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Protests: Colombia faces its worst moment in the pandemic amid social unrest | International

A group of protesters participates in Cali in a protest against the Government of Iván Duque, on April 30, 2021.
A group of protesters participates in Cali in a protest against the Government of Iván Duque, on April 30, 2021.LUIS ROBAYO / AFP

Just a few days ago, Colombia exceeded half a thousand deaths a day for the first and only time during the pandemic.

This third wave caught the country by surprise, as did for many (not others) the outbreak of protests that opened with the National Strike last Wednesday. Citizens came to him with (and in no small measure also by) a relative poverty rate that closed 2020 at 42% according to the National Department of Statistics, data that had not been seen since 2012.

The figure was higher in the cities, which actually accounted for practically all of this increase. The epidemic, as an inevitably urban phenomenon both in contagion and in the measures implemented to contain it, produced three million new poor people in Colombia according to DANE accounts. 1.1 million in Bogotá.

A cross section on the deaths reveals that, indeed, the large Colombian cities have “shifted” the peaks: first the Caribbean ones Barranquilla (along with its lonely neighbor) and Cartagena; then the capital would enter; and from there Medellín would seek more sustained growth during the third quarter of 2020.

Medellín would also be the first to explode in this third peak, together with a regrowth in Barranquilla that surprised those who considered that the prevalence of the virus during the previous year would be a sufficient immunological barrier, which reached 60% according to studies based on representative samples of tests. of antibodies carried out by the national epidemiological authority.

It was not for various reasons, all of them related to the fact that immunity is not an absolute value but a relative one. In this case, it is at least two things: first of all, the distribution of past cases did not have to be territorially homogeneous. If they had been concentrating in certain neighborhoods, in certain families or areas within each city, that means that the virus had enough to insert itself into these potential contagion spaces. To this must be added a second, crucial factor: in this pandemic year, we have given the virus time and space in the world to mutate and improve its ability to evade the immunity acquired by past infections. Not totally, but enough. For example: it is estimated that these defenses only serve 54% -78% against the variant known as P1, of Brazilian origin. Something similar happens with the one that was born in the United Kingdom. Both with a proven presence in Colombia, it is more than likely that they have played a key role in the unusual speed acquired by this new peak.

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It should be remembered that the effects of the protests, if any, do not yet appear in the data, due to the double delay between the date of infection and the onset of symptoms, and between this and confirmation of the infection in the official data.

Vaccination goes up, but is missing

The only universal tool the world has found against the virus is vaccination. In Colombia it has been underway since mid-February, but its growth has been slow compared to Argentina, Brazil or Mexico.

The main bottleneck for this curve to rise faster is the arrival of doses to Colombia, impeded by a restricted supply and a demand that reaches the entire world population. In order to overcome this restriction, the Colombian government added to the agreements announced in December and January an emergency purchase of several million doses from the pharmaceutical company Sinovac, which were due to arrive between March and April. With this, it was hoped to achieve a sustained 200,000 doses administered daily, a necessary rhythm for the objective that the government set itself: 70% of the population vaccinated before the end of the year.

But Sinovac delayed deliveries, postponing expected increases (and leading to the necessary second dose for many people over 70 having to be rescheduled). Thus, although the trend is upward, and there have been several days with figures above 150,000, only on rare occasions has the aforementioned target of exceeding 200,000 been reached.

As the global supply bottleneck does not open, the Colombian authorities have chosen to relax the order they had established for the administration of vaccines: for example, including all people between 50 and 59 years old in the next stage, that in principle only considered people with comorbidities and certain job profiles. In addition, the Ministry of Health it is de facto following a policy of overlapping phases: it activated the first doses of those under 65 when there are still second doses of older people to be applied (but ensuring that the necessary vials for this are reserved); and the stage to come will begin before those aged 60-65 are fully vaccinated.

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This decision points to a prioritization of efficiency over other considerations, such as equity. The territorial incidence of vaccination by entities also indicates how inequalities in access to health are seeping into the implementation of the Plan.

Territories traditionally worst served by the state lag behind in vaccination rates. The exception of the Amazon area is due to a containment strategy against the penetration of the virus from Brazil, a border country that passed its worst peak a few weeks before Colombia. But, outside of that, areas such as the port city of Buenaventura have coverage that represents only one fifth of the Caribbean’s Barranquilla, with a more robust health system.

A pending health reform is in fact another contentious issue in the ongoing mobilizations. Beyond the details of said regulation, which is rather unambitious, the underlying issue is that the 95% of health coverage that the Colombian population enjoys on paper does not translate into equal access for the entire population. Thus, although the protest can be addressed with arguments more or less tuned to the reform, its most plausible basis is a claim for territorial leveling and between people of effective access to health.

Here, as in other individuals hovering around discontent, the problem seems to be more one of effective and above all equitable development of state capacities, than of large announcements or regulatory changes.

Meanwhile, the third wave is advancing along with a vaccination that, as in other countries, seems to be working. At least this is what the less pronounced evolution of deaths in the best-covered segment of the population suggests in a preliminary way: those aged 80 and over. Their immediate predecessors, those from 70 to 79, nevertheless follow the same rhythm, adding one more tragedy to a country that, lately, accumulates them.

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