Going Local in coronavirus: The Viral versus The Virus

In Colombia, coronavirus conspiracy theories are growing online. Is there an antidote?

A voice audio drops in my WhatsApp: “Dear friends and family, gather close to hear this important message”.

The voice is firm, female, confident, middle class with a touch of paisa accent, like honey on rust. Soothing. The message is anything but.

“Doctors called my mother to the clinic for asthma control, but they are looking to kill her for 30 million pesos. Please, stay away from hospitals. Never go to the doctor, watch out, they are injecting people with coronavirus to kill them.”

The voice continues calmly: “It’s all part of a plan to reduce the population. All over the world families have had to give their quota. Don’t let it happen to you.”

This perfectly produced fake news from a seemingly educated and articulate source is just a small part of a social media infestation that in some corners of Colombia has converted hero health staff into villains.

It’s called the Cartel de Covid and plugs into a wide range of genuine public fear and frustrations wrapped in culture war zeitgeist that somehow coronavirus is at best an invented crisis, at worst a murderous scam.

Find the flower arrangers

The narrative reached its zenith this month when a doctor in Soledad, Atlántico, was sent two funeral wreaths after a patient he was treating died of COVID-19. The doctor is now under protection and an investigation is underway to find the flower arrangers.

Meanwhile, the COVID-19 death scam trope keeps trending. Last week’s was a video of protestors outside a Bogotá clinic chanting “Here are doctors in the Cartel de Covid” organised by a bereaved family who said their “grandma went in fine but got coronavirus and died.”

How did we get here?

Unpicking the Cartel de Covid conspiracy tells us something about Colombia, its health system, our collective behaviour, how we test and treat COVID-19, and quite a bit about the virus itself.

And like most urban myths, it has roots in facts: This one being the unusually high number of COVID-19 patients in ICU (intensive care beds) in Cali. In fact, city hospitals were reporting twice as many patients in the ICU than the national rate.

Read our latest coverage on the coronavirus in Colombia

Of course, there could be many legitimate medical reasons for this, many of them in the interests of the patients. But for local politician Abraham Jiménez it had to be money.

“While a normal bed for a COVID-19 patient costs 15 million pesos, an ICU bed costs 29 million,” announced the Cambio Radical senator, demanding a government investigation to uncover possible price gouging by the city health facilities.

The script was written: Hospitals were cashing in on sick and dying COVID-29 patients.

Sick of corruption

In Colombia, there are many good reasons for people to believe this. The complex public-private health system is rife with corruption, stories of which are drip-fed to a public already worn down by daily tramitología battles while trying to deal with their local privatised health clinic.

Some scams happen on a spectacular scale, such as with the infamous Cartel de Hemofilia lead by a local governor and health secretary who conspired to defraud the state of billions of pesos by creating a fake cohort of haemophilic patients.

But these big-scale embezzlements or desfalcos were headed up by politicians and back-room state officials. In contrast, the Cartel de Covid conspiracy aims its ire at front-line medical workers.

The “29 million-pesos ICU bed” calculation has warped into the “30 million cash” sum pocketed by medical doctors for every sick and dying patient they infect. In fact, it has doubled to 60 million pesos in recent days.

The irony is many medical workers in Colombia never even receive their regular salary, let alone a cash bonus for killing their patients.

Invisible menace

Another factor in these nutty theories surrounding COVID-19 lies in the illness itself, and the SARS-CoV-2 virus that causes it. It’s new and startlingly strange; a vascular disease that spreads like a respiratory one (an early error was comparing it to flu) that scientists are only beginning to understand.

What we do know is that COVID-19 is a truly invisible menace with a long incubation period (14 days) and an ability to spread through symptom-free carriers (80% of infected have mild illness or nothing at all).

And while in its early days, the coronavirus outbreak could be tracked from patient to patient, Colombia long ago reached “community spreading” stage whereby its stealthy advance makes it pop up seemingly randomly. This just feeds the “granny got sick at the clinic” narrative – rather than believing granny got infected by dad who works in the market.

Testing times

Then there’s the testing. Nasal swabs sent to centralised labs for PCR testing are highly accurate but take days or weeks for results. The much-hyped blood drop rapid tests give feedback in minutes, but many false negatives, especially early on in infection.

Discordant results between these types of tests is fertile ground for conspiracy theorists.

“I tested negative last week – but now the hospital says I’m positive. They infected me,” is one story circulating. This follows the proliferation of paid-for rapid tests in private clinics that are happy to take your money but unlikely to explain the finer points of validation studies, viral loads, sensitivity and specificity. A bad test is worse than no test, as the virologists say.

Meanwhile, local health authorities are scrambling to scotch on-line theories that even the rigorous PCR tests – free to patients – are somehow a scam.

These unscrupulous posts “persuade people not to be tested, which causes yet more cases because those who are infected delay the isolation processes and it is easier to infect people,” wrote Cúcuta’s Health Secretary in their local paper this week.

Testing is vital for identifying at-risk patients and treating them on time. If no-one tests then vulnerable folk – mostly the elderly, but also with underlying health problems – turn up late and die.

Bully-boy doctrines

The fearful messages and lockdown rules emitted by authorities nationwide have been amplified and twisted into the bully-boy doctrines imposed with extreme prejudice by the country’s myriad armed gangs.

“Anyone with COVID-19 will be killed,” is one message from pandilleros in the Pacific port of Tumaco, writes a friend. In some barrios the locals throw rocks at medical teams trying to trace and track positive cases.

“We need to urgently put out messages to confront these attacks on the medical mission,” says my contact there.

In some barrios, people are too terrified to report anyone sick or seek help at the hospital. The result is empty wards for mild cases but overflowing critical beds as desperate people take the severely sick only as a last resort. And often too late.  

It happens at all social levels; Estrato 6 families have threatened elite clinics with lawyers if they test sick a sick relative.

And it happened to my own family when an aunt was hospitalised in a private clinic on the coast. She clearly had COVID-19 symptoms. No test was done. She died and was laid to rest with a traditional family funeral. We watched in Bogotá on Zoom.

“Why the hell didn’t they test her for COVID?” a doctor friend asked, puzzled.

“Maybe the clinic was scared to report a coronavirus case,” I suggested. “They didn’t want protestors outside with waving placards. Bad for business.” 

So keeps turning the vicious circle: Delayed medical assistance means more hospital deaths which in turn reinforces the Cartel de Covid rumour that has taken root. Front-line doctors now face furious family members barging their way into wards to remove the sick and dying, arguing that “doctors are making money from each body they cremate.”

Victims to victimisers

As if medical staff didn’t have enough problems already.

Since the start of the outbreak, the shortage of PPE – personal protection equipment – has caused rifts between front-line medical staff and health authorities and governments across the globe.

Colombia is no exception, and doctors and nurses’ unions have clashed with the government.

First, there were the state’s clumsy decrees attempting to force medical staff to work on COVID-19 wards (the legal moves failed). Then medical unions revealed the government was bucking its duty to provide masks, gloves and other protective material (it palmed that off onto workplace insurers then failed to follow up).

Then there were pay disputes, mass sackings, promised COVID-19 bonuses that never materialised, and the usual shenanigans that show up in Colombia when workers claim their rights.

“The health minister turned us from victims into victimisers,” states Herman Bayona, president of the Colegio Médico de Bogotá, writing in Las 2 Orillas this week.

The minister’s comments have “questioned the ethics and professionalism of the doctors, making them seem like the determinants of criminal and corrupt behaviour”.

“Doctors are being attacked and sent death threats as part of a political power struggle,” affirms a close friend who works at high level in the medical profession. “The state doesn’t want doctors to denounce the government for its wrongdoings”.

Whacky WhatsApp

This plays to a counter-conspiracy theory: That behind the “Cartel de Covid” rumour runs a deep state plot to scare medical staff and soften the ground for any upcoming failures.

But that makes no sense. Colombia has done better than most to protect and prepare the population – and risk the economy – with some of the strictest lockdowns on the planet. Why bring it all down with some whacky warbling on WhatsApp?

The fact remains that even as Colombia enters its most critical phase of the coronavirus outbreak – deaths are over 2,000 and rising fast – the Cartel de Covid rumours could mean sick people stay home, doctors don’t work, no-one wants a swab, and clinics cover up COVID-19 deaths.  

In effect, the country is fighting viral attacks on two fronts. We need to win on both.