Coronavirus: test are lacking in Latin America

The coronavirus entered Latin America and one of the most affected countries so far has been Ecuador, whose population is just over 17 million and already has 1291 deaths.

After Wuhan in China confirmed 50 percent more deaths from coronavirus than those that were on record, the WHO called on countries to review their numbers and complete all records so the numbers were up to date. Just a day after this warning, Ecuador went from confirming 474 deaths from COVID-19 to adding another 817 deaths that have not been proven but were related to respiratory diseases.

In addition to the new deaths, days before, the case of the province of Guayas, where most of the cases are located, added to the country's concern. In addition to the tragedy that has circulated due to the lack of places to cremate the dead in Guayaquil, the number of deaths in March and April has exceeded the province's normality.

According to El Tiempo, "in this territorial district, an average of 2,000 deaths are registered every 30 days: in January of this year 1,943 death certificates were established and in February, 1,676." However, in the first days of April there was a record of 6,700 and although the numbers continue to rise, in most cases it is unknown that the virus has spread.

This means that the official figures do not correspond to the possible actual number of infections and deaths from coronavirus. And, unlike what can be judged at first glance, the inconsistency does not correspond to the attempt of governments to hide the truth, but to the inability of their health systems to keep up-to-date records of cases. This, mainly, is due to the few tests that the countries of the region have.

Also read: Ecuador and Coronavirus: (un) expected crisis

In countries such as South Korea, by contrast, attention was focused on conducting tests, reaching around 15 thousand tests per day outside hospitals. This control allowed them to take the necessary measures at the time, in addition to keeping a more accurate record to control the situation in the health and emergency system.

The lack of tests, on the one hand, prevents massive testing of the population to rule out possible causes and reveal foci of infections in the cities. This directly affects the number of cases, since many people stay at home waiting for a test, despite having the symptoms and complications of the virus. On the other hand, specifically in the case of Ecuador and also in Brazil, the tests are being carried out on living people, so many suspects who die cannot be verified.

Another problem in relation to the COVID-19 tests is the process to analyze the results. Although tests should standardize results within 24 hours, in some countries it is taking days or even weeks. This means that the results we see today are really the numbers of days ago, which has led to underreporting of cases and deaths throughout the region.

Likewise, in many countries in the region, such as Mexico and Brazil, the registry of "atypical cases of pneumonia" and diseases related to "influenza" has increased. These cases, then, would not be registered as coronaviruses or treated as such, so the tests are not being carried out either.

"All we see is the tip of the iceberg," says doctor Carolina Lazari, medical chief of the molecular biology laboratory at Hospital das Clínicas.

Brazil and the quarantine

In Brazil, the situation is similar to that of Ecuador in terms of inaccuracy in the count of the tests and official figures. This has become the country with the most cases, reaching around 40 thousand cases and 2,500 deaths. The numbers, although high, are proportionally not the worst, since it has 210 million inhabitants.

Despite the fact that in general the entire region has this problem related to access to tests, the case of Brazil stands out because its president has had controversial management to prevent and contain the spread.

President Jair Bolsonaro has given strong statements since the beginning of the contingency in the region, affirming that it is a simple "flu" that if, for example, he got it, it would not be serious and he would be cured. Thus, he has tried to go against preventive isolation despite the recommendations of international organizations and his own government.

Also read: Coronavirus challenges Latin American governments

Due to this strong position against social distancing, Bolsonaro ended up dismissing his Health Minister, the doctor Luiz Henrique Mandetta, with whom he had been arguing since March when the need to reinforce the measures increased. The situation prior to the dismissal was one of tension between the two figures and the president repeatedly rejected the minister's statements. This affected the effectiveness of the measures in the country, as citizens did not know which of the two they should pay attention to.

As the last sign of his position regarding the measures, Jair Bolsonaro led a massive demonstration last Sunday in front of the Army Headquarters in Brasilia to ask for military intervention and the closure of Congress, thus breaking the preventive isolation. The president criticizes some parliamentary members, governors and mayors, who are against drastic measures of distancing and asks to support "AI-5 (institutional act number 5), which in 1968 closed Congress and abolished numerous constitutional guarantees", according to El Tiempo. Around 600 people attended the demonstration.

Currently, epidemiologists in Brazil assure, as it happens in the entire region, that the real figures must be well above the official ones, and they also blame the lack of tests for this.