At the beginning of the pandemic, Peru led auspicious rankings such as that of the first countries that imposed restrictions and that of those that allocated greater aid packages for people affected by the suspension of the economy.
But months later, media around the world began to report on the high numbers of Coronavirus in Perú, the deficiencies of the quarantine and the sharp economic decline that hit the country.
Now, more than five months later, the South American country leads one of the perhaps most painful rankings: it is the one with the highest death rate from covid-19 of the 20 countries most affected by the virus, according to Johns Hopkins University.
Accumulates 87.53 deaths per 100,000 inhabitants. This measurement puts it ahead of countries like the United States, Brazil and Mexico.
Peruvian media reported that it was the highest death rate from covid-19 in the world.
In absolute terms, until this Friday, Peru was the ninth country with the most deaths in the world, with an official total of 28,277; and the fifth with the most infections of Coronavirus in Perú, with 621,997 cases.
The daily death toll has dropped slightly in the last week. On Wednesday, the Health Ministry reported 123 deaths, the lowest number since June. But on Thursday it rose again to 153.
A mixture of public health, economic and social factors, structural limitations and conjunctural errors explain why Peru reached this situation, says Hugo Ñopo, principal investigator of the Grade group, to BBC Mundo.
We look at four of those factors.
1. Deficiencies in the health system
One of the factors of the crisis was the fact that the pandemic surprised Peru with a low investment in health, with a shortage of hospital beds and intensive care, with poorly paid personnel and a single laboratory capable of processing molecular tests.
Public spending on health, as a percentage of economic growth, has increased slightly in the last two decades.
In 2017 it reached 4.9% of GDP, according to the latest estimate that the World Bank has.
But it is still “a country with low per capita spending on health, for its relative level of development,” said economist Elmer Cuba, from the Macroconsult consultancy.
At the beginning of the pandemic, Peru had 100 intensive care beds and 3,000 hospital beds.
By the end of June, it had 18,000 hospital beds, according to the president, Martín Vizcarra, and now it has 1,660 intensive care beds.
“But the pandemic is always one step ahead,” Dr. Gotuzzo tells BBC Mundo.
2. Focus on intensive care rather than prevention
For Gozzer, the most important factor is “that there was a more hospital-centric approach than preventive and detection or public health.”
“Despite the successful early measures (school closings, borders, quarantine), the enormous increase in the availability of hospitalization and intensive care (ICU) beds and the dedication of health personnel and officials in charge of responding to the pandemic, the results have not been as expected, “Gozzer said.
“Those of us who work in public health are looking to contain an outbreak, that (patients) do not go to intensive care,” Gozzer said.
Gozzer also criticizes that the government has used more serological or rapid tests as diagnostic tests for Coronavirus in Perú, when they serve other purposes, such as epidemiological control, instead of molecular tests.
Rapid tests do not tell you if someone is infected at the moment, but show past infections. Molecular tests do confirm current cases of covid-19.
But not only were more molecular tests lacking, but also labs that would allow them to be mass-processed, says Gotuzzo.
3. Oxygen shortage
Another problem that affected the fight against the pandemic was oxygen shortages.
In June, the government declared oxygen a product of “national interest” and ordered a purchase of close to US $ 25 million of medical gas to meet demand.
“The lack of oxygen influenced mortality, because people who needed oxygen and could have been cured with that, probably got worse and had to go to the ICU or no longer reached the ICU,” Gozzer told BBC Mundo.
4. Government reaction
At the beginning of the pandemic of Coronavirus in Perú, in mid-March, the government reacted quickly and decreed one of the most restrictive quarantines in the region.
At the same time, it allocated between 9% and 12% of its GDP to help people who had lost their jobs (or self-employment) and companies that had been left without income due to the closure of the economy.
But Hugo Ñopo believes that they lacked “a twist” in these measures to adapt them to the Peruvian reality.
Around 71% of the economically active population in Peru lives in the informal economy or works in trades where they earn their income from day to day, so they could not stay at home and had to go out to work on the streets.
In addition, people had to go to stock up on crowded places such as markets, which in May Vizcarra identified as “the main sources of contagion.”
The distribution of economic bonds also led to the formation of agglomerations in banks, since only 38.1% of adult Peruvians have a bank account. The rest had to go in person to collect the money.
For Dr. Gotuzzo, “good social measures (bonuses) ended up being negative public health measures.”
Once the government identified some of these problems, it took steps such as intervening and reorganizing the markets, and extending the banking hours.
It also ordered the automatic opening of a savings account at the Banco de la Nación for all Peruvians over 18 years of age.
The economist Janice Seinfeld, executive director of the Videnza consultancy, also pointed out that when the quarantine was decreed and transport services were suspended, many people walked back to their cities of origin.
“A slightly finer closure would have been much more positive, it should have been spun a little finer according to national reality,” Seinfeld told BBC Mundo.
5. Compliance with restrictions
In recent days, many people blamed those Peruvians who fail to comply with the restrictions aimed at preventing infections. The trend arose from the fact that last weekend 13 people died and another six were injured in a stampede that occurred due to the intervention of the police in a clandestine party held in Lima.
Some 120 people had attended the event in Thomas Restobar, despite the fact that meetings are prohibited in Peru as a measure to prevent the spread of covid-19.
“People have continued to go out to work, they have continued to move, there has been interaction in the markets, in the banks, all of this has been added,” said Lavado.
“Without a doubt (the meetings) have contributed, but I am left wondering how much they have contributed. All the agglomerations have contributed, but I could not say which one more,” he says and assures that “more people take care of themselves.”
What does the government say about the high mortality rate?
The president of the Council of Ministers, Walter Martos, acknowledged in an interview with the Peruvian network RPP that Peru has the highest death rate from covid-19, but that the record is due to the government’s transparency in disseminating the death toll.
“I do not know another country, apart from Peru, that during the pandemic is being transparent with the number of deaths during the pandemic of Coronavirus in Perú. There are numbers of suspects of Coronavirus in Perú that have passed (to the official count) and that raises the number worldwide, “Martos said Thursday.