COVID-19 and Ecosyndemic Vulnerability: Implications for El Niño-Sensitive Countries in Latin America

Abstract

Latin America has emerged as an epicenter of the COVID-19 pandemic. Brazil, Peru, and Ecuador report some of the highest COVID-19 rates of incidence and deaths in the region. These countries also face synergistic threats from multiple infectious diseases (that is, ecosyndemic) and quasi-periodic El Niño-related hazards every few years. For example, Peru, which is highly sensitive to El Niño, already copes with an ecosyndemic health burden that heightens during and following weather and climate extreme events. Using an ecosyndemic lens, which draws on a multi-disease hazard context of place, this commentary highlights the importance of El Niño as a major factor that not only may aggravate COVID-19 incidence in the future, but also the broader health problem of ecosyndemic vulnerability in Latin America.

Keywords

Coronavirus / COVID-19 / Ecosyndemic / El Niño / El Niño-Southern oscillation / Infectious disease vulnerability / Latin America

References

[1] Anyamba, A., J. Chretien, S.C. Britch, R.P. Soebiyanto, J.L. Small, R. Jepsen, B.M. Forshey, J.L. Sanchez, et al. 2019. Global disease outbreaks associated with the 2015–2016 El Niño event. Scientific Reports 9(1). https://doi.org/10.1038/s41598-018-38034-z.

[2] Bayer AM, Danysh HE, Garvich M, Gonzalez G, Checkley W, Alvarez M, Gilman RH. An unforgettable event: A qualitative study of the 1997-98 El Niño in northern Peru. Disasters, 2014, 38(2): 351-374

[3] Burki T. COVID-19 in Latin America. The Lancet, 2020, 20(5): 547-548

[4] Caminade C, Turner J, Metelmann S, Hesson JC, Blagrove MSC, Solomon T, Morse AP, Baylis M. Global risk model for vector-borne transmission of Zika virus reveals the role of El Niño 2015. Proceedings of the National Academy of Sciences, 2017, 114(1): 119-124

[5] Campbell-Lendrum, D., L. Manga, M. Bagayoko, and J. Sommerfeld. 2015. Climate change and vector-borne diseases: What are the implications for public health research and policy? Philosophical Transactions of The Royal Society B 370(1665). https://doi.org/10.1098/rstb.2013.0552.

[6] Caviedes CN. El Niño 1982-83. Geographical Review, 1984, 74(3): 267-290

[7] Confalonieri UEC, Marinho DP, Rodriguez RE. Public health vulnerability to climate change in Brazil. Climate Research, 2009, 40: 175-186

[8] Cornejo, M.P., and M. Zavala. 2017. Ecuador study report. In El Niño ready nations and disaster risk reduction (DRR), ed. M.H. Glantz, 68–76. Boulder: Consortium for Capacity Building. https://www.ccb-boulder.org/wp-content/uploads/2017/05/Final-El-Nino-ready-Nations-and-DRR-April-2017.pdf. Accessed 10 Oct 2020.

[9] Ebi KL, Bowen K. Extreme events as sources of health vulnerability: Drought as an example. Weather and Climate Extremes, 2015, 11: 95-102

[10] Engels, D., and X. Zhou. 2020. Neglected tropical diseases: An effective global response to local poverty-related disease priorities. Infectious Diseases of Poverty 9: Article 10.

[11] Enriquez, D., S. Rojas Cabal, and M.A. Centeno. 2020. Latin America’s COVID-19 nightmare. Foreign Affairs. https://www.foreignaffairs.com/articles/americas/2020-09-01/latin-americas-covid-19-nightmare. Accessed 25 Sept 2020.

[12] French, A., R. Mechler, M. Arestegui, K. MaClune, and A. Cisneros. 2020. Root causes of recurrent catastrophe: The political ecology of El Niño-related disasters in Peru. International Journal of Disaster Risk Reduction 47: Article 101539.

[13] Glantz MH. Currents of change: Impacts of El Niño and La Niña on climate and society, 2001, Cambridge, UK: Cambridge University Press

[14] Glantz MH. Once burned, twice shy: Lessons learned from the 1997-98 El Niño, 2001, Tokyo: United Nations University Press

[15] Gueri, A. 1984. Lessons learned: Health effects of El Niño in Peru. Disasters: Preparedness and Mitigation in The Americas, April 1984. http://helid.digicollection.org/en/d/Jdi019e/2.html. Accessed 12 Oct 2011.

[16] Hijar G, Bonilla C, Munayco CV, Gutierrez EL, Ramos W. El Niño phenomenon and natural disasters: Public health interventions for disaster preparedness and response (Fenómeno El Niño y desastres naturales: Intervenciones en salud pública para la preparación y respuesta). Revista Peru Med Exp Salud Publica, 2016, 33(2): 300-310

[17] INDECI (Instituto Nacional de Defensa Civil/National Institute of Civil Defense, Peru). 2017. Update for rainfall and information from the Ministry of Health about the consequences associated with the El Niño Costero (Reporte de Situación Lluvias y Reporte de Información del Ministerio de Salud como Consecuencia del Niño Costero): 12 May.

[18] Jutla A, Whitcombe E, Hasan N, Haley B, Akanda A, Huq A, Alam M, Sack RB Environmental factors influencing epidemic cholera. The American Journal of Tropical Medicine and Hygiene, 2013, 89(3): 597-607

[19] Kovats RS, Bouma MJ, Hajat S, Worrall E, Haines A. El Niño and health. The Lancet, 2003, 362(9394): 1481-1489.

[20] Litewka SG, Heitman E. Latin American healthcare systems in times of pandemic. Developing World Bioethics, 2020, 20(2): 69-73

[21] Mahler, D.G., C. Lakner, R.A. Castaneda Aguilar, and H. Wu. 2020. The impact of COVID-19 (Coronavirus) on global poverty: Why Sub-Saharan Africa might be the region hardest hit. World Bank Data Blog, 20 April 2020. https://blogs.worldbank.org/opendata/impact-covid-19-coronavirus-global-poverty-why-sub-saharan-africa-might-be-region-hardest. Accessed 1 Jun 2020.

[22] Marengo JA, Alves LM, Alvala RCS, Cunha AP, Brito S, Moraes OLL. Climatic characteristics of the 2010–2016 drought in the semiarid Northeast Brazil region. Annals of the Brazilian Academy of Sciences, 2018, 90(2 Suppl. 1): 1973-1985

[23] McCormick, B., and D.R. Lang. 2016. Diarrheal disease and enteric infections in LMIC communities: How big is the problem? Tropical Diseases, Travel Medicine and Vaccines 2: Article 11.

[24] McGregor, G.R., and K. Ebi. 2018. El Niño Southern Oscillation (ENSO) and health: An overview for climate and health researchers. Atmosphere 9(7): Article 282.

[25] McPhaden MJ, Zebiak SE, Glantz MH. ENSO as an integrating concept in earth science. Science, 2006, 314(5806): 1740-1745

[26] Merow C, Urban MC. Seasonality and uncertainty in global COVID-19 growth rates. Proceedings of the National Academy of Sciences, 2020

[27] Ministry of Health, Peru. 2015a. The El Niño phenomenon (Fenomeno de “El Niño”). https://www.gob.pe/institucion/minsa/campa%C3%B1as/409-fenomeno-de-el-Niño. Accessed 1 Jun 2020 (in Spanish).

[28] Ministry of Health, Peru. 2015b. Situation report Peru for epidemiological week 2 (Sala de Situacione de Salud – Peru a la SE2) – 2015. https://www.dge.gob.pe/portalnuevo/publicaciones/salas-de-situacion-semanal/. Accessed 1 Jun 2020 (in Spanish).

[29] Ministry of Health, Peru. 2016. Situation report Peru for epidemiological week 52 (Sala de Situacione de Salud – Peru a la SE52) – 2016. https://www.dge.gob.pe/portalnuevo/publicaciones/salas-de-situacion-semanal/. Accessed 1 Jun 2020 (in Spanish).

[30] Ministry of Health, Peru. 2017. Situation report Peru for epidemiological week 52 (Sala de Situacione de Salud – Peru a la SE52) – 2017. https://www.dge.gob.pe/portalnuevo/publicaciones/salas-de-situacion-semanal/. Accessed 1 Jun 2020 (in Spanish).

[31] Ministry of Health, Peru. 2018a. Situation report Peru for epidemiological week 52 (Sala de Situacione de Salud – Peru a la SE52) – 2018. https://www.dge.gob.pe/portalnuevo/publicaciones/salas-de-situacion-semanal/. Accessed 1 Jun 2020 (in Spanish).

[32] Ministry of Health, Peru. 2018b. Situation report Peru for epidemiological week 1 (Sala de Situacione de Salud – Peru a la SE1) – 2018. https://www.dge.gob.pe/portalnuevo/publicaciones/salas-de-situacion-semanal/. Accessed 1 Jun 2020.

[33] Ministry of Health, Peru. 2019a. Situation report Peru for epidemiological week 3 (Sala de Situacione de Salud – Peru a la SE3) – 2019. https://www.dge.gob.pe/portalnuevo/publicaciones/salas-de-situacion-semanal/. Accessed 1 Jun 2020 (in Spanish).

[34] Ministry of Health, Peru. 2019b. Situation report Peru for epidemiological week 47 (Sala de Situacione de Salud – Peru a la SE47) – 2019. https://www.dge.gob.pe/portalnuevo/publicaciones/salas-de-situacion-semanal/. Accessed 1 Jun 2020.

[35] Ministry of Health, Peru. 2019c. Population estimates by department, 2020. https://www.minsa.gob.pe/reunis/data/poblacion_estimada.asp. Accessed 1 Jun 2020.

[36] Ministry of Health, Peru. 2020a. Total number of positive cases by department (Total casos positivos por departamento) – COVID-19 Peru, 5 Sept. https://www.dge.gob.pe/portalnuevo/covid-19/covid-cajas/situacion-del-covid-19-en-el-peru/. Accessed 25 Sept 2020.

[37] Ministry of Health, Peru. 2020b. Total number of positive cases by department (Total casos positivos por departamento) – COVID-19 Peru, 29 May. https://www.dge.gob.pe/portalnuevo/covid-19/covid-cajas/situacion-del-covid-19-en-el-peru/. Accessed 5 Jun 2020.

[38] Naranjo L, Glantz MH, Temirbekov S, Ramírez IJ. El Niño and the Köppen-Geiger classification: A prototype concept and methodology for mapping impacts in Central America and the Circum-Caribbean. International Journal of Disaster Risk Science, 2018, 9(2): 224-236

[39] NOAA (National Oceanic and Atmospheric Administration). 2020. Cold and warm episodes by season. https://origin.cpc.ncep.noaa.gov/products/analysis_monitoring/ensostuff/ONI_v5.php. Accessed 1 Jun 2020.

[40] O’Reilly, K.M., M. Auzenbergs, Y. Jafari, Y. Lui, S. Flasche, and R. Lowe. 2020. Effective transmission across the globe: The role of climate in COVID-19 mitigation strategies. Planetary Health 4(5): Article e172.

[41] PAHO (Pan American Health Organization). 2017. Emergency associated with the El Niño phenomenon Costero (Emergencia por impacto del Fenomeno “El Niño Costero”) – Peru, 2017. https://www.paho.org/per/index.php?option=com_content&view=article&id=3710:emergencia-por-impacto-del-fenomeno-el-Niño-costero-2017-peru&Itemid=1060. Accessed 1 Jun 2020.

[42] PAHO (Pan American Health Organization). 2020a. PAHO Director says fight against COVID-19 pandemic must include chronic disease care. 26 May 2020. https://www.paho.org/en/news/26-5-2020-paho-director-says-fight-against-covid-19-pandemic-must-include-chronic-disease-care. Accessed 1 Jun 2020.

[43] PAHO (Pan American Health Organization). 2020b. Vector borne diseases (VBD) in the region of the Americas. http://ais.paho.org/phip/viz/cha_cd_vectorborndiseases.asp. Accessed 1 Jun 2020.

[44] Ramírez IJ. Vuruputur V, Sukhatme J, Murtugudde R, Roca R. Exploring tropical variability and extremes impacts on population vulnerability in Piura, Peru: The case of the 1997–98 El Niño. Tropical extremes: Natural variability and trends, 2019, New York: Elsevier 263-297

[45] Ramírez IJ, Briones F. Understanding the El Niño Costero of 2017: The definition problem and challenges of climate forecasting and disaster responses. International Journal of Disaster Risk Science, 2017, 8(4): 489-492

[46] Ramírez IJ, Grady SC. El Niño, climate and cholera associations in Piura, Peru, 1991–2001: A wavelet analysis. EcoHealth, 2016, 13(1): 83-99

[47] Ramírez IJ, Lee J. COVID-19 in a time of El Niño and ecosyndemic vulnerability: Insights from Latin America. Earth and Space Science Open Archive (ESSOAr), 2020

[48] Ramírez IJ, Grady SC, Glantz MH. Reexamining El Niño and cholera in Peru: A climate affairs approach. Weather, Climate and Society, 2013, 5(2): 148-161

[49] Ramírez, I.J., J. Lee, and S.C. Grady. 2018. Mapping multi-disease risk during El Niño: An ecosyndemic approach. International Journal of Environmental Research and Public Health 15(12): Article 2639.

[50] Rodriguez-Morata C, Diaz H, Ballesteros-Canovas J, Rohrer M, Stoffel M. The anomalous 2017 coastal El Niño event in Peru. Climate Dynamics, 2018, 52: 5605-5622

[51] Rodriguez-Morales, A.J., V. Gallego, J.P. Escalera-Antezana, C.A. Mendez, L.I. Zambrano, C. Franco-Paredes, J.A. Suarez, H.D. Rodriguez-Enciso, et al. 2020. COVID-19 in Latin America: The implications of the first confirmed case in Brazil. Travel Medicine and Infectious Disease 35: Article 101613.

[52] Sajadi, M.M., P. Habibzadeh, A. Vintzileos, S. Shokouhi, F. Miralles-Wilhelm, and A. Amoroso. 2020. Temperature, humidity, and latitude analysis to estimate potential spread and seasonality of coronavirus disease 2019 (COVID-19). JAMA Network Open 3(6): Article e2011834.

[53] Schneider, M.C., X.P. Aguilera, J.B. da Silva Junior, S.K. Ault, P. Najera, J. Martinez, R. Requejo, R.S. Nicholls, et al. 2011. Elimination of neglected diseases in Latin America and the Caribbean: A mapping of selected diseases. PLOS Neglected Tropical Diseases 5(2): Article e964.

[54] Silva Chávez, J.H., and J.G. Hernández Córdova. 2017. Impact of the El Niño Costero phenomenon on the Peruvian population’s health in 2017. Medwave 17(8): Article e7052.

[55] Singer M. Introduction to syndemics: A critical systems approach to public and community health, 2009, San Francisco, CA: John Wiley and Sons

[56] Sorensen CJ, Borbor-Cordova MJ, Calvello-Hynes E, Diaz A, Lemery J, Stewart-Ibarra AM. Climate variability, vulnerability, and natural disasters: A case study of Zika virus in Manabi, Ecuador following the 2016 Earthquake. GeoHealth, 2017, 1(8): 298-304

[57] Stewart-Ibarra AM, Lowe R. Climate and non-climate drivers of dengue epidemics in southern coastal Ecuador. American Journal of Tropical Medical Hygiene, 2013, 88(5): 971-981

[58] Tallman PS, Riley-Powell AR, Schwarz L, Salmon-Mulanovich G, Southgate T, Pace C. Ecosyndemics: The potential synergistic health impacts of highways and dams in the Amazon. Social Science and Medicine, 2020

[59] Thomas, D.S.K., S. Jang, and J. Scandlyn. 2020. The CHASMS conceptual model of cascading disasters and social vulnerability: The COVID-19 case example. International Journal of Disaster Risk Reduction 51: Article 101828.

[60] UN (United Nations). 2020a. Everyone included: Social impact of COVID-19. Department of Economic and Social Affairs. https://www.un.org/development/desa/dspd/everyone-included-covid-19.html. Accessed 1 Jun 2020.

[61] UN (United Nations). 2020b. Report: Impact from COVID-19 in Latin America and the Caribbean (Informe: El impacto del COVID-19 en América Latina y el Caribe). https://peru.un.org/sites/default/files/2020-07/SG%20Policy%20brief%20COVID%20LAC%20%28Spanish%29_10%20July_0.pdf. Accessed 1 Sept 2020 (in Spanish).

[62] UN (United Nations). 2020c. Sustainable development goals indicators webpage. https://unstats.un.org/sdgs/indicators/database/. Accessed 16 Oct 2020.

[63] UNICEF (United Nations Children’s Fund). 2020. Hygiene baselines pre-covid-19. UNICEF Regional Office for Latin America and Caribbean. https://data.unicef.org/resources/handwashing-data-covid-19-response/. Accessed 15 Jun 2020.

[64] UNDRR (United Nations Office for Disaster Risk Reduction). 2015. Sendai framework for disaster risk reduction 2015–2030. https://www.preventionweb.net/files/43291_sendaiframeworkfordrren.pdf. Accessed 1 Sept 2020.

[65] U.S. Census Bureau. 2020. 2019 Midyear population and density estimates. International Programs, International Data Base, Version 12.03.21. https://www.census.gov/data-tools/demo/idb/informationGateway.php. Accessed 1 Jun 2020.

[66] WHO (World Health Organization). 2020. Coronavirus (COVID-19) – Weekly epidemiological update. 14 Sept 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. Accessed 25 Sept 2020.

[67] Zapata, R., C. Chavez, M. Estrada, and A. Tovar. 2020. Three years after El Niño: Only 4.0% of health centers are rebuilt (Tres años después de El Niño: solo 4% de centros de salud está en reconstrucción). Ojo Publico, 7 July 2020. https://ojo-publico.com/1947/nino-costero-solo-el-4-de-centros-de-salud-esta-en-reconstruccion. Accessed 1 Sept 2020.