Ecuador considers the end of the covid-19 pandemic amid doubts
President Guillermo Lasso prescribed the discharge of covid-19. On October 3, 2022, he diagnosed that “the pandemic has ended in Ecuador ” and the only thing missing is for the National COE to issue an official resolution to return “to normal life, without restrictions of any kind.”

80% of the Ecuadorian population older than 3 years is vaccinated with the initial two-dose scheme.
The decision is supported by the fall in coronavirus indicators. In the last fortnight of July 2022, during the most recent Omicron outbreak, there were 2,690 cases of covid-19 on average per day; last week it added about 40 daily cases. Despite the decrease in infections, hospitalizations and deaths from the virus in Ecuador, local and international experts recommend a dose of caution.
The Ecuadorian Medical Federation and its Committee of Experts are analyzing the Government ‘s announcement. Prior to an assembly, the president of the Tungurahua College of Physicians, Patricio Mayorga, announced that the first assessment is not to declare the end of the pandemic yet.
Although since July 2022 the reports of infections have decreased almost 20 times, outbreaks cannot be ruled out due to possible new sublineages of Ómicron. This variant of covid-19 has been shown to have a high transmission capacity, although without serious effects in most cases.
Fray Cleiton Martínez, professor at the University of Azuay, sees the data from another perspective. For the specialist, the marked decrease suggests that the coronavirus emergency is coming to an end, but he clarifies that this does not mean that the disease will disappear.
Martínez says that the reporting of cases from now on will respond to a cyclical-seasonal process, with possible spikes throughout the year after holidays or due to the high turnout in certain concentration spaces.
The University of Azuay , like other higher education centers , has implemented mechanisms to analyze the evolution of the pandemic in Ecuador. One such tool is the Harvard Index , which measures the occurrence of new cases per week.
“According to this method, when there is one case per 100,000 inhabitants, it means that the population is in the green zone; from one to 10, yellow zone; from 10 to 25, in orange; and 25 onwards, in the red zone”, explains the professor.
Until last October 2, 2022, Ecuador reported 1.52 cases of covid-19 per 100,000 inhabitants, according to the method applied by the University of Azuay . And if it is applied by territories, the figures tend to go down. For example, Cañar registers an index of 0.76 and Cuenca shows 0.45.
The world forecast of covid-19
The director of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, announced on September 14, 2022 that “the end of the pandemic is in sight”. In that week there were 11,000 deaths from covid-19 in the world, the lowest figure since 2020. However, he asked to maintain efforts to combat the virus due to the risk of new variants .
On October 12, 2022, after informing the actions to control an Ebola outbreak in Uganda and another of cholera in Haiti , he acknowledged that the current panorama due to coronavirus is different from the beginning of the declaration of global emergency , but clarified that “the pandemic is not over.
Today, Thursday, October 13, 2022, the Emergency Committee on covid-19 will meet to analyze the risks to which the global population is still exposed, including low rates of diagnostic tests, poor epidemiological surveillance and “large gaps” in vaccination.
In Latin America and the Caribbean, the Pan American Health Organization (PAHO) also recommends not letting your guard down. Ciro Ugarte, director of Health Emergencies, acknowledges that Ecuador has good levels of immunization (in the initial schedule of two doses), and that the numbers of infections and deaths continue to drop. But in other countries the reality is different, which is why he recommended maintaining measures to protect, especially, risk groups.
That is why it advises activating consolidated and permanent response plans, with the timely identification of cases of respiratory diseases, taking samples for analysis, continuing with vaccination -including reinforcements-, and maintaining epidemiological surveillance, which allows detecting and controlling possible outbreaks. of covid-19.
Contrast vaccination
Phase zero of covid-19 vaccination in Ecuador began in January 2021. Four months later, with the change of regime, the Government launched the 9/100 plan. The goal of vaccinating 9 million people in 100 days was exceeded and so far, 82% of the population over 3 years of age have completed the initial two-dose schedule.
The most recent goal, to increase the number of reinforcements by the end of September 2022, stalled. There are 6.5 million people over 12 years of age who still do not have access to the first booster (47% of this group) and 9.6 million people over 18 years of age still need to be covered with the second booster (82%).
The decrease in deaths and hospitalizations due to covid-19, as well as failures in communication strategies, affect the low scope of reinforcements. Experts have insisted on turning the campaign around and presenting vaccines not only as weapons that save lives, but also as tools to counter future post- Covid consequences.
Fernando Sacoto, director of the Master‘s in Public Health at the International University of Ecuador, recommends that the Government prioritize the message of prevention before talking about the end of the pandemic.
“From public health, the important thing is to prevent, because the virus is circulating. It is true that they do not have the severity of the beginning of the pandemic , but it can affect vulnerable people.
That is why he believes that the use of the mask should be maintained on public transport and in closed spaces. And from the State , he affirms, the public health response system must be reinforced so as not to relive chaotic scenes like those that Guayaquil faced between March and April 2020, with hospitals full , without beds or equipment, nor with spaces for so many corpses .
The Ecuadorian Medical Federation has on its agenda to evaluate the announcement of President Guillermo Lasso . “We will issue an official statement so that the measure is analyzed by the authorities and decisions are not made in a hurry,” says Wilson Tenorio, president of the union, who also emphasizes that the pandemic continues in the world. And although countries like the United States have determined their end, Tenorio assures that Ecuador is not yet ready.
Cases vs. covid-19 tests
1,004,995 cases of covid-19 have been notified by the Ministry of Public Health (MSP) since the start of the pandemic until October 12, 2022. Pichincha represents 37% of diagnoses and Guayas accounts for 15%. Both provinces have greater access to PCR tests.
The application of tests has been one of the weaknesses of Ecuador. Experts assure that the figures are not entirely real, due to the lack of evidence. At contagion peaks, it is advisable to carry out about 50,000 tests per day and 25,000 when there is a decrease; last week there were 1,000 tests per day.
In total, the MSP registers 3.2 million PCR tests carried out since the health emergency was decreed (68% had a negative result). At the beginning of the pandemic , the tests were scarce in the world and the diagnosis was made based on symptoms , complementary tests and X-rays. In 2021 there was greater access to specific tests, but the demand has been low because the symptoms are now lighter.
The national director of Epidemiological Surveillance of the MSP , Carlos Chiluisa, explains that in the last week they have carried out some 5,000 antigen tests and about 2,000 PCR. It is not the optimal figure, but the official reiterates that there is a low attendance, despite the fact that they ask the population with symptoms to go to the health units for the exam to confirm or rule out the disease .
“But this amount of evidence also shows that the Ministry is still active in covid-19 surveillance , ” says Chiluisa. We are even acquiring more rapid tests to monitor suspected cases with respiratory symptoms and have a clearer view of what is happening in the territory.”
The percentage of positivity of the most recent analyzes averages 5% (4% for antigen and 6% for PCR). These figures, according to the director of Epidemiological Surveillance , show the low incidence of covid-19 .
This trend has been maintained in the last nine weeks. The 40 is the most recent and the data from the National Epidemiological Surveillance System there were 288 reports, about 40 cases per day.
A diffuse mourning for covid-19
35,903 have died from covid-19 in Ecuador since March 2020, according to the Ministry of Health . They are confirmed cases (by PCR test) and probable (symptoms or complementary tests). But the data from the Civil Registry warn of a greater impact.
In 2020 alone, 115,990 people died -for different reasons-, 58% more deaths than in 2019, prior to the pandemic. The speed of contagion of the original variant of SARS-CoV-2 and the collapse of the health system were some of the causes of the excess deaths in Ecuador.
Now the landscape is different. The MSP reports record 2% occupancy of hospital beds for covid-19 patients in its units and 0% occupancy in the ICU. The behavior is similar in Social Security hospitals and in private clinics. Four people have died from the disease so far in October.
These data justify the pronouncement of President Guillermo Lasso. His announcement would imply the elimination of the few current restrictions, such as those related to entering the country. The use of masks has not been mandatory since last April, although the measure is maintained in medical units.
But even the health authorities say that it is not possible to speak of the end of the pandemic because SARS-CoV-2 is here to stay. That is why it has been included in the surveillance plans for respiratory viruses.
The analyzes of the National Institute of Public Health Research (Inspi), the reference laboratory of the MSP, warn of the presence of the sublineages BA.2, BA.4, BA.5 and BA.2.12.1. They are all mutations of the Ómicron variant which, although characterized by milder symptoms, can cause severe cases in vulnerable patients.
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