The Chilean contradiction: Why doesn't the success of the vaccination stop the pandemic?

Something does not add up. At an impressive rate since the beginning of February, Chile has inoculated almost 30% of its population with one dose and 15% with both. The achievement of reaching one of the first places in the world ranking of vaccinated by population It is celebrated by the government of Sebastián Piñera and highlighted by the international press. And Chileans are excited about the idea of ​​starting to leave the coronavirus behind.

Despite this success, the numbers of infections, hospitalizations and deaths show a completely different reality. The country not only has one of the highest death rates from COVID in Latin America -more than 1500 deaths per million inhabitants, with a total of almost 30 thousand deaths-, but registers the highest number of active cases so far since the pandemic and a worrying upward trend.

Last Saturday marked the record of daily infections -7084 new cases- and every day an average of 100 people die: one deceased every 15 minutes. With the overflowing hospitals, the occupancy of critical beds close to 95% and the health personnel to the limit, the panorama worsens. In the last week, Chile was the third country with the highest number of new cases per inhabitant in Latin America, after Uruguay and Brazil, according to figures from Our World in Data.

"We haven't reached the peak yet. There is an increase in hospitalized in ICU, many seriously ill. The numbers of deaths, which were relatively stable, began to rise last week and infections continue to rise”, Says to DW Ernesto Laval, engineer doctorate in education and specialist in data communication.

"We are living the worst and this will continue", warns Dr. Muriel Ramírez, specialist in public health and epidemiology, and academic at the Faculty of Medicine of the Universidad Católica del Norte, consulted by DW. Experts fear a collapse of the healthcare system. The current increase in infections could impact the healthcare network this week. According to the Health Minister there would only be beds until Wednesday.


New patients entering mechanical ventilation are getting younger and younger. At the peak of the first wave it was also like that and it is still too early to assume an effect of the vaccine, which began with health personnel, the elderly and patients with underlying diseases.

"Vaccine coverage so far is still partial”, Alerts Dr. Ramírez. Protection is not immediate either. The highest immunity is reached after two weeks of laying the second dose, which for the first inoculated is only now happening.

But also success – and failure – has to do with the epidemiological situation and containment measures. "Vaccines are not the only tool for controlling the epidemic. They are one more tool, which prevents serious disease, but not transmission. Viruses keep circulating”, Says the expert.

"Experts and studies indicate that vaccination alone is not enough. It is a strategy that must be added to others. It is also very important to continue with measures to contain the pandemic”, Confirms Laval. An article in The Lancet magazine, with models for the UK, confirms that If the strategy is based only on vaccination, the pandemic will continue to expand.

Even before vaccination began, the government began to relax measures. Appealing to mental health and seeking to reactivate the economy, he gave vacation permits that left a trail of infections in the most visited areas. The shopping centers continued to operate, the casinos opened and in March the return to classes generated sources of contagion, to which was added the difficult distance in public transport.

The> The first wave was never completely lowered and, as a result of the holidays, the cases multiplied. And while Israel maintained containment measures alongside its successful vaccination, Chile did the opposite.

The new variants also arrived, observes Dr. Ramírez: "Unfortunately, the government did not close the borders and this allowed the most dangerous variants of Europe and Brazil to enter, which could explain the rise in recent weeks”.

From overconfidence to triumphalism

Chile began vaccinating with a small batch of Pfizer-BioNTtech in December, but the massive campaign started with CoronaVac, from the Sinovac laboratory, with which it has an agreement for 10 million doses. The rapid acquisition was possible thanks to efforts by the Catholic University (PUC) to carry out the phase three study, to which the Confederation of Production and Commerce (CPC) contributed 1.6 billion pesos (1.8 million euros).

Chile authorized the emergency use of CoronaVac on January 20 and began to inoculate on February 3. Before China even approved it for use in their own country. There, unlike Chile, it is only authorized for people under 60 years of age.

Thanks to the State's primary health network, the country has been able to vaccinate at record speed. But success has put the need to maintain preventive measures in the background. "The strategy of having the vaccine has been spectacular, but let's look at the results, at the number of people who are suffering and dying. We had all the signs, it was appropriate to say that this is serious, so that personal measures are taken. From a health point of view, it is totally counterproductive to convey a message of success”Says Laval.

The vaccine would prevent a serious disease and with it the risk of dying, but not completely the contagions. The Sinovac laboratory has not yet published the final phase three study indicating the effectiveness of its vaccine. The most recent information provided by the PUC indicates that, after two doses, antibodies were found in 90% of those inoculated, but it is not known at what level. According to preliminary reports, in Brazil it would have registered an efficiency of 50% and in Turkey of 83%.

At the current rate, Chile should have 70% of its population fully vaccinated in 67 days, according to the Time to Herd site. But depending on the efficacy of the vaccine and current contagion levels, the long-awaited herd immunity could be delayed. "There are still unknowns about how the vaccine that we are applying in Chile is going to behave and there is a lack of surveillance of new variantsLaval observes.


"We are with a very high ICU occupancy level, many patients under 60 years of age are arriving. At this rate, critical patient units can become saturated and mortality can increase.”, He warns Laval. They are the highest levels of the entire pandemic: 2,200 patients Covid-19 in ICU and there are less than 200 critical beds available nationwide.

Doctors call for extreme care, because not only are the beds running out, but the human capacity for attention is reaching the limit.

The situation also puts in check the holding of the next elections on April 11, in which Chile elects members of the unprecedented Constituent Convention, mayors, councilors and governors. As a first step, it was decided to carry out the process in two days, but voices arise calling for its postponement to ensure sanitary conditions and greater participation.

Risk of a possible Chilean variant

Experts emphasize that there are no immediate effects and that today's actions – confinement and vaccination – will be seen in weeks. For its part, the government is putting more communes in quarantine and finally ordered control and isolation measures for travelers entering from abroad. It also proposes to recruit health personnel from students and retired doctors.

"I am very concerned about the situation. At the same time that it is being vaccinated, we have a very large increase in infections and that combination is not good, because it makes the viruses tend to defend themselves and mutate. I would not be surprised if the situation continues like this we can have a Chilean variant”, Alerts Dr. Ramírez.

"There is a large success that the vaccine is the only solution and it is not. This will be controlled with public health measures and even beyond, which have to do with an improvement in the quality of life of people, because it affects more those who live in overcrowding, poverty or malnutrition. There must be a more social outlook on how to face the epidemic and not just biomedical”, Proposes the specialist.

Consulted by DW, Dr. Sandra Cortés, health-care worker and academic from the Faculty of Medicine of the Catholic University, agrees: "If we put all our hopes only in the vaccine, we are going to go through successive vaccination campaigns of very high cost. The strategy cannot rest only on this pillar, it must be based on cutting off the transmission chain and with comprehensive social and economic measures”.

The specialist draws attention to how the high number of deaths has been normalized and the need to take into account the impact on the population: "We will have people with sequels, even disabling, and an aggravated mental health crisis, also in the families of the health teams. Many have gone months without seeing their parents or children”.

"Our task is to educate, that they know what we have learned and where we have failed. We are a country that has resources to spend on this, but an unequal country. Public health shows that prevention and containment is cheaper and saves lives”, Emphasizes Dra. Cortés.

"The case of Chile will be in the sights of many countries that also have the hope that vaccination can be the silver bullet that allows us to get out of the crossroads we are at”, Points Laval. The measures put in place by the government and personal commitment will be key to correct the course.