Moderator:  Greetings to everyone from the U.S. Department of State’s Media Hub of the Americas in Miami, Florida.  I would like to welcome our participants who have dialed in from the United States and across the region.  This is an on-the-record briefing with Dr. Emily Zielinski-Gutierrez of the U.S. Centers for Disease Control and Prevention, commonly known as CDC, and Deputy Assistant Secretary John Piechowski of the U.S. Department of State.

The speakers will assess the U.S. response to COVID-19 in Latin America and the Caribbean, including the scientific partnership led by CDC and Department of State activities to confront the pandemic.

We are pleased to offer simultaneous interpretation in Spanish and Portuguese for this briefing.  I request everyone to keep that in mind and speak slowly.

I’ll now turn it over to Dr. Zielinski-Gutierrez for her opening remarks.

Dr. Zielinski-Gutierrez:  Thank you so much, Namita, and it’s a pleasure to be with all of you here this morning, this afternoon.  

COVID-19 is an unprecedented global health challenge.  As of April 28th, the World Health Organization has reported a global total of 2.878.196 confirmed COVID-19 cases, and 198.668 deaths.  For the countries represented on this call today, there are over 151.000 confirmed cases and over 7.500 deaths.  We can’t forget that there’s a person behind every one of these numbers.  CDC’s top priority in working in our work with the United States and around the world is to prevent illness and prevent loss of life.  We’ve been working with global partners for 70 years and we have more than 50 international offices where we work side by side with host countries to address pressing public health issues like measles, polio, and HIV, as well as today’s challenge of COVID-19.

CDC has collaborated with public health institutions in Central America since the 1960s.  CDC’s regional – CDC’s Central America Regional Office, referred to as CAR, based here in Guatemala, opened in 2005.  We are also opening a regional office in South America, located in Brazil.  We’ve partnered with ministries of health to provide technical assistance for public health programs, improve disease surveillance and response, build laboratory capacity, and assist with workforce development.

We’re proud of our work and our partnerships in the Western Hemisphere.  Thank you so much for having us here today.

Moderator:  Thank you, and now over to Deputy Assistant Secretary Piechowski for his opening remarks.

DAS Piechowski:  Thank you very much, and good morning.  I’m happy to be here and to be joined by Dr. Zielinski-Gutierrez from the CDC to talk to you about how the United States is working with our friends throughout the Western Hemisphere and fighting the shared challenge that COVID-19 poses for all of us.

Confronting this crisis worldwide has been an all-of-America approach.  From repatriating thousands of Americans to providing millions of dollars’ worth of humanitarian aid and working with international partners and governments to combat the spread of the outbreak, we’ve all had a hand in fighting this virus.

The U.S. Government has no higher priority than the protection of American citizens, and the Department of State is rising to meet the historic challenge posed by this pandemic every day, all over the world.  The staff at our embassies and consulates have been on the front lines in these efforts.  And just last Friday, our embassy in Havana, Cuba, worked with Delta Air Lines to arrange two flights that brought home over 300 Americans.  To date, we’ve repatriated more than 35.000 American citizens in the Western Hemisphere alone.  

In the face of the COVID-19 pandemic, we are building on our decades-long partnerships with health ministries in the region by allocating more than $64 million dollars to more than 30 countries to help them fight the coronavirus.

American generosity isn’t limited to our assistance that comes directly from the U.S. Government.  American businesses, NGOs, and faith-based charities have joined this all-of-America effort to saving lives all across the world.  We estimate that the American people have given nearly $3 billion dollars in donations and assistance in the fight against COVID-19.

As an example, U.S. companies like Cargill and Walmart donated food and other supplies to Hondurans directly as well as to the Honduran Government to distribute to local communities affected by the virus.  

Our people-to-people diplomacy exchange programs has also empowered entrepreneurs, medical professionals, activists, and government leaders to contribute to their countries’ COVID-19 response.  Whether they study, made connections, or found inspiration from counterparts in the United States, we are seeing exchange alumni around the region step up, each in their particular capacity.

A fantastic example of this is the 2017 alumni of our Young Leaders in the Americas Initiative from Argentina, who is part of a team that has developed a molecular diagnosis kit.  This is just one of many examples of the vast network of State Department exchange alumni who are working together to find solutions to today’s most pressing issues.

The relations we have with the governments and people in the Western Hemisphere are very important to this administration, and we’ll continue to stand with our friends as we confront the challenge of COVID-19 and work to reignite economic prosperity for our citizens.  There are a lot of important issues we can talk about, and I’m happy to take your questions now.  Thank you. 

Moderator:  Thank you.  We will now begin the question and answer portion of today’s call.  For those on the English line asking questions, please state your name and affiliation and limit yourself to one question related to the topic of today’s briefing.  If you submitted your question in advance, I have incorporated those into the queue.

Our first question will go to Laura Barros of EFE News Services.  The question is, “How do you assess the situation in Central America in the face of the pandemic?  How prepared are Central American countries for this challenge?”

Dr. Zielinski-Gutierrez:  Hi, Namita, this is Emily.  I’m happy to start off that question.  And being based here in Central America, I feel like I’ve had a front seat to see some of the ways in which the preparedness efforts over the last number of years have been put into action.  One of those, for example, is the availability of rapid response teams within the ministries of health that are responsible for a great deal of the case response, tracing, and the follow-up of contacts, and then any subsequent testing, providing information about quarantine, and being able to have the facilities to track the data on those cases.  As well, we see a much higher level of laboratory capacity than you would have if you looked a decade ago, with countries throughout the region being able to take on the RT-PCR testing, the gold-standard testing, to look at current infection.

This doesn’t mean that we don’t face a large number of challenges throughout the region.  Certainly, if you look at some of the baseline challenges to health with continuing infectious disease threats as well as increasing chronic disease threats, and then lay COVID over these existing risks and the challenges currently with some reduced health capacity at some hospitals in order to ensure that they are effecting the best infection prevention and control measures, it means that we need to think about how we serve those routine needs.

So I think in ministries of health throughout the region you see really strong preparedness, plans that are in place, complex guidelines that are being issued to deal with things like some of the new drugs that are becoming available and discussed in the media and what will countries use as an approach to deciding about their use in trials or otherwise in countries.  But nonetheless, the need to have enough beds, have enough PPE, have enough trained professionals is something that’s being confronted in each one of these countries as well.

Moderator:  Our next question goes to Raquel Krahenbuhl of TV Globo of Brazil.  Please go ahead.

Question:  Thanks for this call.  I have a question for Dr. Zielinski-Gutierrez and also for Jon Piechowski.  To start with Dr. Zielinski, is the CDC concerned about the situation in Brazil?  You were talking about the challenges.  What is the biggest challenge that you see for Brazil, and what do you think about President Bolsonaro’s response and behavior to this crisis?

And also, for Jon Piechowski, the question is:  In the United States, is there any consideration for travel restrictions to Brazil?  And as you said, the United States provided assistance to address this public health challenge to many countries – more than 10 million to Colombia.  Could you be more specific about the assistance to Brazil?  Secretary Pompeo just said that Brazil would only get help with medical equipment and supplies after the United States turns the corner, and now the President has said the peak has passed.  So can Brazil expect to get some help now?  Has Brazil requested assistance?  Thank you so much.

Dr. Zielinski-Gutierrez:  Hi, I’m happy to start off with the response to your question.  So CDC does have a country office in Brazil.  They typically focus on the HIV/AIDS challenges in the region, but they have been fully engaged in working on COVID as well during the last several months.  CDC has expanded to some other health areas in Brazil and we work closely with the ministry of health, with the secretariat of health surveillance specifically, as well as other partners.

The focus has been on program planning, strengthening some of the efforts in monitoring and evaluation, as well as really looking at the epidemiologic surveillance and building the laboratory capacity.  So those have been the primary areas of our interaction, I think, as well as working through the Field Epidemiology Training Program, which, I think, Brazil has trained – I’m looking for the number here – over 315 medical epidemiologists, very similar to our EIS program in the U.S.  A lot of the challenges facing Brazil as well as the other countries throughout the region are really trying to bring together all the different pieces of data and being able to understand how those can be used to promote decision-making and to use the resources as well as possible.  And I think I did mention a little bit earlier that we do see CDC expanding our presence in the country through the establishment of a new regional office for South America, and that will provide, I think, more of an opportunity for ongoing interaction on the policy level as well.

Over.  I’ll turn it over to my State colleague.

Question:  Just can I do a follow-up?

DAS Piechowski:  Wonderful.  Thank you very much, Dr. Zielinski-Gutierrez, and thank you, Raquel, for the question.  In terms of travel, right now the State Department has issued a global travel advisory.  I think it’s at Level 4, which is the strongest level that we have in terms of cautioning Americans in their travel.  So that’s – right now that’s global and applies everywhere, and I don’t have anything further to say on that.

But in terms of the question about assistance, about supply chains, we are in touch with the leadership in Brazil on a daily basis and looking at different needs.  And so while we didn’t announce anything Brazil-related, certainly we’re always in discussions.  And as you rightly pointed out, what we are focused on right now, even as we do provide assistance to our partners throughout the hemisphere, right now we’re really focused here in the United States on taking care of American citizens and making sure that we have the provisions we need to confront the virus.  Thank you.

Moderator:  Our next question was submitted in advance from Ariel Jara of Channel 19 in Paraguay.  It’s one for each of the speakers.  “Will the State Department further strengthen ties with Latin American countries, especially Paraguay, to deal with this pandemic?  And also, how will the scientific cooperation between the CDC and Latin America work to face the pandemic?”

Dr. Zielinski-Gutierrez:  Thanks so much.  I’m happy to start.  CDC does not currently have an office in Paraguay, but there has been engagement through our office in Atlanta with all of the countries in the region.  And I think in – we try to advance the key programs or the key aspects of the COVID response, including community practices, strong surveillance, as well as following the lead of our colleagues with PAHO and WHO guidance specific to the region.

So one of the things that has been done in Paraguay is work with the Field Epidemiology Training Program.  Since 2017 there have been over 140 medical epidemiologists who have been trained, and in many countries throughout the region they are providing some of the leadership to go forward.  And so I think just reinforcing that this epidemic, as much as anything in our recent history, shows us that we really have to think globally – and then particularly about our hemisphere – because the ability of any one country to contain the epidemic, the pandemic, really affects the ongoing risks for each one of us.

So I think this will also be something that will be part of the charge of the new South America Regional Office to engage a little bit more closely with each of the countries in South America, which is very exciting. 

Just to your kind of second question, which I think is really exciting, about what is the scientific collaboration between South America, Central America, and CDC:  There are really exciting studies and surveillance efforts as well as work in the laboratories.  I think you heard that referenced earlier, really in countries throughout the region.  I know our colleagues in Colombia were one of the early ones to come up with their own RT-PCR test using the sequences that had been made available.  We are collaborating here out of our office with the Dominican Republic, Belize, and Guatemala to look at causes of acute febrile illness in the region to better understand a lot of those cases that typically just go undiagnosed.  And I think now we will see efforts throughout the region building off the work in COVID to better understand the rates of infection in the virus, really who is infected, what are the dynamics of transmission.  

I think that this is really an opportunity to strengthen our scientific collaboration, and only by understanding what’s happening in each of the countries with their unique context, and also there have been very different and very, I think, thoughtful takes on what community mitigation strategies have been implemented in the region, often very early and with some very strict social controls, and being able to see what effect those have is, I think, really going to teach us a lot about how a community needs to confront the pandemic.  And that’s certainly one of the things we’re focusing on here in Central America, and I think that would extend to the work in South America as well.  Over.

Moderator:  DAS Piechowski, anything you’d like to add on that one, on the second part?

DAS Piechowski:  No, thank you.

Moderator:  Cooperation?  Okay.  All right.

Well, the next question is from Ariel Perez from Dominican Republic.  And Ariel, please introduce the name of your outlet.

Question:  Hi, good morning.  Thank you for the invitation.  Really, I would like to ask:  How has the CDC helped Dominican Republic?  On the same matter, how much money the U.S. has made available for the Dominican Republic?  And just lastly, what are the recommendations after you flatten the curve of the contagions of COVID-19?  Thank you.

Dr. Zielinski-Gutierrez:  Thank you so much for your question.  So CDC does have an office in the Dominican Republic.  That office is there full-time and it’s primarily focused on the HIV response.  However, they have, like CDC everywhere, turned the majority of their attention to COVID these days, and my office here in Guatemala interacts very regularly with the office there as well.

So there has been quite a bit of interaction between the ministry of health and the CDC office, looking at infection control and prevention recommendations, having some support of the laboratory capacity in particular, looking both at resources but as well as kind of best practices and some of the ideal way forward.

The ministry’s reliance on CDC expertise also includes some technical assistance and leadership on surveillance and data monitoring activities and kind of adaptation and use of global guidelines, as well as scaleup of testing diagnostics, contact tracing, as well as looking at some of the issues around clinical care.

Your – oh, and I also just did want to mention that they have for a much longer time been working with the Government of the Dominican Republic on laboratory accreditation, making sure that labs are fully up to standard in the ability to carry out diagnostics in a safe environment, biosafety training, and then some of the influenza surveillance activities which set the stage for continuing COVID.

You asked a question about how much additional funding would be directed to the DR.  I do not have the exact figure, but the Dominican Republic is included in both of our – in the activities for the immediate term as well as that includes – excuse me – activities such as laboratory capacity, increasing the – some of the epidemiologic measures, and even looking forward to some issues around vaccine preparedness further down the road.  And we are collaborating both with some of the government in country as well as COMISCA, which is the Council of Ministers of Health that includes Central America and the Dominican Republic, and that’s one of our primary partners in the region currently.

So I don’t have an exact figure to give you because I think all of those details are still being worked out, but it is part of the package of $800 million dollars that was in supplemental funding that was directed to CDC for international activities.

And your last question is particularly intriguing, right.  How do we go forward?  How do we go forward after we see the peak but we know that that doesn’t mean that COVID will not continue to be a threat because we are still seeing vulnerable people who have not yet been infected in the community and who remain vulnerable until we have a vaccine on the line?  And I think there are slightly different answers for every country, for every community.  If you look at urban versus rural areas, and there – we will have to be looking at what is the package of testing, tracing, and treating of really well-organized epidemiologic efforts to know where infections are happening, to ensure that those people who are sick are able to isolate, those who are contacts are able to quarantine in order to be able to start looking at activities that can come back online, but that we’re able to continue our efforts to contain the virus.  And this is so multidisciplinary, and that is it involves labs; it involves epidemiology; it involves informatics to be able to have the data available to do this; it involves social science because people need to be able to understand and conceptualize what it is they’re – that you’re asking them to do over the longer term.  

So we are looking at a kind of full response that engages different disciplines within public health, within the health sector that will continue over a longer period of time as we figure out and hone the interventions going forward. 

DAS Piechowski:  If I could just add to what Dr. Zielinski-Gutierrez said just to supplement that I believe the numbers for Dominican Republic include $1.4 million dollars.  And as Dr. Zielinski-Gutierrez said, this money, really it goes into building and strengthening the capacity of the Dominican ministry, as does so much of our assistance in the other countries in the region.  It’s building on linkages.  It’s building on a body of knowledge.  It’s building on best practices.  In the case of Dominican Republic, of course, the United States has provided more than $1 billion dollars to the country in the past 20 years, and that includes nearly $298 million dollars in health assistance.  So as we announce additional assistance for countries as they fight COVID-19, this assistance is really building on years and years of work, and we’re proud as Americans to be part of that, but it also reflects a lot of the progress and the advancements that scientists and other public health experts have made in all of the countries in Latin America and the Caribbean.  Thank you.

Moderator:  We have time for one last question, and that last question goes to David Alandete of ABC.

Question:  Hi, how are you?  Thank you for doing this, I really appreciate it.  This is a question for Assistant Secretary Piechowski.  My question has to do with Venezuela.  Yesterday or the day before, I believe, the Secretary of State called Juan Guaido.  He – in the statement that the State Department put out afterwards, they talk about how the Maduro regime is repressing journalists and doctors that are treating and getting news out of the coronavirus.  So my question is, do you suspect that the data of contagion and that it’s higher than what the Maduro regime is saying?  And also, do you have evidence of this repression against doctors and journalists?  Thank you very much.

DAS Piechowski:  Thank you, David, for the question.  We have no reason to believe in any of the figures that Maduro has put forward in terms of the impact of COVID-19 on the Venezuelan population, and it of course would not surprise us that they were making up numbers and sharing false data because that is what authoritarian regimes do in the face of crises like that.  And we haven’t just seen that kind of activity in Venezuela; we saw it in China in some of the early days.  And our calls for transparency we will continue to make because we know that only with full transparency will we, as a – as the peoples in countries all around the world, be able to confront this virus and ultimately defeat it.

In terms of increased repression, that is also part and parcel of what authoritarians do.  We’ve seen NGO reporting from Venezuela of different arrests and harassment of journalists that continues, as well as people in the public health field.  So it’s lamentable that this is continuing, and our sense that the situation in Venezuela is bad is, I think, matched by the fact that we have allocated $9 million dollars in humanitarian assistance there in Venezuela to help the Venezuelan people get what they need, and we’re also dedicating money to those Venezuelans who have had to flee the country because, of course, COVID-19 is just one – it’s a disease, it’s additional misery on a repressive and dire situation that’s affecting so many Venezuelans.  

So thank you.  Thank you for the question.  The data is most likely bogus.  That would be what authoritarians do, and we continue to stand by the Venezuelan people.  

One last thing I guess I would offer is the situation that Venezuelans are confronting today is another reason why on March 31st, the United States put forward our – put forward a democratic transition framework.  It just reminds the world of the urgency and need for Venezuela to transition to a democratic government where people will have opportunities once again.  Thank you.

Moderator:  And with that I’d like to turn it over to Dr. Zielinski-Gutierrez for her closing remarks.

Dr. Zielinski-Gutierrez:  Thank you so much, Namita.  In closing, I just want to note that the U.S. Government works closely with our international partners and host governments around the world to support countries to prepare for, detect, prevent, and respond to public health threats.  Lessons learned from addressing HIV, influenza, Ebola, dengue, Zika, and many other viruses are now being applied to the COVID-19 response.  

We’ll be here to help during this pandemic and long after it ends, so please take care of yourself and stay safe.

Moderator:  All right, that concludes today’s call.  I want to thank Dr. Zielinski-Gutierrez and Deputy Assistant Secretary Piechowski for joining us, and thank all of our callers for participating.  If you have any questions about today’s call, you may contact the Miami Media Hub at MiamiHub@state.gov.  Information on how to access the English recording of this call will be provided by AT&T shortly.  Thank you and have a good day.

U.S. Department of State

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