C-19 Global South Observatory

COLOMBIA

Information last updated: May 29, 2020

  • Total population: 49 M
  • Population +65 yo: 8%
  • GDP Per Capita: 14,834 USD
  • Informal employment: 57% (2018)
  • First registered case: 6 March
  • Hospital beds: 5.80 (per 1,000 people)

Sources: TheWorld Bank and WHO  (Population over 65 years old, Informal employment, GDP-PPP, Hospital beds).

Status

The National Quarantine was prolonged until May 31 (in March 24, the government had first established the deadline until May 11). Following this date, the country seeks to start a gradual process of economic reactivation. The Health Emergency, however, has been extended until August 31. 

Response set up and capacity

The Ministry of Health is the primary institution in charge of responding to the Coronavirus outspread in Colombia, particularly with respect to coordinating health and safety protocols for health-care providers in Colombia (including IPS and EPS). They are in charge of creating and shaping the country’s response and establishing different guidelines and mandates that decentralized and local entities ought to follow (for example, how to report and track cases). Additional entities involved in the emergency and health response include the National Institute for Health (INS) and the National Committee for Emergencies. 

The President remains the focal point for coordinating all health and public order decisions in the country. Notably, mayors and local governors have taken measures applicable to each of their jurisdictions ranging from curfews to complete quarantine measures; yet, in a special decree issued by the Ministry of the Interior, the national government mandated the centralization of all actions and decisions regarding COVID-19, establishing the central government as the sole authority to put these measures in place. Furthermore, these resolutions establish that all actions that Mayors or Governors want to put in place must be consulted and approved by the president first. Since early mid-March, most decisions are centralized and made by the President. 

Stakeholder Mapping

Entities / Organizations

• Ministerio de Salud y Protección Social
• Instituto Nacional de Salud
• Entidades Prestadoras de Salud
• Puesto de Mando Unificado (PMU)
• Instituciones Prestadoras de Salud
• Centro Nacional de Enlace
• Sistema de Vigilancia en Salud Pública

Additional actors

• President of Colombia - Iván Duque
• Minister of Health - Fernando Ruiz Gómez
• Martha Ospina - Director of INS

According to the Colombian Association of Intensive Care, there are 5,349 ICU beds in the country, and only 150 that comply with air filter and isolation requirements. According to the Ministry of Health, in 2018 there were 84,556 hospital beds, from which 39,961 are for adult care, 10,057 for pediatrics, 7,543 for OB GYN and 5,684 for intensive care. However, in several meetings of the coordination committee, the number of beds available for intensive and intermediate care amount to 13,572. 

Mayors are already taking different measures to expand these capacities, particularly in Medellín and Bogotá. 

Mitigating factors - What is being done?

The most important measures taken in the country (at a national level) up to now include the declaration of a Sanitary Emergency, closing all of the country’s borders and declaring a nation-wide quarantine effective from March 24 to April 13. The current quarantine measures include mandatory isolation, but allows one family member to purchase food and medicine, and allows essential staff to continue moving around cities – these include health workers, grocery store workers, amongst others. Public transportation will keep functioning to transport individuals with permission during the isolation period. 

For more information, see the timeline below. 

Risks, vulnerabilities, obstacles

  • Various sources have different projections of what Colombia’s development of Covid-19 will be. In what seems to be the worst case scenario, estimated by Felipe Lobelo epidemiologist and professor at Emory University, the country will have around 8,000 deaths due to the virus. This projections drastically differ from those of the INS – they calculate that 4 million people will be infected, from which 3,000 will die. Specifically, government projections estimate that from those 4 million people, patients with mild cases will account for 81% of the population, critically-ill patients for 4.7%, and  (13.8%) with severe involvement. Even based on official projections, Colombia at the moment does not have the necessary infrastructure to attend the estimated volume of patients;  the country will need, as a bare minimum, to expand its adultive intensive care unit capacity by 10%. Another pressing challenge in the effectiveness of the government’s response is its constrained capacity to process Covid-19 tests. Per day, the INS can only process 1,600 tests daily (more capacity is being developed in departmental public health laboratories of Antioquia, Valle del Cauca and Bogotá). 
  • Protests have erupted in cities across the country, where individuals are taking the streets against the isolation measures put in place by the national government. According to these individuals, they are yet to receive the aid and subsidies promised by the government. The economic outlook of the country makes these measures unsustainable, according to the President of Fedesarrollo. Colombians are facing a grim economic outlook – growth projections have been reduced from 4.5% to 2%, and GDP could even contract by -0.4% this year. Private consumption is expected to drop by 20% and unemployment may rise from 13% to 19.5% if the economy does not grow this year . 
  • Prison riots have been reported in several of the countries’ prisons, due to concerns over poor health services and overcrowding during the outbreak.
  • Colombia’s 1.4 million Venezuelan migrant and refugee population are one of the country’s most vulnerable populations. Facing rising unemployment and lack of income from jobs in the informal economy, many are facing eviction and lack health care coverage if they were to . It is unsure whether Venezuelan migrants without bank accounts or legal temporary residence in the country may be eligible for government aid. 

Potential actions and demands

  • The looming possibility of expanding the national quarantine measures beyond April 13, have reignited debate in the country over the feasibility of such measures for a country like Colombia. Even with increased subsidies for certain parts of the population, having to provide additional aid to over 10 million households is seemingly impossible and unsustainable, according to president of Fedesarrollo. Mayor Claudia Lopez recently announced the possibility of three more months of quarantine – her posture, backed by the Panamerican Health Organizations (OPS) was deemed ‘uninformed’ and inappropriate.  
  • Protests have erupted in cities across the country, where individuals are taking the streets against the isolation measures put in place by the national government. According to these individuals, they are yet to receive the aid and subsidies promised by the government. The economic outlook of the country makes these measures unsustainable, according to the President of Fedesarrollo. Colombians are facing a grim economic outlook – growth projections have been reduced from 4.5% to 2%, and GDP could even contract by -0.4% this year. Private consumption is expected to drop by 20% and unemployment may rise from 13% to 19.5% if the economy does not grow this year . 
  • Prison riots have been reported in several of the countries’ prisons, due to concerns over poor health services and overcrowding during the outbreak.
  • Colombia’s 1.4 million Venezuelan migrant and refugee populations are one of the country’s most vulnerable. Facing rising unemployment and lack of income from jobs in the informal economy, many are facing eviction and lack health care coverage if they were to . It is unsure whether Venezuelan migrants without bank accounts or legal temporary residence in the country may be eligible for government aid. 

Key resources

Contributor(s): María Antonia Bravo.

The C-19 Global South Observatory is a collaboration between