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Yurlenis Moya says that she never felt anything strange. Only when the doctor who went to do the test to determine if she was infected with covid-19 in her apartment in Suba, in the northwestern part of Bogotá, did she remember a small throat clearing that she attributed at the time to the cold.
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If it hadn’t been for the fact that her husband had a high fever and a persistent cough, it would never have crossed his mind to request a test. “It was only when I received the test result that I was convinced that I had coronavirus, but I would be lying if I said I was sick or down at some time,” she says.
That case is far from the only one. Since the emergency began, specialists in different parts of the world have drawn attention to the high number of asymptomatic people who are not identified as carriers of the disease, unless your family or work group is the object of attention by the health authorities.
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Only when I received the test result was I convinced that I had coronavirus, but I would be lying if I said I was sick or down at some time
Estimates vary, although the consensus among experts is that it is the majority of those contaminated by the pandemic. This week, for example, a large study done in India concluded that the proportion of those with less or no affectation is close to 80 percent, while another carried out in the same country showed that it is 92 percent.
In Colombia, the index varies between 63 and 97 percent in the analyzed conglomerates. Both among the inmates of the Villavicencio prison and the Hidroituango workers camp, the virus spread rapidly, but those who had to receive medical treatment were very few.
One of the most frequently cited anecdotes is that of a battalion of 33 soldiers in La Guajira. In a routine control, one of the uniformed men was detected a mild fever, which led to the taking of samples for the whole group.
The report showed that all the soldiers were infected, so the measure adopted was preventive isolation and nothing else. “They didn’t even have to be given an acetaminophen pill,” says someone who knew what happened closely.
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More than you think
The example serves to bring out the characteristics of a virus that is still surrounded by mysteries. Although hypotheses abound, It is still not clear why while some are put to bed and others are killed, the covid-19 passes without a trace among the majority, especially in those under 40 years of age.
One possible explanation is that there are crossed immunities, due to epidemics of the same origin that generated defenses in the organism of a good number of individuals. Another is that certain childhood vaccines limit the impact on the lungs or gut. One more speculates that certain populations have greater defenses as they have been exposed to more diseases.
Be that as it may, it is a kind of open secret that published statistics underestimate the number of people infected. Regarding Colombia, the model with which the National Health Institute (INS) works shows that the number of positive cases would be almost six times that of those identified by the tests: instead of the nearly 600,000 recorded until yesterday, the real figure would be around 3.5 million people.
Other estimates give higher magnitudes. There are those who say that the true margin compared to what the tests applied so far say could be up to twelve to one.
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A more precise inference will be able to be achieved in a few weeks when the INS completes an ambitious study, with the help of Dane, which will begin to collect information on September 15. The point is to specify what the attack rate is in different urban centers, combining three different methods to find out who has or had the virus.
The answer is critical for a reason. If a large number of inhabitants of a given population are already immune to the disease and do not act as a transmitting agent, the number of infections should continue to fall relatively quickly, especially if self-care rules and biosecurity instructions are respected. The mixture of one and the other factor will allow the downward trend in positives to run its course.
What has happened in other places can serve as a reference. At the beginning of April, the eyes of the world focused on the city of New York – where more than eight million people live – which became the epicenter of the pandemic. Overflowing hospitals and cemeteries that did not provide enough to bury the dead were the constant for several days.
The balance was painful: 229,518 infected and 23,680 deceased showed the accounts until Friday. However, by mid-May the crisis had been left behind. So much so that the reopening of the vast majority of activities did not have the outbreaks that many feared and that, in fact, were observed in different populations of the United States.
It does not mean that the threat has completely disappeared. The average of new cases in the metropolis exceeds 200 daily and there are still a few deaths, although increasingly spaced. Even so, a recent report in ‘The New York Times’ hypothesized that the well-known herd immunity – which is that the virus is extinguished because it stops circulating in the absence of carriers – could be closer than what it was believed.
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Think with desire
No official involved in the issue accepts that Colombia is close to this scenario, at least in the largest capitals. Those in charge of the matter recognize that there are towns like Leticia or Tumaco, which could have fallen into that category. A little further behind would be Cartagena and Barranquilla, along with their neighboring municipalities. Bogotá is seen a little further behind, followed by Cali or Medellín.
On the other hand, it is clear that, just as there are municipalities that left the peak behind, others are in the ascending part of the curve. This is the case of Cúcuta, Tunja, Ibagué, Manizales, Armenia or Pereira, where things are getting worse. Referring to local realities is mandatory and more so now that free movement through the territory will make the virus spread more easily than in the time of isolation.
In any case, the expectation is that the decrease in the number of daily positives will continue its march. A quantitative model developed by the experts Álvaro Riascos, Juan Carranza and Juan Martin indicates that by next January the number of deaths attributable to covid-19 in Colombia will be close to zero. Another from the Universidad del Rosario shows that by March of next year the new cases of contagion will be counted in hundreds and not thousands.
Such an eventuality will bring other types of challenges. The biggest of all is that if the perception that the danger has disappeared becomes general, those who are in the highest risk group forget the precautions, which can be paid with their lives. According to the INS, the fatality rate among those over 60 with a diagnosis of coronavirus is 16 percent, while for those below that age the rate is less than one percent.
(Also read: What is happening with the covid-19 tests in Colombia?)
Curiously, in the short term the challenge is the opposite. This consists of ensuring that the greatest possible proportion of activities are resumed, for which not only the appropriate permits are required, but also that consumers – acting responsibly – go out on the street or dare to get on a plane. “The probability of an exponential trigger is much lower now,” recalls a senior official.
Although we will have to wait a few days before knowing if the pace of economic activity picks up, it is clear that there was no option other than reopening. After the closure of thousands of companies of all sizes and the jump in the unemployment rate, it was time for the gears of the productive sector to move more quickly so that the deterioration of social indicators stopped.
For the essay to be successful, several fronts will have to be addressed, including the psychological. “After filling people with fear, oversizing the problem to enforce the confinement, now it will be difficult to moderate the discourse adjusted to its real proportions so that the population acts rationally and civic life is reactivated in all its dimensions,” says the doctor epidemiologist Margarita Ronderos.
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This observation is directly related to the limbo in which education continues. A good number of teachers and parents alike are reluctant to have children return to classrooms, even in a blended or alternating scheme. The fear is that minors will get sick or infect teachers and relatives.
In this regard, evidence from Europe suggests that the danger is very low, especially with respect to the smallest. The World Health Organization pointed out this week that schools do not play a central role in the transmission of evil, while recognizing that the delay in cognitive skills and development of social skills can do much more damage.
Perhaps in the country the controversy would be different if in these months inquiries had been made that provided reliable information on the matter. As that was not the case, The view that “when in doubt, abstain” continues to prevail, which is why students continue to be subjected to virtuality among those who have the means or distance education for others.
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This suggests that the country will move at different speeds in the immediate future. It is foreseeable that the decline in active cases will continue, so the public’s concerns will focus on the general situation of the economy, unemployment or the increase in insecurity.
Given that infections can be reduced to a fraction of the current ones and that several large cities would reach a herd immunity in fact, the concern about the arrival of a possible vaccine would take a backseat, even if it is key for those most vulnerable to the coronavirus . This will lead to the resurgence of the tensions of before, going through the demonstrations in the streets and the samples of popular discontent.
Consequently, the President, ministers, governors and mayors will have to take up what they can from the agenda that they left abandoned because of the emergency and adapt to much more complex circumstances. Ultimately, it is one thing to withstand the hurricane in the best possible way and another to begin to repair the immense damage it left in its wake while the wind is still blowing and the rain is still falling.
There will be no shortage of rulers at all levels who long for those 160 days of mandatory confinement and curfews, in which the citizens seemed so docile. And that, although unjustifiable, is understandable. Because now comes the really difficult period.
(Also read: Underestimation of covid infections in the country would be 82%: study)
RICARDO ÁVILA
Special for THE TIME
