The ‘mistake’ that sent the pandemic over the edge
“In order to control an infectious disease that’s transmitted between humans through a very problematic route, it’s necessary to contain infections,” says Ximénez Fyvie. (Photo: Courtesy)

In the opinion of Laurie Ann Ximénez-Fyvie, the evolution of the pandemic had two phases: before, when the first cases could be traced and management was possible, and after, the result of a bad decision that facilitated the uncontrollable rise in the number of Covid-19 infections.

The ‘mistake’ that sent the pandemic over the edge

As author of the book “Irreparable Harm: Criminal Management of the Pandemic in Mexico”, Ximénez-Fyvie, head of the Molecular Genetics Laboratory at the UNAM School of Dentistry and holder of a doctorate in Medical Sciences from Harvard University, described her view of how the pandemic was handled in an interview with Tec Review.

The academic is clear about the most illustrative example of what happened in Mexico a year ago, when the first Covid-19 cases started to reach hospitals: a woman known in South Korea as “Patient 31”.

The case of “Patient 31” was one of the most documented in that Asian country, since she infected almost 1,000 people with Covid-19, according to the epidemiological tracking done at the time by the Korean Health Service (KHS).

According to South Korean health authorities, this person increased the spread of the coronavirus, causing cases of Covid-19 to jump from 30 to 977 in eight days from infections that were traced back to her.

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Although she had symptoms of the new disease, this woman, originally from Daegu in Cheongdo, attended two religious services of the Shincheonji cult, with more than a thousand worshipers at each one, ate at a hotel buffet with friends, went to a funeral, and visited several hospitals.

How did South Korea identify all the people who tested positive on account of a single patient?

“It’s called an epidemiological control strategy,” Laurie Ann Ximénez-Fyvie replied.

“One of the pillars of containment is detecting cases. From each positive, every contact they had is traced, tested, and the positives are isolated. That’s why case 31 has been well-documented in South Korea,” explained the author, who singled out the Undersecretary of Prevention and Health Promotion, Hugo López-Gatell, for the consequences of the pandemic on the country.

The purpose of epidemiological control is to contain the spread of infections by establishing cordons sanitaires, controlling people entering and leaving the country, mobility monitoring, applying random mass testing, and searching for the contacts of each positive case.

“We only saw this strategy in Mexico during Phase I, because with 12 cases, Hugo López-Gatell said it was immeasurable. Today, despite the number of deaths, it’s not immeasurable,” she said.

An urgent need to contain the pandemic

Ximénez-Fyvie claimed that: “Mexico’s strategy has failed, primarily for that reason, because there was no attempt to contain the spread or propagation of infections. That’s why we’ve had more than 170,000 deaths.”

According to the Federal Ministry of Health’s technical report on Friday, March 13, after almost 13 months of pandemic, Mexico reached 197,219 deaths due to Covid-19. It also specified that there are already more than two million cumulative cases.

This control was carried out in Mexico, but only during Phase I. In this period from February 29 to March 23, 2020, each case was promptly tracked to identify any contacts, who were then tested, and positive cases were notified to isolate themselves.

However, Ximénez-Fyvie questions, “Phase I didn’t last long, and then we went into sentinel model where instead of identifying cases, we made a crude estimate of what was happening. At that point, the strategy was doomed. There was no way to control infections that way.”

“Was it costly to continue tracking on a case-by-case basis?” we asked.

“No, the cost was minimal,” says Ximénez-Fyvie, “In Vietnam, for example, a poor country with social and political problems and a higher population density, they put all their resources into local containment. From a single positive case, they’ve managed to trace six thousand contacts. They regularly do random screening to see if there are any cases or not.”

Worst mistake was not correcting the strategy

In her book, the researcher also explains why it’s important to contain the spread of infections through pandemic management. However, she claimed in the interview that, “In Mexico, the worst mistake is that the strategy has never been corrected.”

The researcher compared the case of Sweden with Mexico and recalled that the Swedes were wrong when outlining their first strategy, but they rectified their mistake and began applying tests, tracing, and isolation for people who tested positive, even apologizing for their initial way of handling the pandemic.

She added that in order to consolidate a containment strategy, we must first understand what we’re dealing with: SARS-CoV-2 means Severe Acute Respiratory Syndrome.

CoV refers to coronavirus (the virus) and the number 2 was assigned because it’s the second known kind of SARS-CoV. On the other hand, Covid-19 refers to coronavirus disease 2019 (the year in which the first case was documented).

Covid-19 is mainly transmitted by aerosols or through the air. This makes it problematic in terms of infection and spread, explained Ximénez-Fyvie.

“In order to control an infectious disease that’s transmitted between humans through a very problematic route, it’s necessary to contain infections,” stated Ximénez Fyvie.

Mexico has sufficient infrastructure to contain the spread of infections, said the head of the Molecular Genetics Laboratory at the UNAM School of Dentistry.

“We have giant research centers, such as the National Institute of Genomic Medicine, all of the UNAM laboratories at the schools of Veterinary Medicine, Dentistry… tests and contact tracing can be carried out through them.”

Committing to vaccination

The researcher laments all the deaths that, according to her, were avoidable. This argument is what gave her book its title, ‘Irreparable Harm’.

“But that doesn’t mean that everything is lost. There’s still a lot we can do because many lives depend on it,” she said.

The researcher added that we must “commit to vaccination as the control mechanism for the pandemic.”

But it’s not just about vaccinating the largest number of people in the shortest time possible. It’s also about prioritizing the people that are becoming infected the most, she added.

The Covid-19 National Health and Nutrition Survey (ENSANUT) revealed that 25% of Mexicans have already been infected with the new disease. This figure is equivalent to 31 million people, who are mainly aged 20 to 59 years old.

“The vaccination campaign in Mexico is going badly. The wrong vulnerable population is being prioritized. It’s true that the elderly population is vulnerable if infected, but they’re not the ones that are becoming infected the most,” she explained.

According to the survey, only 18% of those infected are people over the age of 60. “We must vaccinate the people that are becoming infected the most. That’s how we’ll have an impact. Otherwise, it won’t be achieved until people aged 20-59 are vaccinated.”

The researcher acknowledges that it was a good decision to vaccinate the health sector first and added that she considers it necessary to include the private sector to speed up mass inoculation, as in the United States, where the process is much swifter.

TAGS: Pandemic, Laurie Ann Ximénez-Fyvie, What Does Covid-19 Mean? What Does Sars-Cov-2 Mean? Irreparable Harm