Last weekend, 110,000 people attended the “Vive Latino” music festival in Mexico City, which took place as scheduled despite several confirmed cases of COVID-19 in Mexico’s capital. At the same time, while governments worldwide took drastic measures to slow down the spread of the disease, Mexican President Andrés Manuel López Obrador, known as AMLO, traveled to the south of Mexico and met with adoring crowds, shaking hands and hugging and kissing supporters. During his daily press conferences, AMLO has insisted that his honesty and moral rectitude protect him from the virus and that the threat of COVID-19 is greatly exaggerated. “I have great faith that we will move our dear Mexico forward, that misfortunes and pandemics won’t affect us,” he told reporters at a press conference on Sunday.
The number of confirmed cases of the coronavirus in Mexico may seem low, but it has grown exponentially over the last week, from eight to 118, and the first death from the disease was reported on Wednesday night. Moreover, Mexico has very limited testing capabilities, and the official statistics are not a reliable indicator of the actual number of cases in the country. Although the government’s position is that Mexico is still in “Phase 1” of the pandemic, meaning all diagnosed cases of COVID-19 are people who caught the virus while traveling abroad, most experts agree the virus is already rapidly spreading within Mexico and that the government’s nonchalance about the situation could have disastrous results.
“We need political leaders that are properly advised and understand the gravity of the situation,” said Jeffrey Sachs, director of the Center for Sustainable Development at Columbia University. “A lot of people in Mexico would die unnecessarily unless the government gets very seriously prepared for this.” Getting seriously prepared means taking drastic measures to curb the spread of the virus, bolstering the hospital system, and helping people cope when the economy grinds to a halt.
The Mexican government has not yet imposed any travel restrictions nor encouraged people to stay home, and it seems very unlikely that the public health system, which suffered drastic budget cuts and shortages last year, will be prepared for the magnitude of the imminent crisis.
“The current guidelines are ‘wash your hands, don’t touch your face, and avoid people who are coughing,’ ” said Gordon McCord, a professor at the School of Global Policy & Strategy at the University of California San Diego. “We know from the experiences of Asia and Italy that if all you do is avoid people who are coughing, you’re going to get an explosion of sick folks in the population, so that’s coming.” Italy, which after China has the most confirmed COVID-19 cases and deaths to date, has 340 hospital beds per 100,000 people, which has proved woefully insufficient. Mexico, by comparison, has only 150 hospital beds per 100,000 people, less than half.
Around 5 percent of coronavirus cases become critical, meaning they result in respiratory failure, septic shock, and organ dysfunction. These cases require intensive care to keep the patients alive, which is limited and more expensive. Doctors in Italy, which has an above-average number of intensive care unit beds for European standards (12.5 per 100,000 people), are being forced to decide which patients to keep alive and which ones to let die because there are not enough respirators available for all critical cases. Mexico’s public health care system has 3,000 ICU beds in the entire country. That’s 2.3 beds per 100,000 people.
According to a prominent Mexican epidemiologist, who asked to remain anonymous because of possible hostility from government authorities, Mexico will see a spike in coronavirus cases in the next couple of weeks, and within a month the death toll will begin to rise significantly. “It’s not that Mexico isn’t taking the problem seriously enough. It’s that it did not take it seriously when it should have, and now we are starting to see community spread,” the doctor said. “From my perspective, we have all the conditions for this to turn into a tragedy, similar to Italy, if not worse.”
The government’s nonchalance may be the result of previous experience. In 2009, the Mexican government took severe measures to contain the spread of a new strain of swine flu. Public life was virtually shut down in the capital for several weeks, which took its toll on an already struggling economy in the aftermath of the 2008 financial crisis. Mexico suffered its first recession since 2009 last year, and government officials have indicated they do not want to overreact to the situation out of concern for the country’s economy. In a press conference last week, Hugo López-Gatell, Mexico’s deputy health minister, told reporters that “the  economic loss was directly related, in the most part, to the disruption of tourism, trade and services. … It is so important, with very careful precision, not to take preemptive actions that do not correspond to the magnitude of the risk.”
It is unclear how López-Gatell is assessing the magnitude of the current risk when no significant amount of testing has been done on the population. At the end of last week, the government had tested only around 500 patients. By comparison, South Korea, which has had some of the best results controlling the COVID-19 outbreak, has tested 270,000 people. “I’m sympathetic to the desire of the government not to pull the trigger too early while the number of cases are small,” said McCord. “But if you’re going to do a multiphased approach, there’s one thing you absolutely need if you’re going to get the timing right, and that’s data. Data means mass testing of the population so that you know in real time what’s going on in terms of the epidemiology of this disease.”
López-Gatell announced this week that the government will spend 3.5 billion pesos (roughly $147 million) on tests, protective gear, and other equipment to address the pandemic, and that widespread testing will begin next week. The government’s equipment purchases are based on an estimate of 250,000 cases of the coronavirus over the course of the pandemic and 10,528 people requiring intensive care. That number seems absurdly low, considering that epidemiologists predict around half of the world’s population could get the virus and that the Centers for Disease Control and Prevention’s worst-case scenario estimate for the U.S., Mexico’s next-door neighbor, is 65 percent of the population getting infected. Based on the CDC’s projections, Mexico, which has a population of 130 million, should be planning for a worst-case scenario of 84.5 million infections and 4.2 million cases that require intensive care.
Some new measures to curb the spread of the virus will be implemented in the next few days—public schools are going on spring break ahead of schedule at the end of the week, most colleges are switching to online classes, and the country’s biggest concert promoter canceled all of its shows until mid-April—but the government still insists on delaying more significant measures, like travel restrictions and social distancing. “If one begins these measures too early, one extinguishes the will of society to keep them up,” said López-Gatell in a recent press conference. “And although some of those measures might be useful now, they may be even more useful in the future.”
That is simply not true. The more time and opportunity the virus has to spread in the population, the worse the situation is going to be later on. “The more you refrain from the social distancing message now, the longer people feel ‘Let’s go to the restaurants, bars, beaches one last time’—then the higher the spike will be in two or three weeks when this really hits the health system,” said McCord. “And I think everybody senses Mexico is going to be overrun.”