On June 11, when the undersecretary of health in charge of the country’s COVID-19 strategy, Hugo López Gatell, was fired amid cheers, mariachis and photographs outside the National Palace, Mexico was about to reach half a million deaths from the pandemic.
Wearing a bouquet of white roses, wearing a cherry-icing cover, an attachment he referred to as “false security” at the start of the pandemic, the undersecretary posed for photographs that occupied the front pages of newspapers the next day. That day concluded the transmission of the daily conferences to report on the progress of the pandemic in the country.
He was smiling after 15 months in which he led conferences to report on the progress of the pandemic and containment measures. In one of them, in April he predicted that “the worst scenario” of the pandemic in the country would be to have 60 thousand deaths, but that figure was reached just four months after his declaration, in August of that year and continued to rise.
As of June 22, 2021, there were 229,015 deaths from COVID infection confirmed through testing, according to information from the Ministry of Health.
However, to measure the real impact of the pandemic, not only the confirmed infected are considered, but the number of additional deaths than expected. That is, every year, in each region, practically the same number of deaths occur, but in the face of an unexpected event, such as the pandemic, there are more deaths than expected, which is known as excess mortality.
The country records an excess mortality of 493,503 people who died between April 2020 and June 22, 2021, of which only 71% have confirmed death from COVID and the rest the cause is not yet known but, according to specialists, these are people who suffered from other diseases and were not treated in hospitals , for deaths that occurred at home and others who had suspected the contagion, but were not tested.
For this period of time a million 42 thousand deaths were expected, but in the midst of the pandemic a total of one million 536 thousand deaths have occurred. This means that Mexico registers 47% excess mortality, or deaths ‘over’ than expected.
In the registration by entity, the Ministry of Health has not updated the data until June. But until March 15, 2021, Mexico City was the entity that registers the most excess mortality, with 83%, which means 93,548 deaths. This is because it was expected to have 112 thousand deaths, but instead 205 thousand occurred
It was followed by the State of Mexico, with 81,930 deaths, which represents an excess of 71%; Baja California, with 15 thousand excess deaths, 47%; Sonora, with 11 thousand deaths, 43%.
Possible explanations for the excess
Although in the official speech, both President Andrés Manuel López Obrador and Undersecretary López Gatell maintain that Mexico effectively faced the pandemic, the consideration of other specialists argues the opposite.
For example, Malaquías López Cervantes, professor of Public Health at the UNAM School of Medicine, explained that there was a very clear instruction at the beginning of the pandemic that delayed the attention of the possible infected.
Undersecretary Lopez Gatell told the population through the conference of March 13, 2020, 5 days before the first death from COVID: “If they are not in that situation, they better stay home because it is most likely not coronavirus; and even if it were coronavirus, chances are it’s going to be 80% of people who are not going to have any complications.”
Still in September 2020, the instruction was that patients with “a picture of acute respiratory disease, acute respiratory infection should be accompanied by a person who offers care” and only “for people with severe condition, that is, people who have difficulty breathing, chest pain and an oxygenation level below 93% should urgently go to a hospital” , explained Ricardo Cortés, director general of Health Promotion.
This, says Malaquías Cervantes, was a “very serious error of interpretation because at first it was thought that COVID was like influenza, but it turned out differently. Decisions needed to be adjusted to correct and quickly bring people to hospitals. Respiratory failure meant that it was already a severe case; they were arriving very late to the hospitals.”
Another decisive aspect was the hospital conversion, that is, the hospitals concentrated most of their beds to attend to COVID patients, which meant that almost three million people did not have care to treat the rest of the patients.rmedades.
This is considered “indirect death, because someone did not receive adequate care because the health system was turned to something else,” explained Alejandro Macias, head of the Microbiology and Infectious Diseases Area at the University of Guanajuato.
In fact, Animal Politico published that nearly three million people with a disease other than COVID-19 were left without the possibility of receiving emergency care or being hospitalized for treatment or surgery in public hospitals in the health sector, between March and October 2020.
Another factor is that although hospital occupancy remained below 60% for almost the entire year, in December it increased, especially in Mexico City up to 80% and states like Zacatecas up to 94%. And if people didn’t get a hospital bed, they ended up being cared for at home.
While the restructuring was a reaction to the pandemic even with the cuts to the health sector and the battered hospital system and had important scopes so that the system did not collapse, but this “does not mean that patients have necessarily had good care within hospitals. We know that there are hospitals where even when people had care, but it was not of the best quality,” says Alejandro Macias, who was influenza commissioner during the AH1N1 influenza epidemic in 2009.
The pandemic also started with a deficit of 200 thousand doctors and 300 nurses. Although the federal government hired 44 thousand to join the health workforce, this only accounted for 8.8% of the deficit.
And to this we must add that even with the hiring of that number of health personnel not all were specialists or trained to correctly use ventilators for critical patients with loss of lung capacity, and a wrong use could cause harm to the patient instead of helping him.
“All that combined produces a terrible scenario in Mexico. They are vicious circles and there has been not the remotest intention of recognizing them or acting seriously in search of possible corrections, “concludes Malaquías López.
Alejandro Macias warns that although Mexico is not South Korea, nor China, “you can always do things better, but we also have to see that really those experiences could have been made in Mexico and that is what we can discuss. Among the improvement was more early detection, more contact tracing and isolation, and since May much better promotion of the use of coveralls.”
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