Guatemala and COVID — Health, Not Geopolitics!

The need for an international collaboration to defeat the COVID19 pandemic is perhaps most critically seen in its opposite manifestation – the refusal to respond to pleas for help because of perceived geopolitical conflicts.

It is well known that the US refused to lift sanctions against Iran, despite their urgent request for help in dealing with the COVID pandemic. Similarly, the US refused to assist Venezuela, which country is now receiving desperately needed supplies from China, Russia, Iran and Cuba. But what about Guatemala?  Guatemala is an ally of the US. In a presentation entitled “Reactivating Guatemala’s Economy Post COVID-19” at a May 26th meeting of the Atlantic Council , Dr. Alejandro Giammattei,  the President of Guatemala, delivered stinging remarks regarding his country’s dealings with the US during this crisis. He explained that while Guatemala is an ally of the US, when it comes to COVID-19, the US is not an ally of Guatemala.  He specifically referred to the United States’ practice of deporting people who are infected with COVID19 back to Guatemala. This practice can only spread the disease in a country with few medical facilities, and much poverty. The Health Minister of Guatemala has called the US, with its high rate of infection, .”The Wuhan of the Americas”.

Dr. Giammattei is a trained surgeon who came into office as President of Guatemala in January, 2020, 49 days before Guatemala’s first case of COVID. In the May 21st interview, Giammattei said that his government made preparations before the virus hit Guatemala hard, having seen COVID developments in China and Korea. His government stopped flights into Guatemala from China on February 3, one month before their first case appeared; they began construction of six emergency hospitals, of which five are now functioning; and they attempted to isolate infected persons in hospitals, rather than sending them home where they would infect others. He noted: “We knew that we were going to get hit hard because our healthcare system had been fully neglected for 40 to 50 years. We had only 0.6 beds per 1000 inhabitants. We had a very low number of respirators, most of which did not work.”

Dr. Giammattei’s contention with the US involving the deportations has resulted in some changed policies, but points to much larger crises.  In April, 20% of the deportees from the US were infected with COVID19. Flights were suspended by the Guatemalan government on and off, with the latest suspension on May 13th after almost all 65 deportees were shown to be infected, according to Time Magazine. The flights were resumed June 9th, with requirements that those arriving have certificates from the US showing they are COVID free. These people are tested again when they arrive. The rate of infection indicates a crisis as well in US camps where deportees are held on the border.  

Of course, there is a tremendous irony here, since spokesmen for the Trump administration and allies in the Democratic and Republican Parties have attacked China, charging that the Chinese government  sent infected people to the West after the outbreak of COVID in China, thus using those human bodies to spread the disease.  This charge has been disproven, but what about the case of the US deporting infected people to Guatemala when it is known they will spread the disease?  More problems for Guatemala involve refugees returning from Mexico by land routes.  Clearly, we need a new paradigm for relations among nations, which is spoken to in the Schiller Institute reports.

First Hand Reports from those on the ground in Guatemala

“Roosevelt Hospital is jammed even with tents in the parking lot in the rainy season.  Last week there was a rain storm which must have made things miserable.  They have 146 patients with Covid and no room even when the “bomberos”  (firemen/ambulance) bring people there for an emergency.”  Also see:

The following two reports – one April 11, 2020, and the other on June 6, 2020,  were sent to The Medical Project by an award-winning dermatologist in Guatemala, who has been redeployed into the fight against COVID-19 in her country. The doctor is an internist who works for the ministry of health in one of the public hospitals. The reports, and those in the video she sent, are reports from the front lines of medical personnel in the country.

At the time of the April 11th report, there were 137 confirmed cases of COVID19 in Guatemala, with 19 recovered, 3 deceased, and 115 active cases in household quarantine and in the industrial park.  A curfew had been put in place from 4 pm to 4 am.

By June 6th, there were 7,502 cases, with 267 deaths, and 1,323 recovered.  The death rate was 3.6% per 1000 infected.  To give an eye witness of developments in Guatemala,  the doctor sent a video that updates the situation, which is included below. 

Note that the population of Guatemala is now 17,263,000 — slightly less than the population of the state of New York, which is estimated to be 19.4 million people.  The number of active physicians in Guatemala is 9,000 – 1,918 patients per physician. The Constitution of Guatemala states that medical care is a right for all citizens.  However, resources are low, and access is difficult in rural areas, including in the indigenous Mayan areas.  There are over 22 indigenous languages spoken in Guatemala.

On April 11, the doctor reported that for the COVID-19  emergency, 5 special provisional hospitals were set up in the departments of Peten, Quezaltenango, Zacapa, Escuintla and the Hospital in the Capital in the industrial park. In total, in these 5 hospitals there are 96 beds in intensive care, distributed as follows: 46 beds in the Industrial Park, and 12 beds in each of the 4 provisional hospitals. In the Industry Park there is a CT scanner donated by an individual and X-ray and ultrasound machines donated by Taiwan.

She reported:  “There are 56 ventilators in total for the 5 hospitals, and they were waiting for a donation of 200 ventilators. Currently, the complicated cases are sent to the Villa Nueva hospital that belongs to the national public hospital, which  was prepared for COVID-19 cases. If at some point the provisional hospitals become full, they will start receiving COVID-19 patients in the national public hospitals.”

The doctor works at the general hospital, and Roosevelt hospital, which, she reported was “already organized for this emergency. In these hospitals they have 76 beds and intensive care ventilators, between the two of them. The social security hospital has 33 beds with ventilators. In the 6 best equipped private hospitals in the country, there are 50 beds and ventilators among them all.

“The tests are carried out in the national laboratory belonging to the Ministry of Health. Currently 24 tests are being carried out per day, with the capacity to process 200 tests per day. The tests are also carried out in 6 private hospitals.

“The University of San Carlos, in Guatemala City along with other private universities in conjunction with the Massachusetts Institute of Technology are working on artificial respirators. These do not replace a conventional ventilator, they do not have the same technology, but at the moment the ventilators will not be enough, so the patients will be connected to one of them.”

In her second report sent on June 6th, this doctor included the video of a conference call with doctors and health personnel which is attached. Since the video is in Spanish, a transcription of some reports in English follows here:

Webcast from Guatemala on COVID 19

Mr Capere HGSDD, and Mr Hugo Castro-

“Guatemala made a tent hospital on the largest fair ground in the capital, Guatemala City.  The problem is they have very little supplies, and almost everything is donated from private sources or financiers.  As the healthcare workers tend to, at least a certain percentage, get infected with Covid19, they have to go into quarantine, but the hospital operation must continue.  The personnel are changing over time.  Also for supplies, one day they may have one drug, or one type of personal protective equipment, and then another day, not one thing, but something different.  It is an unstable situation.

“There are false positive tests up to 30% of the time so we have to repeat tests 2 or 3 times for many people.”

Francisco Flores, pneumonologist, and in charge of the Fair Grounds improvised hospital. 

“It’s an improvised hospital, so it is harder to operate.  They recycle the worst patients there.  It was only supposed to be for Covid-19 patients.  But now all the hospitals are becoming packed with Covid-19 patients.”

He has two areas with beds, 120 beds each, total of 240 beds.  “For intensive care (ICU), there are only 48 units for that Fair Ground hospital. In that hospital they only have 24 ventilators, but not all of them are working correctly so not all are used. 

“They have some machines that are not really ventilators, but are ‘assisted breathing’ …  It seems that these are the plastic masks over the face, and then they give the patients enriched oxygen streams to breathe.”

Francisco (Hospital unit director)

… has a total of 55 doctors who are general practitioners.  They had to take 9 internal medicine students who have 1 more year of residency though have not completed residency.  He has 4 pediatricians to treat children, and also some pregnant women show up who have Covid-19.  The problem is that the doctors also can get infected, so the staff keeps changing. The shifts are 24-hour long!!!!  “We also had 10 HIV -positive patients, about 4 of these recovered already.  Of 800 patients, 6 died, which is a pretty low death rate.  Some patients died because they came from rural areas with a long trip in the mountains, without oxygen, so they were near death by the time they arrived, 3 died like this, bad transportation, no oxygen masks even.  So 60% of the patients are in moderate condition.  Some patients that recover are then moved to a hotel, evidently to quarantine them and give them a place to rest.”

In the shift they have an average of 30 patients per doctor.  They had a doctor who was an epidemiologist, but he quit because HE WAS NOT BEING PAID. In the intensive care section, 10 patients were on “mechanical ventilation,” probably full ventilators.

He has 18 patients with a relatively high blood oxygen concentration, so they are on the oxygen masks, not ventilators.  At least, he has tanks with oxygen for “oxygen therapy.”  The big problem is that he can only give 18 patients oxygen at a time, so even the oxygen masks are limited.  He rotates the patients, gives them oxygen to get to a high oxygenated blood concentration, and then passes it the others, so that the oxygen levels are kept up.   From May 15 to June 5, in this area there were a total of 38 patients who died, and 17 who were discharged as being recovered.  People with Covid-19 have other illnesses like hypertension, need for kidney dialysis, women giving birth, and other problems.

“About 20 medical personnel were infected by Covid by working at the Fair Grounds hospital unit and had to be placed in quarantine for at least 2 weeks.”

The entire video, in Spanish, can be viewed below:

The May 26th presentation of Dr. Alejandro Giammattei is included below, in Spanish and in English.

Video of May 26th Presentation by Guatemalan President Alejandro Giammattei at the Atlantic Council

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