Weathering the Pandemic

The pandemic has evolved in an ebb-and-flow pattern across Latin America, with a second wave of confirmed cases towards the end of 2020. This uptick in some countries has been even larger than the first large wave, which surged between May and August 2020. While overall fatality curves have not yet exceeded mid-2020 levels, the confirmed cases and deaths exceed 600,000 and 16,000 each week, respectively.  We recognize that not all COVID-19 cases or deaths have confirmatory evidence, which for both cases is usually the PCR test.

COVID-19 is undoubtedly leaving a literal trail of death. Excess deaths from all causes, observed in the few countries with statistics available, exceeded 200% during certain months of 2020, based on the average deaths of the last 5 years, during the same months. 

Some reports show that more than 65% of all excess deaths are directly related to COVID-19. In the rest, the footprint of the new virus might also be present; for example, patients with a heart condition who failed to go to their examination out of fear of going to a hospital, or were even urged not to do so. There is a large number of conditions that required medical attention, which was not provided for a number of reasons, from presuming they would not be treated, to access limitations, etc.

The pandemic has indirectly impacted preventive healthcare interventions, reducing coverage of essential programs, particularly for children and women. For example, a number of routine vaccination programs have been suspended, which can have terrible consequences and lead to serious setbacks in public health progress made with enormous efforts.

SARS COV-2 has changed our lives by placing a significant burden of uncertainty. But in these tough 12 months of pandemic, did we learn enough, at least not to stumble twice against the same stone and reduce uncertainty at least a little? The answer seems to be: We did not.

Country leaders have responded differently across the board. While it is clear that the response must be comprehensive, both in healthcare and social protection policies as well as agendas to address indirect impacts on the economy, short-sighted decisions based on the dichotomy between health and the economy have plunged them into deep contradictions. Few have consulted experienced advisors who can tell them what they do not want to hear, and to act on it.

The capacity of healthcare systems, which governments tried to reinforce during the first onslaught of the pandemic, still shows significant inadequacies to deal with the second wave, and unfortunately, apparently will still be so for the third wave. The deeply exhausted healthcare personnel is still becoming infected at alarming rates, and—much to our sorrow—also losing their lives. At this point, they are effectively martyrs.

As rarely seen before, this year the population has gone through a series of fairly defined stages. Fear at first, which prompted an acceptable commitment to compliance with lockdown measures, which gradually gave way to weariness, apathy and even denial in some cases, particularly among teenagers and young people.

Authorities have not been able to implement a strategy that—at least moderately—achieves the community’s commitment to follow mitigation measures (social distancing, use of face masks, etc.).

And when the hope of having one or more vaccines seemed to become a reality, painful inequalities were once again exposed. The first vaccines, the result of state-of-the-art technological development, have a preferred market: high-income countries that are investing huge amounts of money, which is unsustainable in principle, because, in the control of infectious diseases that can be prevented by vaccines, universal vaccination of vulnerable groups is essential, regardless of whether they are poor, rich, immigrants, indigenous, etc.  

We learned, once the first two vaccines were approved as an emergency measure by certain regulatory agencies, that some countries in the region had negotiated directly—keeping a “low-profile” or confidentially—with the relevant laboratories with modest success, as proven by a limited number of vaccines. These vaccines require complex “cold chain” logistics, which confirms that the development of these vaccines did not take into consideration the context of underdeveloped countries. These doses are expected to be sufficient to vaccinate at least first-line healthcare personnel.

In the crazy vaccine race, it will be vital for the United Nations mechanism (COVAX) to work, to reach its goals and thus achieve an equitable distribution of COVID-19 vaccines. Although the program has somewhat lagged behind in the first round, it still has a long road ahead, and should be supported all along the way.

In this maelstrom of events, the fight against inequalities becomes increasingly urgent, an all-encompassing struggle with a systemic approach that incorporates new elements, for example, reducing gaps in biotechnology, or in essential public health functions, such as epidemiological surveillance, research, health promotion, training of healthcare personnel, among others.

The need for financial resources and skilled human talent will be pressing, and the role of development banking can be a decisive and fundamental factor in our chances of success, but only if we act in a coordinated and synergistic manner.

Will we ever get back to a pre-pandemic normal?

At least not in the short term, but we could take the time to discuss what kind of normal we want after the pandemic.