About 15 students stood outside the Caracas University Hospital in the Venezuelan capital, behind them a grim stage set: bin bags arranged to look like corpses. The students were grieving and angry. To them, the deaths of several hundred health workers from COVID-19 were personal. Many of them knew the medics that have suffered due to shortages of personal protection equipment (PPE) and the poor conditions of Venezuela’s hospitals. Student councillor Jesús Mendoza chalked the handling of the pandemic up to another of Nicolás Maduro’s callously broken promises. Venezuela’s authoritarian president had guaranteed ten million vaccine doses by May, but managed to secure barely a quarter, not enough to cover even the most vulnerable of the country’s people.
Meanwhile, Venezuela’s medical community is warning that official COVID data is not credible and inadequate testing means there is little indication of the pandemic’s severity. According to the United Nations Office for the Coordination of Humanitarian Affairs, Venezuela is testing anywhere between 2,100 and 2,600 people a day, compared to 25,000 to 35,000 in Colombia.
As of 14 June, Maduro’s government had registered just 2,764 deaths in Venezuela, which is low in comparison to the numbers reported by its neighbours. Colombia had recorded 95,000 deaths by that same date, Ecuador 21,000 and Peru 187,000.
“Cases and deaths are underreported and even misclassified,” said Dr Julio Castro, an infectious disease expert who advises Venezuela’s political opposition and is part of a joint government-opposition task force created to coordinate the country’s pandemic response. Castro, who monitors hospitals across Venezuela through the nationwide physicians’ network Médicos por la Salud, notes that this organization has found that the weekly coronavirus death toll compiled by the government omits patients who weren’t tested or whose results did not arrive on time. An unpublished report from 23 May states that 6,996 people had died from influenza-like illness, while official data had reported 2,499 COVID deaths by then.
Even so, he says, “the real number of cases per 100,000 people in Venezuela is certainly lower than in countries like Colombia, Peru and Chile”. Venezuela’s situation, said Castro, can’t be compared to the horrors of Ecuador, where bodies piled up in the streets of the largest city, Guayaquil. And it’s not like Chile, where military planes transported COVID patients to other cities because hospitals in Santiago had collapsed. “There is no doubt that the magnitude (of the pandemic) has been lesser in Venezuela for various reasons.”
One of these, ironically, is the parlous state of the Venezuelan economy and its failure to provide efficient public transport. “A way to control the outbreak is to limit fuel supplies,” said Castro. “I don’t think Maduro voluntarily controlled the spread of COVID-19. The pandemic’s impact has been reduced by fuel shortages and hyperinflation, which are unique conditions from a regional viewpoint. Life has become something similar to places in Sub-Saharan Africa. People only go to supermarkets to buy essential food and rarely go to restaurants, clubs or cinemas, which are the sort of venues that generate more transmission.”
The pace of COVID testing was extraordinarily slow
But the Maduro administration has continued to promote misleading coronavirus-related theories. In January, Maduro falsely suggested that a thyme and oregano drug known as Carvativir was a cure for COVID-19, leading Facebook to suspend his account, according to Reuters.
There have been other grand claims too. In 2020, Maduro said that 4,500 intensive care unit (ICU) beds were available across Venezuela. A former information minister said the figure was nearer a thousand, but Castro calls both sets of numbers into question. “We have 450 ICU beds: 250 in the public health system and 200 in private clinics,” he said.
Add to that the country’s centralized and inefficient testing and vaccination programmes and many fear a public health crisis. The national testing scheme relies on two Caracas laboratories to verify tests from everywhere in the country but both are said to be overwhelmed and there can be a wait of days or even weeks for results.
The political opposition, led by Juan Guaidó who was recognised as Venezuela’s interim president in 2019 by roughly 60 Western and Latin American countries, says more needs to be done. Guaidó and his aides control access to Venezuelan’s frozen assets in foreign banks and last year, the opposition committed roughly $12m from the frozen funds to purchase medical supplies, PPE and 340,000 rapid antigen tests. The Maduro administration promised to send the tests, which could cover 8,000 to 10,000 people a day, to hospitals across Venezuela’s 23 states, but they wound up in regional laboratories. “Patients go to hospitals,” points out Castro.
The pace of testing was also extraordinarily slow. In March, the Pan-American Health Organization (PAHO) announced that only 21,583 rapid antigen tests had been used. “They did, in three months, what a health system operating normally would have done in three days,” said Castro. Meanwhile, government data continues to exclude results from certain private laboratories that offer PCR tests for up to $100. “We have the worst of both worlds,” said Castro. “PCR tests are now part of an obscure, privately run business that doesn’t contribute to the national tally of infections.”
The state can now use the Carnet de la Patria to choose who is eligible for a jab. That’s the fear of many people
The administration’s missteps are especially stark in the lack of a coherent vaccination plan. Vice-president Delcy Rodríguez said Venezuela would not accept the AstraZeneca vaccine even though it had been cleared for use by both the World Health Organization and the European Medicines Agency. PAHO had previously said that at least 1.4 million AstraZeneca doses had been reserved for Venezuela via COVAX, the global vaccine initiative for low-income countries.
The arrival of the first COVAX shipment continues to be delayed, while opposition members of the joint government-opposition pandemic task force say Venezuela’s vaccination drive should take help from schools, universities, sports clubs, churches and pharmacies. In a normal year, the country vaccinates four million children, they say, and it cannot inoculate an extra 20 million people without a concerted effort by every institution.
But the administration has already rejected a plan from Fedecámaras, Venezuela’s largest corporate group, to vaccinate private sector employees and their families for free. Vaccination has already become a black market operation, says Mendoza, the student councillor. “If you know the right person, you can get a Sputnik jab for $300 or a Sinopharm for $150.”
In April, the vaccine rollout became politicized when jabs were restricted to holders of the Carnet de la Patria, the five-year-old identity document used to condition access to food programs, fuel subsidies and welfare payments. “The state can now use the Carnet de la Patria to choose who is eligible for a jab. That’s the fear of many people,” Mendoza said.
A pilot vaccination scheme launched by a Caracas municipal mayor required elderly people to be cardholders. Recent weeks have seen citizens turned away after hours queuing for a vaccine because doses have run out. “It is extremely hard to prevent vaccines and medical supplies from becoming part of a corruption network unless a massive and properly coordinated vaccination plan is implemented,” said Feliciano Reyna, a human rights activist and NGO leader.In conjunction with PAHO and the Global Fund to Fight AIDS, Tuberculosis and Malaria, local NGOs have monitored the distribution of antiretroviral drugs in Venezuela from 2018. The tracking mechanism requires the health ministry to send information on budgets, quantities and shipment destinations, to PAHO and the Venezuelan Network of Positive People.
“We convinced the Global Fund to implement this mechanism in 2018, amid shortages of HIV medicines,” said Reyna. “It’s not a super structure, though hopefully we can replicate this model to monitor the distribution of COVAX vaccines. But progress has been slow.”
The country’s main opposition parties are outlawed, their prominent leaders either imprisoned, banished or banned from running for office
Reyna and other civil society actors have been pushing the government to cooperate in different areas through a non-partisan umbrella group Foro Cívico (FC). Two opposition members nominated by FC were recently appointed to the governing board of Venezuela’s electoral authority. Though welcome, that’s only a small step forward and analysts say that Maduro needs to agree to several other concessions if there are to be long-term changes in Venezuela.
In November, government officials and Reyna and other activists were set to establish a working group to implement the UN’s Humanitarian Response Plan. But talks stalled early this year after police raided the offices of Azul Positivo, an NGO that serves as a key partner to the UN’s refugee and HIV/AIDS agencies. Six activists were detained.
“We still want the government to sign the memo of understanding and create the working group,” said Reyna, admitting that there are many moving parts before it can happen. On paper, the working group would improve aid delivery, especially for communities in the south of the country, where armed groups have tightened their grip during the pandemic.
But Venezuela needs more than just a government-NGO working group on aid delivery. The country’s main opposition parties are outlawed, their prominent leaders either imprisoned, banished or banned from running for office. Meanwhile, the government continues to use various legal instruments to persecute human rights activists and harass NGOs.
A recent ruling requires civil society organizations to reveal funding sources and alliances. In March, UN human rights chief Michelle Bachelet said her office had “documented at least 66 cases of intimidation, harassment, disqualification and criminalization of journalists, media outlets, human rights defenders, humanitarian workers, union leaders and members or supporters of the opposition” since September 2020. “Some people think: ‘How can we sit and talk with these people, this government? It will lead to nothing!’” said Reyna. “Truth is, if we don’t take these steps, we will achieve nothing.”
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