translated from Spanish: What’s behind high mortality in Mexico, this is what experts say

The four countries with the greatest excess mortality (Ecuador, Bolivia, Peru and Mexico), among those considered in a study, have a “family health system, in which health rests on families,” they said.
A poor health system with no full coverage, comorities, few resources to test, manage and erratic messages from health authorities, stem from confusing messages from international health authorities, low funding, high politicization and an erratic vaccination plan are listed among the factors for Mexico to have so many deaths.
This was noted by several experts, during the talk on the case study to evaluate Mexico’s response to the COVID-19 pandemic, which developed a group of specialists from the University of California, San Francisco, USA, at the request of the Independent Panel of the World Health Organization (WHO), tasked with analyzing how nations have acted during the health crisis.
This study finds that Mexico is one of four countries, out of about 60 that were considered, with worse performance in excess mortality. The authors say that better management could have prevented some 190,000 deaths from all causes (not only by COVID but also by ina lack of attention to other conditions), of the more than 300 thousand that had been documented by the end of 2020.
Find out: Health records 49% excess mortality by 2020; 70% can be attributable to COVID, recognizes
During the talk about the study, participants went deep into the possible causes of this. Ilán Bizberg, professor at the Center for International Studies at the College of Mexico (Colmex), noted that countries that have had the greatest excess mortality in the pandemic have at least one characteristic in common, out-of-pocket health expenditure, i.e. what people have to pay to care for, is between 30% and 40% (of everything that is disbursed by diseases by both the government and people).
This reflects that there is not enough health coverage for the entire population, not only because 20% do not have it, but also because people prefer to go to private services, in the face of deficiencies and delays in the public.
The four countries with the highest excess mortality (Ecuador, Bolivia, Peru and Mexico), among those considered in this study, Bizberg specified, have a “family health system, in which health rests on families. They are systems where a large part of the population is not covered, where a portion of the spending is out of pocket (Mexico is the champion with 50% out-of-pocket spending), and government spending on health is low, between 4, 5 or 6% of GDP.”
In the pandemic, Bizberg said, this has led to the spreads not attending health services until it was too late and that many have died in their homes, because they know that going to the hospital means waiting times, poor services and, above all, expenses.
Read: CDMX posts 15,564 deaths in January (most lethal month)
In Mexico, he stressed, there has been insufficient investment in the health system over the past 30 years, it is fragmented, deficient and insufficient.
The countries of the continent that did better, such as Uruguay, exemplified the Colmex specialist, were those that have coverage of free medical services for the population of 100%, higher health expenditure over GDP (9%) and low spending on the private health sector and that of individuals.
“Half a century of precariousness in the health system, which is reflected in inequity in access and poor quality, is what measures the severity of the impact of the problem today in Mexico,” said Samuel Ponce de León, coordinator of UNAM’s University Health Research Program (PUIS).
Erratic management and polarization
One of the strongest criticisms of the case study is that the authorities acted late, uncoordinated and badly in the face of the health emergency. Jaime Sepúlveda, executive director of the Institute of Global Health, University of California, San Francisco, (UCSF) and one of the authors of the case study, noted that there was a lack of foresight on the part of the Mexican government and in anticipation to respond adequately to the pandemic, as well as failures in the incorporation of scientific knowledge and inability to recognize errors and correct public policies.
Although Ponce de León of PUIS indicated that, with regard to the delay in response and the erratic, it was appropriate to discuss issues, such as the role, precisely from the instance to which(e) the study, WHO, was delivered as a regulator of the global, regional and national response.
“As is customary, WHO did not assess correctly (the risk facing the world) and did not clearly report the problem. News had been made since November 2019 (about the virus), confirmed in December. China’s official announcement does so on 31 December and is up to four weeks later, on January 31, when the Organization declares an emergency. Late and weak the message,” Ponce de León stressed.
He also criticized the pandemic as a purely medical matter: “While the Ministry of Health was trying to organize its activity, the rest of the cabinet was still watching. This pandemic involves all sectors of society. As soon as the alert was given, everyone had to activate protocols. It wasn’t like that. They didn’t know what to do and no one explained it to them.”
You may be interested: 335,000 people died from the pandemic in 2020, equivalent to the mayoral population of Miguel Hidalgo
Sergio Aguayo, he talked about politicization in the pandemic. “We are trapped on two sides: the federal road (Hugo López Gatell, Undersecretary of Health, and the President, Andrés Manuel López Obrador) and his critics of all kinds, very present for more than a year. The questions would be what destination have priority issues in the environment we have in Mexico? Is it possible to have a fruitful dialogue that improves public policies, but thinking about the general interest and not just the philias and phobias that are with 4Q?”
The logical thing about the presentation of this case study, exemplified, would have been a response (by the government). Instead there was silence for nine days, and then the response came through an interview granted to a portal, he noted. “An interview with a belligerent and rude tone (by the Undersecretary of Health), in which he accuses Sepúlveda of ideological resentment and affected businesses.”
Instead of that response in an interview, Aguayo said, the government had to convene at least one press conference, with all national and international media, where clear explanations were to be presented.
Ponce de León also stressed that there have been interpretations of the actions of health authorities and the effects of the pandemic marked by polarization. Testing, for example, he said, has been an overrated issue. “A relationship is established between the number of tests and the high mortality. This is a little disorienting. The tests were initially of limited epidemiological use in establishing practical intervention, because the result could take up to 10 days. Too late for any intervention.”
In addition, “testing intervention requires infrastructure that does not exist in the country,” he added.
Experts invited to the conversational period agreed on two other factors to be addressed and which are impacting the results against the pandemic: the impact of the high incidence of comorities (obesity, weight, diabetes, hypertension) that aggravated COVID tables in the country, and the erratic of vaccination policy.
“The best news we have today, at the worst of our time, has an implementation with an emphasis on the electoral, with the performance that the education sector can give, for example, in voting blocs for future elections,” Ponce de León said.
 
What we do at Animal Politics requires professional journalists, teamwork, dialogue with readers and something very important: independence. You can help us keep going. Be part of the team.
Subscribe to Animal Politics, receive benefits and support free journalism.#YoSoyAnimal

Original source in Spanish