon William J. https://orcid.org/0000-0002-5588-6860. Universidad Continental. Grupo de Investigación Continental. Lima. Perú. E-mail: williamdr_14@hotmail.com
Aveiro-Róbalo Telmo Raúl. https://orcid.org/0000-0003-2409-8324. Universidad del Pacífico. Asunción.
Paraguay. Email: raul.aveiro45@gmail.com
Fernández
María F. https://orcid.org/0000-0002-8932-8437.
Universidad Privada de Tacna. Tacna-Tacna. Perú. Email: miamafer0211@gmail.com
Castro-Pacoricona Diana. https://orcid.org/0000-0002-1628-6205.
Universidad Privada de Tacna. Tacna-Tacna. Perú. Email: dc.castro.pa@gmail.com
Moncada-Mapelli Enrique. https://orcid.org/0000-0002-2297-0695.
Universidad de San Martín de Porres. Sociedad Científica de Estudiantes de
Medicina de la Universidad de San Martín de Porres. Lima, Perú. Email: enrique_1613@hotmail.com
Chanava
Walter. https://orcid.org/0000-0002-0421-815X.
Universidad de Piura. Piura-Piura. Perú. Email: walter.chanava@gmail.com
Mejia
Christian R (Autor de
correspondencia). https://orcid.org/0000-0002-5940-7281. Universidad Continental.
Facultad de Medicina Humana. Huancayo-Junín. Perú. Dirección Postal: Av. Las Palmeras 5713, Los Olivos, Lima, Perú. CP: 15304. Teléfono: (511)
997643516. E-mail: christian.mejia.md@gmail.com
Abstract
The pandemic generated by COVID-19 progresses
differently when it reaches each territory, the progression of Coronavirus
cases in the first week of the pandemic was compared in each country in Latin
America. A descriptive study was carried out, with the information of the
confirmed cases in each country, this since the first case was announced in
each territory. Progressions are shown in graphical forms, with total cases and
adjusted for population density. Uruguay and Panama were the countries that
stood out from all those evaluated, they had a greater number of confirmed
cases weighted in the first week of the pandemic. Likewise, these two countries
were also those with the highest number of absolute cases (not weighted by the
number of population), as well as the country of Venezuela; that he is even
thought to have more cases, due to his political problems. There were some
differences in the number of cases that occurred in each Latin American country
at the end of its first week of the COVID-19 epidemic; this could be due to the
government policies that were taken before and during those first days, which
should serve as an example for acting in future similar cases.
Keywords: coronavirus, health policy, Latin America
Resumen
La
pandemia generada por la COVID-19 progresa diferente cuando llega a cada
territorio, se comparó la progresión de casos de Coronavirus en la primera
semana de la pandemia en cada país en Latinoamérica. Se realizó un estudio
descriptivo, con la información de los casos confirmados en cada país, esto
desde que se anunciara el primer caso en cada territorio. Se muestran las
progresiones en formas de gráficas, con los casos totales y ajustados por la
densidad poblacional. Uruguay y Panamá fueron los países que destacaron de
todos los evaluados, tuvieron una mayor cantidad de casos confirmados
ponderados en la primera semana de la pandemia. Así mismo, estos dos países también
fueron los que tuvieron mayor cantidad de casos absolutos (no ponderados por la
cantidad de población), así como, el país de Venezuela; que incluso se piensa
que tiene más casos, por sus problemas políticos. Hubo algunas diferencias en
la cantidad de casos que se presentaron en cada país Latinoamericano al final
de su primera semana de epidemia COVID-19; esto podría deberse a las políticas
gubernamentales que se tomaron antes y durante esos primeros días, las cuales
deben servir como ejemplo para el actuar en futuros casos similares.
Palabras claves: coronavirus, políticas de salud,
Latinoamérica
Received: 07-04-2020 / Accepted: 03-05-2020 / Published: 22-05-2020
How to Cite: Araujo-Banchon
WJ, Aveiro-Róbalo TR, Fernández MF, Castro-Pacoricona D, Moncada-Mapelli E, Chanava W, Mejia Christian R. Progresión
de casos de Coronavirus en Latinoamérica:
Análisis comparativo a una semana de iniciada la pandemia en cada país. Kasmera. 2020;48(1):e48131621.
doi: 10.5281/zenodo.3830750
Introduction
COVID-19, whose etiological agent is the
SARS-COV-2 virus, has generated a great deal of information worldwide in a
short time; this is due to the fact that it is a pandemic that has changed the
regular behavior of society during the first months of the year 2020 (1-5).
Each government decides how to handle the
crisis. For example, some decided to employ border controls (to a greater or
lesser extent), while others began to cancel massive events and employ measures
of social isolation in large geographical areas of their country (6) as
exemplified by the experience of China, where social distancing, quarantine,
and isolation of populations could contain the epidemic (7-8). However, all
these measures have led to shortages of basic necessities, collective hysteria,
and even a fall in stock markets (9-10).
Likewise, the health contingency measures that
were adopted by governments have economic consequences; however, the failure to
adopt them triggers large-scale fatal consequences in public health. To the
extent possible, these restrictions may cause a probable collapse of health
systems, the main objective being to "flatten the epidemic curve"
(8). Understanding this phrase as an attempt to reduce the transmission of the
disease (8), the actions taken by governments generate changes in the
presentation of confirmed cases, the number of deaths and those recovered,
among others; therefore, it is important to make a comparison between the
different realities (11-12). For all these reasons, the objective of this study
is to compare the progression of COVID-19 cases in the first week of the
pandemic in each country in Latin America.
Methods
Type and design of research: A descriptive
cross-sectional observational study was conducted by collecting statistical
data and contingency measures on the outbreak of COVID-19 in Latin America. All
these were based on secondary information analysis with data obtained from
official information published by each country by its official sources or
media.
Data Collection: The data collection was carried out during the month of February and
March 2020, for which the official websites, verified social networks of
national representation and online journalistic reports of the Latin American
countries were reviewed: Argentina, Bolivia, Brasil,
Chile, Colombia, Ecuador, Paraguay, Perú, Uruguay, Venezuela, Costa Rica, Cuba,
El Salvador, Guatemala, Honduras, Nicaragua, Panamá, Puerto Rico, República Dominicana, México,
Jamaica, Haití y Belice.The
data were collected in a Microsoft Excel 2013 spreadsheet. All data reported by
each of the countries were selected; under this premise, information on the
progression of the cases of COVID-19 that occurred in the first week of the
epidemic in all Latin American countries was included. Three territories were
excluded (Guyana, French Guiana, and Suriname), because they have different
cultural and political characteristics from the rest of the Latin American
countries.
The same work team collected all the information.
It is worth mentioning that this team comprised of professional
epidemiologists, doctors with scientific publications, and students of health
sciences. Training was conducted to standardize the methods by which each piece
of data was collected. The data were verified four times during 2020: twice
during the first few days in March, once during the first few days in April,
and once in May during the time that the
reviewers were collecting observations; this was because on certain occasions,
the reports changed as the days passed (due to an official confirmation or
change).
Study variables: data on confirmed cases, date of occurrence, number of deaths, days of
quarantine, reports by the World Health Organization (WHO), epidemiological
characteristics of confirmed cases, and outstanding health policies of national
interest of each country were recorded daily with respect to the pandemic.
Quarantine was defined as a situation in which a country or region restricts
the free movement of its citizens, limiting them to moving only for the need to
obtain food or medicine. Curfew was defined as the situation in which a country
or region prohibits the total transit of its citizens during a defined period
of hours.
Statistical analysis: descriptive analysis in absolute frequencies was reported for the
preparation of the tables. “Smooth line" graphs were plotted to compare
confirmed cases in each country during the first week of the epidemic. Graphs
were generated for the progression of confirmed cases according to the date of
appearance, and the first seven days of the epidemic for all countries, but
adjusted for the number of inhabitants in each country. For the last graph, the
weighted results were generated by a search carried out in March on the Google
platform, to obtain the total population presented by each country. This method
was chosen for its ease of obtaining an approximate value and because there
were no annual censuses in each territory. The statistical program R was used
for the analysis of the data and the elaboration of the graphs.
Ethical considerations: all data were obtained from freely accessible sources and records, from
official portals, from their ministries of health, from official social
networks, and from government websites; thus, the approval of an ethics
committee was not required.
Result
The
range of the first seven days recorded by each country is stated as follows;
Argentina from March 3 to 9, Bolivia, March 8 to 14, Brazil, 26 February to 3
March, Chile, March 3 to 9, Colombia, March 6 to 12, Ecuador, 29 February to 6
March, Paraguay, March 7 to 13, Peru, March 6 to 12, Uruguay, March 13 to 19,
Venezuela, March 13 to 19, Costa Rica, March 6 to 12, Cuba, March 11 to 17, El
Salvador, March 19 to 25, Guatemala, March 13 to 19, Honduras, March 11 to 17,
Nicaragua, March 18 to 24, Panama, March 9 to 15, Puerto Rico, March 13 to 19,
Dominican Republic, March 1 to 7, Mexico, February 28 to March 5, Jamaica,
March 10 to 16, Haiti, March 20 to 26 and Belize, March 23 to 29. Table 1 describes the location,
date of the first confirmed case, and population size of each country.
Table 1. Total population of each Latin American country
(ordered in ascending order by date of appearance of first case).
|
Country |
Location |
First case date |
Total population* |
|
Brasil |
South America |
26 of
February |
210147125 |
|
México |
North
America |
28 of
February |
127090000 |
|
Ecuador |
South America |
26 of
February |
17023000 |
|
República
Dominicana |
Central America |
March 1st |
10850000 |
|
Argentina |
South America |
March 3rd |
44560000 |
|
Chile |
South America |
March 3rd |
18876190 |
|
Colombia |
South America |
March 6 |
50.372.424 |
|
Perú |
South America |
March 6 |
32970000 |
|
Costa
Rica |
Central America |
March 6 |
5022000 |
|
Paraguay |
South America |
March 7 |
7130000 |
|
Bolivia |
South America |
March 8 |
11501900 |
|
Panamá |
Central America |
March 9 |
4159000 |
|
Jamaica |
Central America |
March 10 |
2934855 |
|
Cuba |
Central America |
March 11 |
11338138 |
|
Honduras |
Central America |
March 11 |
9300000 |
|
Guatemala |
Central America |
March 13 |
17263000 |
|
Uruguay |
South America |
March 13 |
3470000 |
|
Venezuela |
South America |
March 13 |
28435940 |
|
Puerto
Rico |
Central America |
March 13 |
2860853 |
|
Nicaragua |
Central America |
March 18 |
6465513 |
|
El
Salvador |
Central America |
March 19 |
6643000 |
|
Haití |
Central America |
March 20 |
11402528 |
|
Belice |
Central America |
March 23 |
397628 |
*Source: Google search March, 2020.
Table
2 represents a description of the websites where it is
possible to find information on the follow-up of cases of patients with
COVID-19, according to each of the Latin American countries. It should be noted
that Argentina reported the first death in Latin America and Uruguay (n=94),
Panama (n=55) and Venezuela (n=42) reported the highest number of confirmed
cases in their first week. Panama reported its first death by COVID-19 one day
after reporting its first confirmed case. It should also be noted that less
than 50% of these countries implemented quarantine or curfew sanitary policy
measures.
Table 2. Epidemiological and political information on
COVID-19 during the first week of the epidemic in Latin American countries
|
Country |
Case dissemination
media |
Cases |
Deaths |
Quarantine |
Curfew |
|
Argentina |
17 |
1 |
No |
No |
|
|
Bolivia |
12 |
0 |
Yes* |
No |
|
|
Brasil |
2 |
0 |
Yes** |
No |
|
|
Chile |
13 |
0 |
No |
No |
|
|
Colombia |
9 |
0 |
No |
No |
|
|
Ecuador |
14 |
0 |
No |
No |
|
|
Paraguay |
7 |
0 |
Yes |
No |
|
|
Perú |
22 |
0 |
No |
No |
|
|
Uruguay |
94 |
2 |
No |
No |
|
|
Venezuela |
42 |
0 |
Sí |
No |
|
|
Costa Rica |
23 |
0 |
No |
No |
|
|
Cuba |
7 |
0 |
No |
No |
|
|
El Salvador |
13 |
0 |
Yes*** |
No |
|
|
Guatemala |
9 |
1 |
No |
No |
|
|
Honduras |
9 |
0 |
Yes**** |
No |
|
|
Nicaragua |
2 |
0 |
No |
No |
|
|
Panamá |
https://geosocial.maps.arcgis.com/apps/opsdashboard/index.html#/2c6e932c690d467b85375af52b614472 |
55 |
1 |
No |
No |
|
Puerto Rico |
https://twitter.com/DeptSaludPR https://bioseguridad.maps.arcgis.com/apps/opsdashboard/index.html#/3bfb64c9a91944bc8c41edd8ff27e6df |
6 |
0 |
Yes |
Yes |
|
República Dominicana |
2 |
0 |
No |
No |
|
|
México |
5 |
0 |
No |
No |
|
|
Jamaica |
11 |
0 |
Yes |
No |
|
|
Haití |
https://twitter.com/MsppOfficiel |
8 |
0 |
No |
Yes |
|
Belice |
2 |
0 |
No |
No |
* The province of Oruro (Bolivia) was the only one quarantined during the
first week of the epidemic
** The region of Sao Paulo
(Brazil) implemented a partial quarantine during the first week of the epidemic
*** El Salvador implemented
quarantine measures before reporting its first confirmed case
**** Honduras implemented a curfew; however, its
policy measures fit the definition of a quarantine as handled in this document
Figure 1 presents a graph showing the date of appearance of cases in all countries studied. Brazil, Mexico, and Ecuador were the first countries to present cases of COVID-19, while Belize was the last. Uruguay had the highest number of confirmed cases in the stage evaluated.
Figure 1. Confirmed cases of COVID-19 during the first week of
the epidemic by date of diagnosis
Figure 2
shows that the countries with the highest number of positive cases were
Uruguay, Panama, and Venezuela; all of these reported more than 25-30 cases in
their first week (Uruguay reported almost 100 cases). Costa Rica, Peru, and
Argentina ended their first week with a tendency of significant increase in the number of infections.
Figure 2. Confirmed cases of COVID-19 during the first week of the epidemic (standardized to 7 days)
Finally, when the number of confirmed cases in
the first week was adjusted according to the inhabitants of each country (Figure 3), it was found that
Uruguay and Panama stood out the most, followed by Belize, Costa Rica, and
Jamaica; all three with values very close to each other. A large group of the
remaining countries had very similar values.
Figure 3. Population-adjusted confirmed cases of COVID-19 during the first week of the epidemic (standardized to 7 days)
Discussion
SARS-COV-2 took less than 3 months to affect
Latin America, the first case being reported in Brazil on 26 February (4). Thereafter, the infection spread throughout the America in less than a
month (13). This rapid expansion was clearly influenced by
some factors, such as communication through air transport, which is common in
all Latin American countries, the transmission of the virus in its asymptomatic
period, the measures that each government adopted from the beginning and during
the time of its first reported cases, and the rapid spread of the disease,
among many others (14-16). However, it was estimated that up to 80% of
infected cases might not be documented in each country's statistics (17), which would further explain the easy spread of the virus throughout
the continent.
The countries that had the greatest number of
positive cases in their first week were Uruguay, Panama, and Venezuela. However,
each of these countries has differences in their population numbers (Uruguay, 3
million; Panama, 4 million; and Venezuela, 28 million). Thus, after adjusting
for the population in each territory, it was found that Uruguay and Panama had
the highest proportion of weighted cases. Therefore, Venezuela was not among
the first three countries with the highest number of cases. However, the
results of the outbreak in Venezuela should be interpreted with great caution,
because it is known that the government policies in this country are
"questionable.” Hence, the report of the figures should be considered only
a reference, especially because after 1 month and 20 days, Venezuela was one of
the few countries in the world that reported 335 positive cases and 10 deaths,
which is not only incredible, but very suspicious.
The government measures that countries
implemented in each case and the collective behavior of the people to comply
with them, could have influenced the number of positive cases in each country
during the first week of the epidemic (18). One anecdotal case was recorded by Panama, as it reported its first
death a day after registering its first positive case. This means that there
would already be cases before the report of the first positive case; this could
even be extrapolated to the other countries, since each of them has reported
the first symptomatic case. Therefore, the epidemiological surveillance
measures in Panama and the other countries might not have been sufficient,
causing the increase in the number of positive cases to be noticeable at the
end of the first week of the COVID-19 epidemic. Of course, these are reports of
the first week only, and subsequent investigations should show the curves and
progression of cases in the first months.
The rest of the countries present a similar
growth in the number of positive cases during their first week; however, Costa
Rica, Peru, and Argentina began to show a notable growth in their cases at the
end of the first week. This may also be influenced by other factors, since it
is known that the number of positive cases per day is directly proportional to
the number of tests performed in reality (19,20). In the case of Peru, the country began its week with less than 100
tests per day (21-23); by the end of its first week, the daily tests
were more than 300 (24). As described, future investigations would have
to weigh the number of positive cases by the number of tests performed in each
location, considering that often this was not reported. It is also important to
take into account the number of poorly taken tests, false positive or false
negative results because both these factors can influence the number of cases
of COVID19 reported daily (25). Many other factors are very difficult to measure, but serve to provide
an idea of the initial outbreak of the virus in countries with similar
realities; this can then be compared with other realities in the world.
In addition, the implementation of emergency
public health policies, the strengthening of border control, epidemiological
research, -which has been carried out in countries affected by the pandemic-,
the purchase of protective materials, the most appropriate diagnostic tests,
and social behavior, among others, are important in each case (26). The present study reported that a large number of countries
implemented quarantine measures and curfews. However, since the period of
manifestation of symptoms of COVID-19 can take up to 14 days (27), the effects of these isolation measures will be more noticeable in the
month of April 2020 thereby, making it possible to conduct investigations
starting only from May, since, as mentioned above, many estimated figures
change with the passing of weeks and according to the official confirmation. It
is worth mentioning that El Salvador implemented restriction measures, even
before registering its first confirmed case of COVID-19; thus, it is likely
that with the low number of positive cases in its first week, it is in the
group of countries that reported fewer cases during the first week of the
epidemic.
The study’s main limitation was that it was
based on data reported by each country, so, the results must be considered
under that premise, as this can be dependent on the reality in democratic
governments with policies of transparency of their data among those who have an
adequate report of their cases. Thus, the estimation of the exact number of
positive confirmed cases is difficult because some governments in their attempt
to "not cause panic to the population" or to the world, could be
altering their figures. However, these data are still important, since they
reflect what has happened and been reported by each government, and can serve
as a point of comparison for us to learn how a pandemic behaves in the first
few days of interaction in each of our realities.
In conclusion, Uruguay and Panama were the worst
affected countries with the highest number of confirmed cases in the first week
of the pandemic in Latin America. In addition, these two countries along with
Venezuela also had the highest number of absolute cases. All other countries
had a very similar presentation in terms of the number of absolute and weighted
cases.
Conflict of relationships and activities
The authors declare not to have any
relationships or activities conflict.
Financing
This research was financed by the authors
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Authors Contribution:
ABWJ, ARTR, FMF,
CPD, MME, CW and MCR: participaron
en la conceptualization,
methodology, software, validation, formal analysis, investigation, resources, data
curation, drafting-preparation of the original draft, writing-review and
editing.
©2020. Los Autores. Kasmera. Publicación del Departamento de Enfermedades
Infecciosas y Tropicales de la Facultad de Medicina. Universidad del Zulia.
Maracaibo-Venezuela. Este es un artículo de acceso abierto
distribuido bajo los términos de la licencia Creative
Commons atribución no comercial (https://creativecommons.org/licenses/by-nc-sa/4.0/) que permite el uso no comercial, distribución y
reproducción sin restricciones en cualquier medio, siempre y cuando la obra
original sea debidamente citada.