Saturday, February 27

Mexico is one of the countries with the highest mortality from covid in the world


Medical personnel transfer a patient with coronavirus to the General Hospital of the city of Saltillo, Coahuila, in February.
Medical personnel transfer a patient with coronavirus to the General Hospital of the city of Saltillo, Coahuila, in February.ANTONIO OJEDA / EFE

Saving lives from the clutches of covid at the cost of destroying the economy, or saving the economy (and thereby preventing the wasting of many lives on the brink or immersed in poverty) at the cost of allowing more space for the disease? This has been raised in public debate throughout the pandemic. This was understood by the Government of Mexico from the beginning. Just one year after the first case detected in the country, the data are becoming sufficient to make an initial comparative assessment of how each country has acted in this (supposed) dilemma. The results for Mexico are not good.

Mexico is among the first with the most excess deaths in 2020, within a varied sample of 60 countries (including Brazil, Chile, Colombia, Ecuador, Peru), which are the ones that so far offer sufficient data to measure with figures for the year closed . Do not take this as a ranking immovable or complete: the inter-annual comparison of deaths in a country, which gives the excess of deaths that can be attributed to a specific phenomenon, in this case the pandemic, depends on how the average of the previous years is constructed (Brazil, for For example, it varies between less than 200,000 and more than 230,000 depending on whether one methodology or another is used). The structure of the population also influences: in theory, those countries with more people vulnerable to COVID who would not have died in a normal year (for example, affected by comorbidities such as diabetes or lung diseases) are slightly penalized by this metric. Age also matters, because the excess is lower in older populations: after all, they have a higher mortality every other year.

But none of this changes the fact that in Mexico many more people died than expected, around 300,000 extra souls according to the data that can be extracted from a recently published comparative study, despite the fact that the official figure today counts 175,986 deaths. Former Health Secretary Salomon Chertorivski has shown according to this forecast. Other estimates, still provisional, to be halted in mid-December, are in the 270,000 orbit, although to these it would still be necessary to add those that come from the pronounced peak at the end of the year.

The aforementioned previous health conditions of the population have been the argument of the Government, as well as others who tried to clarify the data of the tragedy. But for all of them the argument can be turned against: if from the beginning the vulnerability profile of the citizens themselves was known (comorbidities in Mexico, elderly people housed in residences in Spain, lack of access to emergencies in certain areas of Peru or Brazil ), Why weren’t measures in favor of this vulnerable population strengthened?

The pandemic is not going to be limited to 2020, it continues. But after a year marked by it, the forecasts for the year-on-year decline in GDP are beginning to be an approximate scale of the solvency of these countries in the economic dimension. Mexico, again, is placed in the tail wagon according to the latest IMF estimate.

Any country aspires to be in the quadrant of the graph that combines the lowest number of deaths with a low drop in GDP. Some have succeeded, almost all small nations with considerable state capacity: Norway or Uruguay are at that angle. The theory of the binomial between economy and health should, however, push all these countries towards the side in which there are fewer deaths or towards the one that protects the economy. Two equally wealthy nations such as the US and Canada, a priori with disposable income to weather a health storm, have followed different directions: the first with many deaths, but a muffled economic decline, the second the other way around. But the truth is that a considerable number of medium and large countries have not avoided the worst of both worlds: deaths and economic decline. There is Mexico, along with Spain (worst in economy), Ecuador or Peru (worst in both).

This image suggests that the health-economy dilemma was not inevitable, and posing it as such was a worldwide miscalculation. Perhaps the optimal strategy was to try to avoid as many infections as possible. That is what, in all probability, would have served the economy better, as argued by some experts in the epidemiological field and as successful countries that faced restrictive but precise measures have shown and now enjoy an economy that has returned soon to normal. A country with fewer infections can follow a perhaps minority but reasonable consumption path. In another on the verge of sanitary saturation, there comes a time when restrictions, when they are not imposed from above, are decided in each household.

The reason for the starting conditions remains, defended both by the Mexican leaders and by many others in the world, shifting blame to the “inheritance received” from the past or to other levels (regional, local) of management. It is difficult to capture in a single variable everything that implies a structural disadvantage accumulated for decades: from the health system to access to it; from transportation infrastructure to mobilize resources to the possibility of staying under a decent roof while the virus rages. Today Mexico has serious isolation problems that lead to massive infections in the same family, despite the fact that the Army has had modules to pass a voluntary confinement.

The Human Development Index (HDI) prepared by the United Nations Development Program can serve as a preliminary approximation. If this idea is true, one would expect it to be a negative correlation: the higher the HDI, the less excess deaths. And, indeed, this is how it is observed. In a weak way, but clearly.

Mexico is, yes, above the level of excess deaths that would correspond to it given its HDI. As is the United States, Uruguay is on the other side of the line: it has fewer excess deaths in 2020 than could be expected from its starting condition. Germany is where it was assumed, Sweden as well.

This graph provides information, in some way, on how each of the included countries has performed, compared to what could be expected of them. The downward distance between the point and the line, as indicated in the previous graph, is an approximation to the ability to improve the management of the epidemic. In 2021, a year that is expected to focus on the relentless fight against the virus thanks to vaccines, Mexico, like the rest of the world, has a new opportunity.

Methodology and sources. This analysis uses excess mortality data obtained from three different sources, in order of priority: those from the recently published study by Ariel Karlinsky and Dmtry Kovak, downloadable and reproducible so that anyone can get their own analysis in this repository open; those compiled by The Economist; and those accumulated by Our World in Data. All those countries that did not offer data closed to the penultimate or last week of December 2020 have been excluded. Thus, this table should not be taken as a closed or complete classification, but as a mere cut-off approximation to calibrate the situation of each country when end of 2020.

The GDP data correspond to the latest data published in the IMF database, forecasts for October 2020. The Human Development Index and other population data are compiled by Our World in Data from United Nations sources (UNDP, World Bank).

The graph of the mortality and GDP dimensions owes original credit to this analytical proposal by Eugenio Sánchez, among others (such as this one from Our World in Data).

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