Silent catastrophe: Latin America is losing the battle against COVID-19

While the US and Europe celebrate a return to near-normal, the reopening of tourist routes and even put an expiration date on the use of masks, in Latin America it all seems like science fiction. Despite the illusion generated by the extension of vaccination, the pandemic continues to ravage the region with painful figures reported daily.

When the eyes of the world were on India, its dramatic mass cremations and its collapsed hospitals in its urban centers, in Paraguay, Suriname, Argentina, Uruguay, Colombia, Brazil, Peru, and Chile – a silent catastrophe was brewing whose current figures are eight times more deadly than those in India. In Paraguay, for example, in the last seven days, an average of 17.7 deaths per million inhabitants was registered, while in India the rate is 2.11.

In the last week, about 1.1 million new cases of coronavirus and more than 31,000 deaths were registered in Latin America, most of them in South American countries where transmission continues to be out of control. In addition, nine of the ten countries with the most recent deaths in proportion to their population are in Latin America, where vaccination campaigns are slow and chaotic.

Counting the data recorded yesterday, Latin America and the Caribbean added 1,227,352 deaths and 35,638,660 infections. Of the three countries with the highest number of deaths registered in recent days, two are Latin American: Brazil and Colombia. Among the hardest hit, Peru has the highest mortality rate, with 576 deaths per 100,000 inhabitants.

Alarmed, experts in the region also warned of the increase in young patients requiring hospitalization, and in several cities, intensive care wards are full or almost full, with people under 40.

Currently, less than one in ten people in Latin America and the Caribbean are fully vaccinated against COVID-19. “We are a region of more than 600 million people where cases are increasing, hospitals are full and variants circulate rapidly,” said the Director of the Pan American Health Organization, Carissa Etienne.

COVID-19 infections fill hospitals in cities like São Paulo, Brazil, as well as Bolivia, Chile, and Uruguay, particularly with younger patients between the ages of 25 and 40.

In Mexico, there is a “slight increase” of infections in recent weeks, driven mainly by the Baja California and Yucatán regions. The Caribbean, Cuba and the Dominican Republic, continue to generate the majority of new cases, with high mortality rates in Trinidad and Tobago. There are also increases in infections in parts of Belize, Guatemala, and Panama.

The longer the vaccination takes the slower the recovery, and the more time the new and fearsome variants have to multiply.

“Although vaccines are needed everywhere, we hope that the G7 nations will prioritize donating doses to the countries most at risk, especially those in Latin America that have not yet had access to enough vaccines to protect even the most vulnerable. vulnerable,” Etienne said.

The WHO recommended focusing on the countries where the crisis is most severe, including Colombia, Brazil, Argentina, and Chile. And they warned that sustained large outbreaks in those countries increase the possibility of more dangerous variants of the virus emerging and crossing borders. “Helping developing countries fight the coronavirus is not only a moral imperative, but a necessary step for the economic recovery to be lasting,” said Kristalina Georgieva, Director of the International Monetary Fund (IMF) told the G7 members, the most powerful countries in the world.

COVID-19 in Paraguay

Paraguay is today one of the hot spots of the pandemic in the region. The country has faced the continuing emergency under pressure from entrenched poverty, a historically underfunded healthcare system, and many questions about government corruption. Anger and frustration sparked widespread street protests earlier this year and the Justice Department has opened a case of involuntary manslaughter against the Government.

President Mario Abdo of Paraguay relaxed the health protocals that he successfully maintained in the beginning of the pandemic, shortly after, infections soared alarmingly in this first six months of 2021 with high mortality and a lack of vaccines available. “We had projections of about 7,000 deaths for July. We are in the first half of June and we have already exceeded 11,000. The numbers are very worrying,” said Arturo Ojeda, Executive Director of the Red Cross. “People did not comply with the established sanitary measures and also the government lowered its guard at the controls,” he added.

With 7.3 million citizens, Paraguay has exceeded 400,000 infections and 11,000 deaths since the first case of COVID-19 was reported in March 2020. In the last two weeks, it ranks as the country with the highest mortality in the world, with a rate of 17.7 deaths per million inhabitants, according to the Our World in Data Registry.

Hospitals are overwhelmed and oxygen is in short supply, as well as some medicines. According to Ojeda, the strict quarantine from March to September 2020 “worked”, but then “people relaxed, they got tired of the isolation”.

The epidemiologist Tomás Mateo Balmelli indicated that “in January, it is estimated that some 35,000 Paraguayans went to Brazil to vacation and many of them acquired the different variations of the virus” most contagious. For Balmelli, the government was wrong to “blindly trust” in the purchase of vaccines by the Covax system of the World Health Organization. Given the delay in deliveries, Paraguay has used donations from countries in America, Europe, and Asia.“It is a drop-in vaccination. If we continue at this rate, in three years we will reach the 75% necessary to stop the pandemic outbreak ”, the epidemiologist summarized.

COVID-19 in Brazil

Brazil is preparing to participate in Copa América, South America’s football (soccer) championships, as it is about to reach the terrible milestone of 500,000 deaths. Its president, Jair Bolsonaro, dismissed the coronavirus as a “small flu”, resisted containment strategies, and was fined last weekend for not wearing a mask at a motorcycle rally in São Paulo. Now, he is under investigation by a Congressional Commission for his dire response to the public health emergency.

Those involved in the COVID response – including representatives of pharmaceutical companies – have told the commission that the Bolsonaro government rejected offers to purchase the vaccine last year. So far, the country has only managed to immunize 11.4% of its 212 million citizens.

Worse, acceptance of the vaccine has also been hampered by Bolsonaro’s vehemently unscientific stance. “The biggest problem in Brazil – and one that is having a terrible effect on the acceptance of the vaccine – is denialism in politics,” said Chrystina Barros, a member of the group that fights Covid-19 at the Federal University of Rio de Janeiro. “We have a denier president whose speech and behavior are contrary to medical advice, and who are influencing people not to get vaccinated. It is a perfect storm ”.

With an average of 2,000 deaths a day, Brazil is increasingly isolated in the world. Several nations – including neighboring Argentina – are restricting entry to Brazilian passengers, and the country has been the subject of international disgrace.

“If Brazil does not take the pandemic seriously, it will continue to affect the entire region and beyond,” said Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, at the end of March, and the warning remains in effect. Denise Garrett, Vice President of Applied Epidemiology at the Sabin Vaccine Institute in Washington, warned weeks ago that the situation in Brazil is very worrying. “If the country that does not control its outbreak, it is a risk for other countries, since it is a breeding ground for new variants.”

COVID-19 in Uruguay

In Uruguay, not even one of the fastest vaccination programs in Latin America has been able to contain the spread. The country is going through the worst moment of the pandemic, with more than 4,000 deaths in the last two and a half months of the 5,120 accumulated since March 2020, and 346,515 total cases -31,430 active.

The Uruguayan strategy of rapid testing, timely isolation and personalized follow-up took the country away from the first world wave, but the system began to collapse in November, when it went from 40 to 165 cases a day. The epidemiological tracking was lost months ago. More than half of the infections are of unknown origin.

Currently, more than 60% of the population already has the first dose of the Pfizer, CoronaVac, or AstraZeneca vaccines and 38% have completed the immunization process, but the crisis continues. “Vaccination has to reach a high percentage of the population with complete immunity, that is, two doses plus 15 days of waiting. And only then would the cases decrease … If you do not lower mobility, do not do more PCR tests, or do not track contacts, the vaccine alone does not achieve that. We also don’t know how the variants will evolve. It is an uncertain scenario ”, explained to AP Zaida Arteta, Infectologist and General Secretary of the Medical Union of Uruguay.

COVID-19 in Chile

Chile is experiencing a similar situation, although with a different containment strategy. While “responsible freedom” was the slogan of the government in Uruguay, in Chile, President Sebastián Piñera ordered strict confinements several times.

In fact, the Chilean Medical College (Colmed) presented its proposal days ago to reduce coronavirus infections in the country, which includes a total lockdown of three weeks for a single time, which is being analyzed by the authorities.

The country has been plunged for weeks in a peak of the pandemic that put the health system on the ropes and that led to more than 8,000 infected a day. However, in the last 24 hours, the number of infections was 6,683, one of the lowest figures recorded on a Thursday in weeks. The positivity rate per 100 PCR tests performed also decreased and was 7.8%, the lowest since mid-May, and in the capital, it was 10 percent.

With more than 1.5 million cases and 31,140 total deaths, the country runs one of the most successful vaccination processes in the world: it has managed to immunize 60% of the target population with two doses and more than 76% with one injection. These figures place Chile as the second country with the highest percentage of completely inoculated population in the world, according to data from the University of Oxford.

Despite this, the hospital occupancy rate in intensive care units (ICU) remains above 95%, after accounting for 3,302 patients in serious condition, which implies that only 175 critical beds remain free in the entire country.

COVID-19 in Peru

In troubled Peru, where almost two weeks into the presidential election, the victory of Pedro Castillo has not yet been proclaimed due to allegations of fraud by his rival Keiko Fujimori, everyone’s fears materialized: an official count confirmed that the true number of deaths from coronavirus in the country is more than 180,000, almost triple the official figure. The latest revision made Peru the country with the highest per-capita mortality rate in the world.

Although Peru imposed one of the earliest and strictest closures in Latin America in March 2020, high labor informality, overcrowding in homes, and even shopping habits meant that the measures failed to reduce infections. Thus, the country has had difficulties containing the coronavirus since the pandemic began, and its official death count before the new estimate was already the ninth highest in the world in deaths per capita.

COVID-19 in Colombia

Colombia, meanwhile, reached the record for deaths amid growing social protests, with empty vaccination centers and full hospitals.

The country is going through the third peak and the Intensive Care Units are saturated or on the verge of not having availability for patients with COVID-19 or other conditions. Areas, such as Antioquia, one of the most impacted by the crisis, have had to apply the so-called ‘ethical triage’ to make decisions regarding who is being given space in critical care.

According to data from the Mayor’s Office of Bogotá, the capital of Colombia is on the verge of saturation with 95.3% of beds occupied. Medellín, a city that claims to have gone through the “hardest” of the peak, still has 97% of its critical care units occupied. Recently, Cali, the third-largest city in Colombia, declared itself 100% occupied in ICU beds. In addition, last Thursday, the city reported the highest number of deaths from the disease in 15 months of the pandemic: 35 deaths.

According to the Ministry of Health, in its latest report, of 13,200 beds in Colombia, 8,200 are occupied by patients suspected or positive for the disease; that is, 88% of the total units are occupied.

The country was, and is noted, for its controversial handling of the pandemic. It was one of the last to start the vaccination process in the region, and estimates are not encouraging: the country would only finish its vaccination process in early 2023.

Added to this are the high levels of unemployment and poverty that the pandemic brought with it. The National Administrative Department of Statistics (DANE) established that 42.5% of the Colombian population was in a condition of poverty during 2020; that is, an increase of 6.8% compared to 2019. In terms of unemployment, until April, the rate did not drop below 15%.

COVID-19 in Argentina

Argentina, for its part, continues with one of the most alarming statistics in the world, with a weekly average of 12.6 daily deaths per million inhabitant and a daily average of 493.86 new daily cases per million inhabitants.

The occupancy level of intensive care beds, both public and private, is 91%, a very high percentage that has remained since May 14, when it was 90%, but at that time 58% of patients were admitted for coronavirus and 42% for other illnesses. On June 11, COVID-19 patients occupy 69% of ICU beds, just 3% lower than the June 4 survey, but 11% higher than on May 28, when it was 58%.

Furthermore, according to this latest survey by the Argentine Society of Intensive Care, 23% of seriously ill patients who are connected to a mechanical respirator are housed in common rooms.

Added to these figures, 88% of health personnel “have signs of exhaustion”; They are intensive care physicians, specialized nurses, orthopedists, anesthetists, among other specialists who assist patients admitted to intensive care every day.

This combo is the product of a 15-month pandemic, a period in which it was not possible to rotate the necessary personnel to allow the rest of those who are exhausted; In the middle, uncertainty is generated by the high occupancy of beds and the lack (due to high demand) of sedation drugs for intubated patients.

In fact, in the survey of the Bloomberg agency, which analyzes the management of the crisis taking health, economic and social variables, Argentina fell to the last place in the ranking of management of the coronavirus pandemic during May, followed by three other Latin American countries, Colombia, Brazil, and Peru.

“With the midterm elections in November, the crisis has turned into a shouting match in a polarized political landscape. The right-wing opposition accuses the center-left government of Alberto Fernández of not having managed the purchase and administration of vaccines and of having mismanaged the crisis in general to the point of leading it to financial ruin.

In recent days, in addition, stagnation in the vaccination rate in Argentina was confirmed, which with the data released last Thursday by the Argentine Ministry of Health definitely became a clear decrease in the average daily doses administered. In the last seven days, an average of 259,889 vaccines were administered per day. The week before, the number had been 324,888 doses. It can be concluded that the daily inoculation rate during the last week decreased by 20% compared to the previous one.

This news is even more striking if it is considered that Argentina exceeded 20 million doses received and that there is currently a stock of 3,264,989 doses available, among which are pending application in the hands of the provinces and those pending distribution in power of the national government.

COVID-19 in Mexico

In Mexico, with only 12.2% of the population fully vaccinated, it is unlikely that the immunization campaign was responsible for the openings. For some experts such as Dr. Laurie Ann Ximénez Fyvie, author of the book “An irreparable damage: The criminal management of the pandemic in Mexico”, a highly costly immunity was achieved through infection, after more than 2,467,643 cases and 230,792 deaths, officially recognized, although the Government accepts that the figure is extremely underestimated.

President Andrés Manuel López Obrador, recovering the vaccination rate is essential to avoid a regrowth due to the cold season. And it is that after the elections of June 6, the speed has been reduced almost by half. “The rate of arrival of vaccines has dropped, there is availability, but we can also prove that fewer vaccines have arrived,” he said at his regular press conference on Friday.

At Friday’s cutoff, Mexico City was the entity with the highest number of active cases (> three thousand cases), followed by Tabasco, Yucatán, Baja California Sur, Quintana Roo, Tamaulipas, State of Mexico and Sonora is added as the entities with more than a thousand active cases, concentrating 74% of the active cases in the country.

In Mexico City, every day the hustle and bustle that prevailed before the pandemic is getting a little more intense. The traffic, crowded restaurants, and full public transport give the feeling that normality has returned. In peninsular towns such as Cancun and Los Cabos, the traffic light that indicates the danger of contagion is in orange although tourist activity continues to normalize.

COVID-19 in Venezuela and Nicaragua

Even more worrying are cases in Venezuela and Nicaragua, where reliable information isn’t available. The data presented by the Nicolás Maduro regime in Venezuala are implausible and contrast with the cries for help of the doctors and opposition leaders, who tell how the dead are not registered and how to access the vaccine you have to have the Chavista “homeland card”.

In Nicaraguan, Daniel Ortega seems more concerned with imprisoning his rivals – more than a dozen in less than 15 days – to avoid serious opponents in the November elections, than in reporting on the status of the pandemic. There, figures are not directly offered …The regime does not even bother to invent them, as is reported to happen in Venezuela, information about the pandemic isn’t provided to the public.

Thus, in Latin America, hospitals are still full, vaccines are not enough yet, and the equation is quite clear: the pandemic is far from over.

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