ACCDIS researcher, DRA. Sandra Cortés participated in the DM analysis: Six keys to Chile's worrying increase in contagion
The Chilean case illustrates the risk of putting all hope into a vaccine and all efforts in the speed of inoculation. Here are the keys to understanding the seriousness of the crisis in the South American country.
With an impressive vaccination campaign, where more than five million people have already received a dose, the big question is what Chile is failing, where nearly 30,000 people have died and contagion cases add up to almost one million.
Experts in epidemiology and public health consulted by DW explain some of the causes of the high level of contagion and the worrying upward trend, that threatens the collapse of hospitals.
- Poor risk communication
“There is no campaign that strengthens prevention, the correct use of a good mask and ventilation of enclosed spaces", says Dr. Muriel Ramirez, specialist in public health and epidemiology, and academic at the Faculty of Medicine of the Northern Catholic University.
Prevention message loses strength due to erroneous signals: it is common for the president to take off his mask to speak in public and a bishop went so far as to say that it was OK to disobey the laws when they were unfair, in reference to restrictions on mass.
“Risk communication has been in the hands of actors who are not epidemiologists or healthists", indicates the DRA. Sandra Cortés, health and academic at the Faculty of Medicine of the Catholic University. The population usually obtains more complete information that allows to weigh the situation and risk thanks to the work of doctors, mathematicians and data experts.
- Non-evidence-based decisions
In the face of questions over the opening of casinos, Malls, holiday permit or allow religious trades, ministers in the political and economic area have become famous for justifying measures with arguments such as “there's no scientific paper" that says otherwise, denoting being misinformed.
In response, experts have been quick to upholster social media with evidence on the importance of measures such as avoiding crowds, ventilate or wear mask properly. “Decisions are made by political authorities. This dialogue has become very difficult in which the evidence tells us one thing, but the authorities have a delayed response", says Dr.. Cortés.
In that line, the Dra. Izkia Siches, president of the Medical College (COLMED) has gained leadership in attracting attention to the critical situation of hospitals and health personnel.
- Questioned dynamic quarantine plan
Despite the increase in contagion, the government has maintained “the scheme of non-effective partial quarantines, by communes. It's not a complete lockdown., work activities in enclosed spaces and malls work", observes Dr.. Ramírez.
Restrictions on the initial confinement plan based on contagions have been relaxing, allowing more and more movements and meetings, and encouraging confusion and lower compliance. And although the night curfew remained, as if the virus were deadliest at night, the clandestine festivities continue and the audit has been less effective. Now, in the face of the recent increase in cases, the Ministry of Health quarantined more areas.
- Care focus and TTA on debt
The government has privileged important actions, like raising beds and fans and buying vaccines, but has neglected the public health approach, specialists lament. The TTA strategy (Testing, traceability and isolation) has been poor, says Dr.. Cortés. “To cut the transmission chain we need to do a very good targeted test on those who might be suspected of having the disease, requisition all your contacts, do PCR examination and isolate, And that has failed".
“Lately, the traceability of the contacts was activated, who is in charge of primary care, the same teams that are now vaccinating and have stopped doing traceability", designates the Dra. Ramírez. “Primary care makes a tremendous effort to vaccinate, but neglecting the test, traceability and tracking", corroborates Dr.. Cortés. On average, only two close contacts are identified by contagion and health care homes have low occupancy.
- Lack of social support
In a country with high informality at work, the majority of the population does not have the possibility to make an effective quarantine. The Dra. Cortés indicates that it is essential that the State has comprehensive support strategies, in a society marked by inequality and where the vast majority of the population does not have the conditions to maintain isolation at home and if they stop working, doesn't eat.
Expert alert to how COVID has particularly hit the most vulnerable sectors, who already had high rates of chronic diseases, obesity and hypertension, which has resulted in increased pressure also for the healthcare network. President Sebastian Piñera announced a new COVID fund for six billion dollars, with social aids to combat the crisis and support those most hit by the pandemic.
- New variants and overconfid confidence in the vaccine
The increase in cases can also be explained by a relax in care measures on a par with overconfid confidence in successful vaccination. Experts clarify that it takes time, at least two weeks after the second dose, get the most immunity.
In addition, vaccination amid a high level of contagion could be less effective or even encourage the onset of virus mutations. But it is also about to be seen how effective the vaccine is and its ability to enter dangerous new foreign variants.
Vaccination is a great achievement, but it is also necessary to maintain isolation measures, hygiene and ventilation, in addition to social and economic support so that people can comply with quarantines. On its own, will be unable to control the pandemic.