Today is the last class in our current four class set. We will begin with a casual conversation. Our material today is about covid in Peru. Please listen and follow the transcript.
NOEL KING, HOST:
Peru has the highest per capita death rate from COVID of any country in the world. But could an isolated Peruvian city on the Amazon River avoid the worst of the virus because of its remoteness? NPR's Jason Beaubien went there, and he brought us this.
JASON BEAUBIEN, BYLINE: People in Iquitos refer to the city as una isla, an island, even though it's not an island. Iquitos is a bustling port city of roughly 400,000 people on the Amazon River, but there's no road to Iquitos. You can only get there by boat or by plane. In the early days of the COVID pandemic, being an island seemed like an advantage. It might delay the arrival of the virus. It might make it easier to contain.
RAYMOND PORTELLI: We were hearing news about the pandemic in other countries.
BEAUBIEN: That's Raymond Portelli, a Catholic priest from Malta who's been in Iquitos for the last 25 years.
PORTELLI: But sincerely, we thought it wasn't going to be that disastrous, and it wasn't going to come to Iquitos.
BEAUBIEN: Padre Raymundo, as he's known, is also a doctor. He runs a small medical clinic six days a week on the ground floor of his church.
PORTELLI: The first patients started rolling in around March.
BEAUBIEN: By mid-April, the number of cases in the city had, in his words, exploded. And his early confidence that COVID wasn't going to be too disastrous in Iquitos evaporated.
PORTELLI: Officially, they were saying around 30, 40 deaths a day. But really, there were days where they were on 70 deaths a day for COVID.
BEAUBIEN: The campus of the main public hospital in Iquitos was overflowing with COVID patients. The facility only had seven ICU beds. Soon, all the other wards, even the hallways, were filled with the sick. Some people were lying on cots, some on cardboard on the floor. A nationwide lockdown grounded flights, blocking shipments even of medical supplies, forcing hospital staff to reuse masks for a week in the tropical heat. And then things got even worse. The sole medical oxygen plant for the province had been running 24/7 to try to meet the insatiable demand. In early May, the oxygen bottling plant broke down. Dr. Juan Carlos Celis Salinas is the head of infectious diseases at the Loreto Regional Hospital. He says it was the darkest moment of the pandemic.
JUAN CARLOS CELIS SALINAS: (Through interpreter) When a patient is without oxygen, they don't scream. They die as if a candle were being blown out.
BEAUBIEN: Without oxygen, Dr. Celis says all his staff could do was try to make the patients comfortable.
CELIS SALINAS: (Through interpreter) We weren't doing something heroic; we were just holding it together because we had to do our job. We felt responsible to be there but with immense fear for our children, our wives, our families.
BEAUBIEN: Meanwhile, Padre Raymundo Portelli was overseeing a church-run COVID isolation center. It was supposed to be for mild cases, but the number of patients kept growing, and they were getting significantly worse.
PORTELLI: Patients were dying there for lack of oxygen. And I was sitting here - I remember I said mass. I said mass for them. And I didn't know what to do.
BEAUBIEN: This lack of oxygen was one of the main reasons why COVID was so deadly in Peru. Mariana Leguia, an infectious disease expert at the Pontifical Catholic University of Peru, however, says the country's problems went far beyond just oxygen.
MARIANA LEGUIA: It's a combination of factors, sort of a perfect storm-type situation.
BEAUBIEN: As is the case for many middle-income countries, Peru, she says, is heavily dependent on imports for medical supplies.
LEGUIA: That means that all the PPE, all the tests - all the molecular tests, all the antibody tests - absolutely everything comes from someplace else. So we import all of this stuff. So at the beginning of the pandemic, it was basically impossible to compete for these things because everybody wanted them.
BEAUBIEN: And Peru didn't have the cash or the clout to compete with wealthy nations like Germany or Saudi Arabia for supplies. Given Peru's already precarious health care system, that lack of basic medical necessities made COVID even more lethal. In Iquitos, unclaimed bodies were piling up at the morgue. The crematorium had shut down. Doctors, nurses and medical technicians were getting sick. Families were desperately trying to get canisters of even industrial oxygen for their loved ones. An exasperated Padre Raymundo vented to a colleague in Lima that it had become impossible to get oxygen for his patients.
PORTELLI: He just told me, Raymond, you should bring an oxygen plant to Iquitos. And I told him, Doctor, how am I supposed to do that? It costs around half a million - no? - soles.
BEAUBIEN: The friend suggested that the priests should pass the plate, take up a collection. Padre Raymundo was skeptical, but figuring he had nothing to lose, he posted a request for donations on his Facebook page.
PORTELLI: And in one day, one day, there was a million soles in my - all of my accounts.
BEAUBIEN: A million Peruvian soles is about $250,000. He says an avalanche of donations came in from all over.
PORTELLI: Neighbors came with their 10 soles, which is like $2 or $3.
BEAUBIEN: Within two weeks, Padre Raymundo, working with the health department, secured an oxygen plant in Lima, had it flown to Iquitos. Eventually, he got four more plants shipped to the outpost in the Amazon, which helped turn the tide against the first wave of the pandemic. Still, COVID exacted a heavy price. Standing next to the new oxygen plant at the Loreto Regional Hospital, Dr. Celis says thanks to this and a new 150-bed field hospital, Iquitos is better prepared for a potential third wave of COVID. What his hospital now lacks, he says, is staff.
CELIS SALINAS: (Through interpreter) Among the hospital staff, many people have passed away. Some are exhausted. Others don't want to be in high-risk areas anymore. So instead of more health personnel, you have less.
BEAUBIEN: And that problem isn't just in Iquitos. Nationwide, Peru lost hundreds of doctors to COVID. The pandemic killed more than 200,000 people. And while things have improved, COVID has created new challenges for Peru's precarious health care system.
Jason Beaubien, NPR News, Iquitos.