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The saddest record. This Wednesday a review of the deaths caused by COVID-19 in Belgium made Peru in the country with the highest mortality rate in the world due to the pandemic.
Few knowledgeable about the local situation must have been surprised, since deaths from the coronavirus occur at the rate of hundreds a day and the death toll has exceeded 28,000.
How has the Andean country come to this? “There has been very little investment in health in the last thirty years, in addition to a management that did not keep pace with the evolution of the pandemic; many parts of the country were not prepared for a pandemic of respiratory infection like this one ”, says in an interview with DW Rubén Mayorga, representative of the Pan American Health Organization (PAHO) in Peru.
“The coronavirus pandemic has exposed the deficiencies that the health system had,” he says.
The 28,124 deaths from the SARS-CoV-2 virus registered in Peru translate into a mortality of 85.8 deaths per 100,000 inhabitants.
But the scarcity of diagnostic capabilities in practically the entire planet has made it difficult to understand the magnitude of the pandemic from the beginning, so it is understood that there is a significant underreporting of its mortality.
In Peru there is an excess of more than 65,000 deaths since the beginning of the pandemic compared to previous years. This means that since March, deaths at the national level have increased by 120% compared to the previous two years.
“Peru had less per capita health spending than Ecuador, Colombia, Brazil and Chile, it only surpassed Bolivia in this regard”, explains to DW Farid Matuk, who until recently advised the Peruvian Government as part of the Prospectiva Group.
In the same vein, César Ugarte, professor at the Cayetano Heredia University, pronounces: “We were from the Latin American countries with fewer ICU beds, or with less access to oxygen plants,” says the doctor in an interview with DW.
“Peru made a substantive mistake by reducing the quarantine and producing the most visible cases of lack of bed and absence of oxygen, which produced deaths that could have been avoided”, adds the economist Matuk.
What official numbers cannot count
The interviewees agree, however, that there are other factors that help explain why the mortality rate in Peru has increased so much, beyond this lack of capacity to respond to the most severe cases of infection.
“The concept of deaths confirmed by COVID-19 is heterogeneous worldwide, in that sense comparisons between countries can be misleading,” says Matuk. “The most extreme European case is Belgium, where all excess death is COVID-19, even if it is not,” he explains.
It also recalls, in relation to this statistical heterogeneity, that “in Germany at the beginning only deaths in hospitals were considered deaths from COVID-19 ”.
This Thursday the Peruvian government has attributed having the highest mortality rate in the world to the fact of having included the number of suspected deaths from the disease in the number of deaths with confirmed test.
“We are in the cold season in Peru, there may be another bunch of respiratory infections circulating that are not being diagnosed ”, says Mayorga, from PAHO, who defends that the data is being handled with total transparency. “That is not the case in everyone.”
Professor Ugarte agrees that “a non-negligible percentage has other causes.” And he gives as an example the hospital where he works: a general hospital with 400 beds converted into a center dedicated exclusively to COVID-19.
“The health system has become covid,” laments Ugarte, who is concerned that the rest of health care has been neglected.
How many people are actually dying in Latin America?
Of course, the doctor points out something else, in line with the statistical transparency defended by Mayorga: in his opinion, in the course of the months Peru has been able to better detect the virus and its lethality, compared to other neighbors in the region .
“I think Peru is registering more cases by counting positive tests for detection of antibodies, something that almost no other country in the region does,” he says. In this sense, the three interviewees are against the international comparison of dissimilar systems.
In the end, however, that is a statistical discussion, acknowledges Ugarte. Deaths from COVID-19 do happen, whether they are counted or not. “The main reason is that our health system did not work,” he criticizes. “We were not up to the task. But I think the numbers for Peru are more real ”. The question is then what are the numbers of the pandemic in Latin America that we still do not know.
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