Over 200,000 official dead, the terrible cost of the pandemic in Mexico

435
Trabajadores del Panteón Municipal de San Efren, ubicado en el Municipio de Ecatepec, Estado de México sepultan a un hombre que murió de coronavirus, el 02 de Febrero de 2021. El número de defunciones por COVID-19 en México ha superado los 160 mil al mes de enero de 2021 y alcanzó un nuevo récord de muertes diarias durante el nuevo pico de contagios de la enfermedad, lo que ha generado que los servicios funerarios se vean rebasados e insuficientes para la cantidad de personas que los requieren diariamente.

Last year, just between March 18 – the day the first death from COVID was registered – and December 31, 335,712 people died from the pandemic.

Of this number, only a third is officially recognized as having died from COVID, while the remaining 60% died from other diseases, due to lack of medical attention, or it was not possible to confirm whether they had been infected by the new virus.

The impact of the pandemic in Mexico implied that 1.5 deaths occurred every minute during 2020, that 38 people died every hour

The risk of the new variants and a re-outbreak at Easter continues, despite the fact that deaths and infections decrease every week and the battle has moved to the field of vaccines


The pandemic begins to give Mexico a break after a very high cost. A year after the country began to add contagions and deaths +200,000 official deaths since Thursday-, the statistical curve shows a decrease with several weeks of reduction in both parameters and hospital occupancy is around 20%, very far from the 90% of other weeks. The map of the Republic has gone from red to orange and from orange to yellow and there are already three states in green, the closest thing to normal life, that is, with students about to go back to school. More than 17,000 teachers have been vaccinated in Campeche, practically 100%, to start classes. Even in the most affected areas, such as Mexico City, the stores are open, the restaurants are full, the street vibrates again. This is the danger. Easter is approaching and there is no one who does not fear the worst. On this side of the Atlantic, too. The second fear is the relaxation of the population due to the confidence in vaccines. And the third, the new variants.

https://datawrapper.dwcdn.net/Js2mA/3/

Long months of fighting against death, which today already totals 200,211 deaths, although there are many more because the count is far from being exact in the face of excess mortality, have allowed some learning. The closure since December in those areas most affected with the City and the State of Mexico in the lead, the rapid detection of cases thanks to the multiplication of tests , improved assistance in hospitals that have been able to deploy beds and other assistance alternatives at home they allow today, say the experts consulted, to speak of a pandemic that is slowing down. “Hundreds of scientists are monitoring the new variants and three of the most relevant have already been identified in the country, the United Kingdom, the Brazilian, and the South African. There is an important virological surveillance work, in which there are several institutions such as the UNAM ”, says Mauricio Rodríguez Álvarez, epidemiologist and spokesman for the commission for the care of the pandemic at this university.

The “universe of susceptibles”, as epidemiologists call it, is shrinking. That is, those who have already been infected and have defenses, as well as those vaccinated, promote the brake on infections. That’s why variants are now the concern, for their greater contagion power and because they can escape the current immunization. “Countries with more cases and fewer vaccines will generate more variants, such as Brazil, a country for which some organizations are already asking that vaccination be given priority. Now it is known that the AstraZeneca does not protect against the English variant, so the scientific career continues ”, says Rodríguez Álvarez. The pandemic, then, is far from over, it will not even end, but we will have to wait for its endemicity to settle, that is, for it to become a kind of seasonal flu. Regarding Mexico, the epidemiologist has a clear diagnosis: “Until the United States controls its pandemic, Mexico will not achieve it due to the strong exchange between the two countries.”

A medical worker from the Secretariat of National Defense of Mexico receives the coronavirus vaccine in December of last year.
A medical worker from the Secretariat of National Defense of Mexico receives the coronavirus vaccine in December of last year. MONICA GONZALEZ

In the chapter on vaccines, Mexico can boast of having scored somewhat. He raised his voice at the voracity of rich countries and was left with no choice but to enlist in the ranks of those who opted for laboratory developments that some despised. He signed agreements with the Russians to buy Sputnik V and shipments continue to arrive from AstraZeneca or Cansino, the Chinese, which is already packed by the millions in its territory. Pfizer and Sinovac are also applying. “They are all safe and effective. You have to use them. Mexico has been right in that. The same Cofepris that authorized the Pfizer vaccine has authorized the others. You have to trust, ”says Rodríguez Álvarez.

With the decline in the disease, vaccines are now the battlefield. As shipments arrive, millions of vials pile up with no means to apply them. There have even been problems with packaging due to a lack of supplies. A surplus of around 5 million doses has forced the Government to recruit the Army to inject the population. It is a good step, but more could be done. “They have a hyper-controlled format, very rigid. They should incorporate into the vaccination process other assets of society, such as universities, which could be immunizing their own community or the population in general. Companies could also vaccinate their employees by resorting to their medical services. At the end of the year there will be enough vaccines for that ”, says the UNAM spokesperson. “This is the hard part. The 36 million doses of influenza have taken several months for its application. We must recognize that no one can vaccinate, wherever and however they want, it is emergency immunology and everything must be controlled, if something happens the Government has to answer for it ”, adds Rodríguez Álvarez.

Anyway, the delay in the application of vaccines is causing headaches for Mexicans, especially doctors. Among doctors, nurses, specialists, and other health support workers, 2,159 people have died, according to the data updated by Héctor Hernández Bringas, a researcher at UNAM. This group has been in Mexico the most punished in the world. And not only those who work in hospitals that treat pandemic cases have been affected. With a very weakened public health system and among the lowest in the OECD (36 out of 46) in the number of doctors, just 2.4 per 1,000 inhabitants, the country has developed a whole parallel care system. Hundreds of medical school graduates who have not found a place in public services have set up their private practices, and up to 18,000 pharmacies have an attached consultation where a couple of doctors usually take turns, according to data from the national pharmacy association, Anafarmex. They are not being the priority population in vaccination and it is something that experts have been asking for for a long time. At the insistence of journalists,

“Before coming to intensive care we received thousands of patients with covid, we are their first contact, therefore, the first line, of course, yes, with all due respect to colleagues who are risking their lives in the hospitals, which do not have sufficient protective equipment in many cases, ”says Sergio Palacios. He has a consultation in Tláhuac and in November and December he saw about 30 covid patients daily. He himself suffered the disease in May and has seen “many colleagues” die. “At first we did not know anything, they did not train us, they did not inform us, we learned through daily contact with the disease, which occurs in very versatile ways: I have had patients who came with the desire to commit suicide, with diarrhea, sad and ended up being covid, “he says.

Dr. Palacios knows perfectly how pharmacy offices work. Thousands of doctors without effective protective equipment, he says, many of them without pay, who earn their living on commission from drugs prescribed and sold by pharmacies, especially the cheapest ones. “Others charge from 30 to 70 pesos for the consultation and up to 60% can be kept by the business owner. So these commissioned doctors prescribe COVID treatments that we know are useless, such as azithromycin or oseltamivir, among others, but they have to sell. And the Government pretends that it has a treatment for the sick. Mayan train, refineries, they spend money on that, but nothing on health ”, Palacios gets angry at the lack of vaccines for them. “They are letting us die.”

Samuel Ponce de León, the coordinator of the UNAM Health Research program and one of the thirty experts who participated in the report Reflections on Mexico’s response to the covid-19 pandemic and suggestions to face the next ones, agrees with him. challenges, an exhaustive document from a few days in which the personnel of the Ministry of Health participated. Ponce de León says that what we see in hospitals “is just the tip of the iceberg. The transmission occurs with or without symptoms, but one in every five or six infected develops symptoms that lead them to seek a medical appointment and do so in pharmacies or private offices. This has been handled with little attention. These doctors are the front line. The vast majority of those infected in Mexico and in the world are seen in primary and private consultations. They are often unventilated clinics with high patient demand. All health care centers should be giving their staff vaccinations because the Mexican health system has great experience applying biologics, but there is a ridiculous desire for control, ”he criticizes. “The health sector must be fully vaccinated. If they can’t get there, let them say so, but don’t deny the risk these doctors are running, ”he adds.

The director of Anafarmex, Antonio Pascual, is, however, sympathetic to the government’s strategy for immunization. “We are aware that there is a prioritization scheme, but we have good expectations because we are considered among those who are going to be vaccinated. Both the doctors in the adjoining consultations, as well as the pharmacy operators are susceptible to contagion ”. He affirms that the doctors in the pharmacies have received training and acknowledges that there have been infections, but “it has been a minor situation.” The scale designed by the Government seems to him “a success”. “We understand that priority is given,” he says.

A government worker offers antibacterial gel to passersby in downtown Mexico City last Tuesday.
A government worker offers antibacterial gel to passersby in downtown Mexico City last Tuesday. SEILA MONTES

At the ABC hospital in Mexico City, one of the most prestigious private centers, they have decided to vaccinate all their staff regardless of their proximity to covid cases. But vaccines have barely reached 50%. “They ask us to vaccinate those who are most at risk, but sometimes a specialist is in a worse situation than someone who treats covid because they do not have protective equipment and they can receive infected people,” says the director of the area in charge of the pandemic in the ABC, Francisco Moreno, who ensures that all private health suffers the same restrictions on vaccines. “There is a lack of equipment, there is a lack of medicines and we cannot continue the treatments. It seems that the private was against the fourth transformation ”, he complains.

Despite the imbalances that still exist, Mexico is beginning to breathe, albeit with all precautions, and the health authorities view the outlook with some optimism. But the country has paid a high price in this pandemic, which has had two very pronounced peaks: in mid-July, 836 confirmed deaths were counted in a single day, always with official data, which did not record many deaths that occurred outside the hospital setting. At that time, the daily average exceeded 700. The second escalation came from the hand of the Christmas holidays, which left peaks above 1,000 deaths several days in January and until February. It is true that by then the detection capabilities had improved significantly, so it is possible to think that the intensity of both peaks was more even than what the deaths with official diagnosis reflect. Now, after a new fall that has lasted a month, Mexico is in a tense calm: more than 300 deaths are still reported daily, with important territorial differences that leave a disturbing reflection for those territories with less pandemic incidence: the immunity acquired by their population is smaller, therefore, a new wave could find them more unprotected.

The economy has been another of the great victims of this pandemic. Last year the GDP fell by 8.5% and several million poor people have joined the enormous figure that this country already shows. Many businesses have closed their doors forever and the impact on student education will be felt decades later. It is urgent to fight the disease, but its consequences will last for decades.

At the end of March last year, when the disease was just emerging in Mexico, the governor of Puebla, Miguel Barbosa said that this was a pandemic of the rich to which the poor were immune. The months that followed have been tenaciously responsible for disrupting that occurrence. The profile of the most affected population remains the same: 90% manual workers, laborers, artisans, merchants, street vendors, teachers, taxi drivers. Those closest to poverty, which in Mexico affects 60 million people, with a population of 126 million. “Death has a place to lay its hands-on,” says Researcher Héctor Hernández Bringas. “There are very few executives among the deceased because they are more likely to stop working for a while or to work from home, but public transport is still crowded with people coming and going to work,” he says. “1.8 men have died for every woman, but housewives represent a quarter of the total, more than 50,000 ”, she says. They are the ones who have come to the markets to supply themselves and those who have cared for the sick. “It was to be expected.”

Animal Político and Proyecto Li calculated excess mortality based on requests for information to the National Population Registry (Renapo), to the civil registries of each federal entity, and the data published by the Ministry of Health for the month of December. 

Thus, while in 2019 there were 717 thousand deaths, according to INEGI, in 2020 there were one million 54 thousand deaths. The excess mortality is the difference between the two figures, which means that 335 thousand 712 deaths occurred due to the pandemic – between March 18 and December 31. And of that total, 137 thousand died from COVID.

The most critical point was in July, as 14 entities registered the highest number of deaths in that month: Guerrero, Puebla, Oaxaca, Nuevo León, Nayarit, Yucatán, Sinaloa, Quintana Roo, Guanajuato, Tabasco, Colima, Tlaxcala, Campeche and Veracruz . 

While five more had the worst month in December: Jalisco, Hidalgo, Baja California, Querétaro and Aguascalientes. The State of Mexico, Mexico City and Morelos, registered the highest number of deaths in May. Chiapas and Sonora in June. Tamaulipas, Baja California Sur and San Luis Potosí in August; Michoacán in September and Zacatecas, Durango, Chihuahua and Coahuila in November. 

This resulted in the rate of deaths in addition to those expected in 2020 to be 266 per 100,000 inhabitants in the country. According to The Economist’s measurement of 50 countries, Mexico would be below countries such as Peru, with a rate of 355 or Russia with a rate of 291, but above the United States with 168 or Spain, with 177. 

While when comparing entities in the country, Mexico City has the highest excess death rate with 600 per 100,000 inhabitants, followed by Chihuahua with 360, Tlaxcala with 359 and Baja California with 338. 

And four other entities also exceed the national rate of 266 excess deaths: Puebla (313), Coahuila (308), State of Mexico (294) and Zacatecas (270). 

In addition, at the national level, April had 8,885 excess deaths and each month it grew to 57,539 more deaths in July. It decreased in September and October, but increased in November to end with 52,162 deaths in December.  

Graphic: Jesús Santamaría

This resulted in the death rate additional to those expected in 2020 ending at 263 per 100,000 inhabitants in the country. According to The Economist’s measurement of 50 countries, Mexico would be below countries such as Peru, with a rate of 355 or Russia with a rate of 291, but above the United States with 168 or Spain, with 177. 

While when comparing entities in the country, Mexico City has the highest excess death rate with 613 per 100,000 inhabitants, followed by Chihuahua with 354 and Baja California and Tlaxcala with 350. 

And four other entities also exceed the national rate of 263 excess deaths: Puebla (312), Sonora (204), Coahuila (301) and the State of Mexico (287) exceed the national rate.  

Among the possible factors is the hospital reconversion that resulted in focusing only on treating COVID, leaving the rest of the patients without sufficient care, and, by December, the saturation in hospitals would have limited timely care for those who required it.  

Source: animalpolitico.com, elpais.com

Mexico Daily Post