SANTIAGO, Chile — Chile might have celebrated too soon.
At the same time, new cases of covid-19 are surging. The country has reported more than 7,000 daily cases nine times this month, outstripping its first-wave peak of 6,938 last July, and sounding an alarm for the United States and other countries that have raced out ahead on the vaccination curve.
Analysts here blame a mix of factors: Fatigue with strict and lengthy lockdowns, vacation travel during the Southern Hemisphere summer, the arrival of new and more transmissible variants and reliance on a Chinese vaccine that’s proved less effective than Western inoculants.
On Friday, Chile published its study on the efficacy of CoronaVac in the country, with more promising results than some expected. It showed that among the 10.5 million people it followed from Feb. 2 to April 1 — one-third of whom had received both doses — hospitalizations were reduced by 85 percent and ICU admission by 89 percent two weeks after a second dose.
However, among those who have had only a first dose, protection was far lower, pointing to the need to maintain restrictions and hygiene protocols.
Chile’s vaccination campaign has benefited from a well-developed public health system, with clinics in even some of the remotest areas, and a national immunization program that distributes flu shots and childhood vaccines every year. The government signed contracts for millions of doses from Pfizer-BioNTech, AstraZeneca and Johnson & Johnson.
But its biggest partner has been Sinovac, the Chinese maker of CoronaVac, which has supplied 87 percent of the doses administered so far. Health officials are now considering administering a third dose of the vaccine.
Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention, warned that the fight against the coronavirus is far from over.
“In the U.S., as in many parts of the world where there are ongoing vaccination efforts, we are continuing to see increasing cases and hospitalizations caused by the relaxation of prevention protocols, the rise in covid-19 variants, and the increasing burden on health-care systems,” she said.
“This virus is highly transmissible and still very much a global health threat. … Vaccination efforts alone are not the solution to this global problem — they are one key component.”
Now more than two-thirds of Chile’s districts, including all of the capital, home to 6 million people, have been plunged back into a strict lockdown. The country’s medical union has warned that the health system, down this week to fewer than 200 critical-care beds nationwide, could be overrun by the surge, and called on people to stay indoors when possible.
For nearly a year, Matías Libuy has been working two or three 24-hour shifts every week, one of them in the covid-19 wing of Hospital El Carmen in the Santiago satellite city of Maipú. All 59 intensive-care beds with ventilators there are occupied.
“We are tired, stressed and overwhelmed,” the 30-year-old physician said. “These last few weeks have been incredibly difficult and have had a psychological impact on us all. In my case, I have been receiving therapy since last year.”
One in four doctors on his staff has taken time off work in the last month, reporting stress or other mental health challenges.
Close by the hospital is the family home of 25-year-old Vanessa Duarte Barrios. She and her father have both contracted the virus. They did not meet the eligibility criteria for the government’s income support schemes and have continued to leave the house to work.
“Many Chileans aren’t able to stay at home or work remotely as we’re being asked,” she said. “I have to work at a supermarket six days a week because I need an income.”
Still, she says, she’s frustrated by the “many people who go out to socialize. … It shows a real lack of empathy.”
The streets of the capital are more crowded than during the first wave, and fatigue has crept in among Chileans who have been asked to endure one of the longest lockdowns in the world, including a nighttime curfew that has lasted more than a year.
The Carabineros police force has arrested more than 900 people, largely between the ages of 23 and 27, at illegal gatherings in the first two weeks of April alone. People found with covid-19 in an area under lockdown without a valid permit or exemption face up to $17,650 in fines and five years in prison. Still, police say they’ve broken up more than double the number of illegal gatherings this year than in all of 2020.
“There is no valid excuse,” said Gen. Esteban Díaz Urbina, the head of national security for the Carabineros. “Nobody attends these events out of necessity, but rather irresponsibility.”
While the health ministry has been firm in insisting that people should not let their guard down, the message has been diluted by the government allowing the reopening of malls, gyms and theaters.
Summer vacation travel has also had an impact. From January through March, the government issued permits allowing Chileans to travel throughout the country, except in areas under lockdown, spreading the virus widely and piling pressure on the health system.
Authorities continued to allow most international travel. Santiago’s airport remained open throughout the summer; cheap return flights to Miami, the Dominican Republic and Brazil allowed virus variants to enter the country.
By the time the airport was closed to nonresident foreigners this month, the health ministry confirmed that variants from Brazil, Britain, Nigeria and California had all been detected in the country.
Biobío, a region of 1.5 million people in the south of Chile, has seen a sharp rise in cases, blamed on travelers returning home. Leonila Ferreira, the head of the intensive care unit at the Guillermo Grant Benavente Hospital in Concepción, the region’s capital, said her patients now are much younger on average than during the first wave.
“Continuing to let people travel abroad was a grave error,” she said. “It introduced new variants which Chile has been slow to detect and contain.”
Fears over the efficacy of CoronaVac have layered yet more uncertainty over the country’s early vaccination success. Chile signed a three-year agreement deal for 60 million doses and paid $3.5 million to host a trial.
Although protection afforded by a first dose appears to be weak, Chile’s study has underlined the need for vaccination efforts to press ahead.
The CoronaVac vaccine “protects against symptomatic infection by covid-19, as well as the most severe forms of the illness,” said Rafael Araos, a member of the government’s covid-19 advisory committee who presented the study. “We must not forget that as part of a vaccination campaign, it is not only the vaccine but also other public health measures which are fundamental.”
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