Abstract 021: Identifying and Dismantling COVID‐19 Barriers to Stroke Care
Authors: Ubale Akshat N 
Published: March 2024

Introduction
In Latin America and the Caribbean, stroke is the second greatest cause of both mortality and disability, with different incidence and prevalence rates across the regions due to regional and socioeconomic factors (Camargo et al., 2005; Soto et al., 2022). With decreases in stroke admission across Latin America during COVID‐19, it is evident that the pandemic has negatively impacted hospitals’ abilities to manage as many stroke cases as before (Pujol‐Lereis et al., 2021). As the world recovers from the pandemic, it is important to assess what barriers to stroke care exist in Latin America due to COVID‐19. In this study, we investigate what potential barriers to stroke care exist in the regions most significantly affected by the pandemic in Latin American countries.

Methods
We categorized a list of 23 Latin American countries based on their burden of stroke and COVID‐19 and amount of stroke societies present and found that Argentina, Brazil, Mexico, Panama, Peru, Chile, and Cuba had the highest burden (Global Life Partners, 2023; Worldometer, 2023). We conducted a literature review of barriers to stroke care in Latin America due to the pandemic to formulate questions for the survey and interviews. We then reached out to stroke‐specialized physicians in these nations. Of the 53 we reached out to, 3 filled out the survey and 4 were interviewed. Barriers discussed included a lack of space/beds for patients, staff treating stroke, access to medication, transportation to the hospital, hospital management, and patient finances, as well as poor management and a fear of contagion (Burns et al., 2022; Clement et al., 2021; Pujol‐Lereis et al., 2021). Additional questions revolved around urban/rural disparities in care and potential solutions (Hammond et al., 2020).

Results
Based on the results from the interviews and surveys with physicians from Brazil, Chile, and Peru, barriers preventing stroke care related to COVID‐19 were a lack of awareness of stroke and medical devices and disparities due to living in rural regions. The majority of physicians indicated that a lack of community stroke awareness was a major barrier. All of the physicians who were interviewed also mentioned that increasing awareness would be key to improving access to stroke care. Approximately 57% of physicians indicated that living in a rural region limited access to adequate stroke care due to transportation and resource availability barriers. Approximately 50% of interviewed doctors indicated that a lack of medical devices for stroke care was a barrier. For barriers such as hospital finances, patient finances, fear of contagion, lack of staff and transportation, and shortage of space, results showed that these barriers were no longer present.

Conclusion
All in all, while the past pandemic has hindered stroke treatment in Latin America, many of the once‐present barriers as indicated by the literature review are no longer present. The main issues that still prevail are a lack of awareness of stroke, medical technology, and care in rural areas. Based on the interviewees’ suggested interventions, we are now working on organizing a virtual symposium to raise awareness of stroke in Chile. With Chile’s significant rural population and high COVID‐19 incidence rate, this symposium will help rural community members learn about how to identify and prevent stroke and access care.