Sunday, April 12, 2020

Latin America braces for COVID-19

The Economist has a interesting article on how the Latin American health care system is/will be able to cope with a potential increase in cases of COVID-19. In general, the Latin American health care system may be better than many naive outside observers may think.

…Latin American health systems, though still smaller and less well managed than those of Europe, have matured greatly. Colombia, which introduced universal, taxpayer-financed health care in 1993, has ten times the number of intensive-care beds it did before then. This year Peru’s health budget as a share of GDP—3.3%—is two-thirds higher than in 2015. Across Latin America and the Caribbean, public and private health spending is about 8.5% of gdp, compared with an average of 12.5% in the OECD, a club of mainly rich countries. The region has recent experience of fighting outbreaks of infectious disease, including cholera in 1991, swine flu in 2009 and the Zika virus in 2016.

On the one hand, many large Latin American cities have world class hospitals and clinics. In rural and poorer areas, however, the quality of care is much worse.

Some–but not all–Latin American countries, however, is already bracing for an onslaught of COVID-19 cases.

El Salvador announced a national lockdown when it had three covid-19 cases. With 15 confirmed cases on March 12th, Ecuador suspended large events and shut schools a day later. Peru’s government locked down the country on March 15th. On the same day, with 75 confirmed cases, Chile announced the closure of schools and universities…Chile has suspended its requirement that migrant doctors re-qualify. In Colombia private health insurers, which provide most health care, have been agile. They offer online consultations and have rolled out home delivery of remedies to non-COVID-19 patients, largely through Rappi, an app-based service…Peru’s Congress has given the government powers for 45 days to issue pandemic-related decrees.

However, there are problems. Many of the health care systems are fragmented…although that is the case in the US as well. Corruption is also problematic. And resource allocation is problematic. European and other countries are banning exportation of ventilators to prioritize the needs in their own country.

Tumaco, a Colombian town with 250,000 people, has one public hospital and no ventilators. In late March Ecuador’s government commandeered two ventilators from Lago Agrio, in northern Amazonia, for use in a regional capital, but failed to deliver 1,400 testing kits it had promised. A baby with COVID-19 died.

A very nice review of how a diverse set of Latin American countries are preparing for the potential arrival of the pandemic.



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