Montserrat, one of the world's smallest self-governing territories, is among the latest countries to report its first case of COVID-19, highlighting the growing spread of the disease in Latin America and the Caribbean.

The British territory, which has a population of around 5,000 and whose only air and sea links are with neighboring Antigua, and the Dutch island of Aruba on Wednesday took the number of countries and territories in the region reporting cases to 38. Brazil and Cuba announced their first deaths.

Speaking on the same day, the head of the Americas arm of the World Health Organization urged nations in the Caribbean and Latin America to put their preparedness for COVID-19 into high gear.

"The message is clear – now is the time for countries to increase their capacity to detect cases, care for patients and ensure that hospitals have the space, supplies and staff they need to provide the necessary care," Dr. Carissa Etienne, director of the Pan American Health Organization, told regional health ministers during a teleconference.

As of 1800 GMT on Wednesday, Latin America and the Caribbean had recorded 1,455 coronavirus cases with 11 deaths.

Since Brazil recorded the first case on February 26, countries in the area have been deploying a variety of measures to contain the spread of the coronavirus which causes COVID-19. These policies have been ramped up since the disease gained strength in the United States, which along with Canada, is also a PAHO member.

Temporary hospitals

Latin American and Caribbean nations, which operate uneasily in the shadow of the U.S., would have watched with alarm at what has been widely panned as a shambolic American response to the pandemic.

Argentina, Colombia, Chile, Peru, Panama, Honduras and El Salvador are among countries in the region that have already closed their borders to non-resident foreigners and imposed tough isolation measures. Others have restricted travel only from nations where the impact of the virus has been most severe.

Venezuela, where the economic situation is dire because of a prolonged political crisis, has declared gone a step further by declaring a national quarantine, requiring businesses to close and people to stay home in most of the country.

Argentina's President Alberto Fernández, in one of the most eye-catching announcements, promised to build eight modular emergency hospitals to combat the virus.

Defiant Mexico  

School classes have been suspended and large gatherings prohibited in large parts of the region.

Clusters of countries within South America, Central America and the Caribbean have also held separate conference calls to consider coordinated action.

But some have signaled that there is only so far they can go without being pushed.  

Mexico, whose economy is heavily intertwined with the United States, has kept its borders open, clearly fearing that drastic action would cause irreparable harm to its economy. It has 83 cases so far but has decided, for instance, that events of up to 5,000 people can still be held.

President Andres Manuel Lopez Obrador, 66, has caused consternation by continuing to shake hands as well as hug and kiss supporters at campaign rallies in Latin America's second-most populous country.

"It would almost be better if he had coronavirus because the most likely thing is that he is going to recover and he is going to be immune and no one would have this concern in him anymore," was the dismissive response of Undersecretary for Prevention and Health Promotion Hugo Lopez-Gatell to concerns about Lopez Obrador's seemingly blasé approach.

Fund appeal 

Some of the smaller islands in the Caribbean that depend on foreign exchange from tourism say they can't afford to cut themselves off from the rest of the world. The U.S and Britain are their main source markets for visitors.

"This island is too small to start shutting off borders completely," said the chairman of Barbados' national tourism agency, Sunil Chatrani. "We are totally dependent on tourism and when you think about the contribution it is quite significant so we can't afford to shut it down."  

For some governments, there is not much choice.

LATAM Airlines Group, South America's largest carrier, on Monday canceled 90 percent of its international flights as demand collapsed and the region became increasingly isolated.

LATAM is the continent's main carrier to the U.S., followed by American Airlines which said last weekend it would cancel most flights to Latin America, including all those to Brazil.

With much of the region under financial stress, PAHO has launched an appeal for initial 53.5 million U.S. dollars to support critical response efforts in the neediest countries until September 2020.

"If everyone collaborates, it is not too late to contain the situation, flatten the epidemic curve and thereby avoid overloading the health services so that they can give the necessary care to all who need it," Etienne said.