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      COVID-19 and Hurricanes: The Impact of Natural Disasters during a Pandemic in Honduras, Central America

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          Sir, According to the Global Climate Index, Honduras is classified as one of the nations most vulnerable to natural disasters in the world. It was the scene of the hurricanes in 1974 (Fifi) and 1988 (Mitch), 1 which have been the most catastrophic weather events that have affected the country, causing human losses, material, economic, and health damages. It took many years and great resources for the reconstruction, which is still incomplete. In November 2020, Honduras became the scene again: two major weather events had occurred in less than two weeks, causing incalculable damage that is still being accounted for (Table 1). The hurricanes Eta and Iota devastated the country (Figure 1), already affected during the last nine months by the COVID-19 pandemic. In March 2020, the first cases of COVID-19 were reported in Honduras. By November 29, 2020, the national system of health (SINAGER) reported 107,513 confirmed cases and 2,905 deaths. 2 Besides, the country’s economy has been plunged into a severe crisis by this pandemic and will undoubtedly be aggravated by recent natural disasters. When a decline in the curve of reported COVID-19 cases was finally expected, the new events place the already vulnerable country in an almost impossible situation. At the end of October 2020, the formation of hurricane Eta was announced, a Category 5 hurricane, which would affect the lands of Nicaragua and Honduras. This event caused flood damage in some areas that have the highest reported COVID-19 cases. Some of the victims were refugees in roughly 1,000 shelters with little or no biosecurity measures. Others continue on the streets, along rivers, under bridges, and other public places where the health crisis will worsen. The resurgence of dengue complicates the situation and is endemic in Honduras. Currently, the Health Information Platform for the Americas reported a total of 23,444 cases with a mortality rate of 0.1 per 100,000 population by dengue. 3,4 Table 1. Comparison of Damages During Four Major Hurricanes in Honduras Hurricane Consequences Fifi * (1974) Mitch** (1998) Eta *** (2020) Iota **** (2020) Saffir-Simpson Hurricane Wind Scale Category 2 Category 5 Category 4 Category 5 Hurricane Scale when Entering Honduras Tropical Depression Category 1 Tropical Depression Tropical Depression Deceased Between 5000-8,000 5,657 74 14 Affected People 500,000 1,500,000 3,011,760 664,590 Missing People ND 8,058 8 1 Evacuated People 130,000 285,000 179,136 184,626 Hostels ND 1375 1000 ND Sheltered People 130,000 285,000 86,228 86,570 Recued People ND 112,272 89,665 ND Affected or Damaged Homes 12,500 50,000 26,828 19,372 Destroyed Homes 3,000 66,188 60 29 Affected Roads ND 107 173 87 Damaged Schools 162 2,800 rooms of schools in primary education 8 2 Damaged Bridges 120 More than 200 43 19 Destroyed Bridges 18 189 32 13 Emergency Aid to Honduras USD 2,271,980 USD 38,000,000 USD 9,000,000 ND Post-Climate Event Diseases DysenteryTyphoidMalaria Gastrointestinal infections:Cholera (3 cases)Leptospirosis (172 cases) ND ND Data Sources: * https://repositorio.cepal.org/bitstream/handle/11362/15031/S7400458_es.pdf?sequence=1&isAllowed=y (Access December 1, 2020); http://cidbimena.desastres.hn/ri-hn2/pdf/doch0014/doch0014.htm (Accessed December 1, 2020). ** http://cidbimena.desastres.hn/ri-hn/pdf/spa/doc12140/doc12140-contenido.pdf (Accessed November 30, 2020); http://cidbimena.desastres.hn/ri-hn/pdf/spa/doc12921/doc12921-a.pdf (Accessed November 20, 2020). *** https://reliefweb.int/sites/reliefweb.int/files/resources/Honduras%20-%20Huracanes%20Eta%20e%20Iota%2020Reporte%20de%20situaci%C3%B3n%20No.%2020%20%2822-11-2020%29%201700%20h.pdf (Accessed November 30, 2020); https://reliefweb.int/sites/reliefweb.int/files/resources/SitRep%204%20Tormentas%20ETA%20IOTA%20Honduras%202020.pdf (Accessed November 30, 2020). **** http://sigmof.icf.gob.hn/?page_id=7546 (Accessed November 20, 2020); https://www.oncenoticias.hn/galerias-el-paso-arrasador-de-los-huracanes-mitch-y-fifi-en-honduras/?__cf_chl_jschl_tk__=dc82a5fd7b0cb0ee6cd1527ccfb00a71041da1db-1606673591-0 XyaHF9vxi_rPHR1BXLT1EAV8EMhs_Aix0W6i59TjJPPaLeALhzrBaOt4w09gzIgiC1HjyeriPMYxY2GAs_G92SCZ1gM6tq3yqthwarHMo2hzXRasg0D1EF3rVAfa0c1mGB41Nl8dh3aC3UmQA5xamnn6V5HdIWiS-QsIjAwYimMTJY8pVUZWj9ANGPd05yxhQmCg7q45AOkzodP2JsUqmuC_uuEtUhbNal8XGKVtG4r4nro39OVYYgkBvMEC8EFW9jQ7AgDGr0mXxbIqA44YD_-7u2VYNnv8xKM8m0M-pM1SkhEHyirwiPqEFMlYYwwjL9qZUhZcANLPKoDRnnJBDO33n1nJo6AEg_Lxjssv67XJ5gdlpQnvaBSW51v5b2_EwrbAk46B4bJ2qyT9TA_3xM (Accessed November 20, 2020); Mitch: http://cidbimena.desastres.hn/ri-hn/pdf/spa/doc11026/doc11026-1.pdf (Accessed December 1, 2020); https://www.bbc.com/mundo/noticias-america-latina-54965248 (Accessed December 1, 2020). ND: No Data Available. Figure 1. Hurricane Iota Arriving to the Coasts of Central America on November 16, 2020. Source: Open Meteorological Platform Windy (https://www.windy.com/?13.646,-83.046,8). It is expected that the emerging diseases that usually appear after these climatic phenomena will appear (arboviruses, leptospirosis, malaria, cholera, a considerable increase in dermatological diseases, and an increase in psychological disorders). Not to mention all the acute and chronic pathology that usually occur in the country, which is managed inefficiently. 5 Although the floods caused by the overflowing of the rivers have caused most of the damages, the supersaturation of the soils with possible landslides will increase material losses. 6 The reports of the Secretary of Agriculture about losses or affectations in around 374,000 acres in essential grain crops, such as banana, sugar cane, citrus, cocoa, rambutan, among others, are concerning. 7 Also, human losses and deterioration in living conditions in the affected population are reaching threatening levels. To this day, it is difficult to measure the current and future consequences on the socio-economic development of the country, in this uncertain scenario the increase in health demand in an already collapsed health system in the face of the summation panorama: COVID-19, emerging infections, endemic diseases, common diseases, plus two major natural disasters, turn this situation into a humanitarian crisis without precedent in the history of Honduras. The aftermath of the floods and the probable rebound in COVID-19 cases should alert us not to give up and increase biosecurity measures as much as possible and provide social assistance to more than one million people affected and thousands more at risk in Honduras and other countries of Central America. 8,9 The challenges for the future are innumerable and of great magnitude, the leadership of the different experts in each area is required to be able to solve in a logical, harmonious, fair, and efficient way the situation on all fronts, probably being: health, education, economy, infrastructure, and the severe problem of insecurity being the main ones. It is not an easy task that must be accomplished quickly; otherwise, the consequences for the country are unpredictable.

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          Most cited references 4

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          Climate Change Impacts on Disaster and Emergency Medicine Focusing on Mitigation Disruptive Effects: an International Perspective

          In recent decades, climate change has been responsible for an increase in the average temperature of the troposphere and of the oceans, with consequences on the frequency and intensity of many extreme weather phenomena. Climate change’s effects on natural disasters can be expected to induce a rise in humanitarian crises. In addition, it will surely impact the population’s long-term general health, especially among the most fragile. There are foreseeable health risks that both ambulatory care organizations and hospitals will face as global temperatures rise. These risks include the geographic redistribution of infectious (particularly zoonotic) diseases, an increase in cardiac and respiratory illnesses, as well as a host of other health hazards. Some of these risks have been detailed for most developed countries as well as for some developing countries. Using these existing risk assessments as a template, organizational innovations as well as implementation strategies should be proposed to mitigate the disruptive effects of these health risks on emergency departments and by extension, reduce the negative impact of climate change on the populations they serve.
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            Spatial distribution of dengue in Honduras during 2016–2019 using a geographic information systems (GIS)–Dengue epidemic implications for public health and travel medicine

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              Prevención e identificación temprana de casos sospechosos COVID-19 en el primer nivel de atención en Centro América


                Author and article information

                Prehosp Disaster Med
                Prehosp Disaster Med
                Prehospital and Disaster Medicine
                Cambridge University Press (New York, USA )
                15 February 2021
                : 1-3
                [1. ]Department of Physiological and Morphological Sciences, Faculty of Medical Sciences, Universidad Nacional Autónoma de Honduras , Tegucigalpa, Honduras
                [2. ]Latin American Network of Coronavirus Disease 2019 Research (LANCOVID) , Pereira, Risaralda, Colombia
                [3. ]Universidad Nacional Autónoma de Honduras , Tegucigalpa, Honduras
                [4. ]Departamento de Ginecología y Obstetricia, Hospital Escuela , Tegucigalpa, Honduras
                [5. ]Departamento de Patología, Hospital General San Juan de Dios , Ciudad de Guatemala
                [6. ]Unidad de Investigación Científica, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras (UNAH) , Tegucigalpa, Honduras
                [7. ]Department of Internal Medicine, Faculty of Medical Sciences, Universidad Nacional Autónoma de Honduras (UNAH) , Tegucigalpa, Honduras
                [8. ]Department of Internal Medicine, Hospital Escuela , Tegucigalpa, Honduras
                [9. ]Universidad Cientifica del Sur , Lima, Peru
                [10. ]Semillero de Investigación en Zoonosis (SIZOO), Grupo BIOECOS, Fundacion Universitaria Autonoma de las Americas , Pereira, Risaralda, Colombia
                [11. ]Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas , Pereira, Risaralda, Colombia
                Author notes
                Correspondence: Alfonso J. Rodriguez-Morales, Master in Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur , Lima, Peru, E-mail: alfonso.rodriguez@ 123456uam.edu.co
                © World Association for Disaster and Emergency Medicine 2021

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 1, Tables: 1, References: 9, Pages: 3
                Letter to the Editor

                central america, covid-19, hurricanes, natural disasters


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