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Mexico has moved to 'Phase 3' and faces a looming outbreak. Here's how it got there

James Pasley , Business Insider US
 Apr 23, 2020, 04:35 PM
TOLUCA, MEXICO - APRIL 02: A nurse takes an old wo
A nurse takes an old woman to the controlled common area within the nursing home where she lives to prevent them from getting coronavirus on April 02, 2020 in Toluca, Mexico. Health Emergency was declared by National Government and Non-essential activities have been suspended nationwide until April 30. The Coronavirus (COVID-19) pandemic has spread to many countries across the world, claiming over 44,000 lives and infecting hundreds of thousands more. (Photo by Cristopher Rogel Blanquet/Getty Images)
  • Mexico, a nation of 120 million, with about half of that living in poverty, and 60 percent relying on unregistered businesses, is preparing for a spike in coronavirus cases.
  • On Tuesday, the government moved the country to "Phase Three," the most serious stage of the pandemic, when the coronavirus is meant to accelerate through the country.
  • As of April 23, it had 10,554 confirmed cases with 970 deaths, according to data from Johns Hopkins University. But Reuters reported that the government estimated there were about 55,951 cases across the country.
  • As Mexico entered stage three, President Andrés Manuel López Obrador said: "I want to give a guarantee... that we Mexicans are going to be able to overcome this crisis. We are going to win together."
  • For more stories go to

Mexican President Andrés Manuel López Obrador, who faced criticism early on in the pandemic for hugging and kissing his fans instead of social distancing, told reporters on Tuesday: "We are prepared to confront the most difficult moment."

He said this as the nation of 120 million people entered "Phase Three," its most serious level for dealing with the coronavirus. Phase one was beginning to prepare, phase two was putting in safety measures, like banning nonessential activities. Phase three is when the coronavirus accelerates through the country, according to the Los Angeles Times.

As of April 23, it had 10,554 confirmed cases of COVID-19 with 970 deaths, according to data from Johns Hopkins University. But Reuters reported on Thursday that a government's mathematical model estimated there were 55,951 cases across the country.

Mexico has been handling the coronavirus differently from much of the world. Along with the president defending hugging, Hugo López-Gatell, the man who's leading Mexico's coronavirus response, said as recently as April 17, he still wasn't sure how bad the coronavirus really is.

Mexico's economy has been a major factor, leading authorities to keep its borders open, and refusing to enforce a national lockdown. Mexico has also done little testing compared with other nations. As of March 31, it tested 65 people per million inhabitants, compared to the US which has tested 2,250 people per million, according to The Washington Post.

Here's how Mexico got to the point is it at now and what could come next.

Mexico, a country of 120 million, had some advantages going into the coronavirus pandemic. It's got a young population, which is important since COVID-19 has hit the elderly the hardest. It also fairly recently dealt with a new strain of swine flu that originated in Mexico in 2009.

Source: Los Angeles Times

But its population has high rates of obesity and diabetes, underlying conditions, which make people at risk if they contract the coronavirus. On top of that, about half of the population lives in poverty.

Source: Los Angeles Times

Its healthcare system is also weak. According to the Los Angeles Times, since becoming president, Andres Manuel López Obrador cut healthcare funding and changed how hospitals get medical supplies. Now, Mexico has 50% as many hospital beds per capita as the US and a quarter as many nurses.

Sources: Washington Post, Los Angeles Times

The economy is a major point of concern, too. According to the Los Angeles Times, up to 60% of people living in Mexico make their income through unregistered businesses or by street sales, working as plumbers, gardeners, and taco vendors.

Source: Los Angeles Times

This high poverty rate and reliance on street sales meant the government was reluctant to impose a lockdown.

Sources: Los Angeles Times, Wall Street Journal

Mexico's coronavirus response chief Hugo López-Gatell, who earned a doctorate in epidemiology from Johns Hopkins University, said: "One has to find the correct balance between doing good with an intervention and minimising secondary effects."

Sources: Los Angeles Times, Wall Street Journal

He told reporters that Mexico did not want a repeat of the 2009 swine flu. He said: "the economic loss was directly related, in the most part, to the disruption of tourism, trade, and services. … It is so important, with very careful precision, not to take preemptive actions that do not correspond to the magnitude of the risk.

Source: Slate

So Mexico took few preemptive actions before it reported its first case on February 27, about a month after the US.

Sources: Los Angeles Times, Washington Post

From the beginning, President Lopez Obrador downplayed the seriousness of the pandemic. On March 4, he dismissed social distancing requirements. He said: "With the coronavirus, this idea that you can't hug. You have to hug. Nothing happens."

Ten days later, he posted a video online of him hugging and kissing fans at a rally.

Source: The New York Times

On March 12, López-Gatell told the nation that there was no scientific evidence that travel restrictions "can play a relevant role" in the protection of public health. He also said restricting international travel was not considered since spring break and Easter approached, which normally brought in thousands of tourists.

Source: The New York Times

Three days later, a Mexican woman named Gabriela Gómez went to watch a women's professional soccer game with 22,000 others, while sports were put on hold around the world. She told The New York Times: "Worry? Yes, there's worry. But you have to have fun."

That same evening, 40,000 people attended a concert in Mexico City.

Sources: The New York Times, CNN

At that point, there were 53 confirmed cases. The government steered away from doing anything to hurt the economy, but it did order schools to close, and it expanded the nation's Easter break school holidays from two weeks to a month beginning on March 20.

Sources: The New York Times, Los Angeles Times, The New York Times

The president, who is over 60, continued to downplay the coronavirus, claiming he had charms that protected him. On March 16, López Gatell told reporters who questioned whether his behaviour was wise: "The president's strength is moral in nature. His force is not that of contagion."

Source: Washington Post

On March 18, Mexico reported its first death from COVID-19.

Source: Los Angeles Times

Five days later, on March 23, popular tourist destinations were still busy, like this beach in Cancun.

On March 24, the government declared "Phase Two," which meant the coronavirus was spreading unchecked in communities. The government ordered nonessential businesses to close, banned large gatherings, and enforced social distancing.

Sources: Los Angeles Times, Washington Post

Still, public markets and other establishments remained open. On March 26, Mexico had 475 confirmed cases of COVID-19 and six deaths.

Sources: Los Angeles Times, NBC News

By the end of the month, Mexico's lack of testing was apparent. In contrast to South Korea's mass testing and intense tracking practices, the government did not even try to test all potential cases.

As of March 31, it had tested 65 people per million inhabitants, compared to the US which had tested 2,250 people per million, according to The Washington Post.

Source: Washington Post

On March 31, Mexico declared a "health emergency," with 1,000 confirmed cases of COVID-19. Adding to its problems, Mexico was also dealing with the worst month of homicides since records began in 1997 — in March, 2,585 people were killed.

Sources: France24, The Guardian

In early April, the weaknesses in Mexico's health-system became apparent. Unrest and calls for more protective equipment came after a 42-year-old man died of COVID-19, after being treated in a hospital without being isolated. His treatment led to 41 employees getting the virus.

Source: Washington Post

But, according to The Washington Post, even before the man's death doctors and nurses at the hospital where he died held demonstrations to protest their lack of protective gear. One nurse told a television network: "There's no material, no equipment — gloves, masks, there's never any of that."

Source: Washington Post

Some showed their support however they could. On April 7, this mariachi band wearing masks played for the National Institute of Respiratory Diseases in Mexico City, to give hope to those fighting COVID-19 and the healthcare workers.

On April 17, when Mexico's cases had leaped up to 6,875 with 546 deaths, López-Gatell told the Wall Street Journal he still wasn't sure how bad the coronavirus was and compared it to the common flu. He said: "I don't know yet. The WHO says it could be 10 times that of influenza, but I think we need to see more evidence."

Sources: Wall Street Journal, US News

He said: "I'll repeat: 0.5% of the population will have some kind of symptoms out of the total Mexican population. [The great majority] will develop immunity without ever knowing they were infected." But according to other experts the Wall Street Journal spoke to, he was being unrealistic.

On April 21, Mexico declared it was entering "Phase Three." Obrador, who had not taken the pandemic seriously for weeks, said: "I want to give a guarantee ... that we Mexicans are going to be able to overcome this crisis. We are going to win together."

Source: Los Angeles Times

The following day Mexico confirmed it had 10,000 cases. It had taken only nine days for the cases to double from 5,000.

Source: The New York Times

On April 23, there were 1,000 new confirmed cases in a single day. Even so, Obrador refused to say he would act against those who broke coronavirus guidelines. As Mexico's cases continued to rapidly rise, he said: "Everything is done through persuasion."

Sources: Reuters, Bloomberg

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