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Lack of Scientists Thwarts COVID Response in One of the World's Worst Hit Countries

By some counts, Peru’s COVID-19 per capita death tally is the highest in the world.
Funerary workers bury a coffin in a massive burial ground for low income people and unidentified victims of Covid-19, opened by the regional government of Arequipa in the highland barren lands of Uchumayo, in the Andes of southern Peru.
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LIMA, Peru – Learning that my neighbor Pepe had died from COVID-19 was shocking. Equally so was the news that he had first tested positive a month previously, in early July. No one in my small apartment block had been notified.

Pepe was in his 50s, with health problems and a professional carer. Even at the best of times, he rarely came out of his apartment, the only other one on my floor. It was only by chance, bumping into his devastated sister in the hallway, that I learned of both his passing two weeks earlier and positive test result several weeks before that.

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I immediately messaged the five other residents in the block, all of whom were equally stunned by the unexpected tragedy. How on earth could Peru’s health ministry have failed to inform — never mind test — the rest of us?

The personal anecdote highlights what a growing chorus of critics are describing as a series of glaring failures in the coronavirus strategy of President Martín Vizcarra, failures which have allowed this virulent new disease to ravage Peru worse than any other nation on earth.

Vizcarra’s initial, aggressive response to the pandemic earned him widespread praise. He closed the country’s borders, issued a national mask mandate and ordered one of the strictest lockdowns in the free world in mid-March.

Since then, he has sought to build up Peru’s woeful public hospital infrastructure while the police have arrested tens of thousands of unruly Peruvians for flouting the restrictions, often meeting up for clandestine drinks and parties. The president also launched a $26-billion economic relief package, including direct payments to the poor, one of the largest in the world as a proportion of GDP.

Thanks to those policies and the favorable comparison with other science-denying, populist world leaders, Vizcarra’s approval rating is currently 56%, stratospheric by the Andean nation’s jaded standards.

Despite all that, Peru’s official number of coronavirus cases is 541,493 – sixth highest in the world. Its ‘excess’ deaths have been calculated at 41,100, a 149% rise on the usual per capita rate and the largest such rise in the world. Excess mortality is the term used to refer to the number of deaths above what would be expected under ‘normal’ conditions. Only fatalities that have tested positive for COVID-19 are officially counted in Peru, but doctors suspect many are dying from the disease without getting diagnosed.

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Yet, although most experts believe the pandemic could have been far worse here had it not been for Vizcarra’s decisiveness, critics also argue that the president has failed to evolve his approach over the last five months.

In particular, they want a smarter approach to better fit the complex social realities of a country where corruption and red tape has created an entrenched culture of disrespect for authority, and 70% of the workforce is informal, many of whom live hand to mouth.

There has been limited testing so far to track the disease’s spread — rather than diagnose sickly patients — no widespread contact tracing, or community outreach in neighborhoods where poverty and limited education mean residents are unwilling or unable to miss work.

Ciro Maguiña, an epidemiologist and vice dean of Peru’s doctors’ union, believes the repressive approach has encouraged some people to flout the lockdown.

“The biggest failure is the lack of a community focus,” adds Maguiña, who has for months been desperately calling for localized lockdowns, cordoning off the block whenever a case crops up. “When someone tests positive, then the family needs to be isolated, and they need to be given food to allow them to stay at home.”

“A lot of scientists, including me, have the impression that the government is throwing in the towel, that it thinks Peru is just too complicated, that there’s nothing more that can be done,” says Ed Malaga-Trillo, a neurobiologist at Lima’s Cayetano Heredia University in the final stages of developing a fast, cheap saliva test for the coronavirus that could be a gamechanger for Peru.

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Part of the problem, he believes, is that the government’s coronavirus task force is made up almost entirely of doctors, with a dearth of other experts, including epidemiologists, virologists, behavioral scientists or communications experts. “It needs a multidisciplinary approach,” Malaga-Trillo said.

By late May, the economic consequences of the lockdown were so extensive, with a 40% drop in GDP, that the government began gradually reopening the economy. Since then, the pandemic has taken a tighter and tighter grip, with the country of 31 million hitting more than 10,000 new daily cases for the first time on August 16.

Over the weekend, Peru returned to a total lockdown on Sundays, with no one allowed to leave their homes other than for emergency reasons.

Vizcarra reintroduced the measure to stop highly sociable Peruvians from holding family gatherings, now regarded as the leading source of coronavirus infections. “Enough of this irresponsibility,” demanded the exasperated president.

In the capital, Lima, 22,000 soldiers and police patrolled the streets. They broke up more than 40 underground parties and arrested 1,200 people. Nevertheless, polls suggest that most Peruvians do take the pandemic seriously. Many voluntarily wear face shields as well as masks in public.

But as Peru hangs on grimly for the arrival of an effective vaccine, taking the coronavirus seriously may not be enough for the Vizcarra administration unless it can accompany its political will with a smarter, more comprehensive plan, to stop contagion.

Cover: Funerary workers bury a coffin in a massive burial ground for low income people and unidentified victims of Covid-19, opened by the regional government of Arequipa in the highland barren lands of Uchumayo, in the Andes of southern Peru, late on August 14, 2020. Peru is one of the worst hit countries in coronavirus-epicenter Latin America after Brazil and Mexico, with more than 25,000 reported deaths and over half a million cases. (Photo by Diego Ramos / AFP) (Photo by DIEGO RAMOS/AFP via Getty Images)