• Jun Park

Chile | Coronavirus | Exemplary, so far...

Translated from BBC New Mundo by Fernanda Paul.

There is no truce to the pandemic an in Latin America they are racing against time to avoid the collapse of their healthcare systems as it has happened in Europe and New York.

In this fight, there are nations that have managed to establish successful strategies when it is time to contain and mitigate the transmission, and the amount of deaths caused by Covid-19.

In the case of Chile which, albeit it confirming a large quantity of infected (the second most in South America in absolute terms), so far it reports the lowest mortality rate in the region.

This is how the pandemic has evolved in Latin America.

To understand what is behind the Chilean case we have too look at some numbers.

According to the ministry of health of Chile, since March 3 up to April 3 there were 3,73 cases confirmed of the coronavirus and 22 deceased.

That way, Chile reports in one month a mortality rate of 0.5%, similar to countries like South Korea, Germany or Japan before they reached the peak of infected which are recognized internationally for effective strategies against Covid-19.

Now, what is the situation of Chile in relation to the rest of Latin America?

While it is hard to make comparisons, and the current estimates have margins of error, this all depends on the quantity of tests and the existing in the entire country which have not been diagnosed or reported, Chile together with Costa Rica are the representatives of the lowest mortality rates in the region. (both at 0.5%)

Nicaragua, for example, reports a 20% mortality rate (the highest inLatin America); meanwhile Brazil, is 4%, Bolivia 6.8%, and Honduras 6.7%.

That is even though, if we analyze the infected cases per 100,000 inhabitants since April 2, Chile is the third country with the most level of infected in the region, being at a rate of 18.1 per.

Coronavirus Map : Global spread, April 4, 2020

Data from the John's Hopkins Coronovirus Resource Center

Graphic from BBC.

Panama and Ecuador surpass [Chile], with 35,3 and 18,5, respectively. After, come countries like the Dominican Republic with 12,9 per 100,000 inhabitants, Uruguay with 10,6; and Costa Rica with 7.9.

However, if you compare the number of deceased by this same countries (which, according to experts, tends to be more accurate than the infected) the difference of Chile is palpable.

Panama has 0.88 deaths per 100,000 inhabitants; Ecuador 0.7; and Dominican Republic 0.56. Meanwhile Chile has only 0.09 mortality per 100,000 inhabitants.

This, without a doubt, places the country among those who have best been able to contain the losses from Covid-19 in the region.

Testing, testing, and more testing

But, what is the reason to explain - till now - the success of the Chilean strategy?

One of the keys is related to the quantity of daily testing in the south american country.

According to figures by the government, in average there are 3,000 diagnostic tests a day.

This, according to the president, represent the most number of total tests per inhabitant in Latin America.

Just to give an example, in Ecuador there have been 8,521 tests in total since the beginning of the outbreak, from the 29 of February up to 31 of March. Starting in April among the countries with most deaths in South America due to the Covid-19.

"The numbers are short" : the government of Ecuador admits the Coronavirus crisis was worst than it was reported.

In a conversation with BBC World, representative of the Organizacion panamerican de la Salud (OPS) [Panamerican Organizatoin of Health], Fernando Leanes, affirms that, effectively, in comparison to the rest of the continent, Chile is doing an "impressive" amount of tests.

"I dare to say that that its one of the few countries with the capacity of testing they are doing. They have a very, very big sampling capacity", explained the Argentinean expert.

"It is very important that Chile was able to anticipate, had been able to acquire such large quantity of supplies and train sufficient quantity of laboratories to do this." he added.

According to official data, Chile currently has 49 laboratories that have the capacity for the diagnostic test.

Why is it that important to test?

The fact that pursuing a high number of diagnostics tests not only gives a more certain picture of the quantity of infected in a country, but it also allows to track who my have contracted the disease.

With that, you can have an early identification of the carrier of the virus, which stops the spread.

At the same time, the World Health Organization (WHO) has been firm on its insistence that this is a vital measurement needed to face Covid-19.

In Chile, additionally to the testing, the infected are getting a daily monitoring call by the ministry of Health and have to follow mandatory quarantine protocols.

This is how it was explained by subsecretary of Health in Chile, Paula Daza.

"Our strategy has various elements, the first is to identify early a person who may have Covid-19", she says.

"The Second point is to get an early diagnostic. That is the importance of the tests, because as we detect more people with Covid-19, and we can isolate them and identify who they have had contact with, we have been able to contain the outbreak of the virus" she adds.

The Healthcare system, so far, "has responded"

On the other hand, the low mortality rate in Chile can be explained because of their healthcare system, widely criticized for the brutal inequality between public and private hospitals, which so far have worked.

Even though Chile spends US $2,229 per capita in health, the second country with most expenditure in this subject matter after Cuba, its position in the equality ranking is much worst: ranked at 15.

And even experts agree that so far the amount of equipment and beds that exist in the healthcare facilities have been enough, there are those who believe that we have to wait and see what happens at the end of April, when the country is expected to see the peak of the Cronovirus in the country.

"The Chilean sanitation system has responded today. Critical patients have been detected and have had access to treatment. We have a good capacity of ICU beds for the Latinamerican context." explained the doctor and Master's in Public Health form the Imperial College of London Juan Carlos Said.

Additionally, according to Fernando Leanes, from the OPS, Chile has experience dealing with respiratory diseases.

"Chile has a fairly well acknowledge system of monitoring respiratory ilnesses. It's one of the strongest and is even used as a model for other Latin American countries", he says.

Acccording to the subsecretary Paula Daza, from the beggining Chile prepared for the "worst case scenario".

That way, they say, they strengthen the assistance network and training of healthcare professionals. They also increased the number of beds.

"We accelerated the opening of five new hospitals that add more than 1,700 beds and we did the purchasing of ventilators and other supplies", he points out.

"We can't be triumphalist"

However, the demand for ICU spots for patients is on the rise.

And, the "achilles heal" of the chilean system is, mainly, the availability for mechanical respirators that are key for the critical patients.

According to the Ministry of Health, of the 1,200 which are actually operative, only 240 remain unused.

This could darken the chilean panorama when the peak of cases come, as it is then when this could strain both public and private healthcare system.

"Chile is not immune for this to evolve in a more dramatic situation", said Said. "We need to be prudent when qualifying Chile's strategy as successful because this is just the beginning", he added.

A similar opinion is shared by Leanes.

"They are well prepared, definitively, I would say that they are better prepared than other countries, but we still have to see how severe the spread of the virus and how the people respond to the measurement that we have to take", he says.

"We shouldn't by triumphalist", he concludes.

And the economy?

Chile suspended its classes in school and universities the 15 of march, 12 days after the first case of infection was reported in the country.

Three days later, the state of constitutional exception was decreed which allowed the government to restrict meetings in public spaces, limit transit, and establish curfew and close borders, among other things.

Additionally, it applied mandatory quarantine to strategic zones which, according to explanation from the government, presented a greater number of infections.

Even though this measure has caused controversy among sectors - with complains from local leaders demanding, for example, that they extend the quarantine to the entire country - which according to a detailed report by the bank JP Morgan were all measures adopted "early" in comparison to other countries.

For example, the American Firm (JP Morgan) confirms that Chile's suspension of classes was implemented with only 75 confirmed Coronavirus cases, meanwhile countries like China or Italy decreed this when they were over the 2,00 and 3,000, respectively.

Something similar happened with the closing of the borders.

According to JP Morgan, Chile reported 155 cases confirmed and no deaths when it took this measure, while Italy decided to do so when they had more than 9,000 cases and 463 deaths.

The bank concluded its report with "if the Chilean strategy continues to show positive results, this could end up implying one of the shortest interruption of the economy in comparison with other countries, which would be positive in this environment."

A similar vision seems to come from the Central Bank of the country, which presented its latest report of monetary policies on April 1.

Although the entity forecasts a GDP fall of up to 2.5% in 2020 - the highest since 1980 - it also forecasts "strong comeback" in the last trimester of 2020 y and all of 2021, with a growth between 3.75 and 4.75%.

And like this, even though Latin America is still in the middle of the evolution of the pandemic, the chilean case is worth observing.

At least, for now.