Thursday, April 15

Chile closes its borders on the brink of collapse due to covid-19 | Society

A patient with symptoms of covid-19 is transferred in an ambulance this Thursday, in Santiago.
A patient with symptoms of covid-19 is transferred in an ambulance this Thursday, in Santiago.JAVIER TORRES / AFP

Chile closes its borders for the whole of April to try to control the new wave of covid-19, which has the hospital system on the brink of collapse. This Thursday, the government of Sebastián Piñera announced a tightening of the restrictions, which includes the prohibition of entry for non-resident foreigners and the impossibility of leaving for Chileans and foreigners with residence. Along with advancing the curfew from nine at night, instead of eleven, the activities considered essential that can continue to operate in quarantine have been delimited, which currently have some 16 of the 19 million Chileans confined. The new measures are announced when Chile reaches a record of daily infections throughout the pandemic (7,830), only 159 critical beds available nationwide and when the admissions of patients between 40 and 49 years old to the Intensive Care Units (ICU) exceed to those over 70 years of age.

193 deaths were reported on this day, so there are 23,328 deaths confirmed by covid-19 in the 13 months of the pandemic. “The number of deaths is very impressive,” says epidemiologist Gabriel Cavada, an expert in biostatistics. This Thursday, one million infections were also exceeded. “The available bedding is likely to become increasingly worrying and alarming,” says Cavada.

The epidemiologist explains that this new record of infections occurs “because there is definitely a change in strain: either the Brazilian or British strain is attacking us,” although he favors the Brazilian strain, which is much more contagious. That these have been detected recently and with few cases – the Ministry of Health has reported 64 and 45 investigated, respectively – does not mean that this is the number of cases that have entered, according to the expert. The presence of new strains is shown in that the chances of contagion have been increasing: if in the first wave they increased by 14% or 15% per week, in Santiago that figure today reaches 26% two or three weeks ago. “The history of the strain may have come perfectly from a couple of months ago,” adds Cavada.

But it is not known exactly to what extent the British or Brazilian variants are impacting Chile, the academic indicates. To do so, he adds, authorities should study random samples from the latest PCR tests carried out and analyze the genomics of the virus.

The latest report ICOVID Chile, an initiative led by the University of Chile, the Pontifical Catholic University of Chile and the University of Concepción based on official data, warns that “the hospital system does not withstand a long weekend with high mobility.” The Government has decided to advance the operation of the sanitary cords today, in advance of the Holy Week holidays. At the same time, the departures allowed to the quarantined population have been restricted (of the two available per week, only one can be used on Saturday or Sunday). According to ICOVID Chile, “The observed burden (…) is the highest recorded so far in the pandemic, reaching an estimated 35.5 cases per 100,000 inhabitants nationwide, with a sustained increase and no signs of slowing down.” According to this index, the most complex situation is observed in the south of the country: in the regions of La Araucanía (65.6), Los Ríos (65.5) and Biobío (49).

There are not enough PCR tests —although about 70,000 are performed daily, as never before—, the positivity rate reaches 10% (as it did not happen since last July) and traceability does not improve, according to the university report. The occupancy of ICU beds is at the limit: 95%, with six regions that exceed even that figure, including Santiago de Chile. In Araucanía, in the center of the country, the occupation rises to 98%.

The worst moment of the pandemic comes to Chile precisely when 6,795,818 people have been vaccinated (3,665,965 with two doses). According to government data, for the first time there is a greater number of admissions to the ICU of patients between 40 and 49 years (404) than over 70 (390), in the last seven days. The report ICOVID Chile warns that “we still have to wait a few weeks to better assess this trend and analyze its causes, but two non-exclusive hypotheses are an effect of vaccination in this age group and differentiated access to the ICU due to the adequacy of the therapeutic effort” .

No “strong evidence” of vaccine success

The epidemiologist Cavada made a calculation at the beginning of the first wave, in March 2020, and projected 1.3 million infected in Chile, if the control was minimal. In October he was hopeful about the drop in infected, so it could be observed that the epidemic was in decline, despite the experience of Europe and its outbreaks after the holidays in the northern hemisphere. “But we had an outbreak in summer (in January) and another after the summer (in March). Having these three waves was not in anyone’s forecast. And this third is being much more bloody than the first ”, assures the professor of the Department of Public Health of the University of Chile. Given the current situation, Cavada returns to his initial projections that there will be a total of 1.3 million infections in the country. As today the million barrier was crossed, there would be a growth space for another 300,000 infected. “It is a hypothesis that is disbursed,” says the academic.

It is a rebellious outbreak, infections grow around 4% daily. “If all went well, we would begin to experience the epidemic hill on Monday, but there is no evidence, but only hope,” says Cavada. “The authority has always taken restrictive measures reactively and never preventively and, in general, they arrive late when the fire broke out. Although they say better late than never ”, says the biostatistics expert.

But, why is Chile a success in vaccinating and has it done so badly avoiding infections? The immunization process has been successful in terms of numbers, quantity and speed of vaccination, but Chile has not been accompanied by what experts call a “risk facility”. “Health catastrophes must be handled with sobriety and less success. Chile has always had this infrastructure to be able to vaccinate very well and the plan against covid-19 has not left those margins. The health authority, however, in a dangerous exercise showed that this plan left us to the gates to end the epidemic, so people began to relax ”, analyzes Cavada. If it is this element, pandemic fatigue is added after a year of health crisis, so restrictive measures are ignored, asking the population to stay at home is extremely difficult. “It is a matter of looking at the closed quarantine in the Metropolitan Region (Santiago), where mobility does not decrease,” says the epidemiologist. “If the cases are going to decrease, it will be because of the epidemic dynamics – the curves go up and then down – and not so much because of the success of some coercive measures.”

The Chilean government has rejected the accusations of success for the vaccination. “We have the right to show what we do, we have the right to be proud of the work our health officials do, to be proud of what the Institute of Public Health (ISP) and logistics do. Why are we not going to say it? ”Said the Minister of Health, Enrique Paris, yesterday. “If that caused a false sense of security, that is what needs to be checked. But do they want us not to say anything about what we do, not to advertise anything good? ”Asked the doctor.

The efficacy of the vaccines is focused on preventing moderate or severe courses of the disease (over 90%) and not contagions (around 70%), which was not correctly informed to the population, according to Cavada. But the death curve and severe disease courses remain high. According to the effectiveness of the vaccines, around 15 days after the second dose, “it is quite expected that the deceased will begin to decline at the end of April, as well as those who require strong health care. ”, Says the expert. “The vaccine effect is giving evidence – there is a decrease in mortality – but not strong evidence to ensure that vaccines are doing their job. I hope it happens in the second half of April or at the end of April ”.

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