The COVID-19 Response in Mexico
Actualizado: may 4
19 de septiembre de 2020 COVID-19, México, Pandemia
Coronavirus is rampant among communities and cities all throughout Mexico. Families have felt the visceral impact of COVID-19 not only as it continues to ravage livelihoods but the death toll rises on a daily basis.
To date, officials have reported more than 30,000 deaths in Mexico and over 250,000 confirmed infections.1 Despite the numbers, the current national strategy to combat the COVID-19 pandemic remains futile.
WHAT IS AT STAKE?
Mexico has implemented a set of mitigation measures in response to COVID-19 including social distancing coupled with a national lockdown, scaled-up healthcare systems, and a public health campaign to promote hygienic practices. On March 24th, Mexico declared a national lockdown that lasted 8 weeks to limit and curtail the disease chain of transmission. However, these efforts have been largely underwhelming. First, the country has entered a severe economic downturn that is expected to persist.2 In a country where 52.9 million people live at or below the poverty line and over half of its population depends on the informal economy, its citizens have received very little economic support and lockdown protocols have only exacerbated these socioeconomic inequalities.3,4 And second, COVID19 infection and mortality rates continue to accumulate leaving its citizens unprotected and vulnerable. At the current pace, 628,197 people will be infected and 88,160 will die by October 1st, 2020.1
With the current measures, Mexico will continue to face a dismal economic outlook that will inevitably lead to more death. Exacerbated by lockdown measures, Mexico expects its worst economic contraction yet of up to 10%, including high unemployment rates.2,5 Already, a large percentage of its population has been directly affected by the lockdown measures issued by the national government. So far, Mexico’s response has been short of frugal with only a few states - Mexico City, Chihuahua, Queretaro, and Jalisco - issuing economic stipends to vulnerable populations to curtail the economic burden of lockdown and quarantine. Now that the country is phasing into an open economy, not only are these knee-jerk responses to the pandemic affecting its long-term economic viability, it is indirectly forcing people to risk contagion. When the only option seems to be dying of hunger at home or risking infection at work, the least advantaged will choose the latter.
Mexico’s most vulnerable populations also include the millions that suffer from hypertension, diabetes, and obesity (15.2 million, 8.6 million, and 6.2 million of adults, respectively), and a striking majority of COVID-19 victims have been diagnosed with these underlying conditions.1,6 The state of public health in Mexico has, consequently, rendered millions particularly vulnerable to COVID-19. With the current strategy, Mexico has prioritized ramping up available hospital beds and ventilators for the most severe cases. And the current testing strategy only covers 10% of symptomatic cases including all severe cases. The country is chiefly fighting the pandemic from its hospital wards leaving millions of lives on the line. Under the pressure of burgeoning cases and deaths, Mexico has no choice but to drastically change its national response to COVID-19, and quickly.
The current pandemic has been unprecedented yet a sizable list of countries including Vietnam, South Korea, and Rwanda, have been able to efficiently and effectively limit its effects. Successful public health strategies have included testing, tracing, isolation and quarantine, and social and economic support for vulnerable populations. With the available epidemiological and economic data from these countries, Mexico can do better to prevent unnecessary deaths and protect the most vulnerable, and its policies should reflect that. As Mexico phases into an open economy under its New Normality campaign, proactive measures must be taken to ensure the safety of its citizens. The Mexican government needs an evidence-based approach that focuses on testing, tracing, isolation, and social support with an emphasis on vulnerable populations. An improved and informed national COVID-19 response policy should include, in addition to the current strategy:
Comprehensive testing of all suspicious cases
Contact tracing by phone or door-todoor, depending on location
Case isolation and contact quarantine
Social support for those who cannot fulfill isolation/quarantine requirements
A comprehensive testing protocol should cover and protect all suspicious cases. This would include decentralizing testing strategies to include local testing centers, drive-through testing, and walk-up testing tents. Doing so would expand Mexico’s current testing capacity beyond its hospital walls and encompass a greater percentage of the population at risk.
However, testing alone will not be sufficient. Contact tracing has been implemented in all countries with successful COVID-19 measures. It encompasses actively looking, finding, and testing close contacts of confirmed cases. Evidence indicates that early and efficient contact tracing efforts can curtail chains of transmission.7 COVID-19 has a high transmissibility and patients are likely to become infectious even before symptoms arise with almost half of confirmed cases originating from asymptomatic individuals.8 In Mexico, contact tracing should be implemented in both urban and rural communities to locate and limit spots of contagion. Over 35 million people currently live in rural areas and communities, a population that, with the current response, will most likely be left untested and untraced.9 A comprehensive and effective contact tracing program in Mexico can hone the efforts of medical students, Promotores de Salud, and scholars affiliated with Jovenes Construyendo el Futuro as contact tracers. Mexico has the professional capacity to respond to the current public health emergency, however the current limited approach has greatly impeded its success.
Mexico, in addition, must implement a contingency plan for populations who could not afford to isolate or quarantine in the face of a positive test result. A revised and robust COVID-19 policy response should include targeted social and economic support to alleviate the economic burden of an extended period of isolation or quarantine. Mexico needs to protect the livelihoods of its most vulnerable populations in order to keep an open economy and limit the spread of disease.
If Mexico continues to take a political back-seat amidst the COVID-19 pandemic, it will lead to unsalvageable economic trauma and the catastrophic death of nearly 90,000 people by October 1st, 2020. The evidence is clear, and a robust policy response must include comprehensive testing, tracing, and isolation, with the social and economic protection of vulnerable populations. Mexico’s current response is simply not enough and as cases continue to rise, its window of opportunity is quickly closing. The time is now.
Covid-19 en México. Gobierno de México https://coronavirus.gob.mx/datos/.
The Covid-19 Pandemic Threatens Mexico’s Economy. https://www.csis.org/analysis/covid-19- pandemic-threatens-mexicos-economy.
International Labour Organization. Informal employment in Mexico: Current situation, policies and challenges. https://www.ilo.org/wcmsp5/groups/pu blic/---americas/---ro-lima/documents/publication/wcms_245889.pdf (2014).
Poverty & Equity Data Portal. http://povertydata.worldbank.org/poverty/country/MEX.
Bank of Mexico sees economy shrinking up to 8.8%, outlook hazy. Reuters (2020).
Secretaría de Salud, Instituto Nacional de Salud Pública & Instituto Nacional de Estadística y Geografía. Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/doctos/informes/ensanut_2018_presentacion_resultados.pdf (2018).
Digital tools for COVID-19 contact tracing. https://www.who.int/publicationsdetail-redirect/WHO-2019-nCoV-Contact_Tracing-Tools_Annex-2020.1.
COVID-19 Control Strategies and Intervention Effects in Resource Limited Settings: A Modeling Study | medRxiv. https://www.medrxiv.org/content/10.1101/2020.04.26.20079673v2.
OECD Rural Policy Reviews: Mexico - OECD. https://www.oecd.org/gov/oecdruralpolicyreviewsmexico.html.
College Harvard University.