An effective COVID-19 response in South America: the Uruguayan Conundrum

Abstract

Background: South America has become the new epicenter of the COVID-19 pandemic with more than 1.1M reported cases and >50,000 deaths (June 2020). Conversely, Uruguay stands out as an outlier managing this health crisis with remarkable success. Methods: We developed a molecular diagnostic test to detect SARS-CoV-2. This methodology was transferred to research institutes, public hospitals and academic laboratories all around the country, creating a COVID-19 diagnostic lab network. Uruguay also implemented active epidemiological surveillance following the Test, Trace and Isolate (TETRIS) strategy coupled to real-time genomic epidemiology. Results: Three months after the first cases were detected, the number of positive individuals reached 826 (23 deaths, 112 active cases and 691 recovered). The Uruguayan strategy was based in a close synergy established between the national health authorities and the scientific community. In turn, academia rapidly responded to develop national RT-qPCR tests. Consequently, Uruguay was able to perform ~1,000 molecular tests per day in a matter of weeks. The COVID-19 diagnostic lab network performed more than 54% of the molecular tests in the country. This, together with real-time genomics, were instrumental to implement the TETRIS strategy, helping to contain domestic transmission of the main outbreaks registered so far. Conclusions: Uruguay has successfully navigated the first trimester of the COVID-19 health crisis in South America. A rapid response by the scientific community to increase testing capacity, together with national health authorities seeking out the support from the academia were fundamental to successfully contain, until now, the COVID-19 outbreak in the country.

Nexus Between the COVID-19 Dynamics and Environmental Pollution Indicators in South America

“…We further suggest that emerging economies like south America should follow the lead of Germany and China's successful response, where state and local officials acted simultaneously by providing medical and financial reforms to limit the exposure from the COVID-19 pandemic. 46,50,51 Although we provide rather interesting results, we would also highlight some limitations in the existing research. First of all, the current study only investigates the South American region, which is also facing shortages of medical and financial resources to overcome this pandemic.…”

“…We further suggest that emerging economies like south America should follow the lead of Germany and China’s successful response, where state and local officials acted simultaneously by providing medical and financial reforms to limit the exposure from the COVID-19 pandemic. 46 , 50 , 51 …”

SARS-CoV-2 genomic characterization and clinical manifestation of the COVID-19 outbreak in Uruguay

“…The virus is currently ravaging Latin America, with Brazil, Colombia, Argentina, Peru, and Mexico among the ten countries with the highest numbers of cases worldwide. In contrast, Uruguay, a small country located south of Brazil, has succeeded in maintaining a very low number of total cases (2,145) through the closing of its borders, a partial lockdown, and an early Test, Trace and Isolate (TETRIS) strategy [ 2 ]. Uruguay has a population of ∼3.3 million inhabitants, of which more than a third (∼1.3 million) live in the capital city of Montevideo, according to the last census in 2011 [ 3 ].…”

Evidence-Based Policies in Uruguay Are Successful for Tackling COVID-19

“…An epidemiological analysis shows that one critical aspect was the reduction in the effective reproduction number. Due to a massive testing strategy, most local transmission chains have been efficiently controlled at the second generation of contacts (Moreno et al, 2020). In some contagious events, systematic sequencing of the virus in several patients allowed scientists to determine the origin of the viral spreads which provided unprecedented data for the traceability of SARS-CoV-2.…”