The excess-mortality figure, which includes deaths both directly and indirectly related to the pandemic, is considered the most complete indicator of the damage done by the novel coronavirus. The jump in deaths this spring was similar to surges in urban centers such as London or New York, experts said.
“Certainly it’s on a par with what we’ve seen in the most hard-hit areas of the United States,” said Daniel Weinberger, an epidemiologist at the Yale School of Public Health who has studied excess deaths during the pandemic.
Hugo López-Gatell, the undersecretary of health who is leading Mexico’s response to the coronavirus, told The Washington Post that the study uses average deaths from March through May in recent years as a baseline. “How many people have died now? This statistic, which we are still refining, is about three times more,” he said.
The exact number of deaths is not yet available. The most complete study released to date, an analysis published by the magazine Nexos, found that 27,394 people died in Mexico City from late March to the end of May. That’s more than twice the usual level. The government reported only around 4,000 coronavirus deaths in that period for the capital, the epicenter of Mexico’s outbreak.
López-Gatell said the excess-mortality data included people with problems such as heart attacks who couldn’t get good treatment because hospitals were swamped with coronavirus patients — but “it’s probable that the majority are covid.” They include cases that were diagnosed and those that were not.
The death toll has become a divisive political issue in Mexico; critics claim the government has hidden the true number. Authorities have denied that. Mexico is similar to many countries — and U.S. states — in officially counting only those covid-19 deaths that are confirmed with laboratory tests.
Still, the undercount appears unusually high. Hospitals here are required to test patients with serious symptoms, but López-Gatell said some lacked the personnel to do so quickly. In addition, many people apparently die at home or shortly after arrival at the hospital without being tested.
Officially, 28,510 people in Mexico have died of covid-19. On Wednesday, the country passed Spain for sixth place in the world, according to data compiled by Johns Hopkins University. Mexico City has reported 6,642 deaths.
The country’s first wave of infection is far from over — although authorities say the increase in cases is slowing.
López-Gatell said the excess-mortality estimate was significant compared with even the most virulent flu outbreaks in Mexico. “Of course,” he said, “it’s high or extremely high compared to what we wanted.”
'We didn't manage to contain the pandemic'
Mexican authorities have attributed the death toll to several factors. Many coronavirus victims have put off going to hospitals until they’ve become severely ill. Mexico has extraordinary levels of hypertension, diabetes and obesity — chronic illnesses of the sort linked to around 80 percent of the country’s coronavirus deaths.
“The relative contribution [of such conditions] to the lethality of the epidemic is a disaster,” said López-Gatell. He blames the soaring popularity of junk food and sugary drinks.
Authorities have struggled against serious limitations, including a chronically underfunded, understaffed medical system, and a workforce heavily concentrated in the informal sector — construction workers, street vendors and others who rely on daily earnings to survive.
A strict quarantine like Spain’s would have been impossible, López-Gatell said. There, officials threatened violators with fines of up to $1,000 and reduced movement on public transportation and in stores by around 80 percent. In Mexico, a country with deep inequality and vivid memories of authoritarian rule, such a quarantine “would have been so adverse economically and socially, it would have ended in a domestic social confrontation,” he said.
Mexico closed schools and government offices, but its 70-day lockdown relied largely on persuasion. The country achieved around a 60 percent drop nationally in mobility, officials said.
Critics said the response was too little, too late. “We have a high death rate because we didn’t manage to contain the pandemic,” said Francisco Moreno, an infectious-disease specialist at the capital’s prestigious ABC Medical Center.
Mexican officials decided to conduct only limited testing, given a lack of lab capacity and staff to do contact tracing. “The epidemiological vigilance they did wasn’t sufficient,” said Miguel Betancourt, president of the Mexican Society for Public Health. “They didn’t have the sensitivity to detect the phenomena correctly.”
Mexican authorities argue otherwise. They say they slowed the pandemic’s velocity by around half compared with countries such as Italy or Spain, buying time so hospitals weren’t overwhelmed. But instead of a quick, explosive outbreak, they’ve wound up with a long, slower-moving one.
If there’s one thing on which all sides agree, it’s that the public health message wasn’t clear. Early on, President Andrés Manuel López Obrador ignored recommendations on social distancing, and he’s been eager to open the country back up as it sinks into a profound recession. López-Gatell has warned repeatedly of the dangers of the virus. But he acknowledges that the government’s public health messaging has failed to convince many Mexicans.
The country’s deep political polarization has further complicated matters. Samuel Ponce de León, an infectious-disease specialist at the National Autonomous University of Mexico, said the president’s critics have mocked López-Gatell’s strategy so relentlessly that the public is confused. “Citizens don’t know what actions to take,” he said.
Some say it’s the coronavirus czar who’s to blame. López-Gatell’s early, upbeat predictions about containing the pandemic — and the lack of information on its scale — raised suspicions in a country where governments have long fudged the data on disasters.
Weinberger said that in most nations, it’s extremely difficult to adopt widespread contact tracing at the height of a pandemic. But up-to-date death statistics, he said, are a different matter.
“It’s really important for the public to have an accurate picture of what’s going on, and the severity, as they weigh these different measures in terms of closings and various restrictions on freedoms,” Weinberger said.
The rising global death toll
Normally, it takes a year or more for Mexico’s slow-moving bureaucracy to produce complete death data. But after the national and foreign media began to question the coronavirus fatalities, Mexico City Mayor Claudia Sheinbaum spearheaded an effort to determine excess mortality for the capital.
The committee, which includes federal health officials, plans to further break down the numbers to determine how many deaths are from covid-19, López-Gatell said. A separate team is looking at the rest of the country.
Similar efforts are gradually getting underway around the world. A new study done by three scholars at the MIT Sloan School of Management estimates total covid-19 deaths for 84 countries at roughly 600,000, well above reported figures.
And that’s through mid-June. According to the researchers, if there’s no vaccine or treatment by next spring, the death toll could hit 1.75 million.