Travel Plans to Mexico? An Update on the Other Corona Situation South of the Border

President Trump’s calls to “Build the Wall” have never sounded more hollow than when he recently claimed that this was a viable tool against the spreading Coronavirus. The virus knows no borders and needs no passport. There are also vastly more confirmed cases in the United States than in Mexico—20,000 and growing compared to just over 100 in Mexico. While the relative lack of testing in Mexico could suggest their numbers are higher, the lack of any deaths so far and the country’s relatively young population deserves some optimism. On the other hand, the Mexican President’s apparent disregard of the risks—holding large rallies where he hugs supporters and kisses babies—and problems with the country’s new healthcare system raise some concerns. The following is a brief summary of the Coronavirus situation in Mexico and possible challenges ahead.

“Sana Distancia”

As of March 18, Mexico had nearly 100 confirmed cases of the virus compared to 10,000 in the United States. Some commentators worry that because of the significant commercial and cultural links between the United States and Mexico, a spike in cases south of the border is likely. Andrew Selee, President of the Migration Policy Institute and author of the book Vanishing Frontiers told Forbes that “the multiple links between border communities, family networks, commercial flows, and industries manufacturing together across the border means that there is no easy way to stop transmission between the two countries.”

Mexico is also approaching high tourist season, which may result in additional infections if a significant number of visitors move forward with their travel plans. Last year, Mexico received 48.8 million visitors by airline. Just during January of 2020, Mexico received 1.9 million passengers on U.S. airlines and 277,497 passengers on European airlines.

Experts also suspect that the actual number of cases could be much higher as testing has been limited. Mexico's Deputy Health Minister Hugo Lopez-Gatell said Mexico is approaching an "inflection point", when the virus begins to spread widely, requiring more aggressive containment measures.

"The spread of the disease is something that is inevitable," said Lopez-Gatell.

Only a few hundred tests have been performed nationwide in Mexico, and testing has been restricted to people who have travelled to a high-risk country and to those who have been in contact with a confirmed case.

The country has also been slower to adopt aggressive containment measures, but has recently followed the lead of other countries by suspending nonessential activities like conferences. They urged people to work from home and expanded Semana Santa (“Holy Week”) for students from two weeks to a full month beginning last Friday.

The health ministry recently unveiled the "Sana Distancia" (or "Healthy Distancing") initiative, urging the public to avoid intimate contact like cheek kissing, a customary greeting in Mexico.

Unfortunately, one of the persons not following Sana Distancia is Mexican President Andres Manuel Loprez Obrador (“AMLO”).

"Imagine if I were to come here wearing a mask, if the president is like this, how are the people going to be? I have to keep the people's spirits up," AMLO said at a Monday news conference.

Last weekend, he posted a video at a rally in the State of Guerrero showing him posing for photos, shaking hands, and hugging and kissing dozens of supporters.

"Leaving the hotel in Ometepec, I greeted and attended to the petitions of the people," AMLO tweeted. Sound familiar?

Despite the President’s nonchalance, much of the population in Mexico is not following this example and instead practicing a similar degree of Sana Distancia as in the United States. People I have spoken with spanning from Jalisco to Tabasco say that people are nervous, mercados are closed, and shelves are empty. Like everywhere else, working people are waiting it out and hoping for the best.

Mexico’s Healthcare System

The biggest challenge in Mexico, as with the United States, is that the country would suffer a severe shortage of necessary equipment like beds and ventilators if cases surged past a critical point.

Alejandro Macias, a former commissioner who managed the H1N1 outbreak, told Al Jazeera: "We all know that if this epidemic intensifies, like it has in other parts of the world, Mexico does not have a sufficient number of intensive care unit beds, and those we do have are already occupied.”

"The government is aware of this problem and it may be the case that we are hiding our heads in the sand and praying that the spread will have little intensity like in other parts of the world," Macias said.

Another challenge is that much of Mexico’s population is dispersed in far-flung communities and mountainous regions in states like Tabasco, Chiapas, Oaxaca, and Guerrero. Many hospitals in those regions are small and ill-equipped to handle a major outbreak. Despite its high number of hospitals, Mexico has just 1.3 hospital beds per 1,000 residents. Italy’s rate is more than double. Another challenge is that 56% of Mexico’s workers are employed in the informal economy, and it may not be an option for them to simply stay home and self-quarantine.

These problems are not new, but they have been exacerbated by AMLO’s policies budget cuts to the healthcare system in an effort to promote austerity and rollout a new federal health system. 50 million Mexicans depend on coverage through a state-run insurance scheme, which AMLO has remodeled as the Instituto de Salud para el Bienestar (“INSABI”). The rollout of the new system has already been marked by service disruptions and delays in enacting regulation to govern the new system. INSABI’s director Juan Antonio Ferrer is the former head of Mexico’s anthropology institute and has no background in medicine.

Critics say that Mexico’s transitioning healthcare system will require a significant reallocation of resources for the country to effectively limit the impact of the Coronavirus.

“There's no budget. If we have 6,000 patients we won't have the resources,” Xavier Tello, a Mexican health policy consultant, told Americas Quarterly (“AQ”).

“It's a train wreck you see coming, and you can't stop it,” said Tony Payan, a Mexico scholar at the Baker Institute at Rice University, told AQ. “The INSABI system is nowhere near ready,” said Payan.

Side Note: Before the virus hit the United States earliest this year, Dr. Payan discussed the problems with Mexico’s healthcare system and pharmaceutical capacity at a recent Rice panel discussion that we summarized in a prior article.

Despite these challenges, Mexico’s healthcare system has relative benefits over other countries, including the United States. Mexico’s arsenal of 4,629 hospitals and health clinics equates to 37.5 facilities per million residents, and its per capita coverage is roughly the same as Germany (37.3) and nearly twice as high as the U.S. (17.1), Canada (19.7) and Italy (17.6).

Mexico also has an expansive network of over 31,000 pharmacies, over 22,000 of which have in-house doctors. If you have ever been sick in Mexico, you probably learned that the ease of going to a pharmacy and getting an adequate prescription from a doctor leaves much to be desired in the United States. The country also has several institutions with the capacity to test patients for coronavirus, including at least one specialized laboratory in each state, and the prestigious medical institute at the National Autonomous University of Mexico (“UNAM”).

Mexico’s population is also relatively young. Only 7% of Mexico’s population is over age 65, compared to almost 16% in the U.S. and nearly 23% in Italy.

Based on these positive factors, America Quarterly’s conclusion is that Mexico should be equipped to manage the virus under current circumstances, but the country will have a rough road ahead if there is a significant spike in cases and hospitalizations.

So Should I Cancel My Trip?

You may not have a choice. Representatives of both countries recently imposed nonessential travel restrictions that allow exceptions for commercial activity and essential services like healthcare. “If someone is coming for recreation purposes, that’s one thing,” U.S. Representative Henry Cuellar (Tx. 28) told Reuters. “But you have people who come over to work or go over to buy food and medicines. Those we would consider essential and they’re trying to work on that.”

For permitted types of travel, people must constantly stay informed and evaluate their trip on a case-by-case basis. Mexico is an important economic partner that was already on rocky waters before “Coronavirus” became a household word. Camino Aztlan believes that the significant economic toll of the virus requires that we be conscious of the businesses that are hurting, including those of our southern neighbors, and try to find creative ways to keep some activity afloat while people ride out the storm.

If you have to postpone or cancel an existing reservation, Airlines like United and Jet Blue are waiving change fees for the near future, though it may be an ordeal to get a representative on the phone. In the new post-Coronavirus world, travel insurance may also be something to add to the travel checklist.

There are no doubt rough times ahead on both sides of the border. Fortunately, both countries and their people are resilient and will overcome this crisis as they have all others in the past. Please subscribe to our newsletter below to stay informed about future developments.