• • The increasing dryness of soils into April may be compounded by short term drought in a number of locations across the region, especially in Cuba. The associated increase in dust, as well as, potential soot and smoke from bushfires may contribute to higher concentrations of airborne particulate matter. This could result in an increase in acute respiratory illnesses.
  • There may be an increase in symptoms in persons with chronic respiratory conditions such as asthma, and in persons prone to allergic rhinitis due to more frequent episodes of Saharan dust incursions into the Caribbean, as well as due to local dust being suspended in the air when the ground surface is dry.
  • This may be offset by a decrease in allergic reactions to fungal spores from mold at least until the end of April. By contrast, increasing humidity across the region from May onwards could cause dampness in some poorly ventilated residences and offices resulting in the growth of mold. This could be particularly so in the Guianas. In the Caribbean islands, increased allergens in the atmosphere may occur from plant materials (e.g. pollen) driven by increased wind speeds and reduced washing out by rain. These factors may also trigger increased incidences of upper respiratory tract symptoms.
  • Where episodes of flooding may occur, there is an increased risk of ear, nose, and throat infections from contaminated water across the region, particularly in May.

• Ongoing dryness and drought conditions may increase concentrations of water pollutants. Additionally, a drop in water pressure in the pipes of water supply systems may result in cross contamination and reduced access to water by consumers. Alternative use of unsafe sources of water, in turn may potentially contribute to higher incidences of gastrointestinal illness.
• Cases of gastroenteritis may increase in frequency across the region from May, particularly in the Guianas, due to contamination of food and water supplies, and contact with flood waters.

• Higher temperatures and the occurrence of heat waves begin in April (for Belize, Cuba and Trinidad) or May (elsewhere in the islands). This can increase the risk of morbidity and hospitalisations from heat related health effects. Such effects include apathy, general weakness, dizziness, fainting, and exhaustion (heat strain). These effects may be exacerbated in persons with chronic illness, children, pregnant women and the elderly and, in extreme cases, lead to kidney failure. For information on heat and health see: https://www.who.int/health-topics/heatwaves#tab=tab_1 and https://ghhin.org/
• During this period, excessive exposure due to dangerous UV radiation can cause skin damage in persons who spend extended periods outdoors, especially on sunny days (for more information, see: https://www.epa.gov/sunsafety/uv-index-scale-0). For simple action steps on sun protection see: https://www.who.int/news-room/questions-and-answers/item/radiation-the-ultraviolet-(uv)-index
• There is the increasing possibility of skin infections due to contact with contaminated stagnant and/or floodwaters in the region in May – particularly in the Guianas.

• Increased rainfall and the more frequent occurrence of stagnant water from flooding towards May, particularly in the Greater Antilles and the Guianas, may create additional breeding sites for the Aedes aegypti and Aedes albopictus mosquitoes which are the vectors of diseases such as Dengue, Chikungunya, Zika and Yellow Fever. These diseases remain a perennial concern for Caribbean territories.
• With increasing dryness and recurrent dry spells across the region in this period, there may be increased use of containers for water storage. This may be further exacerbated in Cuba, where drought is evolving.
• At the household level, careful attention should be given to the management of water storage containers. This includes mosquito proofing of water tanks, barrels, drums and buckets.
• The focus should be on public education and awareness on source reduction and personal protection. If fogging operations are considered by the Ministry, advice from the local meteorological services on temperature, wind speed, humidity, etc. should be sought.
• Access useful materials on mosquito control measures here: (https://www.paho.org/en/campaigns/caribbean-mosquito-awareness-week-2020); Join the fight against mosquito borne disease in the Caribbean: https://carpha.org/What-We-Do/Public-Health/Dengue and http://missionmosquito.carpha.org/
• Flooding may increase the risk of Leptospirosis due to displacement of rodent vectors from their usual habitats into houses, increasing the risk of contamination of slow moving or stagnant waters, household surfaces and food-stores with rodent urine.

• Severe weather systems, which can come with a range of hazards, including high winds, landslides, flash floods, among others, may possibly affect Caribbean territories. With the possibility of tropical cyclones before the official start of the 2023 Atlantic Hurricane Season, health practitioners and administrators should maintain a state of readiness.
• Food insecurity and associated possible undernutrition would be a concern due to the potential for extensive crop damage and/or loss associated with frequent dry spells across the region. This may be exacerbated in Cuba where drought is evolving. A similar concern arises as a result of the high flood potential in the Guianas in May.
• The occurrence of heatwaves in April or May may increase exhaustion during intense outdoor activity and tends to limit labour productivity. It can further increase sweating and water consumption and, during prolonged heatwaves, lead to fatigue, irritability and aggression.
• Whereas extreme weather events are fairly rare in this part of the year, their occurrence, impacts and associated alerts may negatively affect mental health. Health Care Professionals are therefore advised to be aware of these issues, as they interact with patients.

• Water quantity and quality is critical to support prevention strategies to combat the COVID-19 pandemic, especially with regards to safe water for hygiene purposes. Flooding and drought may affect continuous access to safe water. Therefore, special attention should be paid to impacted communities.
• Any disaster occurring will compound psychosocial impacts related to the COVID-19 pandemic, particularly disasters arising from extreme weather events. Health care professionals are therefore advised to be sensitive to these issues, as they interact with patients.
• Extreme weather events or disasters may cause an increased burden on already stressed healthcare services and the rollout of vaccination campaigns. Countries should factor this into their contingency plans and actions.

This Bulletin provides a broad overview of climate conditions up to 3 months in advance. It is based on insights drawn from CIMH’s suite of technical climate information products and epidemiological insights from CARPHA and PAHO. The information contained herein is provided with the understanding that the CARPHA, the PAHO and the CIMH make no warranties, either expressed or implied, concerning the accuracy, completeness, reliability or suitability of said information. The Bulletin may be freely used and disseminated by the public with appropriate acknowledgement of its source but shall not be modified in content and then presented as original material.