Caracas Chronicles

On the morning of Sunday, March 6th, Rubén Peralta, an old friend of mine who works as a gynecologist in Valencia, Carabobo State, wrote me to offer a fresh, moving piece about a colleague who had passed away the day before. Rubén was very sad and angry, and he had spent part of the night drinking Scotch and trying to cope with the news by writing an obituary that was, at the same time, the story of a friendship. Teófilo Ortega, his deceased friend, was the perfect example of a Venezuelan who came from a disadvantaged background and became a well-known doctor, thanks to his own effort and the opportunities that public education gave him before chavismo came to power and destroyed it all. 

I published Rubén’s piece immediately on Cinco8 and it went viral. His story struck a chord in Valencia, and in the medical community: Ortega died of COVID-19, like many other doctors and nurses in Venezuela. In the following days, more people like him would succumb to the pandemic, also friends with Rubén and with my other doctor friends over there.

The reasons are easy to imagine, for anyone who knows what kind of place Venezuela’s today: if we see doctors and nurses dying from coronavirus everywhere in the world, or abandoning the workplace because of fear or burnout, or even taking their own lives, why would it be different in a country ravaged by a complex humanitarian emergency, where the healthcare sector had to deal with wartime conditions and was already severely understaffed when the pandemic began?

Doctors Counting Their Own Dead

Now that COVID-19 is finally exploding in Venezuela, as we can deduct from the myriad of crowdfunding requests, searches for oxygen, and news of ill and deceased people on social media, we still have no official figures we can trust. But thanks to the advocacy group Médicos Unidos Venezuela, we have an idea of the impact the pandemic’s having from the appalling numbers of nurses and doctors who are falling. By keeping an unofficial account that’s based not on the official report of COVID-19 victims but on adding the reports from the medical community that expand the government’s criteria to determine whether someone died of COVID-19, the group found, for example, that on September 11th, 2020, 28 members of the medical community died, and that on March 13th, 2021, 27 passed away. 

We still have problems assessing how bad things are, at least in quantitative terms, because we lack a reliable figure of total cases and deaths.

By March 29th, Médicos Unidos Venezuela was counting 408 deaths among the healthcare personnel, while the official death toll on March 30th, reported by the Johns Hopkins University pandemic map, is 1,589.

If we trust the figures provided by the Maduro regime—the only nationwide count, widely seen as severely impacted by under-registration—then 25% of victims in Venezuela are professionals in the frontlines, the nurses and doctors who work at those hospitals whose catastrophic conditions have been widely documented by international media, but who also try to do their best in the crowded private clinics where a day in intensive care can cost over $3,000. 

The Unknown Proportion

We still have problems assessing how bad things are, at least in quantitative terms, because we lack a reliable figure of total cases and deaths. We can try, however, to compare it with other countries. 

A country similar to Venezuela, Colombia, by February 11th, 2021, had 42,177 cases among health workers and 208 deaths. This means that healthcare workers in Colombia accounted for 0.36% of deaths, from a total of 56,983 accumulative deaths in that country by that same date of February 11th, 2021. If Venezuela has that same proportion of healthcare workers fallen in the pandemic, we’d have a total of 113,333 COVID-19 deaths. 

That’s almost a third of what has accumulated in Brazil, a country that’s been particularly affected and which has a population of more than 200 million people. Let’s suppose Venezuela is under registering cases and deaths by about 70%, given its diminutive capacity to do PCR tests and collect data; if we triple the official 1,589 and project a national death toll of about 4,500, that still means that healthcare workers are about 10% of it. 

It’s a spiral: the more they die, the more they leave, and more of them will be at risk of exhaustion and contagion from the doctors, nurses, technicians and clerks who insist on going to the hospitals.

That one tenth of deaths are happening among healthcare personnel is too much anywhere, especially in a country that’s been suffering from a brain drain and massive migration in that sector. Only a really strong commitment can keep nurses and doctors going to chaotic hospitals. It’s like Soviet soldiers pushed into battle in Stalingrad.  

This week, after the Maduro regime announced it won’t approve the AstraZeneca vaccine that was supposed to enter after an agreement with the opposition via the COVAX initiative, many voices started to rise under the claim “let the vaccine in”, the National Academy of Medicine among them. 

In Valencia, my doctor friends working at private hospitals have no idea when they’re going to be vaccinated. Some of them speak of colleagues who are ignoring the safety measures, in the workplace or in the streets. Some doctors distrust the Russian and Chinese vaccines the regime is importing. Some are behaving as carelessly about the virus as thousands of Venezuelans who misuse the masks or attend crowded events, from parties to political rallies and religious processions.

Meanwhile, in the public system, the lack of protective equipment and services will surely have a profound impact on the mortality rate of healthcare workers. It’s a spiral: the more they die, the more they leave, and more of them will be at risk of exhaustion and contagion from the doctors, nurses, technicians and clerks who insist on going to the hospitals. This week, on Twitter, some people were saying that the coronavirus ward in Maturín’s Central Hospital was completely depleted of doctors: only family members were caring for patients.