As Mexico enters the darkest days of the COVID-19 pandemic, its vaccination plan suffers a blow

TIJUANA, BAJA CALIFORNIA - WEDNESDAY, APRIL 29, 2020: Wearing protective clothing and equipment, Red Cross paramedics push Eduardo Dionisio Molina, 41, who has symptoms related to COVID-19, on a stretcher toward a ambulance for transport to a nearby hospital from his home in the Pobladoejido Matamoros neighborhood of Tijuana, Mexico, on April 29, 2020. (Marcus Yam / Los Angeles Times)
Red Cross paramedics push a man with symptoms related to COVID-19 on a stretcher toward an ambulance in Tijuana. (Marcus Yam / Los Angeles Times)

Almost a year after the start of the COVID-19 pandemic, Mexico is entering its darkest phase.

More people are infected than ever before, including the nation’s president, Andrés Manuel López Obrador. Hospitals in many states are almost full, ventilators and oxygen tanks are scarce and every day they seem to bring a new record number of mortality.

In a temporary medical center set up at a military base in Mexico City, the morgue is out of space.

“In the end, you are just stacking people in piles,” said Dr. Giorgio Alberto Franyuti Kelly, head of biosafety for the military, who treats patients in the makeshift hospital.

Large-scale vaccination is widely seen as the clearest way out. Still, last week, the government announced that its vaccination program – one of the most ambitious in Latin America – had virtually stopped.

The country of 128 million people received only 766,350 doses of the vaccine, all produced by Pfizer-BioNTech.

That number was expected to reach 1.5 million by the end of the month, but Pfizer now says it cannot meet that target because it is renovating one of its factories in Europe to increase production.

Mexican officials described the delay as a minor setback and said that Pfizer shipments are due to resume on February 15.

“It will simply be temporarily postponed,” said Mexico’s undersecretary of health, Dr. Hugo López-Gatell, who is leading the country’s response to the pandemic.

But health experts warned that the pause in vaccinations could have serious consequences, because about half a million medical professionals who received an initial dose will be forced to wait longer than ideal for the second critical dose.

Pfizer says its injections should be administered three weeks apart.

Dr. Hugo López-Gatell leads the response to Mexico's pandemic.
Dr. Hugo López-Gatell leads the response to Mexico’s pandemic. (Marco Ugarte / Associated Press)

López-Gatell said there is no reason to panic, pointing to studies showing that the vaccine can still be quite effective if the second dose is administered in four weeks.

After failing to recognize the coronavirus threat at the start of the pandemic and conducting the widespread tests needed to combat it, the Mexican government received praise for its vaccination strategy.

In the beginning, Mexico made agreements with several companies that work with vaccines and was the first country in Latin America to start vaccination, on December 24th.

A healthcare professional receives a dose of the COVID-19 vaccine in Mexico City
A healthcare professional receives a dose of the Pfizer COVID-19 vaccine on December 30 in Mexico City. (Marco Ugarte / Associated Press)

Officials here said they had already made deals to buy enough vaccine to inoculate the entire country.

They signed agreements with Pfizer, Chinese CanSino Biologics and British company AstraZeneca to buy enough vaccine for 128 million people. They are also trying to align enough of Russia’s Sputnik V vaccine to another 12 million.

Buying from a number of companies helps to diversify risk and protect Mexico from unforeseen events, such as the postponement of Pfizer deliveries this month, say officials at the Ministry of Foreign Affairs, which helped negotiate the deals. Even so, there is no official vaccine delivery date for most companies.

Pfizer’s delay could not have come at a worse time.

Mexico has officially registered almost 150,000 official deaths from COVID-19 – the fourth highest number of deaths in the world – although officials acknowledge that the actual count is much higher. Last year, the country recorded 274,486 more deaths of all types than in a normal year, and health experts said the vast majority are probably attributable to the pandemic.

Epidemiologists blame the current rise on the Christmas holiday, when many families have gathered in large groups despite calls from health officials.

They said the deaths in the past week are likely the result of meetings on December 24. Another major wave of deaths is expected in the next five weeks, a consequence of the celebrations to mark the New Year and the Day of the Three Kings on January 6. .

“It’s a giant snowball,” said Dr. Laurie Ann Ximénez-Fyvie, who heads the microbiology laboratory at the National Autonomous University of Mexico, to the newspaper Reforma. “What is happening now is a perfect storm, the result of three holidays with a week-long break.”

Georgina Barajas Rios cries for her mother, who died at her home in Tijuana.
Georgina Barajas Rios cries for her mother, who died at her home in Tijuana. (Marcus Yam / Los Angeles Times)

For doctors in the wards of COVID-19, work has become a nightmare that becomes more frightening every day.

“Death by COVID-19 is becoming more grotesque,” said military doctor Franyuti.

During several long shifts in the past few weeks, he has been one of the few doctors who care for more than 100 critically ill coronavirus patients. Without enough fans, he sometimes watches patients breathe hard until they die.

It happened last week with Pedro, 35 years old.

“I had to let him die in agony because I had nowhere to transfer him,” said Franyuti. “I was only able to hold his hand.”

He expressed anger that Mexico City had waited until the end of December to enter a second blockade, despite data showing that cases are on the rise, and said he was upset that the city had allowed restaurants to resume operations. outdoor dining.

“We need to establish measures that limit people’s ability to put themselves at risk,” he said.

The vaccine distributed so far appears to have gone almost exclusively to frontline health workers. Franyuti, who recently received his second dose, said he was excited that distribution guidelines were being followed – a notable achievement in a country often hampered by corruption.

López Obrador announced that he had tested positive for COVID-19 and had mild symptoms on Sunday. The president hardly ever wears a mask in public, including during his daily press conferences, sometimes in the presence of dozens of other officials and journalists.

López Obrador, a center-left populist who has maintained high approval ratings since taking office in 2018, has been criticized by some for his response to the pandemic, including his refusal to invest in widespread testing. But he is willing to spend money when it comes to building a robust vaccination plan.

At first, the president insisted that all vaccination efforts be carried out exclusively by the military, which he has repeatedly turned to in recent years to deal with a range of civil issues, from infrastructure projects to immigration enforcement.

But last week, after news of Pfizer’s delay and intense pressure from state politicians, he gave the country’s governors permission to purchase vaccines on their own, as long as they buy only vaccines approved for use in Mexico.

Local leaders welcomed the decision, although some criticized the president for waiting a month and a half to give them permission, saying that global competition for vaccines will mean delays of more than a year.

“The global supply of vaccines has been talked about,” said Miguel Riquelme, governor of the state of Coahuila, which borders Texas.

The prospect of long waiting times has raised concerns about the black market.

The Federal Commission for Protection against Health Risks – the Mexican version of the US Food and Drug Administration – warned last week about the illegal sale of vaccines on the internet, in pharmacies and hospitals.

In particular, it drew attention to the unauthorized sale of a vaccine manufactured by Moderna, which has not been approved for use in Mexico. Authorities are probably concerned about the Modern vaccine being smuggled across the border into the United States, where it is produced.

There has also been growing talk about “vaccine tourism”, in which those with resources travel to countries where the vaccine is most widely available. Private doctors, who were not part of the initial vaccination plan, spoke of going to the United States to get vaccinated.

Last week, Florida surgeon General Scott Rivkees issued a statement demanding that vaccine distributors in the state verify that the patient is at least a part-time resident in Florida. The change comes after several reports suggest that wealthy people from other countries, including Mexico, were traveling to get vaccinated.

This story originally appeared in the Los Angeles Times.

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