The plaza in the historic center of Iztapalapa, in Mexico City, is divided in two. On the one hand, an endless line of people wait patiently for a free coronavirus test in one of the tents set up by the emergency caused by hospitals on the brink of collapse. The long queue, a vivid reflection of the incidence of the virus in the capital, goes around the square as medical personnel rush to perform nasal scrapes. At the other extreme, a smaller tent has not yet opened its doors, but dozens of people await the arrival of trucks of free oxygen supplied by the local government in the cold. This row is also a reflection of the enormous need for gas in Mexico. Patients resort to its submerged market, since, despite the fact that several stores have opened to meet the demand, the high cost of treatment and its shortage of supplies push them to resort to equipment loans between families and personal contacts.
Diego Ortega has been there since 7:00 in the morning, two hours before the distribution of the product begins, to be one of the 50 lucky daily that receive the possibility of recharging the tank for free. He takes turns with his aunt to stand in line and collect oxygen for his mother, whom he believes he infected himself after catching it at work. “I spent 4,000 pesos ($ 200) on the first day of his diagnosis on the doctor, medicines and the oxygen tank. Then it was 1,000 more pesos (50 dollars) in recharges and now I have had to quit my two jobs to be able to come to train, ”he narrates while trying to warm his hands. He, along with thousands of Mexicans, participate in the submerged market of this scarce, but essential drug for those who become seriously ill from covid-19 and decide to treat themselves at home.
With the capital’s hospitals touching 90% of their capacity, the possibility of finding an available bed is scarce. The saturation has forced many patients to knock on various doors for assistance. Many are turned away at the entrance of the clinics. This is added to the negative public perception of the treatments in hospitals, which are prioritizing seriously ill people in the admission process. Consequently, patients fear that they will never see their relatives again and spend the last hours alone.
Companies that sell oxygen have noticed this situation firsthand. Patients being treated at home, whether forced by hospital collapse or fear, have skyrocketed the market for buying and selling the gas that helps lungs damaged by the virus. The growing demand in recent months has led to the opening of several distribution stores near hospitals. At the gates of the National Institute of Respiratory Diseases (INER), south of the capital, some employees conveniently distribute business cards at the emergency exit. The enormous need for gas has led to a shortage of the equipment required to use it. Both the rental and the purchase of the tanks is increasingly difficult, the concentrators that generate the gas are no longer available and the oximeters to measure the saturation of oxygen in blood have disappeared from the establishments, according to users.
The Ortega family was lucky. When Diego’s mother tested positive, they began a pilgrimage through the city’s stores to get a tank and a refill. “We borrowed one because we couldn’t even find one to rent,” explains Verónica Ortega, Diego’s aunt. With a lot of fatigue in his eyes, he explains that he has spent so many mornings formed in the free recharging queues that he already knows the operation and the rules by heart: you must take the positive test that shows covid, they do not allow large tanks to be recharged and when they have already filled in 50 teams is finished and they are gone. That is why it is important to arrive early. “I have to provide for my family, it is very hard because being here I have to leave my children and it has been weeks since I can be with them,” he says between the tears caused by having spent the day of Kings in the queue without his family. The tank that you can fill should make it run for three hours. He will take it to his sister and then his nephew will take the opportunity to take the spare to recharge, so his mother will never be disconnected. Each team takes 30 to 40 minutes to fill up, so they can be formed up to nine hours. Despite the severity of the patient, they never considered taking her to a public medical center and opted for a private doctor. “We don’t trust the free service so much, people are dying there,” he says.
The lethality of the virus in Mexico is around 6% of positive cases and about 90% of registered deaths have been in hospitals. Christopher Pegueros, a surgeon specialized in intensive care, has witnessed this in several specialty hospitals. Pegueros has several private patients in addition to his work in medical centers. Patients send photos of the oximeters to corroborate their condition, some saturate 35% (95% is the limit of healthy and below 85% hospitalization is necessary). The doctor indicates that many patients need oxygen at home because they cannot find beds in hospitals. Some have tried as many as 10 centers before reaching their hands. “A lady called me because her husband was so sick that he couldn’t even detect the oximeter and I told him that he had to go directly to the hospital. He couldn’t find a place and he called me back. I thought that by then the man would have already died, but I got to his house and was able to treat him with oxygen and medicine, ”he says. He has not slept for days between shifts at the hospital and his private patients.
Jessica Slim is a young woman who had to resort to private services as well. “It all started with me, unfortunately I infected my father,” he laments. Despite avoiding meetings and parties, he caught it at work. Living with his parents, he believes that he was able to bring him home. His father became seriously ill, but they could not afford to admit him to a private hospital, which would ask for a deposit of half a million pesos ($ 25,000), and distrusted the public. “We thought it was worse because our doctor told us that they only admitted you to emergency tubes,” he details. With home health care, he got a tank thanks to an acquaintance with contacts at an Infra store. This company is the government’s main oxygen supplier and, along with the other gas distributors, was investigated by the Federal Commission for Economic Competition, the country’s antitrust body, for alleged abusive practices. In December, the Federal Consumer Protection Agency (Profeco) closed 16 establishments that violated the law by selling at inflated prices during the pandemic.
Finally, the Slim family’s bill came to 90,000 pesos ($ 4,450) between equipment, refills, medicines and private assistance. “We thought about asking the bank for a loan like many do, but finally with the help of my brothers we were able to face it,” she says relieved. However, his father has yet to heal and the bill continues to grow.
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