Mexico made more than 9,000 coronavirus infections from indigenous people invisible

By Gibrán Mena Aguilar - Fifth Element Lab

On an April morning, the Mayan nurse Luis Cauich received a call from a friend asking him to receive her daughter at the José María Morelos Integral Hospital, in the Mexican state of Quintana Roo.

At that time, the world still knew little about the SarsCov2 virus that was spreading across the planet.

But Cauich already knew this:

if the 23-year-old was infected with COVID-19, there was no hope.

Full of anguish, Cauich took vital signs and registration data for his file: he had diabetes, immunosuppression, kidney disease, pneumonia, COPD, and a disability.

In addition, he was indigenous, information that he recorded in the file along with the rest of the information about his case.

"He was Mayan, his entire family is Mayan," says the nurse.

Due to his state of health there was not much to do.

The next day,

his lungs collapsed from the virus that finally took his life

, and his death in a hospital was added to the official database of the federal Ministry of Health (SSA), but with one missing:

it was not reported that the young woman was indigenous

.

The column indicating that she recognized herself as an indigenous woman was added by the Ministry of Health to the database six months after her death, until October 7.

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The case of this young woman is not the only one.

As revealed by the continuous monitoring and analysis of the data that today add up to almost 4.3 million patient records in hospital centers throughout the country,

the agency made more than 9,000 suspected cases of COVID-19 invisible among people belonging to indigenous peoples

(adding to those who This is how those who speak a language were identified), with hospital admission dates between January and October 2020, despite having had this data from the beginning of the publication of the database.

“Now it turns out that an institution is going to tell us if we are indigenous.

If the last name is enough, ”Cauich said, angrily, upon learning that in the official data there was no record of the ethnicity of her friend in June, two months after her death.

The variable omitted until October, under the name “INDIGENOUS” (sic), allows us to contrast the official number of indigenous patients who died from COVID-19 with respect to the total number of sick indigenous people, a proportion known as lethality and to compare it with the fatality among people non-indigenous.

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Of the cases of infected patients who were registered as indigenous or speakers of indigenous languages,

14% died since the beginning of the pandemic, compared to 9% of non-indigenous people,

according to an analysis of open data from the Ministry of Health Federal (SSA) conducted for this investigation, as of January 22.

In other words, the fatality of COVID-19 for indigenous people is 50% higher than for the rest of the population, taking into account the national average.

The fact that indigenous people have a higher lethality, according to official data, was not mentioned in any of the daily conferences on coronavirus, according to their stenographic record.

The disparity in fatality at the municipal level soars even more.

Up to 6 out of 10 infected indigenous people died in Motul —a 73% indigenous citrus, cattle and tourist community, located 25 miles from the capital of Yucatán — compared to 2 out of 10 non-indigenous people.

Motul is just one of the more than 195 municipalities in the country that have registered deaths of people from indigenous communities and where half, or a higher percentage, of indigenous people infected with COVID-19 died.

According to statistical calculations, indigenous deaths in Mexico are underestimated by more than 20,000.

Megamedia

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A seven-month omission

The follow-up to the database, its records and variables, detected that on October 7 the column “INDIGENOUS” (sic) was added with a discreet note that reads: “The variable 'INDIGENO' is included, the description and its respective catalog ”, without further explanation.

In an interview, the Ministry of Health argues that it

excluded this information for months to protect the privacy of patients.

“This variable is found in all epidemiological studies.

What we must always do is protect the data, so that people cannot be identifiable, because the data speaks of a health condition.

So we do the query of what variables are, and what variables are not published, "replied Christian Zaragoza, director of epidemiological information at the Ministry of Health.

However, this justification is inconsistent with the practice of the Ministry of Health until then.

Since April, the agency published various data on each patient such as if they speak an indigenous language, their age, sex, birth entity, entity and municipality of residence, if they suffer from diabetes, COPD, immunosuppression, asthma or if they have a smoking habit, among others.

In other words, it did not apply the same criterion of "protecting the data" on any of these variables.

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Before, the Ministry of Health published exclusively a column that specified whether the patient admitted to the hospital system "speaks an indigenous language."

The universe of speakers of indigenous languages ​​is substantially smaller than that of people who recognize themselves as indigenous.

Of the approximately 21.5 million indigenous people in Mexico, only about 6.5 million are speakers of any language.

Before the change to the database, only 18,262 indigenous language speakers had been recognized in COVID-19 data.

From the adjustment, the number rose to 27,611 indigenous people - adding speakers and people who identify themselves as indigenous - without it being a requirement that they speak any language.

Between March and September, 9,349 cases of indigenous people suspected of having contracted COVID-19 were under-registered.

The official from the Ministry of Health also acknowledged that the data on indigenous people that are integrated into the database are deficient.

Until the end of January, there were 5,307 cases of people registered as speakers of an indigenous language who, simultaneously, are registered in the non-indigenous category.

This combination of a person who speaks an indigenous language but is not indigenous is unusual in Mexico, where the population does not usually learn the native languages ​​unless they are spoken at home.

In addition, as of January 22, there were 194,205 cases in which the column on indigenous identity was filled with "not specified."

Between March and September, 9,349 cases of indigenous people suspected of having contracted COVID-19 were under-registered.

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“There is a topic called data quality.

This means that the data is incorrectly filled.

That is why we always insist that the states make a correct review of their databases and request support to make a correction, ”Zaragoza pointed out in October.

During the months that this column was omitted from the public base, the Ministry of Health itself prepared four reports dated between July and October where it admits the highest fatality among that population, but began to make these reports public only until October 16.

“

There is a higher fatality compared to the general population.

The distribution of lethality corresponds to the mesoregions where a greater number of indigenous population is described, such as the southeast, center and northeast region, therefore, it is important to pay more attention to these groups ”, describes the first of these reports , dated July 22.

And the trend has not changed.

With the official data included only in October, it is possible to draw a map of how the virus has decimated the indigenous population: until January 22 there is a record of almost 2,424 people who recognize themselves as indigenous or speak an indigenous language and died from COVID-19 .

To find the most lethal municipalities, this research took into account those where 10 or more indigenous people have died in official data.

These are: Motul, Yucatán, where 59% (19 patients) of the 32 registered sick indigenous people died;

Puente de Ixtla, Morelos (half of the 25 infected indigenous people died);

Cozumel, Quintana Roo (47% with 14 deaths);

Tecoh, Yucatán (44% with 10 deaths);

Etchojoa, Sonora (42% with 11 deaths);

Acanceh, Yucatán (42% of deaths, equivalent to 10 deaths), Ocosingo, Chiapas (40% with 10 deaths) and San Felipe Orizatlán, Hidalgo (39%, which is equivalent to 10 deaths out of the 26 disease registries).

In absolute figures, the municipality of Benito Juárez, Quintana Roo, has remained the number 1 place in the registry of indigenous deaths (January 61 to 22).

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As of January 22, 2021, at the entity level and adjusting by population, the highest rates of official indigenous death records are in Oaxaca (270 total deaths, 1.7 / million inhab.);

Tlaxcala (17 deaths and 1.6 / million inhab.);

Veracruz (104 deaths, 1.1 / million pop.);

Hidalgo (190 deaths and 1.1 / million inhab.);

Campeche (55 deaths, 1 / million pop.);

Yucatán (378 deaths, .6 / million pop.);

Guerrero (87 deaths, 0.5 / million pop.);

Morelos (26 deaths, 0.5 deaths / million pop.);

Quintana Roo (145 deaths, 0.5 / million inhab.);

Michoacán (100 deaths, 0.4 / million inhabitants), and Nayarit (20 deaths, 0.4 / million inhabitants).

Among these entities, the municipalities with the most deaths are Benito Juárez, Quintana Roo (61 deaths in the area, better known as Cancún);

Mérida, Yucatán (42), Valladolid, Yucatán (also 42) and Ixmiquilpan, Hidalgo, (41).

The SSA does not make public the information on the indigenous peoples to which the deceased belong

, but in the municipality of Benito Juárez - where Cancún is and where COVID-19 has been most lethal for the indigenous population - members of the Mayan peoples live , Tseltal, Tsotsil, Chol and Tojolabal.

The deaths, rates and the percentage of fatality for each municipality, both indigenous and non-indigenous, can be consulted on this map made with data from the Ministry of Health.

The market of Coyomeapan, a community in the Sierra Negra of the state of Puebla, where indigenous people of the Nahuatl ethnic group live.Marlén Martínez / SIDE B

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Figures that do not convince

At a press conference for the Day of the Dead ceremony at the National Palace, the head of the National Institute of Indigenous Peoples (INPI), Adelfo Regino Montes, acknowledged the death of 1,494 people, as he excluded people who speak poorly registered indigenous languages as non-indigenous.

A difference of 300 deaths if speakers of native languages ​​are counted who, although they were poorly registered according to authorities, do speak indigenous languages, and by that date had been confirmed as deceased by COVID-19.

However, both figures generate skepticism among experts.

"It is very little, and I hope it was," said Arturo Erdely, a doctor of mathematics and a specialist in statistics at the National Autonomous University of Mexico, referring to the proportion of indigenous people counted in relation to the total deaths in the database.

"

That number of deaths does not make sense in Mexico, where the indigenous population is so high

[21.5%]."

If one of every five inhabitants of the country is indigenous and there is only a record of 2,000 deaths, the underrepresentation does not fit, he added.

Of the 146,174 deaths registered in total until January 22, 21.5% correspond to

around 30,000 indigenous deaths.

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“I am not saying that that amount must necessarily be found,” explains the mathematician, “because the government database is not representative, it is not a random sample.

But even so, the most logical thing is that the poorest people were more represented in the death statistics ”.

Professor Erdely proposes an exercise to estimate a figure that can be closer to reality, and that is schematized as follows: there are municipalities in which the indigenous population is very high and there are dozens of deaths from COVID-19.

However,

very few of those deaths are registered as indigenous

.

In these municipalities, a more “real” figure should be close to the percentage of indigenous population for these types of municipalities.

For example, a municipality classified as “indigenous” such as Halachado, Yucatán, is 99.8% indigenous.

But in the COVID-19 data, less than half of the 21 deaths in Halajó are registered as indigenous.

In that case, the registry of indigenous deaths should be much closer to the total number of deaths (20 or 21 indigenous deaths in a municipality that is almost 100% indigenous would be much more credible).

“It is better to see the municipality of residence and classify whether it is an indigenous or non-indigenous municipality and you have to make a calculation, contrast [against official data] in this way.

If these calculations differ a lot, I would believe the issue of indigenous residence municipality more ”, explained the mathematician.

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Each municipality has a certain percentage of indigenous population according to the census information.

If it has more than 40% of indigenous population, it is classified as indigenous and if it has less than that percentage but more than 5,000 indigenous inhabitants, it is classified as "municipality with indigenous presence".

By replicating the Halachio exercise for all municipalities classified as indigenous and with an indigenous presence, an estimate of 23,520 indigenous deaths is obtained using the method proposed by the statistician,

a difference of 21,096 with the official records.

Underreporting of total cases has been the norm in Mexico and, to varying degrees, throughout the world.

In Mexico, the health authority has said that patients were deliberately classified as positive for COVID-19 using exclusively laboratory test results, which in themselves show high rates of positivity, that is, they are very scarce.

In addition, until August the federal strategy considered very few symptoms as characteristic of coronavirus, as recognized by the Undersecretary of Prevention and Health Promotion, Hugo López Gatell.

Until October 7, some of the positives found by methods other than the test began to be incorporated into the database.

All these data also depend on who can reach a COVID-19 hospital.

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Other data

While the Government omitted the high lethality for indigenous people from the public data, it also omitted it in the evening conferences, the main communication body for managing the pandemic of the federal government.

In one of the most recent conferences dedicated to the indigenous issue, on September 12, Jose Luis Alomía, general director of epidemiology of the Ministry of Health, omitted to report on the increased fatality, despite the fact that it appears in official reports.

“Finally, as a third information component, we are going to review the statistics of the impact that at the time has been given to the indigenous population.

They had asked us for it in some of these conferences, ”said Alomía.

But in his review of the subject he only mentioned the total number of deaths and presented statistics of concurrent diseases of the deaths.

It did not compare indigenous versus non-indigenous fatality.

In another presentation, López Gatell used the incidence statistic (how many get sick) and not the lethality (how many die among those who get sick) to talk about the indigenous population.

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"Fortunately so far, the proportion of disease, say, the incidence in indigenous populations is substantially lower than in non-indigenous populations," said the official at a press conference on July 20, two days before the date of the first report of lethality that, although confirming this statement, also indicates that despite being "few" the records of indigenous people who died from COVID-19, compared to those of non-indigenous people, it

is 50% more likely that indigenous people die compared to the rest of the population. the population.

And although the number of total cases of deceased indigenous people (incidence) was and continues to be lower than that of non-indigenous people, officials omitted that the probability of dying for an infected indigenous person was already around 40% higher than that of a non-indigenous person. indigenous population for September, probability that is now 50% at the national level, as explained before.

Consistently, in other conferences where journalists asked about the issue, the secretariat evaded it by offering convenient figures.

At the June 24 conference, the head of the public program IMSS-Bienestar, Gisela Lara answered questions using exclusively data from her program that serves very few indigenous people compared to the national total.

“If you look at it, the incidence per 100,000 people is not true that the indigenous people are doing worse, let me tell you no [...] So, it is not true that they are poorly cared for;

on the contrary, I think they are doing better, the indigenous people are more careful, those who call themselves indigenous, ”Lara said at the June 24 conference.

Although there is no evidence that indigenous bodies are less resistant to disease,

the continuous struggle to access the conditions of a dignified and full life is wearing down the body

and contributing to produce the conditions that are risk factors in many diseases. as explained by Dr. Leslie Korn, an expert in Behavioral Medicine and former Fulbright researcher in Mexico.

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COVID-19, according to the specialist, operates through a set of inflammatory processes of various organs, against which the body can finally lose the battle.

Diabetes, cancer, heart disease, even depression starts with chronic stress and inflammation.

“

Let's not forget the effect of poverty and the stress of poverty

due to not being able to bring food or not being able to pay your expenses.

They will also create an inflammatory process in the body, ”Korn explained.

That young Mayan that the nurse Luis Cauich saw die in a hospital in José María Morelos, last April, suffered from diabetes, immunosuppression and kidney disease.

It was the illnesses she was carrying on that had brought her to a medical check-up in the first place, and not COVID-19.

She was so sick that she didn't even have a chance to find out that it was the Sars-Cov2 virus that ultimately made her health worse

.

The doctors learned about it two weeks after confirming the test that they performed on him while he was still alive, which barely managed to add it to an incomplete statistical record.

For her, there was never much alternative to death.

Diabetes, which in the 1930s was a "disease of the rich", today afflicts those who are forced to opt for available food that is cheap, but rich in sugars and processed flours.

Those who live with constant tension due to discrimination and racism end up suffering from hypertension, the highest comorbidity among indigenous people according to data from the Ministry of Health.

"There is no way that racism is not involved

,

"

explains Yásnaya Aguilar, linguist, Ayuujk writer and activist for the rights of her people.

“Racism is not just an act of individual discrimination.

There is terrible racism in the health, education and justice system, "he added.

According to the most recent data,

72% of the indigenous population is below the poverty line in Mexico

.

His poor health is the result of structural conditions that the coronavirus turned literally lethal, but that even the survivors are economically impacted.

It is a vicious circle.