During the first wave of the pandemic—from January to October 2020—it took a month for the municipality’s caseload of COVID-19 cases to reach the hundreds.
By Nov. 2, when the mayor tightened sanitary measures, 695 cases had been registered, and 23 days later, on Nov. 25, the figure had risen to 926. At the close of this issue, the figure was 1037, an increase of 342cases in one month.
On average, the Red Cross transfers two COVID patients daily to different health units, and the Health Jurisdiction has pinpointed areas of high contagion. The municipality’s Hospital General Felipe G. Dobarganes, known as Hospital General (State General Hospital) is not authorized to treat COVID-19 patients, but does perform intubations and then refers patients to other hospitals. In a joint effort, Civil Protection and Public Security are responsible for closing down businesses that do not respect health measures during the contingency.
Hospital has 16 beds and 40 ventilators
Hospital General has 16 COVID-19-dedicated beds and 40 ventilators.
When the health contingency began, several hospitals in the state, such as IMSS T1 León, formerly General Hospital, and the mobile hospital in León, as well as one in Salamanca and one in Celaya, were readapted and now care exclusively for patients seriously ill with COVID-19.
In San Miguel, according to, Dr. Martín Millán, director of Hospital General, that hospital could not be converted to a COVID-19 facility because there are no other public infrastructures that serve patients needing surgery, pregnant women, or other emergencies. The Hospital General has 90 beds and an assigned isolation area for COVID-19 patients that can accommodate up to 16 patients (so far that has not been necessary). If patients are seriously ill, they are referred elsewhere. Hospital General’s 40 ventilators are available for general use, said Millán.
“Zero rejection” is the state hospital’s policy in San Miguel, said Dr. Millán. According to him, if patients are referred from Institute of Social Services for State Workers (ISSSTE) or the Mexican Institute of Social Security (IMSS), the same protocol applies as for any patient, with the patient being given treatment, or interned, if necessary, and then referred to an appropriate hospital. In the case of foreigners who come to the hospital with COVID or not they are attended to and charged based on their socioeconomic profile, as with any other patient. Of the total COVID-19 patients in San Miguel, 235 have reached Hospital General; of these, only 141 have had to be hospitalized (81 men, 60 women), and of these, 27 have been intubated.
Dr. Millán indicated that of the 141 COVID-19 patients, 67 have left the hospital with improved health, 30 were referred to other hospitals, and 31 died. Six requested voluntary discharge, signing an official health department document.
“Transmission is speeding up. Cases are increasing. We are filling up the isolation area. There were times when there were few patients. In the first wave [of COVID-19] until the end of September, the most affected were over 60 years old. Now they are young people aged 40-50, and even under 40. This tells us about the displacement of [the most affected] age group,” said Millán. He invited the population to follow the health protocols, especially on the street: wear a facemask, wash your hands frequently, and practice healthy distancing from others.
High-risk zones
Jorge Vidargas, Head of Sanitary Jurisdiction II, told Atención that after Guanajuato changed from the orange to yellow epidemiological traffic light in October, mobility increased, and people and businesses began to relax sanitary protocols.
“The gel bottles are dirty, the entryway mats are dry, measures [have been neglected], and transmission speed has increased. In 18 days cases increased by about 100,” said Vidargas. He noted that the COVID indicators are low, however lethality is currently 5.4 per one hundred thousand inhabitants and “every death counts.” According to Vidargas, from Sept. 1-15, cases rose to one hundred; from Sept.16-Oct. 16, there were only 100 cases (a slowdown); and cases increased in the next two-week period.
Regarding business inspections, Vidargas said that his department works together with Municipal Security, and that the Health Jurisdiction has only closed eight businesses; “Surveillance applies to all: ‘one soldier in each child’ we have to work on everyone’s conscience. No matter how great the force of inspectors, they will not cover all businesses. We have closed about eight due to various circumstances. These places are different from those [inspected by] Civil Protection.” Vidargas encourages the young to stay home. “We want to make the teenagers who go out on the streets or to parties understand that by doing so they bring the disease home, getting their parents and grandparents sick. The people who are [typically] dying are between 50 and 80 years old. We live in a constant state of risk, and the traffic light could turn red.” Vidargas stated that constant monitoring of the circumstances will determine the need for economic closures, saying, “We will have to see the variants. The situation is dangerous.”
The areas with the most infections remain constant: Olimpo, Bella Vista, Malanquín, Alamedas, Jardines, Landeta, and San Luis Rey.
Closures, fines, and fisical aggression
The Day of the Dead holiday weekend (the first weekend of November) was not as challenging for the local authorities as the weekend of Nov. 6, when they had to close several businesses that disregarded health protocols. Two of them were OXXO shops—the one on Juárez and the one on Mesones—because they sold alcohol and other products with too many people inside the store and others waiting outside in a disorderly manner.
According to local authorities, since Nov. 9 the waiting lines outside of businesses—in the public area around the business location—is now the responsibility of the business. If customers do not respect the protocols, they can be denied service.
On the weekend of Nov. 6, the municipal administration closed other establishments in Centro, including Silverios restaurant and bar, which still had clients at 11:58pm (the restaurant was supposed to have been padlocked shut at 10 p.m.). “They said that the people were friends, not clients. However, they were open,” said Josafat Enriquez, director of Civil Protection. Also closed was the neighboring MX, which at 11pmstill had people cleaning up. These places, which were allowed to reopen after a week, had to reapply for their “Health First” authorization.
On Nov. 6 streets in Centro had significant pedestrian traffic, especially around the bar areas (Mesones and Umarán). Photographs of youths gathering, which caused consternation in Sanmiguelenses—were taken on Mesones at Duke nightclub.
On the second floor of Duke is Comrade, a terrace with capacity for 200 people. The concentration of locals and visitors outside the business was reported to the emergency service at 10:03pm, and when the inspectors arrived, they made a mistake. According to Enríquez, Duke received a “warning,” yet all the clients were evicted at the same time. This caused crowding, said Director Josafat. “The inspector had reviewed the notes, the place had 100 people in it, although the capacity is for 200. The camera images were reviewed. The error was to evict everyone at the same time. They were issued a warning due to the mass eviction of the 100 people. Administrators were reminded to make evictions gradually to avoid the unnecessary concentration of people and avoid business closures. Further, that day many young people were waiting outside to enter Duke, although they had already been told that there was no more space,” Josafat said, and continued, “Suspensions will continue for those who do not follow the guidelines.” In addition to the above-mentioned, other sanctioned businesses include BBVA Bancomer at Luciérnaga Plaza; Coppel at Ancha de San Antonio; bars, restaurants, and other shops. Although the director of Civil Protection did not want to reveal the amount, sources have told Atención that fines paid have risen to 30,000 pesos.
We note that there is disagreement and complaints about bars being legal gathering places, while private social gatherings are considered illegal.
In the case of El Tupinamba restaurant on Zacateros, on Nov. 10 a worker from Civil Protection arrived at the premises to undertake an inspection. The last customers were about to leave, and workers were already cleaning the premises. When the inspector requested access to the site, the premises’ owner punched him, causing a nosebleed, for which the inspector was taken by the Red Cross to a hospital. The subsequent protocol, according to Enriquez, is for Tupinamba’s owner to place himself at the disposal of the Public Ministry and for the inspector to file a formal complaint. The municipal administration offers people access to a lawyer. According to Enriquez, relatives of the aggressor searched for the victim in order to reach an outside settlement, and they have offered him an apology.