Mexico City clenches its jaw as a new wave of covid-19 continues to grow.
The head of the Government, Claudia Sheinbaum, has declared the capital in emergency, hardening prevention measures such as the advance of closing hours for shops or the prohibition of street food.
This Sunday, the millions of pilgrims of the Virgin of Guadalupe, the patron saint of Mexico, will find the basilica closed and protected by hundreds of policemen.
The data draw a scenario that has not been experienced since the peak of May, with an increase in hospitalizations in the last month of more than 40% and record numbers of infections during the first week of December.
The authorities argue that more cases are being registered than six months ago because much more tests are being done, one of the pending accounts in Mexico since the beginning of the pandemic, and they emphasize that the positivity rate - the percentage of people who test positive on the total number of tests carried out— has dropped considerably from the first wave, as has the mortality rate.
In any case, the official forecast is that with the arrival of the Christmas holidays and the false sense of security caused by advances with the vaccine, cases will continue to rise in the coming weeks.
The declaration of the alert this Friday was followed by a new battery of complementary measures announced this Saturday: closing of shops at 5:00 p.m., cutting of streets to avoid crowds or prohibition of the sale of street food.
The measures came after Sheinbaum held several meetings with different business chambers on Friday.
The capital, in any case, remains on an orange traffic light, the penultimate phase of the disease monitoring system in Mexico, with which the de-escalation began in June after the slight improvement in infections.
The new acceleration has increased the pressure on the capital authorities, who hide behind the fact that "the color of the epidemiological traffic light is defined by the federal government", whose strategy is led by the Undersecretary of Health, Hugo López-Gatell, who this Friday again charged against the media in the face of criticism.
During the first wave, the head of government herself marked a dividing line in May.
As long as the bed occupancy was above 65% or there were two weeks of sustained increase in infections, the city would remain on a red light.
The two conditions are now met.
The hospitalization rate is 78% for general beds and 62% for ventilator beds.
Both sections are practically double the average registered in the country.
Despite the growth of the epidemic, only two states, Zacatecas and Baja California Sur, have activated the red traffic light, which would mean an even greater tightening of the hours of shops or schools, even reaching their closure.
“We need to have certain avenues open to avoid a strong economic crisis that could compete with a strong health crisis.
Taking the capital to confinement again is impossible, "said Eduardo Clark, general director of the Digital Government of Mexico City, the body that is centralizing the publication of data during the pandemic on Friday.
Despite registering a slightly lower drop in economic activity than the national average - around 10% - Mexico is the business, tourist and cultural heart of the country along with the industrial states of the north.
The authorities of the neighboring, and much poorer, State of Mexico decided directly on Friday to close shops from five in the afternoon on a similar contagion scenario.
From the federal government, meanwhile, they have also declined to raise the bar.
Already during the first wave, it was flexible with the autonomy of the States and municipalities, giving free rein for them to take their own measures.
"The message remains the same," insisted López-Gatell in his press conference on Friday.
“Whether the epidemic accelerates or decelerates depends on our behavior.
It is a matter of public conscience.
The Secretariat is not going to close a shopping center ”.
Despite daily records in early December, at this second peak, the rise in cases is being less pronounced, as befits a new normal in which numerous personal care measures have been adopted.
But the levels it reaches, albeit little by little, are those that were already seen at the end of May and June.
Not only in general hospitalizations: also in more serious cases, which require intubation.
However, when interpreting these data and comparing them with those of the first wave, it is essential to take into account the substantial improvement in the processes for tracking and detecting cases in the Mexican capital.
Better detection
According to official data from the National Epidemiological Surveillance System (SINAVE), in May Mexico City confirmed 28,097 cases of SARS-CoV-2 infection, which in turn precipitated 3,483 deaths.
With a ratio resulting from dividing both figures of 12.1%.
During November, 1,925 deaths were recorded for 51,559 cases with a date of admission.
The division changes, and a lot, to 3.6%.
Most likely, it is not that the virus has become less lethal, but that now the denominator is better defined: that the detection capacity of the capital has improved.
Throughout the pandemic, Mexico has remained one of the countries with the apparent (but fictitious) death / case ratio in the world.
As a result of the lack of tests, the cause was perfectly reflected in its very high rate of positivity: of all the diagnostic tests that were performed, an unusually high number, between 30% and 50%, ended up with a positive result .
This figure is well above the recommendations of the World Health Organization, which has been suggesting thresholds of 5% and 10% as acceptable levels of positivity all year long.
Anything above that is considered excessive precisely because it involves putting too much faith in the criteria to decide who gets tested and who doesn't.
With a virus like SARS-CoV-2, which produces between a third and more than half asymptomatic infections, the epidemiological recommendation is to assume large margins of error and compensate for them by doing much more testing.
The capital authorities affirmed that this was their intention since the reopening in the middle of the year, doubling the arsenal of free public tests as well as a system for tracking infections through a QR code.
Official figures estimate that more than 80,000 businesses of the 250,000 registered in the capital have already implemented the system.
Street modules for both rapid tests and PCR have also grown, with the aim of continuing to increase their detection capacity to 10,000 daily tests.
The exclusive positivity data for Mexico City in recent months suggest that there has indeed been a considerable increase in screening and detection instruments.
Without reaching the points recommended by the WHO, the positivity has remained below 30% in this second peak, despite the fact that the cases have increased.
This improvement in detection is expected to affect especially the milder cases, which were the most frequently missed in the insufficient Sentinel system.
A method based mainly on samples and projections, implemented in 2006 and designed for another type of detection: early warning of known viruses, no detailed monitoring of new pandemics.
It is not possible to know for sure with the data available today how much of this new peak shown by the data is the result of improved vision.
We will only know that once the wave has passed, comparing positive, suspicious and excess deaths compared to deaths at this same time in previous years.
For now, with the figures for the midst of the storm, it can only be said that the contagion has accelerated in the capital, but that the measuring instruments allow a more complete observation of this new installment of the epidemic.