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Control of the coronavirus slips away as holiday behavior causes widespread increase in cases and deaths

Published on January 06, 2021

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Tracking the spread and outcome of the coronavirus in Ecuador: UPDATED FOR TUESDAY, JANUARY 5, 2020

THE NUMBERS

In our last two reports, we were optimistic with the COVID-19 situation in the country; unfortunately, that optimism has been replaced with serious concern as the statistics representing the Christmas holiday were released.

The increase in cases and deaths occurred during the state of emergency that limited mobility last week; we expect to see worsening numbers on January 10th that will reflect the full two-holiday period for Christmas and New Year.

As is clear to see in the accompanying charts and graphics, there is very little good news to report. To summarize:

  • A staggering 22 of 24 provinces saw increases in the rate of new cases (16 significantly),
  • Half of the provinces saw an increase in the rate of new deaths (4 of them significantly),
  • The overall rate of new cases rose,
  • The overall rate of new deaths rose,
  • The number of new deaths rose by 25%,
  • The rate of new sample collection fell,
  • The number of hospital admissions rose by 21.5%,
  • The number of people in ICU beds rose by 7.5%,
  • The rate of new hospital admissions jumped from 2% last week to 16% this week, while the rate of discharge remained at approximately 2%, and
  • Pichincha added 1,596 new positive cases, more than twice what it added last week.

As for good news, statistically there is little to report. We can say that the government increased the number of tests it ran by 3.04%, and that it reduced the backlog of tests by 2.63%. Also, the positivity rate continues to fall, as it has since September.

Rates of hospitalization raise serious concerns in Quito and Guayaquil

Statistically, the number of new hospital admissions and the ICU occupancy rate if very concerning. More so are the anecdotal reports form the Ministry of health that came out on Tuesday morning.

First and foremost, the Ministry reported that the rate of positivity nearly doubled in the provinces of Carchi, Cañar and Cotopaxi, and in the mountain areas of the country.

Of equal concern is that over the last week, while the percentage of occupied beds in intensive care units (ICU) nationwide has remained between 54% and 68% (a slight increase), Minister of Health Juan Carlos Zevallos reported that the Guasmo Sur General Hospital in Guayaquil(the largest public hospital in the country) and the Hospital del Sur Enrique Garcés in Quito, along with many other IESS hospitals in those cities, are 100% occupied.

Three private hospitals in Quito—Hospital Metropolitano, Axxis Hospital and Hospital de los Valles—are also full.

Quito Mayor Jorge Yunda reported that over 1,800 people have died of COVID-19 in the capital and the city’s doctors are worried about the impact they are yet to see from the two recent holiday periods. “Quito continues to struggle with the mortality rate, with the health system in general—there are no intensive care unit beds … ”, said Yunda.

Hugo Espejo, the Deputy Director of Critical Medicine at the IESS Sur Hospital, said that there has been a rebound in COVID-19 cases. He reported that over the last two weeks, the average number of CCOVID-19 patients (80 to 100) has doubled.

The hospital has filled its normal 170 beds and have had to resort to placing 20 additional beds in the cafeteria area of the hospital. He also reported that military tents have been set up with another 80 spaces in the parking lots of the hospital.

The hospital’s ICU is full with 43 patients; there are 27 patients on the waiting list for an ICU bed, said Espejo.

Other Quito hospitals are reporting between 90% and 100% ICU occupancy.

Cuenca also sees hospital overcrowding

Like Quito and Guayaquil, Cuenca is also facing serious issues in bed availability in its hospitals.

As of Tuesday, 100% of the ICU beds in the IESS public hospitals are occupied, while 58% of the ICU beds in the city’s private hospitals are occupied.

Julio Molina, coordinator of zone 6 of the Ministry of Health, said that a contingency plan is being instituted to increase the number of ICU beds available in Cuenca.

The Sierra and the Amazon are facing similar occupancy issues

Similar to what is happening in the country large cities, small towns are also facing their own problems with overflowing hospitals and ICUs. Here are just some of the figures that were reported over the last week:

  • There are only four ICU spaces available in the province of Cotopaxi to serve COVID-19 patients in Zone 3—which is also made up of Tungurahua, Chimborazo and Pastaza, reported the district director of Salud Ambato, René Sanmartín.
  • The Riobamba General Hospital, in Chimborazo, has a capacity of 35 beds for COVID-19 patients, of which 25 are available, while all 7 of their ICU beds are occupied.
  • In Cotopaxi, Latacunga hospital has 45 inpatient spaces, of which 29 are available. They do fortunately have 4 of the 10 beds in the ICU available.
  • The Puyo hospital, in Pastaza, has 10 inpatient beds, of which 2 are available and the only ICU bed is occupied.
  • In Tungurahua, in the Ambato General Teaching Hospital, 4 of the 43 regular hospital beds are available, but all 9 ICU beds are occupied.

Sanmartín added that in Zone 3, 43% of COVID-19 infections are in people aged between 20 and 39 years old; 38%, are recorded in patients between 40 to 64 years old; 8% are in seniors from 65 to 74; and 6% are found in patients 75 years and older.

TESTING

Even with its improvement in processes, Ecuador’s test collection and processing pales in comparison to other countries

Over the last several months we have highlighted the government’s failures in testing, though recently it seemed that they were moving forward with improving their methods and releasing more timely test results.

However, in the month of December, the government’s efforts in both sample collection and testing have fallen behind once again.

In fact, according to the Ministry of Health’s reports, December was the worse month for collection and testing in the last four months.

According to the official statistics, in October a large number of tests that had been in backlog were cleared; a total of 133,414 samples were tested. In December, however, only 91,342 were processed, representing a 32% drop between the two months.

The contraction also occurred in sample collection. In October 114,189 samples were collected; while in December, only 96,944—a 15% drop—samples were taken.

Compared to the rest of South America, Ecuador’s testing program is a failure

With the exception of Bolivia, Ecuador continues to lag behind all of South America (Argentina, Bolivia, Brazil, Brazil, Chile, Colombia, French Guiana, Guyana, Paraguay, Peru, Uruguay, and Venezuela) in both the percentage of population tested and the number of tests given per million.

Based on the Ecuadorian Institute of Statistics and Censuses (INEC) population projections, Ecuador has only tested about 4.27% of its population. With 760,021tests completed, Ecuador has tested 42,747/1 million people, settling in at 147thout of 215 countries tracked worldwide. This is dismal when compared to Ecuador’s direct neighbors.

Its neighbors Colombia, Peru and Chile (who’s population is size is closest to Ecuador at 19.18 million people) have tested 16.33%, 16.77% and 34.53% of their populations, respectively.

Colombia has tested 163,274/1 million people and ranks 96th on the list. Peru has tested 167,675/1 million people and ranks 95th on the list. Chile has tested 345,273/1 million people and ranks54th on the list.

[Chile only has 8.1% more people than Ecuador but has tested 8.72 times more people!]

Venezuela, who’s economy is considered to be in the worse shape in South America has tested 8.52% of its 28.4 million people. Even Argentina, who also has serious economic issues, has tested 10.90% of its citizens.

GRAPHICAL HIGHLIGHTS

Here is a quick review of the graphical highlights below (as of Sunday, December 27, 2020 at 8:00AM):

  • 14,051deaths have been attributed to COVID-19.
  • 755,929test samples have been collected.
  • 214,614tests have returned positive (+).
  • 495,172tests have returned negative (-).
  • 46,143test samples remain “dammed” or backlogged in the testing process.
  • 8% of the deaths have been among the ages 20 to 49 years old.
  • 3% of the deaths have been among the ages 50 to 64 years old.
  • Only 13.1% of the deaths have been among the ages 65 years and older.
  • 7% of cases have been on males, 47.3% in females.
  • Guayas province accounts for 12.9% of confirmed cases (27,630) and 25.24% (down from 25.32% last week) of the confirmed deaths (3,547).
  • Pichincha province accounts for 35.4% of confirmed cases (75,878) and 16.39% (down from 16.48% last week) of the confirmed deaths (2,303).
  • Azuay province accounts for at6.4% of confirmed cases (13,769) and 1.72%of the confirmed deaths (242).
  • No province has escaped deaths due to COVID-19.

HOW ACCURATE ARE THE NUMBERS?

The numbers from the government are only “accurate” as historical references, since they cannot guarantee that tests completed this week are from samples collected over the last seven days.

However, the graphic accompanying this article (it is provided by the government, but has been modified for easier readability), does offer some recent graphical dated information on four provinces, and at a national level.

The numbers and statistics below are based on all case data collected by the government as of 8:00 a.m. on Sunday, January3, 2021. More detail of all of the numbers are available in the graphics that follow.

The numbers in the graphic reflect the number of people who tested positive or negative for the virus, with both the polymerise chain reaction or (PCR) test which looks for antigens and identifies the presence of the virus in the body, and the “Rapid” test which looks for antibodies to the virus and identifies a person’s immune response to the virus. The PCR test gives an earlier identification of those who have been infected by the coronavirus and whether they have an active infection. Ecuador is now only reporting new PCR test results (however, prior Rapid tests are included in its report).

These numbers do not reflect the actual total number of people infected across the country or the number of deaths that can be attributed to COVID-19. The dates on the graphic are also adjusted back to when symptoms began, not when the positive test occurred.

For those who want a deeper level of information for a particular town or city, see: https://www.gestionderiesgos.gob.ec/coe-nacional/

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