Week 14: The interesting situation in South America

This blog will deal with Colombia (an equatorial country on either side of the Andes), Peru and Chile (two countries west of the Andes) and with Brazil and Argentina (two countries east of the Andes). These are countries with fairly high GINI indices indicating inequality, but what might have been just adequate GDP’s per capita to provide a basic health service. The number of tests /K population is generally very low, so the data is not very reliable. The most curious problem in South America is between Brazil and Peru.

 

	BRAZIL	PERU	CHILE	COLOMBIA	ARGENTINA	USA (for cf)
Popln.	209M	32M	19M	50M	44M	331M
GINI	53.3	42.3	44.4	50.4	41.4	49
GDP/cap	9.0K	6.9K	16.9K	6.7K	11.7K	62.8K
Tests/’000	2.3	5.7	43.8	9.7	5.2	21.0
TOTAL CASES	923K	232K	179K	53K	33K	21100K
Cases/M	181	122	353	62	31	71
Daily new   Cases/M	32	37	36	2.1	1.4	27,762
TOT.DEATH	44.1K	6.8K	3.3K	1.5K	0.8K	155K
Death/M	211	214	174	31.8	19.4	348
Daily new death  3 day rolling av.	1263	200	160	75	25	769

 

  

Brazil versus Peru

 

Many have wondered how Peru, a totally different country from Brazil

can have measures that are almost as bad. If you consult the table, you will find that they are very similar for Cases per million and Death per million, as well as daily new cases. The mystery gets worse when one finds that (unlike Brazil), Peru was early in declaring a lockdown, and by March 15 there was a national lockdown with closure of all schools, and the stringent quarantine enforced by both police and army. Since we last mentioned Brazil Blogs (Numbers 10 & 13), it can be seen that Brazil has continued its downward path (see daily deaths).  

 

However the explanation of what is wrong becomes clearer when one discovers that although near the equator, only 49% of Peruvians have a refrigerator. If they are to eat they must break the lockdown and get punished by the police and military, or stay at home and starve. 3,000 people were detained by the police for disobeying the order to stay at home. It is also necessary to visit many markets for food: social distancing is not observed in the wild scramble for food. The plans for sending financial help was limited by the fact that only 38% have a bank account, so plans to deal with financial hardship could only be dealt with by the well heeled. Over 72% of the economy is informal and unregulated, so few have managed to save any money. The poorest people were hit the hardest, and investment in education and heslth care has been inadequate.

 

Peru is one of the poorest countries in this report, and many public hospitals have had to close down face with poor resources and unending need. Speculation increased the price of oxygen five times over the previous price. A paper by Gonzalo Zagarra, (infobae.com) on 31 May, states that public investment in health as a percentage of GDP is 3.3%, a number that is very low South America, (being only above Venezuela  - 0.8%),  There is a contradiction between what is being claimed and individual behavior, mediated by the ‘chicha culture’  of turning the authority over, of looking for a bribe to give the police, the conviction that everything can be settled in an informal way "People die at the hospital door. We are getting worse and this is going to burst" lamented a doctor at the Cayetano Heredia Hospital, the capital's main northern cone health center, with 90% of the current coronavirus patients. His forecast is bleak: if quarantine continues to break and contagion increases, with already-collapsed hospitals, the consequence will be an increase in the rate of lethality, with patients who could be saved not receiving the necessary care.

 

 

The problems with the remaining countries

 

Chile has easily the highest rate of cases per million, and almost the highest rate for daily new cases. Its rate for deaths /million at risk is below Brazil and Peru, but well above Colombia and Argentina. On 13 March there was a ban on meetings of more than 500 people, and by 18 March a 90 day ‘state of catastrophe’ was declared with quarantine was applied to the whole of Santiago. By 6 June there were 100k cases and well over one thousand deaths. The Ministry of Health has massaged the data about the virus, sometimes to its own advantage (reducing active cases from 59,100 to 21,326 overnight; sometimes to acknowledge an increase in morbidity. They also have misled the people by wanting to issue certificates to indicate the people who had survived the virus were now immune from it: this produced a paper in Lancet (9 May) as well as a rebuke from WHO. In short, one can understand why the Minister of Health resigned on 14^th June. There is still a need to understand why the illness is so suddenly virulent. Photos of crowds show no social distancing, and there seems  to be a lack of faith in the Ministry which perhsps in accompanied by poor observation of procedures. Finally there is a severe drought that makes hand washing very difficult.

 

The last two countries are both success stories. Colombia did well for a poor country, with only 50K of cases, very much lower than the three countries considered so far, and with only 2 daily new cases. Their first case was on 6^th March, yet by 24^th all people aged above 70 had been quarantined by the end of May. Lockdown was applied on 27 April, and flights both international & domestic were cancelled. Lockdown was gradually released from 31 May.  Argentina had only 31 cases per million, and only 1.4 daily new cases. The virus came from Italy on 3^rd March, and the first death occurred 4 days later. Lockdown was from 19 March to 10 May, when it began to be lifted. Policy was fitted to conditions in various parts of the country, with Tierra del Fuego put under lockdown on March 16^th, and Buenos Aires from March 23^rd.

 

 

Conclusions

 

Brazil will probably end up as the most disastrous country in the world when the pandemic is over. It has the highest level of inequality of the five, the lowest rate of testing, and a truly terrifying rate of daily new deaths, combined with a leader who accepts no responsibility for the mess that he presides over.

 

Peru has a government that has failed to maintain even a basic investment in its health service, which knows very little about the poorest members of its population. It clearly thinks that a firm hand, from both police and army, can somehow rescue it by punishing people. It is a tragic story, with consequences almost as severe as those in Brazil. The Peruvian government completely failed to respond to the horrors of a broken health service and a people whose needs have been largely ignored.

 

Chile is a country that is now well into the second stage of the pandemic, where there is a sudden huge increase in prevalence. It illustrates a story in many ways comparable to that in Peru, where the public has lost faith in the government, despite having an annual per capita GDP well over double that of Peru, and a GINI index lower than that of Brazil or Peru. Once a government has lost touch with the people, this sort of catastrophe (so much dreaded by those in the US and the UK), is to be expected in the immediate future.

 

It is a pleasure to record the excellent records of both Argentina and Colombia.