Analysis of Inés Capdevila in LN +
The numbers improve in the biggest foci of the
the curve flattens
, Britain’s intensive therapies and
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There are already more healed per day than infected. And South America? For now, between confines of very different styles, it resists with much more positive numbers than other regions.
There are chilling foci of disease and death
, like San Pablo, Manaus, Guayaquil or Lima. Data from the region show that there are three groups of countries: one with low impact, which includes Uruguay and Paraguay; another moderate, which includes Argentina, Colombia and Chile, and the rest with serious scope, which brings together Brazil, Ecuador and Peru.
But the general cut in the South American situation – excluding Bolivia and Venezuela, which have very little data – is encouraging; his x-ray shows four positive and one negative result. The future will depend on the exit strategies chosen by each nation and the times in which they are implemented.
The benefit of absolute numbers
It came to South America long after it began circulating in Asia, Europe, the Middle East, or North America.
confirmed the first imported case on February 26; ten days later the virus had already entered several other countries. There is still no data to determine, as it happens in Italy, Spain or the United States, that the outbreak was already circulating in the region before the Brazilian government reported the first contagion.
Benefited by the dramatic lessons that came from other continents, Latin America reacted early in the fight against the pandemic: in the following 20 days practically all the countries had applied some type of isolation and social distancing, which was gradually hardening.
Just over a month later, South America, with 422 million inhabitants, records encouraging absolute numbers compared to other areas of the world. Until today, the total number of infected is 115,000 and the number of deaths is around 5,100, figures similar to that of Turkey (100,200 infections and 2,500 deaths) and much lower even than some European countries have individually or
Europe, with its 725 million inhabitants, already accounts for more than a million coronavirus patients and more than 110,000 deaths, while the United States, with a population of 330 million people, reaches 880,000 infections and has more than 50,000 deaths.
The tests, insufficient
The region is also below the Middle East, which has 125,000 infections, the majority focused on Iran. It is, however, well above the African numbers (27,000 infections) and Oceania (about 8,000 patients). And these differences in numbers are influenced by one of the most controversial figures in South America, that of testing.
The number of African infections is low because the number of tests carried out in almost the entire continent is also minimal.
The opposite happens in Oceania: Australia and New Zealand are two of the biggest success stories in this initial stage of fighting the pandemic because they tested a high percentage of its population, which allowed them to have an accurate diagnosis on the state of local health. Today, both nations have a reproduction rate (the number of people infected by an infected person) well below 1, a level that epidemiologists define as a “controlled outbreak.”
The number of
tests in America
del Sur is low even in the country that carries out the most tests. Chile has an average of between 5,000 and 7,000 tests per million inhabitants, ten times more than Argentina but just above the amount performed by the least-tested European nations, Bulgaria, for example, or, unusually, France.
Does this mean, then, that the South American numbers seem good but are misleading or, at least, insufficient to carry out a health X-ray of the region? Although the lack of evidence makes us fumble, there are other indicators that help us understand where we are in the outbreak and how the nearest future is projected. And they are a little more precise and they are optimistic.
Contagion speed slows down
South America lags behind, but it is also true that its use increased substantially throughout the almost two months of pandemic in the region; in Argentina, for example, ten times more tests are carried out than in the first week of March, when the coronavirus made its local appearance. And despite this growth in the verifications, the percentage variation in the growth of the cases begins to stabilize in the region, that is to say that the curve begins to slow down.
The percentage variation indicates how much contagion cases increased from one day to the other; after peaks of up to 60% in the last week of March and the first days of April, today that number ranges from 7.92% in Peru – the highest figure – to 1.1% in Uruguay, the lowest. Little by little, the speed of contagion slows down and the peaks of each country begin to appear at the end of April and May.
Despite being a rate, this number is also not very representative, because in almost all countries in South America only suspected cases are tested. This strategy complicates the detection of asymptomatic patients, who are – as more and more studies reveal – a significant portion of the infected population. There is, then, a more definitive and easy to count number, that of the dead.
Low death toll
In China, Europe, and the United States, a severe Covid-19 patient dies on average two weeks to one month after contracting the virus. Therefore, the number of deaths describes the state of the pandemic for at least 15 days; However, even so, many specialists use it to compare the progress of the outbreak between countries because it is a more complete number than the number of confirmed infections to chart the true situation of a nation.
South America lags not only in absolute death toll, but also in each country’s count of deaths per million inhabitants, a more reliable indicator for comparison.
The countries with the lowest figures are Paraguay (1.3), Chile (3.3) and Uruguay (3.4). Colombia and Argentina trace a very similar outbreak curve: they are close in number of infections, deaths and also in the number of deaths per million inhabitants, which is around 4 in both countries.
The group of countries hardest hit is far ahead of its South American neighbors in this indicator: Ecuador has 33 deaths per million inhabitants; Peru, 16, and Brazil, 14. All these figures are far from the numbers of the United States (151), Italy (415), Spain (464) or France (318).
Like their neighbors, these three South American nations have a problem of underreporting in the number of infections and also in the number of deaths: only the deceased who were diagnosed with coronavirus count and not the suspects.
Of course that also happens in the rest of the world. The only country that has so far dared to count suspicious deaths – mostly in private homes – in addition to deaths from coronaviruses in hospitals and nursing homes is Belgium. The small European nation tops the list of most deaths per million inhabitants with 549; his authorities warn, however, that if other countries did the same they would have 50% more deaths.
Ecuador is aware of its underreporting problem, so its authorities look carefully at two other records: that of suspected deaths and the difference in total deaths between the first quarter of 2019 and that of this year. The first of these figures is 952 and the problem is in the second: in the province of Guayas (whose main city is Guayaquil) that difference reaches up to 2,500. In other words, the actual number of deaths in Ecuador could reach 4,000.
However, even with this increase, the indicator of deaths per million inhabitants would be 235, heartbreaking and higher than that of the United States, but lower than that of European nations where the impact of the coronavirus was more limited, such as the Netherlands, which has an indicator 250.
Sanitary capacity, still standing
In the fight against the coronavirus, intervention measures on social distancing are as important as the capacity of a health system to contain and care for critically ill and critically ill patients. In this pandemic, these first patients represent between 10 and 15% of the infected population while the critics are 5%.
The region’s early quarantines aimed both to protect citizens and to care for and expand hospital capacity. And the vast majority of regional countries still have resources – from professionals to critical beds – not used precisely because delaying or flattening the peak. The Argentine government estimates that this capacity is used today at 50%, with 132 patients in intensive care (a number, again, similar to that of Colombia); The Chilean services are somewhat more pressured, with Brazil, Ecuador and Peru being the most overwhelmed and the closest to their limit.
The largest and richest nation in Latin America is also the most complicated in terms of the number of critically ill patients; They are 8,000, a figure only lower than that of the United States, with 15,000. There, specialists warn that five state capitals are approaching their sanitary saturation, Manaus, Macapá, San Sablo, Fortaleza and Palma, and that three others are on yellow alert, San Luis, Recife and Río.
However, the capital collapse index for hospitals, prepared by various universities, also shows that many cities in the rich Brazilian south have their capacity almost intact, which would allow the federal government to distribute resources and develop a strategy to combat the coronavirus in depending on that availability.
Today there is another number that puts pressure on South America, that of the great recession in the making. And the dilemma of all countries is the same: how to preserve the positive numbers of the health crisis without deepening those of the economic crisis.