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The end of summer leaves Chile at a bad time in the fight against the coronavirus.
The South American nation is experiencing a rebound again in cases similar to June and July, the worst covid-19 moments in the country that led to a strict quarantine.
“The current situation in Chile is very serious. We are reaching a record of cases per day which is similar to the most difficult months of the pandemic in 2020”, Dr Juan Carlos Said, Master of Public Health at the Imperial College of London.
“In terms of hospitalized patients, we also achieved a figure similar to that of the most complicated months, with occupancy rates of critical beds above 95%, which speaks of a saturation of the system and a situation extremely complex. in health terms, ”he adds.
The increase in cases in the country comes at a time when infections are also rebounding globally due to the emergence of new variants of SARS-CoV-2 and the relaxation of measures, according to the WHO recently alerted.
The current situation in Chile is seen by many as a red flag for the rest of Latin America, not only because the country has been one of the countries that has carried out the most tests since the start of the pandemic, but also because he is at the forefront of the coronavirus vaccination campaign in the region.
According to the vaccine monitoring carried out by the University of Oxford (England), Chile ranks fifth in the world in doses administered per 100 inhabitants, only surpassed by Israel, the United Arab Emirates, the United Kingdom and the United States. United.
But, how to explain then that, despite the progress of its vaccination campaign, the number of cases and hospitalizations is again at the same level as the most critical moments of the pandemic in 2020?
The causes of the increase
Chile has celebrated a year this month since reporting the first case of covid-19 with one of the worst numbers of infections since 2020.
According to data from the Ministry of Health, since the end of February, the country has again started to reach about 5,000 new cases per day.
Since the start of the pandemic, Chile has recorded some 860,000 cases and more than 22,000 deaths, according to official figures.
“What we are currently seeing in Chile is a similar situation to the one experienced in the UK after the summer holidays, in which there was a very strong second wave,” Dr Claudia Corts told BBC Mundo. Academic at the University of Chile. and vice-president of the Chilean Society of Infectology.
Experts consulted by BBC Mundo agree that the causes of the new increase are varied and are due to reasons which range from policies implemented to contain the virus since the start of the pandemic to fatigue from the measures a year later.
“Chile has never succeeded in effectively controlling the pandemic. Unlike some European countries, Oceana or Asia which recorded a significant decline after the first wave, in Chile what happened is that we stabilized in what we call a high endemic, ie a persistent number of cases that never descended, ”says Said.
Chile is among the countries that have carried out the most coronavirus tests in the region since the start of the pandemic.
According to the expert, although the country has developed a “very significant” capacity to perform COVID tests, it has not been very effective in locating contacts of those infected, which has kept the virus circulating.
“ There is also fatigue in the face of the pandemic and, if at the beginning the population was very adherent to the measures and restrictions, the economic and social fragility of the country and the high rate of informal employment, particularly in the poorest municipalities. poorer, have meant that people have to go to work despite mobility restrictions, ”he adds.
Corts, for his part, explains that another element behind the current increase is the lifting of some mobility restrictions during the summer months.
“The government has authorized special permits to go on vacation, which means that between 4 and 5 million people have been mobilized in different areas which are currently experiencing a very extreme crisis, with hospitals with full beds, with very high positivity percentages., In some cases. superior to the first wave, ”he emphasizes.
In this sense, the Ministry of Health recognizes that the summer vacation has played a fundamental role in the current situation.
“The increase in cases is mainly linked to the relaxation of self-care standards during the summer, which has also happened in other countries around the world,” he said in a statement. sent to BBC Mundo.
“For this reason, as we develop the process of immunizing priority groups, which today reaches 28.39% of the total target population (15 million people), we insist that citizens continue to use masks, washing hands frequently with soap and water. , maintain a physical distance, avoid crowds, among other things, ”he adds.
The arrival of vaccines
Unlike several Latin American countries, Chile negotiated with several pharmaceutical companies the purchase of vaccines almost from the first months of the pandemic, which facilitated priority access to several brands since their authorization, this, associated with a effective primary immunization system. level, developed over the years, has allowed it to be at the forefront not only at the regional level, but also among the countries of the world with the highest percentage of its population vaccinated to date.
Chile has consolidated its vaccination system over the years, which has facilitated the new campaign against covid-19
According to data from the Ministry of Health on Monday, more than 4 million people had been vaccinated (in a country of 19 million), several times more than other countries in the region with more populations, such as Mexico, the Brazil or Argentina. .
“To date, a total of 4,364,136 people have been vaccinated in the country, of which 2,688,850 are people over 60 years of age and over who participated in the campaign,” the ministry said.
However, Corts considers that the very success of the vaccination campaign may be one of the causes of the current epidemic, given that many people were confident about the start of vaccinations.
“Unfortunately, with the start of vaccination, there was a mismanagement of information provided to the population and risk communication, implying that with the vaccine this had already been resolved and was not transmitting the disease. message that the vaccine is one more thing. in preventing infections, ”he says.
“So when the vaccination started, many people thought that since the vaccines had already arrived, the problem was over and the self-care measures were considerably relaxed,” he adds.
Experts also do not rule out that the new variants circulating in various countries of the world may be the cause of the new increase, as has happened in other countries.
On Monday, Chilean authorities acknowledged that the Brazilian variant had been in the country for weeks and had also identified the British variant.
“The problem is that in Chile they determine the variants more or less in isolation. We know we have the UK variant and it was reported that we have the Brazil variant. of reports at the time of the South African variant, but in the scientific community it is not known if there are no reports because there are no cases or because they do not look in that sense, ”he says.
“This is why, as a scientific community, we have requested that a more serious study be carried out to determine the variants,” he says.
The effectiveness of vaccines
The fact that Chile is leading regionally in immunization at a time when cases are on the rise again, has not only led the authorities to decree new quarantines, but has also led many to wonder how it is possible that this is happening despite the promised benefit of vaccines.
However, experts consulted by BBC Mundo agree that vaccines are effective, but not “magic” in reducing infections overnight.
“There is no contradiction between the increase in cases and the vaccines. We would really be asking for something that cannot be expected from vaccines. Vaccines do not work immediately,” says Said.
“Many vaccines, like Sinovac, which is the majority here, require the application of two doses three weeks apart and the highest immunity begins to be obtained from the second week of the second dose”, he explains.
“So, even though Chile vaccinated 20% of the population with the first dose, less than 5% received two doses of the vaccine and are effectively immunized. So we see that it is vaccinated quickly but that means that this percentage of the population is effectively vaccinated, ”he emphasizes.
Most of the doses inoculated in Chile belong to the Chinese Sinovac.
According to the infectologist, for the effects of the doses to be visible, a much larger number of the population must be vaccinated with them.
“In terms of population, to reduce the number of hospitalizations and deaths, the vaccine is effective when 80% of the population is vaccinated. And we are still very far from it, ”he said.
Said believes the country will begin to see the first results in declining hospitalizations and deaths by the end of March, if the current vaccination rate is maintained.
However, he does not expect infections to decrease to the same extent.
“This is because the Sinovac vaccine is used in Chile, which is less effective in terms of preventing contagion than others, like that of Pfizer,” he explains.
“The greatest effectiveness is that it can prevent hospitalizations and deaths in almost the same way as others. So the first impact that we are going to see is a reduction in deaths and hospitalizations probably at the end of March and the reduction in infections will probably take longer and depend on reaching a herd immunity threshold, ”he believes. -he.
Until this point is reached, the Ministry of Health recommends not to “let our guard down”.
“We insist on always maintaining the self-management measures which are currently the most effective while obtaining collective immunity, which we hope to achieve by the end of the first semester”, indicates the institution.
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