When Mexico’s coronavirus czar said last week that case growth in the nation’s capital had stabilized, few found cause to cheer. Hugo Lopez Gatell had claimed such victories before.
“The epidemic is slowing down,” the deputy health minister declared in a May 5 press conference. Three weeks later, during his May 25 nightly briefing, he said: “We’ve flattened the curve.”
But the numbers tell a different story. A day after Lopez Gatell’s June 11 tweet about Mexico City, the nation reported a record 5,222 new cases of the deadly disease. As of Wednesday night, Mexico’s infections have more than doubled since May 25 to 159,793, with a quarter of them in the capital. Deaths stand at 19,080, according to the official count.
Throughout the pandemic, Lopez Gatell has sought to diffuse public panic and support the arguments of his boss, President Andres Manuel Lopez Obrador — known as AMLO — who prioritizes the economy over sweeping lockdowns. Lopez Gatell’s nice-guy demeanor and a knack for breaking down complex ideas into easily understandable bits has helped make him the most popular official in AMLO’s administration. But, critics say, it’s also allowed him to obscure the magnitude of the crisis, endangering lives and exacerbating the outbreak.
“He knows how to communicate and he knows how to put on a show,” Laurie Ann Ximenez-Fyvie, who heads a molecular genetics laboratory at UNAM University in Mexico City, said in an interview. “He has his talking points and he uses them to convince people that this is under control.”
Lopez Gatell declined to comment for this article after canceling two scheduled interviews in recent weeks. His press official did not respond to requests for comment. The virus czar has said that by flattening the curve he means the government’s actions have prevented up to 75% of new cases. That’s not how the term is commonly used.
Man of the Moment
Before the crisis struck, Lopez Gatell was a relative unknown in Mexican public life. The 51-year-old doctor with salt-and-pepper hair and a thin frame previously served as director general of epidemiology alongside Alejandro Macias, Mexico’s czar during the H1N1 epidemic in 2009. Quien Magazine dubbed Lopez Gatell the “Unexpected Man of the Moment” in April, and a poll by newspaper El Financiero pegged his approval rating at 56% in May (although it had taken a 6 percentage point hit from the previous survey).
Like a number of emerging markets, a combination of low testing, rickety health systems and unreliable tracking leave many wondering just how bad the outbreak is here. Lopez Gatell himself has acknowledged the numbers are likely higher, further adding to the confusion.
“We don’t know where we are” on the curve, said Sebastian Garrido, coordinator of the data science unit at CIDE University. Garrido has studied government data showing it’s still tallying deaths from late March. That lag can probably be blamed on outdated systems, as well as legal and medical hoops to certify Covid-19 deaths, he said, raising the possibility that the real death toll for recent days may not be known for months.
Lopez Gatell has been saying since early May that peak contagion was right around the corner, leading to multiple memes poking fun at his forecasts.
Early on in the crisis, Mexico’s Health Ministry chose a so-called sentinel surveillance strategy, based on selecting a few reporting units with a high probability of seeing cases to identify trends. The World Health Organization has said the system may not be effective for detecting rare diseases.
It’s partly because of that strategy that Mexico’s testing rates are so low — and still falling. For every 1.77 tests administered, one new case is confirmed. That compares with a ratio of 19.28 for the U.S.
Adding to evidence the outbreak may be far worse than the government is letting on is a 124% surge in mortalities in Mexico City. Nexos Datos published research showing 17,310 more death certificates were issued in the capital between March 30 and June 7 when compared with the four-year average. In addition to coronavirus fatalities, some deaths were likely due to people who delayed seeking medical help, the researchers said.
“They’re not doing it on purpose; they’re not hiding bodies somewhere,” Macias, the former H1N1 czar, said about Lopez Gatell and other Health Ministry officials. “It’s just that they haven’t figured out how to do it properly. The systems weren’t ready for this.”
A Warning From WHO
Mexico is in one of the most complex moments of the pandemic, a WHO representative warned last week, adding that social distancing measures shouldn’t be relaxed yet.
Since Mexico’s first case was diagnosed on Feb. 28, Lopez Gatell has twice revised likely death toll estimates after initially downplaying the threat of the virus in March. In early May, the government estimated mortalities could total 6,000. A month later, Lopez Gatell said as many as 35,000 people could die. A projection from the University of Washington’s Institute for Health Metrics and Evaluation forecasts up to 52,000 fatalities by August.
Lopez Gatell has courted controversy in other ways, too. Last week, he railed against media outlets for publishing new death figures on their front page, saying that 24-hour tolls include deaths from previous periods. He also initially rejected the importance of wearing face masks.
One of his most contested ideas has been to push the public to focus not on infections or deaths, but “active” cases, in which only patients with symptoms in the previous 14-day period are taken into account. Johns Hopkins Medicine says for severe cases, symptoms can last much longer and recovery may take six weeks or more.
“It’s a maneuver to manipulate interpretations,” said Ximenez-Fyvie from UNAM University.
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