A Quito doctor and infectious disease specialist disputes claims that most of the excess deaths recorded in Ecuador are from Covid-19 infections. Instead, he says that a majority of the deaths are the result of fear that keeps people sick with other health conditions from seeking medical attention when they need it.
Romero Enríquez, a former public hospital administrator and consultant to the World Health Organization, also questions the effectiveness of a vaccine to end the pandemic, saying that herd immunity through direct infection will, most likely, be needed.
“The suggestion among some officials is that most of the above-average deaths are the result of Covid-19 but the facts to do not support this view,” he says. “Most of these deaths are the result of people with life-threatening conditions not seeking treatment because they fear being infected with Covid. They either die at home or come to the hospital too late to be saved.”
According to statistics from the national Civil Registry, the number of deaths since March is running well above deaths from the same period in 2019. The excess count ranges from a low of about 10 percent in Cuenca to over 50 percent is several coastal communities.
“Indirectly, the excess deaths are the result of Covid. I worry that the public campaign to keep people indoors and to protect them is promoting an atmosphere of unnecessary fear,” Enríquez says. “People should be concerned with the dangers of this virus and take the recommended precautions – this is a very, very serious disease – but I’m concerned that the message from the government creates excess fear that ultimately leads to extra deaths.”
He adds that the vast majority of excess deaths, as well as those confirmed as being from Covid, are of people who are elderly and in deteriorating health. “We are reluctant to say it for fear of sounding insensitive but almost all the deaths in Ecuador involve very sick people. They are very old with heart conditions, diabetes, respiratory disease or other comorbidities, and many of them are within the last few months of their lives under normal circumstances.”
Enríquez worries that too much hope is being placed on a vaccine to end the pandemic. “If you notice, the World Health Organization and other experts are beginning to downplay expectations for a vaccine. This week, Dr. [Tedros] Adhanom [director of the WHO] said that a vaccine is only one tool in stopping the spread. Earlier, many of us thought a vaccine might be effective for over 50 percent of the world’s population but now, some are saying the effectiveness could be 20 percent or lower, given the reluctance of many people to be inoculated, lack of vaccine availability, and the fact that a vaccine will only be 60 to 70 percent effective for those who do take it. In the end, I believe it will be herd immunity from infection that will get us beyond the crisis.”
Enríquez also questions the public response, worldwide, in combating Covid. “I do not blame public health experts because we are all learning as we go, but it may turn out that the measures now being praised for helping slow the spread of the virus in some countries will prove to be little more effective than those taken in countries with higher infection rates. I hear frequently that if only Ecuador had taken the action of Asian and European countries the numbers would be lower. Now, however, we are seeing cases growing rapidly again in Germany, Korea, France and Spain, so I would say the jury is out on the most effective way to deal with the disease.”
Enríquez adds: “I should be clear that I fully support efforts to slow the spread of the virus to protect the health system. I wear a mask when I go out, practice social distancing when I can and am in support police efforts to discourage large public gatherings. These things are just common sense and we should all practice them.”