The pandemic is ahead in Mexico, one of the countries with the highest number of deaths and new infections in the world. Three clear errors are the causes and are key to correcting the course, according to experts.
“There is no strategy. That word has been misused. The General Health Council (CSG) should have taken control of this and should have had a group of specialists from various sectors, from the private sector, from NGOs, from various universities “, affirms the Mexican doctor and analyst in health policies Xavier Tello.
In conversation with DW, the expert emphasizes that from the beginning the dimension of the problem was underestimated and that is why the CSG, a body of the Mexican State responsible for health emergencies, was not convened. “The General Health Council is the one that has the constitutional mandate to take charge of an emergency like this. It is chaired – in this case unfortunately – by the President of the Republic, who decided that the Undersecretary of Health, Hugo López, should take charge Gatell “.
For Xavier Tello, the first mistake was underestimating the pandemic, and wanting to compare it to influenza. “Surely because it was the only experience Hugo López Gatell had.” That was followed by not conducting screening tests. Several times, according to the expert, they repeated that the tests do not save lives. Another mistake was to say that asymptomatic patients were not contagious. “Hugo López Gatell was based on the assumption that if the person was asymptomatic it was because he had a low viral load, and therefore had little risk of infecting others.”
On February 27, 2020, Mexico confirmed the first case of coronavirus infection. On March 18, the first death was registered. Until May 3, the country followed the sentinel surveillance model, used in several countries to monitor seasonal influenza. López Gatell clarified in early May that upon entering Phase 3 on April 21, the country stopped using the sentinel model and switched to a method based on the occupation of hospitals and available beds, a model that is still in force at the time to decide the economic opening.
In the middle of the pandemic, López Obrador continued to greet his followers, without a mask (March 30, 2020).
The internist and infectologist, and professor of Postgraduate Internal Medicine at the ABC Medical Center, Francisco Moreno, agrees with Xavier Tello. For Moreno there are three very clear errors: “The first is not having done the tests that are needed to detect asymptomatic patients that spread the disease. They did not do tests to save the cost of doing them. The number of tests in Mexico is 158 per million inhabitants, only two countries have fewer tests carried out than Mexico per million inhabitants: Haiti and Nicaragua. “
The second mistake was the politicized use of the mask (or mask), according to the doctor. “The most effective measure to avoid contagion has become politicized. The president himself has said that he will not use a mask because he already had the disease. He should be the first to use a mask. We have seen the Undersecretary of Health, who is in charge of the pandemic, getting on a plane without a mask, being on a beach without a mask, and now that he was infected, in a park without a mask. There is no message to the population about the need to wear a mask, “he insists.
For Xavier Tello, the doubt about the effectiveness of the mask does not come from any scientific analysis. “It was plain and simple, to agree with the president. López Obrador does not want to use the mask for a political-ideological issue and Hugo López Gatell was not going to contradict the president.”
The poorest population is the most vulnerable, also during the pandemic.
Mortality in public hospitals greater than 30%
The third serious mistake, according to Francisco Moreno, is to think that having beds available in hospitals has controlled the pandemic. “In Mexico, it is said that economic activities can be opened depending on the number of beds available. The problem is that mortality in public hospitals is higher than 30%. One in three patients who arrive at the hospital dies because the Hospitals that assigned COVID patients were not equipped with the material that they must have so that the patient can get ahead. The reality is that we have terrible mortality, a critical situation that has already lasted more than a year. “
The doctor who is in charge of the pandemic at the ABC Medical Center, affirms that a fourth error can also be spoken of: “Despite everything that has happened, there has not been a correction.”
More than a year after the pandemic hit, Mexico, after the United States and Brazil, is one of the hardest-hit countries in the world, with an official death toll approaching 200,000 marks and more than 2 million detected cases of infection.
Added to that is the problem of medications. The antiviral Remdesivir, a drug that has been considered an effective remedy in seriously ill patients with COVID, was approved for emergency use by the Federal Commission for the Protection against Sanitary Risks (Cofepris) on March 12, after a long controversy over its effectiveness and high price.
“It is not a panacea, but nothing is against COVID. As it is an expensive drug when approving it, it would have to be supplied by public hospitals, and if they cannot use it, let no one use it. The announcement was made on Friday and so far we do not have the medicine, “says Francisco Moreno, an internist at the ABC Medical Center. “There have been many obstacles that Cofepris has put to medical work when caring for patients. They took away the serological tests for a while, they have not allowed us to use medicines, they force us to write a tremendous amount of prescriptions. Each medicine that I send to a patient who is hospitalized has to bring a prescription. We have hospitalized about 50 patients, each patient receives eight medications, 400 prescriptions have to be written daily to send to Cofepris “, warns the doctor.
The first phase of public vaccination aims to protect older adults.
The vaccine challenge
Now Mexico faces the challenge of vaccines. On December 23, Mexico was the first Latin American country to receive the COVID-19 vaccine. The government agreed to purchase more than 234 million doses of five different vaccines, but as of the first week of March, it had only received 1.7%. The determining factor in negotiations with pharmaceutical companies is financing for the development of their vaccines.
“There is a very sad speech in Mexico, which accuses other nations of hoarders of vaccines and that does not work like that. All countries want to protect their citizens,” says expert Xavier Tello. “If the full cost of the vaccine was paid in advance, the research would be sponsored, as Chile did. Now we would have the vaccines insured, we would be claiming a breach of contract if the vaccines had not been sent to us. Pfizer, Moderna, and other laboratories, to AstraZeneca, work like this. ” Tello regrets that there is no vaccination strategy, nor is there a person responsible for vaccines.
At the ABC Medical Center, not all health personnel have been vaccinated. “At the hospital, we have not received more than 30% of the vaccines we needed. 70% of the doctors and nurses who work here have not received the vaccine. The argument is that we are not on the front line, but we see patients and we have risk. There is much more lag in private hospitals than in public hospitals. ” Why? “Because this government does not want the private,” says Francisco Moreno.
The Army has assumed numerous functions during López Obrador’s administration, including vaccination.
Both experts urge to correct the course. “Increase the number of tests to detect asymptomatic infected people and prevent the infections from continuing. If there are fewer patients, there will be less occupation of hospital beds, which are useless”, highlights Moreno. The second thing is to stop politicizing the use of the mask and start using it all. It should not be a choice, but an obligation, a measure of solidarity. Open vaccination like the United States, making it easier for companies, private hospitals and Social Security itself, which has a huge vaccination infrastructure, and not having to do it through the military, by people assigned by the government of a totally centralist way, which is not enough to vaccinate the entire population. “
Health crisis on several fronts
The federal government decided in 2019 to disappear the Seguro Popular, and replace it with the Insabi (Institute of Health for Well-being). Additionally, with the conviction that there was a market plagued by corruption, in which the distribution companies were hoarders that made the final product more expensive, the drug supply chain was dismantled, which has caused a shortage and lawsuits before the Inter-American Court of Justice. Human rights. The shortage of medicines has affected patients with numerous diseases, particularly children and adolescents with cancer.