Authors:
Prof. Dr. Agueda Muñoz del Carpio Toia | Peru
Prof. Emanuele Valenti | Instituto de Ética Clínica Francisco Vallés, Spain. University of Bristol School of Medicine, UK | Spain
Lucia Begazo Muñoz del Carpio | Universidad Católica de Santa María, Arequipa, Perú | Peru
Introduction: Since the beginning of COVID-19, governments have faced the challenge on two fronts: in the front line and then at the public health level. Methods: Qualitative study to determine the perceptions of key social actors, on the factors associated with the shortage and ineffective public health measures to prevent the contagion and collapse of hospitals in Latin America, normative review and ethical analysis. Outcome: Factors before the pandemic: low investment in health, segmented health services, poor public health management, social determinants that lead to health inequities, especially in rural areas, jungle and regions far from large cities, where there are high levels of inequity and injustice. Factors during the pandemic: Lack of effective public health programs with intercultural adaptation, lack of intersectoral coordination, people facing cultural and economic barriers in accessing health care, people with working or living conditions that lead to prioritize their economic survival, over their lives or vulnerability of their relatives and elderly people. Social and economic support programs that do not reach the poorest. Lack of contact tracing in the community. Conclusion: Governments made fundamental decisions such as social isolation, protection of vulnerable people and generalized use of masks, to attenuate the contagion while waiting for effective treatment or vaccines, they prepared the health services for the massive hospital care of critical patients; however, on this path full of urgent needs, they neglected public health, which is responsible for ensuring the common benefit, eliminating inequities, preventing neglect of other diseases, and promoting social justice.