A. Situation analysis
Description of the disaster
Between January and 2 May 2020, a total of 42,710 cases of dengue were registered in Paraguay. This recent outbreak has led to the death of 64 people across 19 of the country's health regions, mainly in the departments of Asunción and Central departments. A total of 175,082 suspected cases1 were reported - 70.74 per cent in the Metropolitan Area consisting of Central (111,104) and Asunción (12,750). Three serotypes (DEN-1, DEN-2 and DEN-4) are currently in circulation across the country, although the most commonly identified at the country level is the DEN-4 serotype. The number of dengue cases reported dropped in the last week of April (week 18) compared to initial weekly epidemiological statistical numbers for arbovirus. This could be attributed to the current COVID-19 context, considering that government recommendations and prevention measures suggest people refrain from going to health centres or referral hospitals if they present symptoms and instead use the hotline established for reporting these symptoms. As dengue and COVID-19 share certain symptoms from an epidemic health management standpoint, people presenting fevers are considered as possibly suffering from COVID-19 and are not being treated as having dengue. This could lead to the loss of the actual dengue threshold in the general population.
The country is currently under a health emergency due to the COVID-19 pandemic, reporting 431 people who are positive for the virus and 10 dead in 16 departments from this viral strain.2 On 16 March, the national government declared a National Health Emergency due to COVID-19, imposing preventive isolation, mobility restriction and social distancing measures. These measures were extended to the end of April, which hindered the implementation of the Plan of Action activities to response to dengue in communities, especially actions related to the organizing and training of community brigades, interventions in schools, and the performance of community health and hygiene assessments and surveillance actions in communities, among others. On 3 May, the government began gradually easing general preventive isolation measures (smart quarantine)3 , activating basic services and allowing partial population mobilization. It is expected that conditions could become more stable if corresponding prevention measures are observed.