Mexico Model Updates for October 29, 2020 Covid.Healthdata.Org Institute

Mexico Model updates for October 29, 2020

ESPAÑOL

Durante la tercera semana de octubre los casos positivos muestran un incremento por arriba de 5 mil por día. Así mismo, las muertes muestran modifican su tendencia, y en la última semana de octubre muestran un ligero incremento a 391 muertes diarias. IHME estima que para el 1 de febrero de 2021 en México habrá 134 mil defunciones acumuladas, es decir aproximadamente 5.2 mil más que las estimadas hace una semana para la misma fecha. Si se generaliza el uso de cubrebocas se salvarían 9.3 mil vidas al primero de febrero de 2021.

Situación actual

• Los casos confirmados se mantienen relativamente constantes hasta la tercera semana de octubre y en la cuarta muestra un ligero incremento en el número de casos diarios por arriba de 5 mil (Figura 1). • Las muertes diarias muestran una tendencia descendente desde el mes de agosto. Pero para la cuarta semana de octubre se observa un ligero incremento y se estiman 369 muertes al día (Figura 2). Al 21 de octubre, COVID19 sigue siendo la primera causa de muerte a nivel nacional (Tabla 1). • Las estimaciones de muertes en México por COVID19 acumuladas al 21 de octubre indican que alrededor de 62% de ellas suceden entre 55 y 79 años. La mitad de las muertes por COVID en México suceden antes de los 63 años. • La R efectiva al 15 de octubre – basada en el análisis combinado de casos, hospitalizaciones y muertes –cambia con respecto a las estimaciones de la semana anterior. Son 14 estados con una R efectiva mayor a 1. Con una R efectiva mayor a 1.16 están Chihuahua y Yucatán; con valores entre 1.08 y 1.11 se ubican Quintana Roo, San Luis Potosí, Aguascalientes y Colima; y con valores por arriba de 1, pero menor a 1.04 se encuentran la Ciudad de México, el Estado de México, Tlaxcala, Michoacán, Jalisco, Nuevo León, Coahuila y Baja California (Figura 3). En los últimos meses no se había observado una situación similar a la presente lo cual indica un potencial incremento en la propagación de la infección. • Para el 26 de octubre hay 8 estados con cifras de población infectada por COVID19 por encima de 30%: Tlaxcala, Aguascalientes, Baja California, Sinaloa y Colima (30-35%); Tabasco y Quintana Roo (36-41%) y la Ciudad de México con valores superiores a 50% (Figura 4). • Debido al bajo número de pruebas realizadas, el número de casos positivos detectados representan 2.5% de la población infectada. • La mortalidad diaria por COVID-19 para el 26 de octubre es mayor a ocho por un millón de habitantes en tres estados, Chihuahua, Ciudad de México y Aguascalientes (Figura 6).

Factores impulsores de las tendencias de transmisión (movilidad, uso de cubrebocas, pruebas y estacionalidad)

• La movilidad de la población sigue aumentando en todo el país en promedio. En algunos estados se ha mantenido como estaba en la última semana. Otros presentan movilidad similar a la que había en enero de 2020 entre ellos se encuentran: Durango y Zacatecas; con ligeramente menor movilidad que los anteriores están, Baja California, Baja California Sur, Sonora, Coahuila, Guanajuato, Querétaro y Michoacán. En contraste la movilidad es muy baja en la Ciudad de México, Yucatán y Quintana Roo (Figuras 8a y 8b). • No hay cambios en el uso de mascarillas en comparación con la semana anterior. En promedio el 81% usa mascarilla al salir de casa en el país (Figura 9). • México se mantiene como uno de los países que hace menos pruebas diagnósticas en comparación con los demás países de la región (Figura 10a). Al desagregar por estados se observa un desempeño muy pobre en todo el país y ligeramente mejor en Ciudad de México, Tabasco, Nuevo León, Coahuila, San Luis Potosí y Guanajuato (Figura 10b).

covid.healthdata.org Institute for Health Metrics and Evaluation Mexico Model updates for October 29, 2020

Proyecciones

• La proyección de muertes acumuladas para el 1 de febrero de 2021 es de 134 mil, es decir 5.2 mil muertes más que las estimadas la semana pasada para el 1 de febrero. Entre el 26 de octubre y el 1 de febrero se incrementarán 45 mil muertes. De aumentar el uso de mascarillas al 95% se pueden salvar, al primero de febrero de 2021, 9.3 mil vidas si se compara con el escenario de referencia, reduciendo el número esperado de muertes en 7.0% (Figura 12). • Las proyecciones de defunciones por día muestran una tendencia ascendente a medidos de noviembre y después de esa fecha se mantendrán entre 420 y 460 muertes diarias hasta febrero de 2021, el peor escenario muestra 560 muertes al día y el mejor llegará a 300 (Figura 13). • Dado el incremento de la mortalidad diaria por COVID es urgente regresar a los mandatos en el mes de octubre en Chihuahua y Colima; en el mes de noviembre en Yucatán y Aguascalientes; y el resto de los estados no necesitan reimponer mandatos hasta febrero de 2021 (Figura 15). • Se estima que para el 1 de febrero alrededor de un tercio de los mexicanos estén infectados por COVID19. Chiapas será el único estado que para febrero de 2021 tendrá menos de 5% de la población infectada. En contraste, seis estados rebasarán 54% de la población infectada Baja California, Chihuahua, Aguascalientes, Colima, Quintana Roo y Ciudad de México; y otros seis estarán con prevalencia mayor a 40%, Tabasco, Puebla, Tlaxcala, Estado de México, Coahuila, Sinaloa y Sonora (Figura 16). • La tasa de mortalidad diaria para el 1 de febrero de 2021 en el país es muy heterogénea. Por abajo de 2 por 1 millón de habitantes se ubican Baja California Sur, Tamaulipas, Tabasco y Campeche. En contraste, por arriba de 5 por un millón de habitantes estarán Chiapas, Oaxaca, Guerrero, Michoacán, Sonora y Guanajuato (Figura 17). • Ofrecemos una comparación de nuestros pronósticos con otros modelos que proporcionan actualizaciones periódicas y archivan sus resultados. Al comparar los pronósticos del pasado con lo que ha ocurrido, nuestro modelo tiene el error porcentual medio más bajo para las muertes acumuladas. Como muestra la Figura 18, nuestros pronósticos son marcadamente diferentes. IHME establece que se estiman 430 muertes diarias en promedio hasta el mes de febrero de 2021. El modelo de la Universidad del Sur de California (SIKJalpha) pronostica que la epidemia en México seguirá ascendiendo después del mes de noviembre y otros modelos sugieren que la epidemia está llegando a su fin con una disminución de las muertes diarias hasta el final del año. Encontramos una fuerte correlación estadística de la R efectiva en los últimos 6 meses con el patrón semanal de muertes por neumonía visto en cada país o estado. Esta variable de estacionalidad combinada con nuestra predicción de que los mandatos continuarán disminuyendo durante las cuentas de otoño para nuestros pronósticos marcadamente diferentes. • La presión que reciben los hospitales por demanda de camas se presenta a lo largo del tiempo y por entidad federativa. Para el mes de noviembre con excepción de Baja California Sur, Campeche y Chiapas se espera una presión alta en 10 estados y extrema en 19. La proyección indica que para febrero de 2021 se sumará Tabasco a los estados con presión moderada y Chiapas cambiará a presión extrema (Figura 19). • La presión por camas de terapia intensiva en México es muy similar para noviembre solo Campeche y Chiapas no tendrán presión, en contraste 11 estados tendrán presión alta por camas de Terapia intensiva y 19 presión extrema. En febrero de 2021 Tabasco estará en moderado y Chiapas en presión extrema (Figura 20). • Al terminar 2020, de acuerdo con las estimaciones de IHME, la primera causa de muerte será COVID-19 en México (Tabla 3).

IHME desea agradecer calurosamente el apoyo de estos y otros que han hecho posible nuestros esfuerzos de estimación de COVID-19. Gracias.

Para ver todos los recursos de COVID-19 en IHME, visite http://www.healthdata.org/covid.

Preguntas? ¿Peticiones? ¿Realimentación? Comuníquese con nosotros en https://www.healthdata.org/covid/contact- us. covid.healthdata.org Institute for Health Metrics and Evaluation Mexico Model updates for October 29, 2020

ENGLISH

During the third week of October, the number of positive cases increased to over 5,000 per day. Likewise, deaths show a change in their trend, with a slight increase to 391 deaths per day in the last week of October. IHME estimates that by February 1, 2021, there will be 134,000 cumulative deaths in Mexico, which is approximately 5,200 more than those estimated a week ago for the same date. If the use of face masks becomes widespread, 9,300 lives could be saved by February 1, 2021.

Current situation

• Confirmed cases remain relatively constant through the third week of October and in the fourth week show a slight increase in the number of daily cases to above 5,000 (Figure 1). • Daily deaths have shown a downward trend since August. But by the fourth week of October, a slight increase is observed, with an estimated 369 deaths per day (Figure 2). As of October 21, COVID-19 continues to be the leading cause of death at the national level (Table 1). • Estimates of cumulative deaths in Mexico from COVID-19 through October 21 indicate that about 62% occur between the ages of 55 and 79. Half of the deaths from COVID-19 in Mexico occur before the age of 63. • The effective R as of October 15 – based on the combined analysis of cases, hospitalizations, and deaths – changes from the previous week’s estimates. There are 14 states with an effective R greater than 1. Chihuahua and Yucatán have an effective R greater than 1.16; Quintana Roo, San Luis Potosí, Aguascalientes, and Colima have values between 1.08 and 1.11; and Mexico City, the State of Mexico, Tlaxcala, Michoacán, Jalisco, Nuevo León, Coahuila, and Baja California have values above 1 but less than 1.04 (Figure 3). In recent months, a situation similar to the present one had not been observed, which indicates a potential increase in the spread of the infection. • As of October 26, there are eight states with over 30% of the population infected with COVID-19: Tlaxcala, Aguascalientes, Baja California, Sinaloa, and Colima (30–35%); Tabasco and Quintana Roo (36–41%); and Mexico City, with values above 50% (Figure 4). • Due to the low number of tests performed, the number of positive cases detected represents 2.5% of the infected population. • Daily mortality from COVID-19 by October 26 is greater than 8 per 1 million inhabitants in three states: Chihuahua, Mexico City, and Aguascalientes (Figure 6).

Trends in key drivers of transmission (mobility, mask use, testing, and seasonality)

• Population mobility continues to increase throughout the country on average. Some states have maintained the same levels observed in the last week. Others present similar mobility to that of January 2020, including Durango and Zacatecas; states with slightly less mobility are Baja California, Baja California Sur, Sonora, Coahuila, Guanajuato, Querétaro, and Michoacán. In contrast, mobility is very low in Mexico City, Yucatán, and Quintana Roo (Figures 8a and 8b). • There are no changes in mask use compared to the previous week. On average, 81% wear masks when leaving home in the country (Figure 9). • Mexico remains one of the countries that performs fewer diagnostic tests compared to other countries in the region (Figure 10a). When disaggregating by states, better performance is seen in Mexico City, Tabasco, Nuevo León, Coahuila, San Luis Potosí, and Guanajuato (Figure 10b).

covid.healthdata.org Institute for Health Metrics and Evaluation Mexico Model updates for October 29, 2020

Projections

• The projection of cumulative deaths for February 1, 2021, is 134,000, which is 5,200 more than those estimated last week for February 1. Between October 26 and February 1, 45,000 more deaths will occur. If the use of masks is increased to 95%, 9,300 lives can be saved by February 1, 2021, compared to the baseline scenario, reducing the expected number of deaths by 7.0% (Figure 12). • Projections of deaths per day show an upward trend as of mid-November and after that date will remain between 420 and 460 deaths per day until February 2021, with the worst-case scenario showing 560 deaths per day and the best-case scenario reaching 300 (Figure 13). • Given the increase in daily mortality due to COVID-19, it is urgent to return to the mandates in the month of October in Chihuahua and Colima, and in the month of November in Yucatán and Aguascalientes; the rest of the states do not need to re-impose mandates until February 2021 (Figure 15). • It is estimated that by February 1 about a third of Mexicans will be infected with COVID-19. Chiapas could be the only state with less than 5% of the population infected by February 2021. In contrast, six states will exceed 54% of the population infected: Baja California, Chihuahua, Aguascalientes, Colima, Quintana Roo, and Mexico City; and another six will have a prevalence greater than 40%: Tabasco, Puebla, Tlaxcala, Estado de Mexico, Coahuila, Sinaloa, and Sonora (Figure 16). • The daily mortality rate for February 1, 2021, in the country varied substantially. A rate below 2 per 1 million inhabitants is observed in Baja California Sur, Tamaulipas, Tabasco, and Campeche. In contrast, a rate above 5 per 1 million inhabitants is found in Chiapas, Oaxaca, Guerrero, Michoacán, Sonora, and Guanajuato (Figure 17). • We offer a comparison of our forecasts with other models that provide periodic updates and archive their results. When comparing past forecasts with what has happened, our model has the lowest average percentage error for cumulative deaths. As Figure 18 shows, our forecasts are markedly different. IHME states that an average of 430 deaths per day is estimated through February 2021 in Mexico. The University of Southern California model (SIKJalpha) predicts that the epidemic in Mexico will continue to rise after November, and other models suggest that the epidemic is coming to an end, with a decrease in daily deaths until the end of the year. We found a strong statistical correlation of effective R in the last six months with the weekly pattern of pneumonia deaths seen in each country or state. This seasonality variable, combined with our prediction that mandates will continue to decline during the fall, accounts for our markedly different forecasts. • The pressure on hospitals from bed demand is presented over time and by state. By November, with the exception of Baja California Sur, Campeche, and Chiapas, high pressure is expected in 10 states and extreme pressure in 19. The projection indicates that by February 2021, Tabasco will be added to the states with moderate pressure and Chiapas will shift to extreme pressure (Figure 19). • The pressure for intensive care beds in Mexico is very similar. By November, only Campeche and Chiapas will have no pressure, while 11 states will have high pressure for intensive care beds and 19 extreme pressure. By February 2021, Tabasco will be under moderate and Chiapas under extreme pressure (Figure 20). • By the end of 2020, according to IHME estimates, the leading cause of death in Mexico will be COVID-19 (Table 3).

IHME wishes to warmly acknowledge the support of these and others who have made our COVID-19 estimation efforts possible. Thank you.

For all COVID-19 resources at IHME, visit http://www.healthdata.org/covid.

Questions? Requests? Feedback? Please contact us at https://www.healthdata.org/covid/contact-us. covid.healthdata.org Institute for Health Metrics and Evaluation Mexico MODEL OVERVIEW

COVID-19 Results Brieﬁng: Mexico

Institute for Health Metrics and Evaluation (IHME)

October 29, 2020

This brieﬁng contains s ummary i nformation o n t he l atest p rojections f rom t he I HME m odel o n C OVID-19 in Mexico. The model was run on October 28, 2020. For more information on the model, including interactive visualizations, downloadable results, and model details, please visit our site covid19.healthdata.org.

Model Overview

Updates to the model this week include additional data on deaths, cases, and updates on covariates.

covid19.healthdata.org 1 Institute for Health Metrics and Evaluation Mexico CURRENT SITUATION

Current situation

Figure 1. Reported daily COVID-19 cases

10,000

7,500

5,000 Count

2,500

Apr May Jun Jul Aug Sep Oct Nov Month

Daily cases

covid19.healthdata.org 2 Institute for Health Metrics and Evaluation Mexico CURRENT SITUATION

Table 1. Ranking of COVID-19 among the leading causes of mortality this week, assuming uniform deaths of non-COVID causes throughout the year

Cause name Weekly deaths Ranking COVID-19 2,585 1 Ischemic heart disease 2,044 2 Diabetes mellitus 1,420 3 Chronic kidney disease 1,395 4 Cirrhosis and other chronic liver diseases 891 5 Stroke 729 6 Chronic obstructive pulmonary disease 630 7 Interpersonal violence 590 8 Alzheimer’s disease and other dementias 455 9 Lower respiratory infections 434 10

Figure 2a. Reported daily COVID-19 deaths.

1,200

900

600 Daily deaths

300

Apr May Jun Jul Aug Sep Oct Nov

covid19.healthdata.org 3 Institute for Health Metrics and Evaluation Mexico CURRENT SITUATION

Figure 2b. Estimated cumulative deaths by age group

5 Share of cumulative deaths, % deaths, Share of cumulative

<5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 99 Age group

Figure 3. Mean effective R on October 15, 2020. The estimate of effective R is based on the combined analysis of deaths, case reporting and hospitalizations where available. Current reported cases reflect infections 11-13 days prior so estimates of effective R can only be made for the recent past. Effective R less than 1 means that transmission should decline all other things being held the same.

<0.84 0.84−0.87 0.88−0.91 0.92−0.95 0.96−0.99 1−1.03 1.04−1.07 1.08−1.11 1.12−1.15 >=1.16

covid19.healthdata.org 4 Institute for Health Metrics and Evaluation Mexico CURRENT SITUATION

Figure 4. Estimated percent of the population infected with COVID-19 on October 26, 2020

<5.5 5.5−11.4 11.5−17.4 17.5−23.4 23.5−29.4 29.5−35.4 35.5−41.4 41.5−47.4 47.5−53.4 >=53.5

Figure 5. Percent of COVID-19 infections detected. This is estimated as the ratio of reported COVID-19 cases to estimated COVID-19 infections based on the SEIR disease transmission model.

10 Percent of infections detected of infections Percent

0 Mar Apr May Jun Jul Aug Sep Oct Nov

Argentina United States of America Colombia Mexico Brazil

covid19.healthdata.org 5 Institute for Health Metrics and Evaluation Mexico CURRENT SITUATION

Figure 6. Daily COVID-19 death rate per 1 million on October 26, 2020

<1 1 to 1.9 2 to 2.9 3 to 3.9 4 to 4.9 5 to 5.9 6 to 6.9 7 to 7.9 >=8

covid19.healthdata.org 6 Institute for Health Metrics and Evaluation Mexico CRITICAL DRIVERS

Critical drivers

Table 2. Current mandate implementation All nonessential businesses closed All nonessential businesses restricted businesses Any gatherings Any restricted Mask use School closure home order Stay limits Travel Aguascalientes Baja California Baja California Sur Campeche Chiapas Chihuahua Coahuila Colima Durango Guanajuato Guerrero Hidalgo Jalisco Mexico City Michoacán de Ocampo Morelos México Nayarit Nuevo León Oaxaca Puebla Querétaro Quintana Roo San Luis Potosí Sinaloa Sonora Tabasco Tamaulipas Tlaxcala Veracruz de Ignacio de la Llave Yucatán Zacatecas

Mandate in place No mandate

covid19.healthdata.org 7 Institute for Health Metrics and Evaluation Mexico CRITICAL DRIVERS

Figure 7. Total number of social distancing mandates (including mask use)

Mandate imposition timing Aguascalientes Baja California Baja California Sur Campeche Chiapas Chihuahua Coahuila Colima Durango # of mandates Guanajuato Guerrero 0 Hidalgo 1 Jalisco Mexico City 2 Michoacán de Ocampo Morelos 3 México Nayarit 4 Nuevo León Oaxaca 5 Puebla 6 Querétaro Quintana Roo 7 San Luis Potosí Sinaloa Sonora Tabasco Tamaulipas Tlaxcala Veracruz de Ignacio de la Llave Yucatán Zacatecas Feb Mar Apr May Jun Jul Aug Sep Oct Nov

covid19.healthdata.org 8 Institute for Health Metrics and Evaluation Mexico CRITICAL DRIVERS

Figure 8a. Trend in mobility as measured through smartphone app use compared to January 2020 baseline

−20

−40

−60 Percent reduction from average mobility reduction from average Percent −80 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov

Argentina United States of America Colombia Mexico Brazil

Figure 8b. Mobility level as measured through smartphone app use compared to January 2020 baseline (percent) on October 26, 2020

=<−50 −49 to −45 −44 to −40 −39 to −35 −34 to −30 −29 to −25 −24 to −20 −19 to −15 −14 to −10 >−10

covid19.healthdata.org 9 Institute for Health Metrics and Evaluation Mexico CRITICAL DRIVERS

Figure 9a. Trend in the proportion of the population reporting always wearing a mask when leaving home

25 Percent of population Percent

0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov

Argentina United States of America Colombia Mexico Brazil

Figure 9b. Proportion of the population reporting always wearing a mask when leaving home on October 26, 2020

<45% 45 to 49% 50 to 54% 55 to 59% 60 to 64% 65 to 69% 70 to 74% 75 to 79% 80 to 84% >=85

covid19.healthdata.org 10 Institute for Health Metrics and Evaluation Mexico CRITICAL DRIVERS

Figure 10a. Trend in COVID-19 diagnostic tests per 100,000 people

300

200

100 Test per 100,000 population Test

0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov

Argentina United States of America Colombia Mexico Brazil

Figure 10b. COVID-19 diagnostic tests per 100,000 people on October 05, 2020

<5 5 to 9.9 10 to 24.9 25 to 49 50 to 149 150 to 249 250 to 349 350 to 449 450 to 499 >=500

covid19.healthdata.org 11 Institute for Health Metrics and Evaluation Mexico CRITICAL DRIVERS

Figure 11. Increase in the risk of death due to pneumonia on February 1 compared to August 1

<−80% −80 to −61% −60 to −41% −40 to −21% −20 to −1% 0 to 19% 20 to 39% 40 to 59% 60 to 79% >=80%

covid19.healthdata.org 12 Institute for Health Metrics and Evaluation Mexico PROJECTIONS AND SCENARIOS

Projections and scenarios

We produce three scenarios when projecting COVID-19. The reference scenario is our forecast of what we think is most likely to happen. We assume that if the daily mortality rate from COVID-19 reaches 8 per million, social distancing (SD) mandates will be re-imposed. The mandate easing scenario is what would happen if governments continue to ease social distancing mandates with no re-imposition. The universal mask mandate scenario is what would happen if mask use increased immediately to 95% and social distancing mandates were re-imposed at 8 deaths per million. Figure 12. Cumulative COVID-19 deaths until February 01, 2021 for three scenarios. Cumulative deaths per 100,000

90 100,000

50,000 30 Cumulative deaths Cumulative

0 0 Feb Apr Jun Aug Oct Dec Feb

Continued SD mandate easing Reference scenario Universal mask use

Fig 13. Daily COVID-19 deaths until February 01, 2021 for three scenarios.

600 Daily deaths per 100,000

0.4

400

0.2 Daily deaths 200

0 0.0 Feb Apr Jun Aug Oct Dec Feb

Continued SD mandate easing Reference scenario Universal mask use

covid19.healthdata.org 13 Institute for Health Metrics and Evaluation Mexico PROJECTIONS AND SCENARIOS

Fig 14. Daily COVID-19 infections until February 01, 2021 for three scenarios.

200,000 150 Daily infections per 100,000

150,000 100 100,000

Daily infections 50 50,000

0 0 Feb Apr Jun Aug Oct Dec Feb

Continued SD mandate easing Reference scenario Universal mask use

covid19.healthdata.org 14 Institute for Health Metrics and Evaluation Mexico PROJECTIONS AND SCENARIOS

Fig 15. Month of assumed mandate re-implementation. (Month when daily death rate passes 8 per million, when reference scenario model assumes mandates will be re-imposed.)

October November December January No mandates before Feb 1

covid19.healthdata.org 15 Institute for Health Metrics and Evaluation Mexico PROJECTIONS AND SCENARIOS

Figure 16. Forecasted percent infected with COVID-19 on February 01, 2021

<5.5 5.5−11.4 11.5−17.4 17.5−23.4 23.5−29.4 29.5−35.4 35.5−41.4 41.5−47.4 47.5−53.4 >=53.5

Figure 17. Daily COVID-19 deaths per million forecasted on February 01, 2021 in the reference scenario

<1 1 to 1.9 2 to 2.9 3 to 3.9 4 to 4.9 5 to 5.9 6 to 6.9 7 to 7.9 >=8

covid19.healthdata.org 16 Institute for Health Metrics and Evaluation Mexico PROJECTIONS AND SCENARIOS

Figure 18. Comparison of reference model projections with other COVID modeling groups. For this comparison, we are including projections of daily COVID-19 deaths from other modeling groups when available: Delphi from the Massachussets Institute of Technology (Delphi; https://www.covidanalytics.io/home), Imperial College London (Imperial; https://www.covidsim.org), The Los Alamos National Laboratory (LANL; https://covid-19.bsvgateway.org/), the SI-KJalpha model from the University of Southern Cal- ifornia (SIKJalpha; https://github.com/scc-usc/ReCOVER-COVID-19), and Youyang Gu (YYG; https: //covid19-projections.com/). Daily deaths from other modeling groups are smoothed to remove inconsistencies with rounding. Regional values are aggregates from availble locations in that region.

600

Models

400 IHME Imperial LANL

Daily deaths SIKJalpha YYG 200

Nov Dec Jan Feb Date

covid19.healthdata.org 17 Institute for Health Metrics and Evaluation Mexico PROJECTIONS AND SCENARIOS

Figure 19. The estimated inpatient hospital usage is shown over time. The percent of hospital beds occupied by COVID-19 patients is color coded based on observed quantiles of the maximum proportion of beds occupied by COVID-19 patients. Less than 5% is considered low stress, 5-9% is considered moderate stress, 10-19% is considered high stress and greater than 20% is considered extreme stress.

All hospital beds

Aguascalientes

Baja California

Baja California Sur

Campeche

Chiapas

Chihuahua

Coahuila

Colima

Durango

Guanajuato

Guerrero

Hidalgo

Jalisco

Mexico City Stress level Michoacán de Ocampo Low Morelos Moderate México High Nayarit Extreme Nuevo León

Oaxaca

Puebla

Querétaro

Quintana Roo

San Luis Potosí

Sinaloa

Sonora

Tabasco

Tamaulipas

Tlaxcala

Veracruz de Ignacio de la Llave

Yucatán

Zacatecas

Apr Jun Aug Oct Dec Feb

covid19.healthdata.org 18 Institute for Health Metrics and Evaluation Mexico PROJECTIONS AND SCENARIOS

Figure 20. The estimated intensive care unit (ICU) usage is shown over time. The percent of ICU beds occupied by COVID-19 patients is color coded based on observed quantiles of the maximum proportion of ICU beds occupied by COVID-19 patients. Less than 10% is considered low stress, 10-29% is considered moderate stress, 30-59% is considered high stress and greater than 60% is considered extreme stress.

Intensive care unit beds

Aguascalientes

Baja California

Baja California Sur

Campeche

Chiapas

Chihuahua

Coahuila

Colima

Durango

Guanajuato

Guerrero

Hidalgo

Jalisco

Mexico City Stress level Michoacán de Ocampo Low Morelos Moderate México High Nayarit Extreme Nuevo León

Oaxaca

Puebla

Querétaro

Quintana Roo

San Luis Potosí

Sinaloa

Sonora

Tabasco

Tamaulipas

Tlaxcala

Veracruz de Ignacio de la Llave

Yucatán

Zacatecas

Apr Jun Aug Oct Dec Feb

covid19.healthdata.org 19 Institute for Health Metrics and Evaluation Mexico PROJECTIONS AND SCENARIOS

Table 3. Ranking of COVID-19 among the leading causes of mortality in the full year 2020. Deaths from COVID-19 are projections of cumulative deaths on Jan 1, 2021 from the reference scenario. Deaths from other causes are from the Global Burden of Disease study 2019 (rounded to the nearest 100).

Cause name Annual deaths Ranking COVID-19 119,985 1 Ischemic heart disease 106,300 2 Diabetes mellitus 73,800 3 Chronic kidney disease 72,500 4 Cirrhosis and other chronic liver diseases 46,300 5 Stroke 37,900 6 Chronic obstructive pulmonary disease 32,800 7 Interpersonal violence 30,700 8 Alzheimer’s disease and other dementias 23,700 9 Lower respiratory infections 22,600 10

Mask data source: Premise; Facebook Global symptom survey (This research is based on survey results from University of Maryland Social Data Science Center) and the Facebook United States symptom survey (in collaboration with Carnegie Mellon University); Kaiser Family Foundation; YouGov COVID-19 Behaviour Tracker survey. A note of thanks: We would like to extend a special thanks to the Pan American Health Organization (PAHO) for key data sources; our partners and collaborators in Argentina, Brazil, Bolivia, Chile, Colombia, Cuba, the Dominican Republic, Ecuador, Egypt, Honduras, Israel, Japan, Malaysia, Mexico, Moldova, Panama, Peru, the Philippines, Russia, Serbia, South Korea, Turkey, and Ukraine for their support and expert advice; and to the tireless data collection and collation efforts of individuals and institutions throughout the world. In addition, we wish to express our gratitude for efforts to collect social distancing policy information in Latin America to University of Miami Institute for Advanced Study of the Americas (Felicia Knaul, Michael Touchton), with data published here: http://observcovid.miami.edu/; Fundación Mexicana para la Salud (Héctor Arreola-Ornelas) with support from the GDS Services International: Tómatelo a Pecho A.C.; and Centro de Investigaciones en Ciencias de la Salud, Universidad Anáhuac (Héctor Arreola-Ornelas); Lab on Research, Ethics, Aging and Community-Health at Tufts University (REACH Lab) and the University of Miami Institute for Advanced Study of the Americas (Thalia Porteny). Further, IHME is grateful to the Microsoft AI for Health program for their support in hosting our COVID-19 data visualizations on the Azure Cloud. We would like to also extend a warm thank you to the many others who have made our COVID-19 estimation efforts possible.

covid19.healthdata.org 20 Institute for Health Metrics and Evaluation