In the first week of April Peru reported an average of almost 10,000 new cases and 300 deaths per day from a population of around 33 million, according to WHO data. The number of deaths represented an increase of more than 50 percent over the previous week. The country is suffering from the highest number of excess deaths in the world relative to population size.*
Medical staff are already stretched to their maximum capacity and beyond, while intensive care resources are insufficient to meet needs.
These issues are compounded by scarce access to badly-needed vaccination: just three percent of the population has received at least the first dose. All of this is preventing the health care system from mounting an adequate outbreak response.
Following an assessment carried out earlier in the year, Médecins Sans Frontières (MSF) has launched an emergency intervention in collaboration with the health authorities in Huaura province, north of Lima, where the regional hospital in the provincial capital, Huacho, is severely shorthanded and facing a surge in the number of COVID-19 patients.
“Our intervention has two main objectives,” says Jean-Baptiste Marion, MSF head of mission. “We want to help take pressure off Huacho hospital and the local health care system by opening an annex where we can treat COVID-19 patients and provide them with oxygen when needed. Today, many non-critical patients are ending up in Huacho hospital, overwhelming the facility.
“To complement this activity, we’re working with the community to improve early detection, looking to identify patients and provide them with the required level of care before their condition worsens and they end up critical.”
MSF teams are also supporting Huacho hospital’s intensive care unit, to improve patient management and assist at every step of patient flow management.
The approach adopted by MSF is centred on a 50-bed inpatient facility connected to Huacho hospital and a network of local health care centres. Half of these beds are equipped for clinically monitored isolation, while the other half can provide patients with oxygen, including for patients in severe conditions.
The country has now reached a cumulative total of over 1.7 million COVID-19 cases and over 57,000 deaths, according to the Ministry of Health.
A major issue observed by MSF teams on the ground is that people are often reluctant to seek medical care in hospitals when they start showing symptoms, choosing private practices which may not always be able to offer the required level of care, or even opting to self-medicate.
The health system has been outmatched and the consequences are devastating: people in many cities are queueing overnight and sleeping rough to fill up their oxygen tanks from the few working reservoirs, hoping to take care of their relatives at home.
For this reason, MSF is partnering with the local authorities to deliver community outreach activities, to ensure that COVID-19 patients in the province are identified as early as possible and signposted in the right direction when seeking healthcare.
“Improving screening and patient management is a priority today,” said Jean-Baptiste Marion. “But without an urgent boost in access to vaccination it is hard to expect an improvement any time soon.”
* Financial Times, How excess deaths compare around the world since Covid-19 outbreaks began
Excess deaths are defined as the number of deaths above the historical average for the period.