Vaccination, contagion, and deaths from COVID-19 in its second year
Published: 23 de abril del 2021
Antonio Peña Jumpa*
*Professor at the Pontificia Universidad Católica del Perú and the Universidad Nacional Mayor de San Marcos. Lawyer, Magister in Social Sciences and PhD. in Laws. The author appreciates the comments of Imelda Campos Ferreyra.
Despite having begun the vaccination process in the countries of the world, the COVID-19 pandemic has developed a second wave of infections with increasing numbers of deaths without its trend being able to
reverse to date. In the month of April, countries like Peru show a record of deaths, rising from 200 to 400 daily deaths. The phenomenon has been repeated in proportion to the number of inhabitants in other Latin American countries such as Brazil, Mexico, Argentina, Colombia, Guatemala, Paraguay, Uruguay, Chile, Ecuador, Bolivia, and it has not stopped in the United States and in European countries. Each government has measures to face its crisis, without achieving a satisfactory result.
The main cause of death is contagion. Daily urban life in the world, and in particular Latin American urban-popular life, could not withstand the long confinement of about a year, and since the Christmas holidays it has made compliance with the health emergency regulations that force social isolation more flexible. In countries like Peru and Brazil we have seen how the number of infections and deaths increased as the month of January and February passed, worsening in March and April 2021.
After the massive contagion, three direct causes-effects are known in countries such as Peru that produce the death figures: the collapse of health systems, the lack of medicinal oxygen and the appearance of new strains or variants of COVID-19.
The collapse of the public and private health systems confirms once again the weak health service at the national level that we have in Latin American countries. Although the greatest collapse is seen in public health, which is still difficult to manage despite the disposition of the national treasury, the private system also shows its inefficiency. The number of infections exceeds any number of hospitalization and intensive care beds, whether in public or private hospitals. The infected middle-class population is afraid of reaching public hospitals, making an economic effort to pay for a private clinic; but upon completion of the clinics, they undergo private treatment at home. The low-income or poor population fear reaching public hospitals because care is congested and viral load increases, preferring to be treated at home with greater limitations.
When resorting to private home care, the poor or middle-class population requires medicinal oxygen, and
it is when they submit to the business that operates with corruption and in an irregular manner in its distribution and sale. Given the shortage, due to private (and public) demand, the price of medicinal oxygen exceeds any limit. I have witnessed, in March 2021, a low-income family that had to rent a 10 cubic meter balloon to care for the sick mother, and then the sick father, paying for each recharge (every 1.5 days) the sum of 900 soles or 270 dollars. If this family had not counted on the family and friend solidarity to pay for each oxygen refill, surely their situation could be worse. Most of the poor families do not have the resources to pay this price of medical oxygen and, added to the lack of sanitation in their homes, they are the ones who increase the death toll the most.
But neither the crisis of the public and private health service, nor the shortage of medical oxygen is a greater challenge compared to the danger of the new strains and variants of COVID-19. Health services and the shortage of medical oxygen can be made up for with alternative management by our authorities and social leaders. But, the new strains and variants of COVID-19 do not depend on any alternative management, except that of vaccines. However, vaccines are still a slow and contingent process, compared to the speed of infections and the reproduction of strains or variants. According to the scientific information disseminated in the media, the strains or new variants of COVID-19 have been reproducing in different countries and moving from one to another, generating mutations and even double mutations (see news of 04-06-2021 and of 04-18-2021) with major damaging effects.
What to do?
Faced with the current global crisis situation, in its second year of COVID-19, the only solution is to contain the cycle of contagions. If we reduced the number of infections, the number of seriously ill patients would be reduced; then, the congestion of hospitals and clinics would be reduced, and there would be better conditions to care for the most vulnerable people, reducing deaths. But unfortunately, there is no exact or precise measure to contain the contagion, especially in Latin American countries like Peru, where the extreme inequality and poverty of most of the population forces them to leave their home for work.
This means that we are unprotected and in a situation of uncertainty like what we experienced in the first year of COVID-19. Under these conditions, it is convenient to remember two basic actions suggested in the first year for countries like Peru:
1) Face the current health emergency as one of Disaster Risk Management (DRM) with measures of changes in public management at the national level. This means concentrating public management on health care and nutrition for the population, directing the budget from other items. In society, we all must sacrifice ourselves, sharing our material resources, without exploitation or abuse.
2) Breaking with the centrality of disaster risk management. Each region, like each province and district, must have autonomy to provide contagion prevention measures and solidarity measures and management of the health and food service to attend to their cases. The DRM operations center, which is in the capital of the country, should only coordinate national measures and provide resources to the district, provincial and regional units. These units must diagnose before acting, and constantly evaluate their actions, under the control of their population.
It is not admissible that the vaccination process has started in the capital of a country, and has not expanded to its regions, provinces, and districts with the same efficiency. It is also unacceptable for political leaders and their families to benefit from vaccination before vulnerable people. These are human acts that require sanction and must be avoided to materialize the basic actions suggested above.