A study by Colombian researchers published in the magazine International Journal of Infectious Diseases analyzed the management of the pandemic in the country based on the incidence of cases and deaths compared to others in the region.
The research was prepared by Fernando de la Hoz Restrepo (from the Department of Public Health of the National University), Nelson Alvis Zakzuk (from the Department of Economic Sciences of the Universidad de la Costa), Juan Fernando de la Hoz Gómez (from the Department of Evaluation of Health Technologies of the ALZAK Foundation), Alejandro de la Hoz Gómez (of the interdepartmental program of bioinformatics of the University of California), Luz Gómez del Corral (of the research group in infectious diseases of the San Ignacio University Hospital) and Nelson Alvis Guzmán ( of the Department of Economic Sciences of the University of Cartagena).
It was named ‘Is Colombia an example of successful containment of the covid-19 pandemic? A critical analysis of epidemiological data from March to July 2020.
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The experts constructed the analysis based on the incidence and mortality rates shown by covid-19 by age, sex, and geographic areas in Colombia between March and July 25.
By then 240,745 cases and 8,269 deaths had been reported, with a fatality rate of 3.4 percent. And 1,370,271 samples had been analyzed, equivalent to 27,405 per million inhabitants and a positivity rate of 17.5 percent.
It is worth saying that until Tuesday, less than a month after the analysis ended, the number of confirmed cases was 489,122; deaths, 15,619, and the fatality rate, 3.19 percent. In addition, 2,246,595 samples have been analyzed, equivalent to 44,600 per million inhabitants and a positivity rate of 21.77 percent.
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With the studied figures, the researchers confirmed that Colombia has a lower incidence of cases and mortality compared to other countries region of.
And likewise, after approximately 140 days of transmission, the numbers of cases and deaths are “extremely” below the projections of the National Institute of Health (INS). “The INS mathematical model estimated that 21,237,000 cases and 212,000 deaths could occur in the first 100 days of the epidemic without interventions. However, only 0.3 percent of cases and 0.7 percent of predicted deaths were reported after those first 100 days.”, Indicates the analysis.
They say this can be an effect of the general quarantine and other measures taken by the Government (strict early closure, mandatory confinement for those over 70 years of age, closing of schools and universities, suspension of almost all face-to-face work activities and of national and international land and air travel), conditions that were contrasted at the time by the decisions taken in other countries such as Brazil and Mexico.
Also, mention that factors such as the climate and the demographic profile could have influenced the low mortality rates. This is because although transmission peaks and deaths caused by respiratory viruses mainly occur during the rainy seasons, since October 2019 the country has experienced an unusually long dry season. That adds to the majority young population that may have attenuated Sars-Cov-2 mortality.
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But they also blame the low mortality, to some extent, to geographic differences in surveillance capacity. For example, “indigenous populations with little sanitary infrastructure have been the most affected,” say the experts.
The authors show the gaps in the sampling rates that the regions have when they are compared per million inhabitants, because while one department has 2,664 another shows 158,681. “Consequently, the incidence and mortality rate also varies,” they point out.
But the study also evaluated the potential for underestimation of cases detected in the country, which “Due to geographic variations in surveillance capacity it can reach up to 82 percent”, they mention.
Or in other words from the same document, “for July 25, Colombia should have detected 1,328,175 cases instead of the real 240,795 observed, an underestimation of 82 percent ”.
To measure the underestimation of cases, the authors identified the departments with the highest rates of samples processed per million inhabitants and projected them on other regions taking into account the positivity shown.
The researchers clearly point out that “These deficiencies in notification and surveillance can also help to hide the real number of cases and deaths in Colombia.”
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In any case, the article points out the difficulties that the country had due to the shortage of laboratory supplies to carry out PCR tests. And it states verbatim that If all the departments had had the sampling capacity that the Amazon had, “the number of cases would have multiplied by eight.”
This is evident because when reviewing the proportion of COVID-19 positives for each imported case, “it is suggested that some departments were unable to track the majority of imported cases.”
The article ends by saying that although the first imported case was detected in early March, “It is very likely that the transmission began in February or even at the end of January.”
Proof of this are the cases detected in March in various regions and with no known links to imported positives. “One of the first cases, in fact, reported symptoms on February 29, several days before the first imported case was detected.”
This analysis takes the data that, although they show that the collapse of the health system did not occur in Colombia and that there is a low mortality rate, which has remained, the scale of the pandemic is not yet known, Fernando de la Hoz, former director of the National Institute of Health and director of the public health department of the National University and one of the main authors, told EL TIEMPO.
The article – adds the researcher – adjusts the numbers reported by the National Institute of Health and the Ministry to the diagnostic capacity that the country has.
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