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Epidemiological Alert: Recurring waves and outbreaks of COVID-19, 9 October 2020

Situation Report
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In April 2020, the World Health Organization (WHO) alerted on the occurrence of recurrent waves and outbreak, of greater or lesser magnitude, during the evolution of the COVID-19 pandemic. This situation is observing in some areas within and outside the Region of the Americas. Through this Epidemiological Alert, the Pan American Health Organization / World Health Organization (PAHO/WHO) urges Member States to prepare and implement action plans to face a rapid resurgence in cases while maintaining efforts to detect, diagnose, and manage cases at all levels of care.


Since the confirmation of the first COVID-19 cases and until 5 October 2020, a total of 35,109,317 COVID-19 cases have been reported globally, including 1,035,341 deaths. The Region of the Americas accounts for 49% of the total cases and 55% of the total deaths reported globally.

The analysis of trends in COVID-19 cases at the global level, by WHO Region, shows a new increase in cases in the WHO European Region and the WHO Western Pacific Region (Figure 1).

In the Region of the Americas, 10 of the 54 countries and territories reported an increase in COVID-19 cases and deaths in the last 60 days1. The countries/territories that modified their COVID-19 transmission classifications due to increased intensity of COVID-19 transmission are Aruba, Belize, the British Virgin Islands, Curaçao, Guadeloupe, Jamaica, Martinique, Saint Barthelemy, Saint Martin, and Trinidad and Tobago. During this period, Aruba, Belize, Curaçao, Guadeloupe, and Trinidad and Tobago had a >90% relative increase in confirmed cases (range 94% to 97%).

With respect to deaths, a relative increase was observed in 7 of these 10 countries/territories: Aruba, Belize, Guadeloupe, Jamaica, Martinique, Saint Martin, and Trinidad and Tobago, ranging from 29% to 93%.

Comparing the number of new cases reported in the 7-day period from 29 September to 5 October with that reported during the previous 7-day period (22-28 September), there was a relative increase in cases in 10 countries/territories, ranging from 10%-50%: Antigua and Barbuda, Argentina, Barbados, Belize, Canada, the Cayman Islands, Honduras, Martinique, Paraguay, and Uruguay. With respect to deaths, a relative increase of more than 50% was observed in 9 countries/territories: Argentina, Canada, Ecuador, El Salvador, French Guiana, Guadeloupe, Trinidad and Tobago, Turks and Caicos Islands, and the United States Virgin Islands.

According to available data from some countries such as Cuba, Spain, the United States of America, and the United Kingdom, a higher proportion of youth and young adults with COVID-19 has been observed during the current epidemic wave, as well as a decrease in hospitalization rates. However, the distribution of deaths due to COVID-19 remains the same as previously observed, with the highest mortality rate among older adults. Of note, the different characteristics between cases and deaths may vary between countries and territories, and at the sub-national level, and as the data is corrected and adjusted.

The following is a summary of the COVID-19 epidemiological situation in some countries reporting new increases in cases within and outside of the Region of the Americas.