Army Public Health Weekly Update, 28 May 2021

Date Published: 5/28/2021
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​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link .

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Table of Contents


    More than 130 million Americans are fully vaccinated as average daily Covid cases dip below 25,000

    25 May- The seven-day average of daily Covid cases in the U.S. is below 25,000 for the first time since June 19, data compiled by Johns Hopkins University shows, as the pace of new infections continues a downward trend. The country is reporting about 24,900 daily cases on average, down 22% from a week ago. According to the Centers for Disease Control and Prevention, the U.S. is averaging 1.8 million vaccinations per day over the past week, and about 49% of the U.S. population has received at least one dose. Nearly 26,000 cases were reported Monday, bringing the seven-day average of daily new infections to just below 25,000. CNBC External Link


    DOD/VA collaborated to combat mental health challenges women face

    25 May- It's no secret that women face unique challenges in the United States military. What's less known is how deep and wide those challenges can be, and how they affect service members while on active duty and well after leaving the service. With Women's Health Week (May 9 to May 15) falling within Mental Health Awareness Month, we asked experts about the most pressing issues facing women in the military today. They range from the predictable, sexual harassment, to some that are much less talked about, such as female veterans' inability to land jobs compared to their male counterparts. Some trends are well documented but no less alarming during the time of COVID-19, when even more stressors have piled up. That includes the fact that women veterans are more than two times more likely to die by suicide as the general population, as reported by the Department of Veterans Affairs clinical psychologist Jennifer Strauss to attendees of a Defense Health Agency (DHA) event in February. Strauss also said that in 2019, 43% of female users of the VA had diagnosed mental health issues, compared to 26% of male VA users. Many said that these statistics underscore the need for the Department of Defense and the VA to coordinate and prioritize women's mental health needs. One place for women to start is the VA's Center for Women Veterans. It includes information on individual and whole-family services, for post-traumatic stress disorder, military sexual trauma, depression, readjustment, and substance use disorders. The Psychological Health Center of Excellence has a page on women's mental health in the military, too. "Resilience is a little bit different with women," said Air Force Lt. Col. Regina Owen, a psychiatric mental health nurse practitioner and a professor at the Uniformed Services University in Bethesda, Maryland. "A lot of women decide to leave the military because they are not treated equal to their male counterparts. So now (with COVID-19) we have this additional stressor. "With mental health, more people are reaching out, including women. But it depends on what kind of position, what kind of environment these women are in, what kind of leader (they have), how open they are to getting help with the additional stressors that COVID has brought on," she added. "If a woman does not feel supported and her cohort is largely male, she is less likely to seek out help." External Link

    'Excuses are over': Gaps in domestic violence reporting threaten troops' safety, lawmakers say

    25 May- Lawmakers and victims' advocates blasted defense officials on Tuesday for an incomplete and inadequate response to domestic violence incidents in the ranks, saying they may be undermining faith in military leadership by overlooking large numbers of cases annually. "Excuses are over, the safety and wellbeing of our service members is at risk," said Rep. Jackie Speier, chairwoman of the House Armed Services Committee's personnel panel. "We know that over 40,000 incidents met DoD criteria for domestic abuse between 2015 and 2019 and that 74 percent of those incidents were physical abuse. But how many were never counted by the Department? How many were never reported? For more than 20 years, no one can say." Department officials said they are working on reforms to answer those questions, but advocates said they have seen similar past promises go unfulfilled. Military Times External Link

    Indian-born audiologist says serving in the military is rewarding

    24 May- Asian Americans and Pacific Islanders have shaped the history of the United States and have had their lives dramatically influenced by moments in its history. Every May the Defense Department joins the rest of the nation in celebrating Asian American Pacific Islander Heritage Month. Army Lt. Col. Deepa Hariprasad was born in Mysore, India, in 1977. When she was 3 years old, her parents, both of Indian descent, emigrated to the United States. Hariprasad said her parents decided to come to the U.S. for better opportunities and for a better life, especially for their children. She noted that her parents had an arranged marriage, something still very common in Indian culture, although she and her brother did not go that route. India — the second most populous nation after China — is a land of many languages. Her parents speak Tamil and Kannada with each other and among Indian friends. However, they use English with their children so while Hariprasad can understand what they're saying, she said she cannot speak those languages. Hariprasad's mother was one of 11 children. Most of her mother's brothers live in the United States and her mother's sisters live in India. "We have a strong sense of family and we meet at least once a year for mini family reunions." Although Hariprasad didn't choose an arranged marriage or embrace some of the more traditional aspects of Indian life, there are cultural norms that she does embrace. For example, she loves to cook Indian food, and with such a variety, it's easy to be a vegetarian, she said. She also enjoys wearing Indian clothing and watching Indian movies — with English subtitles. In 2003, Hariprasad received a direct commission into the Army, serving as an audiologist in the medical branch. "The initial appeal was to try something new, serve my country, and have the opportunity to live in different places." An audiologist diagnoses and treats hearing loss and also focuses on the prevention of hearing loss. "Providing health education to our patients and teaching service members and noise-exposed civilians about hearing loss prevention is the favorite part of my job, because I feel I am making a difference and helping others improve their quality of life. I also enjoy learning about people's experiences and hearing their perspectives," she said. Hariprasad said that in Indian culture, women are what might be described as shy or reserved. "While serving in leadership positions in the military, I had to overcome my shyness, become comfortable with public speaking, learn to speak up, and develop the personal courage to have difficult conversations. These were not skills I was equipped with while growing up," she said. "I grew up with a very different belief system, always worried about what other people would think and I did not have the confidence to try new things or stand up for myself or others. I believe that my positions in the Army and Air Force have helped shape my character and personality for the better," she said, noting that of her 16 years of active duty service, five years as an audiologist in the Air Force was sandwiched in the middle of her Army service. "I still am shy but have learned to communicate better, learned to hold people accountable for their decisions and their work performance, and I quickly learned to speak up and do the right thing, no matter what others may think. These were not things that came naturally to me before I joined the service," she said. External Link

    Stress relief is an important element to mental health

    May 24- Stress has become a common part of people's lives, especially in our fast-paced world where people try to balance work, family, and life to succeed in meeting goals and obligations. And although short bursts of stress can be positive drivers to keep you safe in moments of danger or push you to meet a deadline, excessive, continuous stress limits our ability to function properly over the long term and can have detrimental effects in our overall health, according to the National Institutes of Health. For Mental Health Awareness Month, the Military Health System focuses on healthy ways to relieve stress. Two service members shared their perspectives about how they relieve stress – whether by seeking professional help and support when needed or by engaging in stress-relieving activities – to remain resilient and healthy. Air Force 1st Lt. Thi Lua is a mental health nurse at Brooke Army Medical Center in Fort Sam Houston, Texas. As a mom, service member, and mental health provider, she understands the value of mental health firsthand. "It is imperative that anyone, which is everyone, with stress or multiple stressors to recognize it and find coping skills to help alleviate each trigger one at a time," she said. "Stress is the No. 1 culprit in exacerbating dormant illnesses and causes new acute illness to develop." For Lua, finding ways to relieve stress is important in preventing it from affecting a person's job and mission, as well as the huge impact stress could have on their personal life. "To help me cope with everyday stressors, I like to go on hikes with my family at least twice a month and enjoy weekly visits to the park with my kids," she said. "I also enjoy playing chess with my son and Sudoku any time I have 15 minutes to spare." And on the occasion that none of those activities helps relieve her feelings of stress, "just sitting alone in a quiet or peaceful place most times help decrease my anxiety," she said. External Link


    CDC expects COVID-19 vaccine data on kids by fall, Walensky says

    20 May- Health officials expect to have more data surrounding COVID-19 vaccines and younger children by late fall, Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky said Wednesday. Walensky, who was testifying before a Senate subcommittee on the agency's budget request said de-escalation studies involving children down to 9 are ongoing, and will involve younger children as more data comes in. "We're working towards getting a vaccine that's available for all people," Walensky said, adding that the agency hopes to "have more available data in late fall and by the end of the year."  She added that even in the absence of COVID-19 vaccines that are authorized for younger age groups, "schools can be a very safe place."Walensky had appeared alongside Dr. Anne Schuchat, the agency's outgoing deputy director who spoke to the protection vaccines can offer pregnant women. Fox News External Link

    Children are at increased risk of accidental poisoning from edibles, study finds

    24 May- Children are at increased risk of accidental poisoning from edibles and other products made from marijuana, according to a new study analyzing calls to poison control centers from January 2017 through December 2019. Calls about poisoning as a result of consuming products such as weed concentrates, extracts, beverages, vape juice and edibles more often involved children under 10 years old, the study found, compared to calls about dried or pre-rolled cannabis plant poisonings. The largest proportion of those calls involved edibles (36.6%), the study found. It's a trend that pediatricians and emergency room doctors have seen over the years as more and more states legalize marijuana, said Dr. Brian Johnston, an executive committee member of the American Academy of Pediatrics' Council on Injury, Violence and Poisoning Prevention, who was not part of the study. "Children are especially vulnerable to poisoning by cannabis in edible products. These products look like cookies, brownies, gummies, candy or soda. Many are even intentionally packaged to resemble popular sweets," said Johnston, a professor of pediatrics at the University of Washington. CNN External Link

    COVID-19 antibodies remain at least 10 months after infection

    25 May- Nearly 87% of naturally infected COVID-19 patients maintained antibodies to the SARS-CoV-2 coronavirus proteins for at least 10 months, according to an extensive Labcorp analysis of specimens announced on May 24, 2021. The study was published in The Lancet - EClinicalMedicine offers real-world evidence of the body's response to the virus and the possibility of protection against future infection. "Our observational analysis provides an encouraging timeline for antibody development and sustainability among the U.S. population," commented David Alfego, Ph.D., Labcorp senior data scientist, and the paper's lead author. "We sincerely hope it sparks more research, helps unearth answers to complex questions, and informs critical post-pandemic planning." Alfego and a team of Labcorp scientists analyzed results from 39,086 individual tests to detect antibodies that guard against "spike" and nucleocapsid proteins on the SARS-CoV-2 virus. Their analysis included specimens collected tested between March 2020 and January 2021. By employing various techniques, Labcorp scientists were able to map rates of antibody positivity and the correlation of a person's age and sex on antibody status. Precision Vaccinations External Link

    COVID-19 vaccine boosters needed as early as September with Pfizer- Moderna CEO aims to deliver by year's end

    21 May- COVID-19 vaccines are now transitioning to the development of booster shots, with Pfizer and BioNTech, and Moderna CEOs discuss the immediacy of its need by year's end and delivering it by September. The booster is to help the immunization response of a person to improve its protection against the coronavirus to end its infection...The development of COVID-19 vaccines was one of the fastest immunization processes in the world, especially as it showed how technology has helped in fast-tracking its development. Currently, mRNA vaccines are leading the world with Pfizer and Moderna's vaccine which has the least adverse health effects, with high rates of protection. Vaccines cannot guarantee full protection or the so-called "perfect" 100 percent immunity rate against COVID-19 or any other diseases or viruses, but it sure helps out to ready people in the body's defense. With the many vaccines available against COVID now, people have even considered mixing and matching these to get the "optimal" results, which is not recommended. Tech Times External Link 

    Multiple heart issues confirmed following COVID-19 vaccination

    24 May- During Connecticut Governor Ned Lamon's video meeting today, it was reported 'at least eighteen teens, and young adults have shown symptoms of heart problems after receiving the COVID-19 vaccine, acting health commissioner Dr. Deirdre S. Gifford announced on May 24, 2021. Dr. Gifford said all but one of the young adults hospitalized for signs of heart problems had been released. Four of those young residents were hospitalized at Yale-New Haven Health and three at Connecticut Children's, reported NBC TV. "All of the cases that were reported to us were hospitalized, the vast majority for a couple of days," Dr. Gifford said at the governor's regular Monday COVID-19 news conference. "One individual that we're aware of is still hospitalized. The other 17 have been sent home, and they're doing fine." Beginning May 13th, individuals 12 years and older became eligible to receive a COVID-19 vaccine in Connecticut. The state is now receiving vaccine supplies from Pfizer, Moderna, and Johnson & Johnson (Janssen). During the U.S. CDC's Advisory Committee on Immunization Practices COVID-19 Vaccine Safety Technical (VaST) Work Group meeting on May 17, 2021, included several presentations on myocarditis following mRNA vaccination from the Department of Defense, the Vaccine Adverse Event Reporting System, and Vaccine Safety Datalink. Precision Vaccinations External Link

    'Music soothes pain': Paris cellist plays for end-of-life patients

    25 May- ROnce a week, the rooms of the Jeanne Garnier palliative care home in Paris reverberate to a different sound: a solo cello. Claire Oppert, a concert cellist trained at the Moscow Conservatory, visits the facility on Fridays to play for its residents - many of whom are struggling with physical pain as well as coming to terms with incurable illness. "I'm in permanent pain," said Micheline Leroux, a cancer patient at the care centre in southwest Paris, one of the biggest of its kind in Europe. "But I find that music helps a little to escape the pain," said Leroux quietly, after listening to a stirring rendition of Albinoni's Adagio, a Baroque classic.  "You pay attention, and if it's a piece you know, you anticipate each coming note," she said. Besides the weekly recitals, Oppert, 55, has made it her mission to demonstrate the therapeutic effects of music by taking part in medical studies on the subject. Staff at the care home are in no doubt. "After Claire leaves, we find the patients in a calmer state, sometimes moved, sometimes happy," said carer Margarita Saldana. "There can be tears or moments of joy." Reuters External Link 

    Zika vaccine candidate found effective and safe

    24 May- Since 2015, the emergence of epidemic Zika virus transmission has been linked to unparalleled reports of serious neurological disorders and devastating congenital disabilities such as microcephaly and other congenital malformations. Despite low transmission rates in the past 3 years, the emergence of new Zika outbreaks remains a looming threat, stated an editorial published by The Lancet on May 18, 2021. Furthermore, as of May 24, 2021, the U.S. FDA has not Approved any Zika vaccine candidate. However, in a separate study published by the Lancet, Japan-based Takeda Vaccines's TAK-426 vaccine candidate was reported well tolerated, with an acceptable safety profile, and immunogenic in both flavivirus-naive and flavivirus-primed adults. This two-part, multicentre, observer-blind, randomized, placebo-controlled, phase 1 trial was done at seven medical clinics in the USA and two in Puerto Rico. Between November 2017 and October 24, 2018, 271 people were enrolled (125 flavivirus-naive and 146 flavivirus-primed participants). Precision Vaccinations External Link


    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 19, ending May 15, 2021:

    Influenza-Associated Hospitalizations- The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in 14 states and represents approximately 9% of the U.S. population.

    Influenza-Associated Pediatric Mortality- No influenza-associated pediatric deaths were reported to CDC during week 19. CDC External Link


    23 tons of fresh and frozen catfish recalled for lack of federal inspection

    22 May- Otten's Seafood Inc. of Tinley Park, IL, is recalling 46,800 pounds of catfish because the products were produced, packed, and distributed without the benefit of federal inspection, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today. FSIS is concerned that some product may be in consumers' refrigerators or freezers because of its long shelf life. Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase...These items were shipped to wholesale and retail locations in Illinois and Indiana. The problem was discovered during routine FSIS surveillance activities when it was determined that the catfish products did not have the USDA mark of inspection and were produced in an establishment that was not inspected by USDA. There have been no confirmed reports of adverse reactions due to consumption of these products. Anyone concerned about a reaction should contact a healthcare provider. Food Safety News External Link

    Investigations ongoing in Hepatitis A outbreak linked to dates

    22 May- More than 30 Hepatitis A infections potentially linked to eating dates are being investigated in the United Kingdom. Since the start of this year 31 people have fallen ill in different parts of England and Wales and a number of them reported eating dates. Those sick range in age from 6 to 93 years old and 25 have been hospitalized. Public Health England (PHE) and the Food Standards Agency (FSA) are investigating the non-travel related cases of Hepatitis A. Marks & Spencer recently recalled Stuffed Medjool Date Selection 350-grams with a best before of July 13. In mid-April, Sainsbury's recalled all dates of 200 and 500-gram Taste The Difference Medjool Dates that had supplier or site code K0014 EW. They had been sold since Dec. 24, 2020. Both were supplied from Jordan. Food Safety News External Link


    Heart attacks look different for women- Know the signs

    20 May- A heart attack occurs when blood flow to the heart is interrupted or cut off completely, depriving the heart of critical oxygen. Heart attacks look different for men and women, and women are less likely to experience traditional symptoms. The most common symptom of a heart attack is mild or strong pain in the center of the chest. This discomfort may last for several minutes, or it may come and go. But chest pain isn't the only symptom. In fact, you might not have chest pain at all.  Chest pain may not always be present with a heart attack," says Dr. Eva Vaishnav, a cardiologist at Geisinger. "Women are more likely to experience shortness of breath, weakness, dizziness or back or jaw pain."

    - Here are some other heart attack signs in women:

    - Indigestion or heartburn

    - Pain in the neck, shoulders or throat

    - Extreme fatigue

    - Breaking out into a cold sweat

    - Stomach pain

    - Feeling lightheaded

    "Some women do have symptoms, but they're often so mild that they just don't recognize them as coming from their heart," Dr. Vaishnav says. Geisinger External Link


    Uganda: 15 people in Kween district treated for anthrax

    18 May- Health Officials in Kween District in Eastern Uganda are reporting 15 people are undergoing treatment for anthrax and over 15 heads of cattle have so far succumbed to the disease since last month. One person has died from the disease. The Kween district Surveillance Officer, Phily Musobo said the outbreak started April 12 after six people reported to Atar HCIII, after reportedly eating meat from a dead cow which had died on the 7th April 2021. Musobo said that the disease is fast spreading but the district is struggling to facilitate the response to the outbreak due to lack of funds. He also cited the lack of cooperation from the community despite intensive social mobilization conducted. Anthrax is a bacterial pathogen in livestock and wild animals. Ruminants such as bison, cattle, sheep and goats are highly susceptible, and horses can also be infected. Anthrax is a very serious disease of livestock because it can potentially cause the rapid loss of a large number of animals in a very short time. Affected animals are often found dead with no illness detected. When conditions become favorable, the spores germinate into colonies of bacteria. An example would be a grazing cow ingests spores that in the cow, germinate, grow spread and eventually kill the animal. Anthrax is caused by the bacterium, Bacillus anthracis. This spore forming bacteria can survive in the environment for decades because of its ability to resist heat, cold, drying, etc. This is usually the infectious stage of anthrax. Outbreak News Today External Link


    Pakistan reports another rabies death at Karachi hospital, Improper and inadequate treatment noted

    26 May- For the second time in a week, a human rabies death has been reported at the Indus Hospital in Karachi. Last week, a 6-year-old boy died from the lethal virus and this Tuesday, a 24-year-old man succumbed to rabies. A report from the Pakistani news source, Dawn,  states "the patients received improper and inadequate treatment at government hospitals". In the young child's case, who received bites to the face, rabies immunoglobulin (RIG) was never administered, proper washing of the wounds and improper administration of the injections were noted in the report. In the case of the young man, who had a wound to the forehead, again RIG wasn't administered, the wound was stitched and a misdiagnosis of diarrhea was given. Outbreak News Today External Link


    Norway investigates Yersinia enterocolitica outbreak

    23 May- The Norwegian Institute of Public Health reports 15 people with infection caused by the bacterium Yersinia enterocolitica O3. All are sampled in late April and early May. The patients are between 16 and 54 years old and most (66 per cent) are women. The infected live in different parts of the country: Viken (3), Trøndelag (5), Rogaland (2), Vestland (3), Møre og Romsdal (1) and Vestfold and Telemark (1). Bacteria with the same DNA profile have been detected in all fifteen people. The patients are interviewed and the local Norwegian Food Safety Authority takes samples from food products in the homes of those who are infected, if residues are available, in order to find the source of the outbreak if possible. Such investigative work can be complicated and time consuming, and in many cases it will not be possible to find the source of the infection or to clarify whether it is a common source. Yersiniosis is an infection caused by the bacterium Yersinia enterocolitica. The most common symptoms are diarrhea, fever and abdominal pain, usually lasting 1-3 weeks. The reservoir for the bacterium is primarily pig. Dogs and cats can also be carriers of the bacterium. Yersinia bacteria are transmitted mainly through food, usually through infected pork products, contaminated vegetables or salads and the use of non-disinfected drinking water. Every year, between 40 and 80 cases of yersiniosis are reported to the National Institute of Public Health. Most are infected domestically (60-80 percent of reported cases). Outbreak News Today External Link


    Malaysia reports nearly 7,000 COVID-19 cases, one day record

    23 May- The Malaysia Ministry of Health reported 6,976 new COVID-19 cases on Sunday, making it a new daily record and bringing the country total to 512,091 cumulative cases. In addition, officials reported 49 deaths today bringing the fatality total to 2,248 cumulative. The 49 death cases today include 14 cases in Selangor, eight (8) cases in Johor, six (6) cases each in Penang and Melaka, four (4) cases in Kedah, three (3) cases in Sarawak, two (2) cases each in Sabah, Negeri Sembilan and the Federal Territory of Kuala Lumpur, and one (1) case each in Kelantan and Perlis. Yesterday, the Senior Minister of Defense has announced various strategies to further reduce movement among the community. The measures announced are among the actions that need to be taken by all parties to break the chain of COVID-19 infection, provide space for the MOH to carry out various public health control activities in the field as well as further increase operational capacity to deal with the wave of COVID-19 cases. found to be still increasing. Nevertheless, the most important thing to determine the success of the actions introduced is compliance by various parties from all walks of life and segments. For example, employers and departments are requested to cooperate with the instructions and Standard Guidelines (SOP) issued by the National Security Council (NSC). This is to ensure that employees who come to work are in accordance with the capacity set by the Government. Outbreak News Today External Link


    U.S.: Detroit- First rabies positive dog in Michigan reported in a decade

    23 May- The Michigan Department of Health and Human Services (MDHHS) and Michigan Department of Agriculture and Rural Development (MDARD) are urging Michigan residents to have their pets and animals vaccinated against rabies after confirmation that a six-month-old dog in the City of Detroit (Wayne County) tested positive for rabies. The infected dog had never been vaccinated against rabies. Prior to this instance, the last rabid dog in the state occurred in 2011 in Oakland County. While any mammal can be infected with rabies, the virus is typically carried by skunks or bats in Michigan. Testing to determine the strain of rabies in the infected dog is still taking place. "Rabies virus is present in the saliva and brain tissue of an infected animal," said Dr. Joneigh Khaldun, chief medical executive and chief deputy for health for MDHHS.  "People can be exposed to rabies when they are bitten by a rabid animal. Other possible routes for exposure include getting infectious material in your eyes, nose, or mouth or on fresh cuts in the skin. Make sure pets are vaccinated and avoid contact with stray or wild animals to reduce your risk of exposure to this potentially fatal disease." The state is working closely with the City of Detroit Health Department to take all necessary precautions. "We are taking proactive steps to keep residents and their families safe," said Detroit Health Department's chief public health officer Denise Fair. "We will have teams going door-to-door in the area to inform residents and educate on the importance of getting their family pet vaccinated. We will also be canvassing for any other injured or sick animals." Outbreak News Today External Link


    Latin America's 'tragic milestone': COVID-19 deaths top 1 million

    22 May- The Pan American Health Organization (PAHO) announced Friday that more than one million people in Latin America and the Caribbean have died from COVID-19, reaching a "tragic milestone". "More than one million lives have been cut short because of COVID-19. This is a tragic milestone for everyone in the region," said Dr. Etienne. "This pandemic is far from over, and it is hitting Latin America and the Caribbean severely, affecting our health, our economies, and entire societies. Yet only about 3% of our citizens have been vaccinated." According to figures reported by countries as of May 21, 2021, 1,001,781 people have died as a result of the SARS-CoV-2 virus in Latin America and the Caribbean. Almost 89% of the deaths occurred in five countries: Brazil (44.3%), México (22.1%), Colombia (8.3%), Argentina (7.3) and Peru (6.7%). Three percent of the deaths were concentrated in Central America and 1% in the Caribbean. "The region is an epicenter for COVID-19 suffering. It should be an epicenter for vaccination, too," Dr Etienne said. More than 153.5 million people have been immunized in the Americas, but only 21.6% of these are in Latin America and the Caribbean. Outbreak News Today External Link