The real fatal figure in Mexico due to COVID-19 two years after the first death and the triggers

Officially, the first death from SARS-CoV-2 in Mexico was recorded on March 18, 2020. Since then and until March 16, 2022, 749 days have passed and according to the figures, 321,375 Mexicans have officially died. Therefore, according to official data, the mortality rate in Mexico is 251 deaths per 100,000 inhabitants. With this rate, Mexico will rank 28th out of 184 countries worldwide.

Recently, the Institute of Health Metrics and Evaluation at the University of Washington in Seattle has published an article in the prestigious British magazine The Lancet. In this article, the institute calculates excess mortality from COVID-19 worldwide. This study concluded that the mortality reported in Mexico by the General Directorate of Epidemiology must be multiplied by 2.67 times and that of INEGI by 1.4. With this correction factor, it is estimated that they have died - directly and indirectly - in reality it is 846,490 Mexicans (827,512-930,548). With this figure, Mexico rises from 28th to 19th place worldwide and its mortality rate rises to 325 deaths per 100,000 inhabitants.

These data indicate that mortality in Mexico is in the 89th percentile, that is, 88% of the world's countries have had fewer deaths than in Mexico. We are only won by 11% of the countries at the level. On the American continent, only Bolivia, Peru and Ecuador have had more deaths than Mexico.

By the way, if Mexico City were a country, its mortality rate would place it fifth in the world (576.9 deaths per 100,000 inhabitants). Tlaxcala would rank seven globally (517.2 deaths per 100,000 inhabitants). The State of Mexico would be in eighth place (433.6 deaths per 100,000 inhabitants) and Puebla would be in ninth place (399.7 deaths per 100,000 inhabitants). The high mortality rates in Tlaxcala, State of Mexico and Puebla are likely to be influenced by the great social and economic interconnection that these states have with Mexico City. This is therefore an example of how the -bad- public policies of the country's capital have also affected its neighbors.

But why have so many died in Mexico? Here are 19 factors that have negatively influenced the management of the pandemic and that have therefore generated our great mortality: 1) use of a poor model for the management of an unknown virus pandemic; 2) not allowing the pandemic to be led by the General Health Council - who by law should be directed by the General Health Council do-; 3) not listen to the recommendations of the national and international scientific community; 4) have a populist presidential model that minimized the impact of the pandemic and that also attacked scientific evidence and international recommendations; 5) sell our hospital supplies to China in January 2020, and then to buy them back in February and March; 6) the disappearance of Seguro Popular and the ill-achieved implementation of INSABI, an institute that has been run by someone with no experience in the area - all this further precarious health care and increased its gap in society; 7) generation by the Ministry of Health and Treasury from the widespread shortage of medicines and supplies, due to the new centralized purchasing system and changes in supply chains; 8) lack of coordination and communication between the federal authority and state and local authorities; 9) the lack of a clear, serious, responsible and based social communication policy on scientific knowledge and not on the president's personal or religious beliefs; 10) use the sentinel model of epidemiological surveillance, which was appropriate for a pandemic of unknown virus; 11) the high level of under-registration of cases and deaths, which resulted in the detection of cases being reactive and non-preventive; lack of control over local transmission of cases; 13) poor financial design and inadequate application of expenditure in public policies in the health sector; 14) use the hospital reconversion model without sufficient numbers of specialist doctors, sub-specialists and supplies; 15) expand the capacity of intensive therapies without understanding that primary care and case prevention was more important than third level care; 16) increasing inequities in access to health; 17) employing a guided vaccination strategy with electoral objectives rather than adequate technical strategies that would allow a further decrease in the impact in a shorter period of time; 18) that the vaccination strategy has been coordinated by the Secretariat of Welfare, IMSS and SEDENA to have CENSIA or CONAVA who are the experts in vaccinating, such as the head; and 19) allowing travelers to enter our country indiscriminately without proof of COVID-19 and/or without vaccination.

After two years of pandemic, it would seem that the federal government and most state and municipal governments, as well as a society that have not learned how to avoid contagion or cut the chain of transmission. It seems that it does not matter that our country has more than 300,000 children orphaned by COVID-19, that we are the #1 country in mortality among health workers, that we have lost more than one and a half cycles of education and that we have recorded an unprecedented drop in GDP. Unfortunately, neither government nor society are showing signs of trying to make a change of course that could stop this humanitarian catastrophe.

If we do not act now as an informed, participatory, critical and demanding society to change the course of managing the pandemic, the tragedy will continue. If we don't stop the transmission of the epidemic and avoid deaths, the health, education, economic, social and cultural gaps in Mexico will continue to grow. Finally, by continuing with the current federal government strategy, we will not only continue to lose more Mexicans, but also one in three of those infected who survive will have to live with the long-term consequences of COVID-19.

* Dr. Andreu Comas García, researcher at the Center for Research in Health Sciences and Biomedicine (CICSAB) of the Autonomous University of San Luis Potosí. Surgeon by the UASLP, teacher in infectious diseases from the INSP, doctor of science from the UNAM. He was a postdoctoral researcher in the department of microbiology of the Faculty of Medicine of the UASLP. He is currently a professor in this department and coordinator of the histocompatibility laboratory of the CICSab.

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