As explained by Peter Sands, executive director of the Global Fund to Fight AIDS, Malaria, and Tuberculosis, many nations are about to face the full blow of the pandemic. Since cases in Africa and Latin America were detected a couple of weeks after they were confirmed in Europe and the United States, there are reasons to believe the continent is between four to six weeks behind in terms of disease progression.
This means our peak of the transmission wave is yet to come.
Over 10,000 cases and more than 400 deaths have already been registered in Africa while 27,000 cases and over 1,000 deaths have occured in South America. But even at their worst, these countries have been spared from the shocking death toll seen in Europe, simply because their demographics “protect them”: with lower life expectancies than those in Italy or Spain, the proportion of people over 65 years old is comparatively lower.
Our peak of the transmission wave is yet to come.
Because these are the most vulnerable patients, one would expect a reduced proportion of complicated cases in these regions. However, health networks are so fragile in Africa, and already have to deal with so many different problems like malaria or tuberculosis, that they can easily collapse by the extra strain of COVID-19. The situation is worsened by the incapacity to endure prolonged lockdowns like those implemented in Europe.
Although the situation in Latin America is generally better (with most countries having solid health systems and stronger economies), Venezuela is the exception.
After 21 years of massive corruption and pervasive economic crisis, Venezuela now resembles more a Sub-Saharan country than a South American one. Malaria and tuberculosis are public health problems and the health network can’t deal with the existing demand. ICU capacity is also akin to that of poor African nations: depending on whether you include private hospitals or not, Venezuela has 0.3 to 0.7 ICU beds per 100,000 people. Liberia, one of the poorest countries in Africa, has 0.1. Colombia, which already ranks pretty low in the list, has 2, while the U.S. has 35.
So it’s unlikely that the country could deal with even a relatively small number of severe cases.
Furthermore, even a small increase in health service demand could cause a significant number of indirect deaths, as already scarce resources are diverted to deal with the COVID-19 pandemic, neglecting patients with other conditions that also require critical care.
Although the situation in Latin America is generally better, Venezuela is the exception.
The collapse of oil prices, partially triggered by a sudden reduction in demand as all major economies in the world imposed lockdowns and social distancing measures, will also be a severe blow to the Venezuelan health system. This has already been identified as a major risk factor that could tamper the response to the pandemic in Middle Eastern countries like Saudi Arabia, and there are no reasons to expect it to be any better in Venezuela.
Dubious official numbers and limited testing make things worse, too. The claim that Venezuela has fewer patients than the Faroe Islands is hard to believe.
It’s still too early to evaluate the impact of COVID-19 in Venezuela, and given the regime’s control on information, we may never be able to do so. But we’re probably yet to see the worst of this disease, so beyond extending the quarantine, real efforts to revamp hospital capacity in the country are urgently needed.