Can we talk about Peru?

[epythymy]

Apparently they had one of the longest and strictest lockdowns in the world. Curfews, not allowed to leave the house at all on Sundays, shops (even grocery stores) on limited opening hours, mandatory masks...

And one of the highest death rates in the world now. Excess deaths at 149% compared to Brazil (seen as a failure in the media due to their less strict locking down) who have only 20% excess deaths.

Why? There doesn't seem to be any particular reason why some countries get a lot of coronavirus and death and some countries get only a little. The strongest link to excess deaths seemed to be obesity but Brazil is a fatter nation than Peru...

No provision by the govt (who couldn't afford it) to keep paying people to stay at home, so people kept having to work
Most people get food from local markets with efforts to prevent transmission but again v difficult
The link is very often poverty despite the best efforts of governments unfortunately

The countries/regions hit hard at the start seem to do better than others when things open up again. New York/UK for example. I wonder if building up some herd immunity is important for long term management of the virus?

www.bbc.co.uk/news/world-latin-america-53150808

I would say timing of lockdown - there is only so long a country can be on a strict lockdown without consequences and more importantly lockdown fatigue. Peru looked to lock down very early in March with very few cases and came out too soon. Also within lockdown poverty meant those who were positive were moving about

www.theguardian.com/global-development/2020/may/20/peru-coronavirus-lockdown-new-cases

@Cavagirl

No provision by the govt (who couldn't afford it) to keep paying people to stay at home, so people kept having to work Most people get food from local markets with efforts to prevent transmission but again v difficult The link is very often poverty despite the best efforts of governments unfortunately

But then surely this proves that masks are ineffective as currently in the U.K. we are mostly open, many people are back at work, shopping, visiting restaurants etc. The masks don't seem to have made a difference in Peru so what's the point?

As @Cavagirl says. Lockdown with no funding for self-employed put people in an impossible situation. While there is some wealth in Peru it is unevenly distributed and many people have few assets. In practical terms that means they had no fridges for food and no funds to keep going without going to work. There was no effective requirements on food markets for how to keep safe and lots of evidence of spread from the markets that people had to frequent every day. It should have been obvious to the Peruvian government that their failure to get money to poor communities would mean people would have to carry on working and on a practical level that people had to go to markets every day. Printing the government's criticism of its people for doing so without challenge and suggesting the government did the right thing has been disgraceful and shows a failure by journalists to use a hint of thought in reporting on the situation.

There are also few medical resources outside the main cities, so there was insufficient help available when people become unwell enough to need oxygen. Lockdown was probably not the right answer for countries with the resources to support it; those resources would have been better used in planning and implementating greater support for social distancing, masks, handwashing and medical support. Reviews of the pandemic will need to come up with better guidelines next time.

Masks were not brought in early in Peru, they tried for a strict lockdown initially.

[quote Quartz2208]www.bbc.co.uk/news/world-latin-america-53150808

I would say timing of lockdown - there is only so long a country can be on a strict lockdown without consequences and more importantly lockdown fatigue. Peru looked to lock down very early in March with very few cases and came out too soon. Also within lockdown poverty meant those who were positive were moving about

www.theguardian.com/global-development/2020/may/20/peru-coronavirus-lockdown-new-cases[/quote]
But they already had one of the longest lockdowns. They couldn't have gone longer?

If the reason it didn't work is because "too many" people flouted the rules that's still evidence that lockdowns don't work. Perhaps if Peru had protected the vulnerable they'd have been able to afford to help those people while the younger and fitter could have worked and wouldn't have needed supporting?

Blanket long lasting lockdowns simply don't work. Whether because they're unsustainable for the population or other reasons. It's impossible. As with the U.K. most people stuck to lockdown but we put all our sick and elderly in nursing homes while other people were looked after in hospital by people who still needed to go home to families, do their weekly shop etc

Plus, that graph shows a big difference between excess deaths and "confirmed Covid" deaths. So did they die of something else?

More likely to be under diagnosis. What else are you suggesting they died of?

@MRex

Masks were not brought in early in Peru, they tried for a strict lockdown initially.

Apparently the government were giving out free masks after making them mandatory on 6th of April

What the Peruvian government say they did, versus what happened on the ground may vary. There were not enough masks at hospitals, never mind easy availability for the general population: www.reuters.com/article/us-health-coronavirus-peru-hospitals-idUSKCN2241C2.

@RandomTree

More likely to be under diagnosis. What else are you suggesting they died of?

I'm not suggesting they died of anything else. I am asking why the difference appears to be so large. Peru supposedly did a lot of testing. If they are all so poor I wondered if perhaps this had had an effect on mortality also. In the same way that more people are starving to death in Africa. Perhaps they were unable or unwilling to get medical attention when they needed it (like people in the U.K.). Perhaps a combination of all of these different factors is an issue.

Peru has a significant population that finds it difficult to access health care rather like the USA that will have had an impact on numbers who died.
But they are probably better than some other countries at tracking infections and deaths.
One of the Spanish Ministers has a made point of saying this has become a poverty disease. Most outbreaks are happening in areas of poverty. Those most badly affected are generally those living in poor conditions.
Not everyone but poverty is a significant factor in the figures.

@Didkdt

Peru has a significant population that finds it difficult to access health care rather like the USA that will have had an impact on numbers who died. But they are probably better than some other countries at tracking infections and deaths. One of the Spanish Ministers has a made point of saying this has become a poverty disease. Most outbreaks are happening in areas of poverty. Those most badly affected are generally those living in poor conditions. Not everyone but poverty is a significant factor in the figures.

This can also tie in, to some extent, with obesity. Which is more common amongst poorer people (in the west).

Early on, there was speculation that exposure to colds (other coronaviruses) might afford some level of protection against the worst of COVID - a primer for the immune response.

Perhaps a total lockdown lowers the rate of colds to such a level that any such additional resistance to COVID is blunted?

@epythymy

Masks aren’t a silver bullet and they don’t magically protect you. Covid will still spread if people continue to get close to others for long periods even with masks.

It doesn’t mean they do nothing. An analogy I’ve used elsewhere is a diet.... If you stop having a couple of biscuits with your mid-morning coffee (ie wearing a mask), that will help you lose weight. However, if you continue to have a pizza, chips and a massive slice of cake for lunch (ie continue to freely mix for long periods without socially distancing), your plans for weight loss won’t work, irrespective of whether you cut out your biscuits!

However, it would clearly be wrong to conclude from this that eating biscuits have no impact on someone’s weight loss, and that someone dieting should continue to eat biscuits to their heart’s content.

@Derbygerbil Great analogy