JMIR Publications

ABSTRACT

Background:

This study updates the COVID-19 pandemic surveillance in Latin America and the Caribbean we first conducted in 2020 by providing two additional years of data for the region.

Objective:

First, we aim to measure whether there was an expansion or contraction in the pandemic in Latin America and the Caribbean when the World Health Organization (WHO) declared the end of the public health emergency for the COVID-19 pandemic on May 5, 2023. Second, we use dynamic and genomic surveillance methods to describe the history of the pandemic in the region and situate the window of the WHO declaration within the broader history. Third, we aim to provide historical context for the course of the pandemic in Latin America and the Caribbean.

Methods:

In addition to updates of traditional surveillance data and dynamic panel estimates from the original study Post et al. (2021), this study used data on sequenced SARS-CoV-2 variants from the Global Initiative on Sharing All Influenza Data (GISAID) to identify the appearance and duration of variants of concern. We used Nextclade nomenclature to collect clade designations from sequences and Pangolin nomenclature for lineage designations of SARS-CoV-2. Additionally, we conducted a one-sided t-test for whether regional weekly speed was greater than an outbreak threshold of ten. We ran the test iteratively with six months of data across the sample period.

Results:

Speed for the region had remained below the outbreak threshold for six months by the time of the WHO declaration. Acceleration and jerk were also low and stable. While the 1- and 7-day persistence coefficients remained statistically significant, the coefficients were relatively modest in magnitude (0.457 and 0.491, respectively). Furthermore, the shift parameters for either of the two most recent weeks around May 5, 2023, did not indicate any overall change in the clustering effect of cases on future cases around the time of WHO declaration. From December of 2021 onward, Omicron was the predominant variant of concern in sequenced viral samples. The rolling t-test of speed equal to ten became entirely insignificant from January 2023 onward.

Conclusions:

While COVID-19 continues to circulate in Latin America and the Caribbean, the rate of transmission had remained well below the threshold of an outbreak for six months ahead of the WHO declaration. COVID-19 is endemic in the region and no longer reaches the threshold of the pandemic definition. Both standard and enhanced surveillance metrics suggest the pandemic had ended by the time of the WHO declaration.