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The preparedness of the Colombian healthcare system for the COVID-19 pandemic appear good compared to other countries in Latin America. Since 1993, Colombia’s health system has undergone positive development and is now one of the best in the world in terms of coverage. 96.6% of the Colombian population has health insurance.1 Nevertheless, there are challenges in the Colombian health system which could have a negative impact on the management of the corona pandemic. For example, an important indicator for coping with the pandemic is the number of beds in hospitals.2 In Colombia there are 1.5 beds per 1000 inhabitants 3, which is below the OECD average.4 Because of this shortage, there is a need to contain the spread of the virus so that the health system is not overburdened.
The first COVID-19 case was reported on March 6 in Colombia.5 Since then, Colombia has seen an exponential increase in confirmed cases, with 3,429 cases confirmed as of April 18. The cases are very concentrated in the large cities of Bogotá (1,493 cases), Cali (481 cases), Medellin (215 cases) and Cartagena (173 cases). So far (April 18) no case has been confirmed in the Amazon region. After the government of Colombia waited to declare a state of emergency and quarantine, governments on the subnational level started to implement regulations. Bogotá, for example, announced a simulation of the lockdown on 17 March, which was carried out on 20th through to 23rd of March. At that time there were already 65 confirmed cases in Colombia.
On 20th March, President Iván Duque announced that from 24th March onwards the country would be subject to compulsory isolation.6 On March 20th, Colombia reported 145 cases of the coronavirus. The Colombian government is trying to support the poorer parts of the population with various forms of financial assistance. For example, the government ensures that school meals can be distributed to the children on some days of the week despite school closures. Financial support as payments of regulated sums of money are also provided.7
In addition to the orders of the president, some municipalities and cities are introducing further orders to try to contain the virus. These include the order ‘Pico y cedula’ (peak and ID), which was introduced in several cities.8 In this arrangement the number on a person’s ID number is used to determine which day of the week a person can go shopping. In addition to ‘pico y cedula’, the city of Cali has introduced ‘Pico y placa (peak and plate), which reduces traffic using a similar system.9 The last license plate number determines on which day a car is allowed to drive in the city.
Even if the government of the country and the individual cities try to slow down the spread of the virus with regulations, some problems may still occur. The first problem relates to compliance and enforcement. In Cali, the number of fines, as of the 6th of April, was 4,028.10 Given the number of penalties, it is questionable how effectively the established rules are being enforced. In addition, the state has introduced a decree, which obligates all human talent in health in practice or in training to be prepared and available for a call to service.11 This is contradictory on the part of the medical staff, as they (in some hospitals/areas) neither receive their payment nor are sufficiently protective equipment available. In the social media there are voices based on media reports accusing the state of not conducting enough tests, compared to other countries in Latin America.12 Another major problem is the increase in domestic violence since the introduction of quarantine.
In summary, it can be concluded that the enforcement and implementation of the mandatory regulations concerning the coronavirus can become difficult to implement over a long period of time. On the one hand, a large number of imposed penalties are already being reported. On the other hand, it must be considered that Colombia is still affected by corruption 13, which could lead to a high number of unpunished infringements. But also, on the part of the population, which will keep to the regulations, there are voices demanding more tests and medical material from the president. To ensure the supply of medical goods, the president announced that the industry should focus on the production of these materials, but this did not come into effect until April 13.14