Why is the coronavirus raging in Chile, despite an excellent vaccination campaign?

Why is the coronavirus raging in Chile

40% of the Chilean population has received at least one dose of the vaccine against Covid-19, but the infection is very high and the hospitals are struggling. And perhaps, in part, it is the "fault" of the efficient vaccination campaign

(Photo: Pan American Health Organization / Flickr) The strange case of Chile causes experts to discuss. Despite having set up one of the fastest and most efficient vaccination campaigns against Covid-19 in the world (40% of the population received at least one dose of the vaccine, better than only Israel and the United Kingdom), the South American country is undergoing the blows of a new pandemic wave, with numbers of contagion never reached before (over 9 thousand new cases on April 9 and now there are 7 thousand a day). What is happening?

[HILO] Balance Diary # COVID_19 - Domingo 18 de abril | Revisa el detalle complete, here -> https://t.co/b6NxTzF4tq y en https://t.co/0BhgJcFuRm pic.twitter.com/F7l9D81VM9

- Ministerio de Salud (@ministeriosalud) April 18, 2021

A poor vaccine?

Chile is one of the countries that uses the Chinese CoronaVac vaccine. The efficacy data for this product are not yet very clear. In the countries where it is used, the data collected are somewhat different from each other. The Brazilian studies attest to an efficacy of around 50%, while the Turkish ones of 83.5%. The latest Chilean study returns a picture that is closer to that of Brazil: 56.5% efficacy but - beware - only two weeks after the second dose of the vaccine; after the first it seems that the effectiveness is just 3%.

A more contagious variant?

Another variable that could have contributed to the surge in cases is the spread of variants more contagious than coronaviruses, especially P1.

This is another reason why Chile (and also the United Arab Emirates) would be thinking of providing for the administration of a third dose of the vaccine.

A false sense of security?

A less effective vaccine than mRna vaccines (but not for this reason to be thrown away) and the advent of variants that spread more easily would not be sufficient reasons to explain the current trend of the epidemic curve, according to some national and international observers.

It is possible, paradoxically, that the efficient and extensive vaccination campaign was the main cause of the increase in infections: it would have given a false sense of security to the population and also to the government.

The Contagion containment and mitigation measures would be loosened at all levels: on the one hand, private individuals would have made less use of masks and would not have respected the distancing, on the other the government (which between March and November 2020 had closed to travel and international passengers) would have allowed reopening of shops, gyms, malls and businesses in tourist resorts too quickly in an attempt to restart the economy.


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Why are Covid-19 cases spiking in Chile?

© Martin Bernetti/AFP/Getty Images A health worker prepares a dose of the Chinese CoronaVac vaccine at a vaccination centre in Santiago.

It was supposed to be Latin America's bright spot in the fight against Covid-19.

Chile, a country of 19 million on the Pacific coast of South America, had gotten a head start on vaccines by making agreements with pharmaceutical companies only months into the pandemic. By the beginning of this year, Chile had reached one of the highest vaccination rates in the world, while other countries in the region had yet to get any vaccines.

As of Wednesday, Chile had a vaccination rate of 38.94 per 100 people, only behind Israel (61.58) and the United Kingdom (47.51). In terms of vaccination, it is ahead of the United States (36.13), according to data published by Oxford University's 'Our World in Data' database.

Yet the pandemic has hardly abated. Last week, Chile broke records on its number of daily cases since the start of the pandemic on two consecutive days: 8,195 new Covid-19 cases on Thursday and 9,171 on Friday. And even though the number of new cases diagnose per day has fallen this week, the reality is that a spike that began in December has continued steadily in Chile.

As of Wednesday, Chile was approaching 1.1 million total Covid-19 cases. Nearly 25,000 people had died of the disease, according to data from Johns Hopkins University. What went wrong?

Health authorities, experts and journalists consulted by CNN say the world can learn a lot from a multi-factor, 'perfect storm' that hit Chile starting with Christmas gatherings and New Year's festivities, a sustained push to reopen all schools and shopping malls, an anticipated sense of safety given the rapid pace of vaccinations and less-than-desired levels of effectiveness of the Sinovac vaccine, which has been widely used in the country.

© Guillermo Salgado/AFP/Getty Images A nurse checks a Covid-19 patient at the Intensive Care Unit of the Guillermo Grant Benavente Hospital in Concepcion, Chile.

Francisco Álvarez, a public health expert and, until recently, the health department director in Valparaíso province, the second-most populated in Chile, says that relaxing Covid-19 restrictions around the end-of-year holidays started it all.

'Just before Christmas, we would see whole families going shopping for presents and there would be crowds at shopping malls. Starting in January, people were allowed to travel between provinces to go on vacation and the virus traveled with them,' Álvarez said. January is summertime in the Southern Hemisphere and, in Chile, it's typically high season for domestic and international travel.

Álvarez, who had his own bout with Covid-19 last summer and spent weeks in the hospital, also said there would be crowds at beaches in Valparaíso province, a top tourist destination and even though his office organized mobile testing sites, people would refuse to get tested because 'they didn't want to be bothered while on holiday.'

'People got two misleading messages: you can go on vacation anywhere in the country or abroad and we're one of the top countries in Latin America in terms of vaccination. People understood that the risk of contracting the virus was probably over and relaxed measures. That created the perfect storm,' Álvarez said. He added that there were also many Chileans who traveled to Europe and other countries with a high incidence of cases, which contributed to the spike.

While at his former post in Valparaíso's health department, Álvarez's office documented 60 infections of mainly young people who had attended the same New Year's Eve clandestine party, when such gatherings were still prohibited.

The establishment where the party was held was fined the equivalent of about $71,000. A young man who failed to quarantine after testing positive to Covid-19 was fined the equivalent of about $35,000.

There were at least six clandestine parties attended mainly by young people visiting from Santiago, the capital. That produced Covid-19 spikes in a region that had until then had a relative low number of cases. Infections among local people began to increase as well.

Authorities were forced once again take drastic measures to fight the pandemic. Schools that had been reopened for in-person classes were once again shut down. Only essential businesses like supermarkets were allowed to remain open. Thirteen million Chileans across the country were again put on lockdown in late March, although enforcement was lax, and CNN could still see plenty of people on the streets of the capital.

On Tuesday, Health Minister Enrique Paris said that, while it's true some measures were relaxed in December, he never told people to stop following preventive measures. 'We've been on quarantine in the metropolitan region for 14 days and we're seeing good results together with our vaccination efforts.'

'We never said vaccination was going to be the only answer. We have to vaccinate, but we also have to remain mindful of other things like reduced mobility, wearing masks, washing our hands and social distancing so that the virus doesn't get disseminated,' Paris said.

And then there's the issue of the vaccine itself. Chile has been successful in widespread vaccinations in part because its government went after any vaccine it could get. But the widely-used CoronaVac vaccine developed by Sinovac, a private company, was found to have an efficacy rate of just 50.4% in clinical trials in Brazil. Another trial in Turkey showed it was 83.5% effective. State-owned Sinopharm said its two vaccines have efficacy rates of 79.4% and 72.5%.

Although it's too early to say whether that contributed significantly to the spike in cases, high-profile cases in Chile of people who were vaccinated and still ended up in the hospital with the disease have stirred anxiety in the country.

Celestino Aos, archbishop of Santiago, was hospitalized Saturday after testing positive to Covid-19, according to Fr. Andrés Moro, spokesman for the Santiago Archdiocese. Aos was released from the hospital Tuesday. Monsignor Alberto Lorenzelli, auxiliary bishop of Santiago who lives with the archbishop, also contracted the virus, Moro said. Both received the Coronavac vaccine.

Gao Fu, director of the Chinese Center for Disease Control and Prevention has acknowledged the less-than-ideal efficacy rate of Chinese Covid-19 vaccines, telling a conference in Chengdu on Saturday that 'the protection rates of existing vaccines are not high.'

Nevertheless, the Coronavac vaccine is thought to be more effective in severe cases. Researchers from Brazil's Instituto Butantan earlier this year confirmed the Coronavac's low overall efficacy, but found the vaccine to be 78% effective in combating mild cases, and 100% effective for moderate and severe cases.

Izkia Siches, who heads 'Colegio Médico', the biggest medical association in Chile, has been critical of the government's response to the pandemic, saying allowing people to travel during the holidays, mixed messages from the top and lack of resources in local clinics compounded the problem.

After a glowing assessment by Minister Paris during an appearance in the Chilean Congress regarding Chile's vaccination campaign, Siches fired back, saying 'we shouldn't be self-indulgent. Our country is going through a fragile period right now,' CNN affiliate CNN Chile reported.

Paris, who has been in his post since June, later recognized that Chile 'has made mistakes that have probably caused pain for many families. I ask for your forgiveness. We have done everything possible to do things the best way possible.'