[ad_1]
The Covid-19 Lancet Commission, created on July 9 and directed by the prestigious British medical journal of the same name – which emerged with the aim of helping governments, civil society and UN institutions to respond effectively to the pandemic – last week he presented his first report / statement for the 75th session of the United Nations General Assembly.
The report, published on Monday, September 14, put on the table the importance of controlling the pandemic around the world – for now – through non-pharmaceutical interventions, pending an effective and safe vaccine; in addition to the need for healthcare professionalism, avoiding the “medical populism” that some politicians such as Donald Trump, in the United States, have addressed; Rodrigo Duterte, in the Philippines; or Jair Bolsonaro, in Brazil.
“We call on governments to prioritize advice from the public health professional community, work in cooperation with international agencies, and learn from the best practices of other nations. All countries must combat decisions that are based on hearsay and misinformation. Leaders must desist from expressing personal points of view that are in disagreement with science, ”says the commission’s text, signed by more than 60 specialists from different areas, including only one Chilean: the former Minister of Finance of Sebastián Piñera, Felipe Larrain, current member of the UN Leadership Council for Sustainable Development.
However, the most striking is centered on an analysis that compares the dynamics of covid-19 during the month of August in a total of 91 countries that have sufficient statistics, in which Chile was ranked 80, at the bottom of the table.
The first to present the report was Gonzalo Bacigalupe, a Harvard health worker, researcher and professor at the University of Massachusetts, who noticed the complex scenario. “Don’t let anyone tell you stories. This is the world situation. Look where Chile is ”, he assured via Twitter.
The figure shows four measurements regarding the pandemic. The first measure is the incidence: the number of confirmed cases per million inhabitants per day, averaged over the 31 days of August. The second is the mortality rate, measured as deaths per million per day, averaged over the same period.
The third indicator is the number of covid-19 tests performed in August relative to the number of new cases in August, which functions as an indirect measure of the testing scale, as each new confirmed case potentially has dozens of close contacts (e.g., family members, co-workers, merchants), thus the number of tests per case it must be in the dozens (or greater).
Finally, the fourth measure is the effective average reproduction rate, indicating whether the epidemic was increasing or decreasing.
The scale establishes 5 classifications according to the number of new cases per day per million inhabitants, as it is “the simplest measure of the virus transmission rate”.
At a low level, consider that a country is suppressing the virus if you register 5 or fewer new cases (as long as the testing rate is large, that is, at least 20 tests per new case).
Meanwhile, the following steps consider a country as a low transmission (10 or fewer new cases); moderate transmission, with 10 to 50 new cases; high transmission, between 50-100; and very high transmission when they register indicators over 100.
Under said standard, Chile ranked 80th, with 95.1 daily cases per million inhabitants each day during August, with whose record it remained in the high transmission category, on the verge of entering the worst category, only surpassed by Bolivia, Spain, Kuwuait, the United States, Argentina, Israel, Brazil, Bahrain, Colombia, Panama and the Maldives, who did remain classified as high transmission.
“This position is quite consistent with the reality of the country and with the number of deaths we have. The number of deaths in the pandemic, in any country in the world, is related to the number of infections, therefore in countries with a lot of contagion you expect to have a large number of deaths in parallel. We are among the top 10 countries in the number of deaths ”, José Miguel Bernucci, secretary general of the Medical College, underlined in conversation with BioBioChile.
Meanwhile, the exemplary countries in this indicator were Taiwan, Thailand, Laos, Cambodia, Vietman, China, Burma, Malaysia, New Zealand, Uganda, Togo, Pakistan, Latvia, Luxembourg, South Korea, Finland, Cuba and Rwanda.
Likewise, our country registered 3.1 deaths per million every day during August, a record that was only surpassed by 7 countries in the aforementioned measurement.
While, Chile registered 13.7 tests per case, a figure considered very low by the specialists in charge of the report; and in whose situation are most of the countries with high and very high transmission, “with less than 20 tests per new case or even less than 10 tests per new case.”
Although the Ministers of Health have said repeatedly – both Jaime Mañalich and Enrique París – that the local testing capacity was one of the highest at the continental level, the comparison shows a different scenario at the global level: Chile is not even close to the countries with the best record. Among the countries with low transmission, the closest are Luxembourg (30.6) and Pakistan (33.7), far from the figure for our country, while among that group the exorbitant case of New Zealand stands out, with 3,368 tests per case. While, the average of exemplary countries reaches 511.5 examinations for each case.
“Unlike what the authorities have insistently said, our amount of testing is in the middle of the table worldwide. We are around 50th place and this study tells us that we have little relative to these countries. But if we compare ourselves to Latin America we have a good amount of testing, enough to make a good amount of diagnoses. It is not the best in the world, it has not served us yet for suppression management, but it is a good amount to know in what epidemiological reality we are ”, Bernucci stressed.
In sum, the figures show that 10 of the 19 countries with the best control are in the Asia Pacific, while 6 of the 11 with the worst record are from the Americas. In this context, the Lancet Commission report criticizes that countries “with high or very high transmission rates are not able to undertake sufficient preventive measures (masks, social distance, isolation, etc.) to control the pandemic”, which “may be controlled, as the countries that have largely suppressed it clearly show, ”even in low-income nations like Cambodia, Laos and Vietnam.
Even worse, the last indicator (effective reproduction rate, ERR) also worries. In simple terms, transmission is decreasing when the figure is less than 1 (R 1). In Chile scores 1.1, a discouraging figure that reveals that in August the transmission of the virus (and therefore the epidemic) continued to rise in the country.
Of course, this scenario is not only worrisome for the local reality, since these numbers show that even the countries in control are vulnerable to new outbreaks.
“It takes us around 4 to 5 months to change the strategy. In moving from the strategy of controlled progressive contagion, as was raised with the former minister, to a strategy of cutting the chain of contagion through traceability. Those four months left us in one of the highest countries in the world and today, despite changing the strategy, we are still very weak in traceability. We are very backward and the only way to suppress viral circulation is by strengthening this traceability “Bernucci remarked.
More reliability is lacking
Meanwhile, the report poses to the countries the need to advance in the reliability of the data, considering that they only take 91 of the almost 200 existing countries.
This is due to the fact that the limitations of the data continue to hinder the adequate measurement and, therefore, the control of the pandemic, as a result of insufficient tests, insufficient reports and different and changing definitions of deaths from covid-19.
Specifically, according to the report, data comparisons show that most cases of covid-19, and in particular cases that are asymptomatic or mild, are undermeasured and underestimated. “Comparisons of reported COVID-19 deaths and excess mortality in a country during the same period compared to previous years imply that many COVID-19 deaths are not being reported as such,” they noted.
[ad_2]
