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CN 2020Mar18 Coronavirus Mexico - Update

Coronavirus Mexico:
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Coronavirus in Mexico - Update

March 18, 2020

The impact of the spread of the Coronavirus on all of us is historic. We are writing this update from home in compliance with the San Francisco Bay Area local governmental requirements to "Shelter in Home". Never have we experienced anything like this.

That said, this will pass. There are limits to the levels of extreme! We don't know what the limits are now. But they will show up in the next few months.

In the meantime, the following article was published today. It appears on Mexicanist and it provides a good marker for today.

Mexico coronavirus update: In Mexico to date, 93 cases of COVID-19 have been confirmed (+11 in a day)
Published Date: March 18, 2020


Federal Health Secretariat (SSA) officials reported in a press conference that the number of confirmed cases of the new strain of coronavirus (Covid-19) has increased to 93 in Mexico, of which two are serious and hospitalized; both are elderly people.

The Federal Health Secretariat also reported that the number of suspected cases of the new strain of coronavirus stands at 206. While the number of suspected cases of Covid-19 was 206 in different states of the country and another 672 have been ruled out.

Nuevo Leon, Puebla and Jalisco where they increased the most: Mexico City has the most positive cases of infection with 21, Nuevo Leon (14), State of Mexico (10), Puebla (nine), Queretaro (seven).

In the lower range are Quintana Roo and Yucatan, with 4 cases each, Durango with 3, San Luis Potosi, Oaxaca, Jalisco, Sinaloa and Guerrero with 2, and Chiapas, Coahuila and Aguascalientes have reported one case of coronavirus each.

With the information from the contact studies, we can determine that we are still in phase 1, but the caseload makes us approach phase 2, where the contagion is communitarian," he said. Phase two is beginning to be characterized by community outbreaks, the official reiterated.

The Ministry of Health has designed a system to monitor the lack of health inputs needed to combat the pathogen in all states of the country.

They also predict that, if Phase 3 is reached in the nation, there will be approximately 250,000 people infected, of which 10,500 will be in intensive care.

No coronavirus deaths in Mexico
Authorities also detailed that no deaths have been recorded in Mexico due to the pathogen originating in China, although there was confusion over the premature news of the death of a Mexican businessman, cousin of Carlos Slim, who so far remains with delicate health reports.

According to data from the Ministry of Health, there are 179,112 people around the world carrying the virus.

Sanitary filters have been in place at airports since January
The undersecretary of Health, Hugo López-Gatell, informed during the press conference from the National Palace that there are 10 airports in the country that receive the largest number of passengers.

Together with President Andrés Manuel López Obrador, the Health sector official went against some media and assured that health filters have existed since the third week of January, but were only applied to passengers coming from countries infected by a coronavirus. As a result, domestic flights were initially never monitored by health authorities.

"The filters have existed since the third week of January, for some reason the various media have wanted to emphasize this measure, at no time has it been intended to review all domestic passengers, the main objective was to identify suspicious cases in international travel, because the main mechanism recommended by the WHO, this model was implemented in all airports and we have been climbing.

Hugo López-Gatell said they already knew how this pandemic would evolve, "it's not that we are pythonists, it's the logic of an epidemic with these characteristics" and he assured that it would be "useless" to filter all passengers inside the airports.

Regarding carriers and people who cross the border into the United States every day, he said it would be impossible to filter out all passengers.

"At the borders, the filtering of passengers would become impossible, we are talking about millions of passengers daily, 10 million cross from the San Diego side to Tijuana".

Finally, Lopez-Gatell denied that they would close the northern or southern border of the country because this would generate effects for both nations.

"Closing the borders is not a situation that will help contain the epidemic, which is colossal damage for both countries, without having a net effect of delaying the epidemic. Only in medieval times, when the reality was different, were there walled cities".

Mexico rules out closing borders for Coronavirus
Deputy Health Secretary Hugo Lopez-Gatell announced this morning at the federal government's morning conference that Mexico will not close commercial borders at this time.

After the most recent events worldwide due to the spread of the SARS Cov-2 virus, several countries in which there have been deaths due to the contagion have decided to close their land, air and sea borders.

The United States and Guatemala have already closed their land borders with Mexico, thus preventing transit from one country to another, with the expectation that this mechanism could prevent the spread of the virus.

The undersecretary of health said it is impossible for the nations to carry out this mechanism "without causing damage with unforeseeable, possibly enormous consequences for society. The official explained that at a time when the mobility of people and international trade are limited, society is paralyzed, but above all the possibility of having inputs for daily life is threatened.

Given this approach, Lopez-Gatell explained that the WHO proposed the International Health Regulations ten years ago, and highlighted one of the fundamental principles, which mentions that the prevention measures to control epidemics should be done trying not to interfere with the mobility of people or international trade.

He also mentioned that today the world is living in a great phase of confusion that has led to measures being taken with little reflection by the scientific and technical communities in some regions of the world. He said that today it is possible to make organized decisions and to implement the elements of the repertoire of containment interventions, as well as to carry out the reorganization of health services and risk communication.

Hugo López explained that so far Mexico is going through Phase 1 of the virus' spread, which consists of the existence of only imported infections and transmission to a first generation, that is, a circle close to the first infected.

In Phase 2, community transmission will begin and there will be hundreds of cases. However, in Phase 3, called disseminated transmission, it will no longer be possible to have a record of the transmission chains and there will be conditions in regions simultaneously.

In these two phases, priority will be given to infected persons who need to be specifically assessed and assisted, with hospitalization and mechanical ventilation. The official explained that these people - mostly older adults - will represent 5% of the total number of sick people.

The situations that Western European countries have experienced are due to the overcrowding of health centres by the larger volume of patients, who have only mild symptoms and could be kept under observation at home.

Undersecretary López-Gatell concluded by calling for continued implementation of the prevention measures taken by the Federal Government, as well as for the sharing of useful information in the media.

Cruise Ship Arrivals Suspended in Mexico Due to Coronavirus
The President of the Mexican Cruise Association, José Arturo Musi Ganem, informed that due to the coronavirus pandemic in the world all cruise ship arrivals are canceled for the next five weeks.

The Covid-19 is generating a severe impact that had not been registered in the history of nautical tourism in the Mexican Pacific, since currently, ships are sailing that are already en route, same that when returning to the ports of origin will not sail anymore, waiting in two weeks to not receive any tourist ship in the ports of Cabo San Lucas, Mazatlan, and Puerto Vallarta.

"We don't know how long this will last, currently the shipping lines said one month, however, the shipping lines could be out of service for up to 2 months, it depends on how things are going since there is new news every day," he said.

Disney, Princess, Norwegian, Holland America, Regent Seven Seas, Carnival, Celebrity, Amadeo, among others, canceled arrivals for upcoming dates. This is an unprecedented situation that has never been experienced before, so the entire industry is concerned about the case.

The issue of coronavirus not only affects nautical tourism but also other industries and productive sectors, because there will be no cruise passengers. The losses are unquantifiable for the Mexican tourism industry, because not only are the cancellations and lack of travelers, but also the effects on the providers of tourism and marine services of each port that will not have its arrival.

How much does a coronavirus test cost in Mexico?
A coronavirus detection test costs 2,300 pesos (107 USD) in a private hospital in Mexico, said Undersecretary for Prevention and Promotion Hugo Lopez Gattel.

During a press conference held Friday at the National Palace to discuss issues related to the COVID-19 pandemic, Health Ministry authorities explained how Mexicans can access detection and diagnostic test.

Lopez Gattel mentioned that it is time to find a fair price to the public for these tests, especially now that cases are on the rise in the country.

The demand for the test has soared in recent days.

Recommendations for prevention
Wash your hands frequently with soap and water or use 70% alcohol-based gel.

When coughing or sneezing, use the label sneeze, which consists of covering your nose and mouth with a handkerchief disposable or with the internal angle of the arm.

Do not touch your face, nose, mouth, and eyes with dirty hands.

Clean and disinfect commonly used surfaces and objects in homes, offices, closed sites, transportation, centers of meeting, etc.

Staying home when you have ailments respiratory tract and see a doctor if any of the symptoms occur (fever above 38°C (86°F), headache, sore throat, runny nose, etc.)

What are the phases of the contingency for the Covid-19 in Mexico?
The federal government, through the Ministry of Health and the General Directorate of Epidemiology, has determined three phases in the Covid-19 or coronavirus contingency.

Import Phase
Being in phase 1 of the contingency represents that "dozens" of cases have occurred in the country and that these are imported, that is, the people who became ill traveled abroad where they acquired the disease.

At this point, it is possible to detect the origin of the contagion and there are no restrictions for greeting people, nor for holding public events in closed or open spaces. Information is disseminated in schools and universities, as well as in workplaces.

Community Dispersion Phase
The second phase is the Community Dispersion phase and is where countries such as Germany are located. In this phase, cases are counted in hundreds and the origin of the infections is lost. Basically it means that people infect each other, regardless of whether they have left the country or not.

This phase could be reached within 40 to 50 days from the registration of 1 case, which represents hundreds of cases.

In this phase, it is requested to avoid the kiss and hug greeting; massive events are suspended, with the attendance of more than a thousand people, in closed and open spaces such as theatres, cinemas, parks, concerts, stadiums, squares, parks, and beaches.

Sanitary filters are also applied in schools and workplaces, to check people as they enter and verify that they do not have symptoms or fever.

Epidemic phase
The third phase is the epidemic phase, which would be reached 2 to 3 weeks after scenario 2 has been reached, when cases are already counted in the thousands. Spain declared itself in this phase.

In the worst-case scenario contemplated by the SSA for this phase, which would imply that no measures had been applied to control the spread of the virus or that no sick person would be cared for, Covid-19 would infect between 0.5% and 1% of the country's total population, which could represent up to 1.2 million people.

However, under current conditions, it is predicted that between 175,000 and 300,000 people could become ill. Of these people, it is estimated that the minority would require hospitalization in intensive care and that more than 70% of those infected may be asymptomatic, meaning that they would only be carriers.

In this phase 3, it is also asked to avoid the kiss and hug greeting and to suspend public events, in addition to suspending classes in schools where there are active outbreaks, as well as activities in workplaces also with active outbreaks.

Mexican government guidelines for coronavirus control
The federal government published guidelines for epidemiological and laboratory surveillance of the new coronavirus that places health care personnel at the highest risk of infection, so those responsible for medical units must immediately report suspected cases to the Epidemiological and Healthcare Intelligence Unit (UIES).

Given that possible infections of medical personnel are particularly relevant, it is recommended that this personnel, regardless of the protective equipment used, be classified within the 'highest' risk of infection," according to the document based on the General Health Law and which is mandatory for the entire country.

The guidelines, with more than 60 pages, establish a person at risk when they had cumulative face-to-face contact for at least 15 minutes, as part of a conversation, or people from communities in the same household.

"Persons with direct contact with body fluids or secretions, particularly respiratory secretions from a confirmed 2019-nCoV case, e.g., kissing, contact with vomiting, mouth-to-mouth resuscitation, coughing; medical personnel with contact with the confirmed 2019-nCoV case as part of medical care or examination, regardless of the protective equipment used.

Epidemiology personnel who follow up on contacts must be fully trained in biosecurity measures and the equipment required to safeguard their integrity and prevent contagion and spread.

Contact covers passengers seated two seats in all directions around the confirmed case and crew members who have served in the section of the aircraft or where the confirmed case was seated. Persons who have had close contact with the case during air or sea travel.

Samples should be taken with sterile plastic-handled swabs and tongue depressors, tubes of viral transport media, and should be provided with coolers containing refrigerants to maintain the temperature at 2-6 degrees Celsius.

"The samples must be considered highly infectious, so it is essential to wear personal protection equipment: NIOSH N95 or N100 respirators; goggles; long-sleeved disposable gown; double pair of nitrile gloves; microporous tape; safety shoes or shoe covers if the first one is not available.

The doctors will take a combined sample of pharyngeal and nasopharyngeal exudate in the same tube. If the patient is intubated, bronchoalveolar lavage will be taken.

In case of death, take a lung biopsy, approximately two centimeters and three of the visibly affected lung parenchyma and place it in a viral transport medium.

If the person goes to the doctor and in the interview reports a history of being in China, "the doctor of the first contact after identifying a patient with the suspected disease by 2019-nCoV should perform the interrogation and care of the case under standard precautions and by drops in an isolated, well-ventilated cubicle and keep the door closed.

"If the patient presents respiratory symptoms, provide a medical mask (mask) to the patient and ask that it be worn as much as possible if it can be tolerated. For patients who cannot tolerate a medical mask, instruct them to apply respiratory hygiene, i.e. covering their mouth and nose when coughing or sneezing, with toilet paper, rigorously.

In those suspected cases that do not require hospitalization, they should be managed in-home isolation and followed up through daily monitoring until the laboratory results are available.

"If the case is confirmed, social isolation of the patient is recommended until 14 days after the resolution of the clinical picture.

Measures for the medical sector include "the use of gloves when there is contact with body fluids, blood, and secretions, with contaminated items, mucous membranes, and wounds on the skin; use a mask with facial protection when there is a risk of splashing blood and body fluids.

"Use waterproof gown if there is a risk of splashing to prevent contamination of skin and clothing; transport contaminated clothing in red plastic bags; use rigid containers (BIPR) for disposal of needles and sharps; never re-cap needles.

Recommendations for entry points
Currently "it is not known whether people without respiratory symptoms pose a risk for transmission of the infection.

"Means of transport should verify that appropriate personal protective equipment is available for passengers and crew in the event that any person develops symptoms during transport according to the guidelines established by each carrier".

Air travel between Mexico and Wuhan, China is not direct. One to three connecting stops must be made at airports in the United States, Korea, Canada, France, Japan or Hong Kong and other cities in China to reach the destination.

Daily flights have been identified from the city of Wuhan with connections in cities of the countries described above, with final destination to the International Airport of Mexico City, International Airport of Los Cabos (San Jose del Cabo, Baja California Sur), International Airport Licensed Gustavo Diaz Ordaz (Puerto Vallarta, Jalisco) and the International Airport of Cancun (Cancun, Quintana Roo).

Also, a direct flight from Beijing (PEK), China, to Tijuana (TIJ), Baja California, operated by Hainan Airlines, has been identified, which arrives twice a week. The surveillance and activities carried out in our country on a routine basis by the international health services should be intensified, with a special interest in flights from the People's Republic of China and possible specific connections with the city of Wuhan.

If required, the international health services at points of entry, in addition to routine surveillance, could conduct entry assessments with emphasis on travelers from countries where cases of the disease have been confirmed.

Such examinations may be conducted through interviews with travelers who meet the operational definition of a suspect case, with special emphasis on respiratory symptoms and travel history.

Thermal controls: evidence has shown that temperature detection to identify possible suspects at points of entry is not highly effective and requires a substantial investment of resources. However, ideally, this type of detection can be done with infra-red medical thermometers if the point of entry has the capacity to do so.

Cases of coronavirus on the rise in Latin America
Following the increase in cases of coronavirus infection, several Latin American countries have chosen to close their borders to prevent the spread of the virus. Chile, where 155 cases have already been recorded, became the latest to do so on Monday.

The measure was taken by the Chilean Executive after a ministerial meeting at the Palacio de La Moneda, the seat of the Executive, and will come into effect next Wednesday, March 18.

This decision will affect any foreign person who intends to enter the country either by land, air or sea, except for Chilean and foreign residents, who will have to pass the mandatory 14-day quarantine established. Below are the other countries that have taken the same decision.

Peru
Peru declared a state of national emergency on Sunday, confining the population and closing all its borders as part of a series of extraordinary measures to deal with the coronavirus pandemic, which has reached 71 cases.

"We have approved a supreme decree declaring a state of national emergency as a result of the coronavirus," announced President Martin Vizcarra in a message to the country broadcast on radio and television. "The measure will be in effect for 15 days and will imply the obligatory social isolation of our population," Vizcarra said.

The state of emergency will begin on Monday. The government said that "these measures do not contemplate the closure of commercial establishments of first necessity," such as pharmacies, banks or food stores. Only people who need access to essential goods will be able to go out on the streets, Vizcarra stressed.

The government also suspended public and private sector activities as of Monday. The armed forces and police will be charged with enforcing restrictions on the mobility of the population, estimated at 32 million.

Argentina
The President of Argentina, Alberto Fernandez, announced on Sunday night the suspension of classes throughout the education system and also the closure of borders of the country, both until March 31, to contain the spread of the new coronavirus.

"We took the decision to suspend classes from tomorrow (Monday) until March 31, with the purpose of minimizing the transit of children and thus, of the virus," the president said at a press conference at the Olivos residence after an emergency cabinet meeting.

Flanked by the governor of Buenos Aires province, Axel Kicillof, and the mayor of the capital, oppositionist Horacio Rodríguez Larreta, announced the closure of the borders for the entry of non-resident aliens without impediment for leaving the territory.

"We have closed Argentina's borders because the coronavirus is beginning to affect neighboring countries and because tourists from high-risk areas are arriving via the land borders," he explained.

Colombia
Colombian President Ivan Duque announced last Friday the closure of the seven border crossings with Venezuela, located along the porous 2,200-kilometer border shared by Colombia and Venezuela. The closure became effective on Saturday.

For his part, Venezuelan Foreign Minister Jorge Arreaza called the measure "irrational" for "not coordinating actions" with the oil-producing country to prevent contagion.

After the beginning of the coronavirus outbreak in the city of Wuhan, China, and its accelerated expansion in Europe, the United States, and other countries, Latin America is no stranger to the health emergency and has been registering its first cases since the end of February. Brazil was the first country in the region to be infected, followed by Mexico, and now Ecuador, Argentina, the Dominican Republic, Chile, Peru, Colombia, Costa Rica, Paraguay, Panama, Bolivia, Uruguay, Venezuela, Honduras, and Cuba have also been added, shaking up the economic sectors in the area at different levels.

Latin America, with 819 infections and 7 deaths from the pandemic, is trying hard to raise awareness and prevent large-scale infection as happened in Italy and Spain, considering that the health infrastructure in the region could be put in jeopardy if there is a massive outbreak of cases, since most countries have an ICU bed rate of less than 0.2% of the population. Businesses are trying hard to cope with the situation with new strategies and policies to meet their own and their customers' needs until at least mid-May.

What does the coronavirus have to do with Mexican beer?
Going to Google for a medical consultation is quite common - although not the most appropriate - nowadays: from checking the symptoms of an illness to knowing what medicines to take or what to do in case of an emergency.

On January 21, Google Trends reported that interest in 'coronavirus symptoms' had increased by 1,050 percent in just one week, in recent days there has been a high volume of users who have searched wrongly for this germ. Coronavirus' is a term that has proved curious in English-speaking countries, where some people have linked it to the Corona brand of beer.

Since January 16, searches for terms such as 'corona beer virus', 'beer virus' or even 'beer coronavirus' have increased considerably as can be seen in Google's tool for analyzing trends. Estonia, Slovenia, the Czech Republic, Mexico, and Belgium are the countries where most searches have been made for this misnomer.

Despite this high volume of searches, there is no relationship between Wuhan's coronavirus and Corona, the well-known Mexican beer brand, known until recently as 'Coronita' in Spain.

Sources: Presidency of the Republic, EFE, Notimex, Ministry of Health
This is a long read. It also appears to be informational. More to come.
Wash your hands, don't touch your face, cough into the V of your elbow and be mindful of hard surfaces. This too will pass....
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