01 June, 2020

COVID-19 Chronicles: A crisis that we never thought could happen in 2020

Study staff have been reaching all participants by telephone calls, particularly to encourage participants to send a young relative to the health post, to get medication for 1-2 months.

graphic of coronavirus knocking down blocks
photo credit: business-standard.com

We started this new decade with an ambitious 10-year plan for our INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC) at the Institute of Nutrition of Central America and Panama (INCAP), unaware that at least a quarter of the first year we would be working remotely from home and that all field work activities would be suspended until further notice. In the particular case of our HyTREC project, patient recruitment has been stopped for 9 weeks already. Fortunately, we have recruited so far 88% of the sample we need. About the intervention, we are doing whatever is in our hands to make sure that participants have enough antihypertensive medications at home all the time. Study staff have been reaching all participants by telephone calls, particularly to encourage participants to send a young relative to the health post, to get medication for 1-2 months. Other components of the intervention that need contact with MoH health personnel (i.e., coaching sessions) have been happening, but to a lower extent.

Restrictions to movement and activities currently in place to prevent the spread of the COVID-19 virus in Guatemala includes the following:

  1. A mandatory curfew from 6:00 p.m. to 4:00 a.m. each day.
  2. All travel between or into the country departments is prohibited.
  3. All individuals must wear masks in public spaces, including in grocery stores and on the street, to prevent the further spread of the COVID-19 virus. Failure to comply with this requirement would result in fines of up to USD 20,000.
  4. Airport operations and routine commercial flights out of Guatemala have been suspended until further notice.
  5. Public transportation within the country is suspended.
  6. Public and private sector labor is suspended, with the exceptions for certain essential government and health personnel, and for specific industries and utilities whose activities are essential to Guatemala’s security, food production, sanitation or infrastructure.
  7. The sale and purchase of alcohol is permitted between 4:00 a.m. and 3:00 p.m. Consumption of alcohol in public areas is prohibited.
  8. All beaches, lakes, rivers, and other tourist sites are closed. All tourist travel to these areas is prohibited.
  9. Public religious gatherings and celebrations of any size are prohibited.
  10. Visits to individuals in hospitals or prisons are prohibited.
  11. Academic activities at all levels are suspended.

Considering that these measures were taken almost all from very early on in the epidemic (5 days after the detection of the first case), the result has been that Guatemala has one of the lowest incidences of confirmed cases of COVID-19 in Latin America (see figure).

COVID-19 confirmed cases since 10 cases/million were reached in each country

The last doubling of the number of cases took 13 days (April 27 to May 11), although the country is still in the ascending phase of the curve, confinement measures must continue for several more weeks. The only countries in Latin America that have already reached the peak of the epidemic and that have reduced the number of daily cases are Uruguay and Costa Rica. For the day 27 (May 10) when Guatemala reached 10 cases/million inhabitants (April 14), compared to other countries on its 27 day of reaching that point, we are still one of the countries with the lowest growth rate of the epidemic (58.7 cases/million inhabitants, see table).

Situation on day 27 of reaching 10 cases/million inhabitants in selected countries

Finally, if we look at the death rates per million inhabitants of the hardest hit European countries (Belgium 751; Spain 572; Italy 508; UK 472; France 408; Sweden 322; Netherlands 318; Ireland 297) and USA (245), Guatemala hardly has 1.5 deaths per million population. Therefore, the Guatemalan government has established timely measures. Now it remains to be seen the effectiveness of the measures to alleviate the economic effect of the paralysis of many of the work activities and their gradual reactivation, without worsening the epidemic that strikes us.

Despite the problems that this crisis has caused in the execution of research studies, our team has taken advantage to advance in the preparation of scientific articles and new research proposals, including some related to COVID-19. In addition, we have elaborated the biosecurity measures that we will have to take from now on in order to approach the participants of research studies. This pandemic will change the way we live, interact, and do research for a long time.