Chile exceeded 30 thousand deaths since the pandemic began and in recent weeks new infections reported stood on a high plateau with an average of eight thousand each day. It also has 49 thousand active cases and more than 3,200 hospitalized patients in intensive care units. Presents a 97% bed occupancy (only 167 are free) and the pressure on the health system is strong.
As happens at the domestic level, the Chilean Society of Intensive Medicine warned about the imminent collapse of the sectorAlthough there are several cities on epidemiological alert, Santiago exhibits the worst figures. It recently exceeded four thousand infections in one day, reaching the record that it had only achieved in June 2020, during the first wave, when infections confirmed by diagnosis reached 4,421. At present, it has an ICU bed occupancy of 98.8%.
Chile has the Step by Step Plan, a phase system very similar to that established in Argentina, with quarantines focused on each district, with openings and closings. The landscape is very similar to what is painted in most of South America. Although there is a not inconsiderable difference: According to the OurWorld in Data site, Chile has already immunized 59% of its population. In fact, it shares the first places with Israel (63%), Canada (61%) and the United Kingdom (59%) thanks to the rhythm that the massive inoculation of its inhabitants acquired. “We have managed to vaccinate more than 8 million people with the two doses, which represents more than 53% of the target population of 15.2 million people,” said President Sebastián Piñera at a recent conference. The immunization strategy also accumulates a 71.2% of citizens with the first dose, with which the coverage process has already been opened for people between 23 and 25 years old.
The paradox is served: although a priori it would be very close to herd immunity, unlike other experiences such as Israel or the United Kingdom, Chile faces a much more complex present. Of the doses he inoculated, 82% were Sinovac (CoronaVac), whose effectiveness in preventing the spread of the disease is around 56%. In this way, although it has a greater capacity to avoid hospitalizations and deaths, the spread of Sars CoV-2 and its variants does not stop.
The focus on the Sinovac
“Chile applied more doses than population, I mean that it inoculated an average of 102 doses per 100 people. Of course, it does not mean that they have immunized one hundred percent, but there is a very important percentage of society vaccinated with a single dose and another not inconsiderable percentage that received both ”, says the virologist from Conicet Mario Lozano placeholder image. And he maintains: “However, in this last week it exhibited the second highest record of infections of the entire pandemic. It is essentially due the low coverage of the technology they use mostly; I mean the Sinovac”. Then, the former rector of the National University of Quilmes continues with his reasoning: “It is a vaccine that in the first dose practically does not protect and with the complete scheme, that is, with the two doses, it manages to protect half of the people. If we think that 80% of Chileans received this formula, 40% of those inoculated do not have the ability to avoid contagion. Yes, on the other hand, it protects better by avoiding serious cases and deaths from Covid ”.
In April, the Ministry of Health of Chile released a report on the effectiveness of the CoronaVac in order to analyze what was happening with the immunization process in real time. “In a study with reference to mid-April, specialists from the health authority evaluated the effectiveness of the two doses and also what happened with only one. There they managed to affirm that 14 days after receiving the second dose, the efficacy was 67% against the disease, 85% against hospitalization, 89% against admission to intensive care and 80% regarding death ” , aim Daniela hozbor, Principal Investigator of the Conicet in the Institute of Biotechnology and Molecular Biology of La Plata. The problem, however, lay in the poor protection conferred on those individuals who only had the former. “With one dose, after 14 days, the effectiveness to avoid infection was 16%, to avoid hospitalization it was 35%, 42% in relation to admission to intensive care and 40% in relation to deaths “explains biochemistry.
“Although with two doses the vaccine would work well, with only one the coverage is a bit loose. Even more so if the aspect of avoiding the disease is taken into account. Your current situation may be because of that”Says Hozbor. ArgentinaIn contrast, it uses vaccines that confer greater efficacy with a single dose. An investigation carried out by the Buenos Aires government with 186,581 people demonstrated the “real life impact” of the first dose of Sputnik V. The study yielded an efficiency of 78.6% to prevent cases of covid, 84.7% to prevent deaths and 87.6% to reduce hospitalizations in people aged 60 to 79 years.
From this perspective, says Hozbor: “That is why in Chile they made rapid progress towards covering a large part of its population with a second dose. The time between the first and the second must be reduced as much as possible in this case ”. Then he finishes: “For Sinovac, a strategy linked to delaying the second dose would not be very convenient”. As Argentina inoculates vaccine options more effectively, the option of deferring the second to protect more population in less time makes more sense. Nations such as the United Kingdom or Canada followed a similar path.
Inequality that worries
The course that each country chooses for the mass immunization process is framed in a context marked by unequal access. “For Chile, the agreement with Sinovac allowed it to quickly vaccinate its inhabitants and reduce the fatality rate. We are in a scenario in which the powerful nations are the ones that monopolize the vaccines, for this reason, it is not easy for peripherals to get the best and in good quantity”, Says Lozano. Then he advances with a hypothesis that points against the media and opposition politicians: “All vaccines have their pros and cons. If our government had agreed with Pfizer, I am sure that the media and political opposition would have made a scandal by reporting some cases of serious allergies., as they were identified in various nations. The sport they practice is the complaint, in any case they would have found the reasons ”.
In addition to Sinovac, Chile also used other vaccines such as Pfizer (with which he immunized 18.5 of the total of those vaccinated), AstraZeneca (al 2%) and CanSino (al 0,6)but to a lesser extent. In 2022 the strategy could turn towards the incorporation of other formulas with greater efficiency, such as Moderna and Sputnik V, or else, try to get more doses of Pfizer, whose landing in the south of the continent has been quite poor. The variants, like the one in Manaus and the one in the United Kingdom, they also complicate things, especially in younger patients who, unlike the first wave, require hospitalizations. Hence the difference with strategies such as Argentina, whose vaccination process is slower but based on vaccine formulas that have shown greater protection.
In this framework, the very inequality that this phase of current capitalism imprints makes the option for a global health policy impossible. “If we could vaccinate everyone at the same time, with the vaccines that we have and those that are going to be produced, it would be enough because we could cut off the viral circulation. We would prevent the Sars CoV-2 from continuing to be modified and the generation of new variants, such as the one from India and the one from Vietnam. If we were able to distribute the doses all over the world, the variants would stop appearing”, Highlights Lozano. And he proposes: “We should have a more equitable global policy, the world is one; that some are protected and others take too long in the long term will not make sense”.