COVID-19 and the collapse of the state

Published in El Pais, 1 Agust 2020.

Emergencies such as COVID-19 could be prevented with co-responsibility functions. This can be achieved with a state that dictates standards, complies with them and enforces them. However, COVID-19 shows that there is a collapse of the state. CNN’s Fernando del Rincón says there are quite a few COVID-19 deaths linked to corruption due to faulty equipment and supplies and the New York Times indicates that politicians are the villains of the virus in Latin America. This reduces respect for institutions and authorities so that people “do whatever it takes to save themselves,” motivating individualism. Pharmacies have a protocol for selling drugs, but as no one is controlling. They have made huge profits in this pandemic. In the same way, private clinics and cemeteries that have financially taken advantage of the collapse of pharmacies, hospitals and public cemeteries. And so do the doctors and witchdoctors who have come out to offer “miraculous treatments” without any guarantee and with great danger to health. Fake companies that have been selling adulterated drugs, etc. Everyone has taken advantage of the collapse of the state because nobody controls.

In the name of COVID-19, almost the entire state apparatus has stopped (for example, education, judicial system, administration) and great opportunities are being lost to generate technology and innovation. In health, for example, it could be used to reinforce first-level health (early detection, prevention) and only admit referrals for the second and third levels of care. This could have prevented the collapse of COVID-19 hospitals and would have motivated a greater investment in the first level, including patient monitoring. It could also be used to collect data and information, for example, from each hospital that is experimenting with different treatments and in the end, see which one worked best.

But one can see people who really need help or the poor who do not have access to the health system due to its collapse or high prices; and other patients with other conditions cannot get to the hospital without fear of getting COVID-19. First-level care physicians do not have the money to make house-visit, they do not have COVID-19 tests, nor the internet or telephone to make follow-up calls to patients who are recovering at home.

Today, more than ever, public officials with experience in solving emergencies, with innovative ideas and government support are needed to make these strategies work. Having hand-picked officials maintains inertia in the health system so that it remains as it has been for the past twenty years.