The exorbitant and sad bill left by death from coronavirus

Among the dust and accumulated garbage left by other funerals in the San Isidro de Ecatepec pantheon, in the State of Mexico, a gravedigger throws dirt on the coffin of an unknown person. It is not known his age, where he was from or if he had a family, since no one has come to his funeral. Juan Cruz, the head of gravediggers, says that paramedics found him lying in the street. The scant information on his file only states that the cause of death is “probable SARS-CoV-2”, one of the more than 165,000 victims that the virus has claimed in the country, especially during the month of January.

A few graves away, on a Wednesday at the end of January, the Reynaga family said their last goodbye to their father, who has died of respiratory complications. “He did not die from covid-19, but the pandemic has affected his wake. They haven’t let us bury him in our perpetuity [espacio del cementerio que se alquila por siete años]. They say it is because it is fraudulent, but I am sure it is because they need the space for the deceased from coronavirus ”, complains Santiago Reynaga Ávila, son of the deceased.

Outraged, Reynaga recounts the complications he had to find a funeral home to care for him. “There is so much saturation that they take several days to attend you and there is no one who will give you the death certificate to bury it. And the prices have gone up a lot. Luckily some friends got us out of trouble and we can fire him as God intended, “he says, raising a beer in the air to say goodbye to his deceased.

The second wave of the pandemic in Mexico has reached an all-time high in deaths during December and January. In the first month of 2021, the deaths from covid-19 reached 1,803 in a single day, and during a week more than a thousand deaths were recorded daily, well above the worst moment experienced in June. On February 5, Mexico City added 397 deaths from covid-19 in one day, almost three dozen more deaths than those left by the 2017 earthquake according to official figures. Since December, the capital – which already accumulates more deaths than entire countries such as Belgium, Turkey or Canada – has experienced the equivalent of two or three earthquakes every week. Consequently, the metropolis must bury under a collapsed system the excess of victims, many of whom die in their homes.

That was the case of Ernesto Martínez, the brother of Gloria Martínez, the head of the Iztapalapa pantheons. She herself is witness to the saturation of the second wave, which has pushed her pantheons to receive more than 100 services a day, when the normal used to be between eight or ten. When his brother became seriously ill with covid in the second week of January, he saw the capital saturation beyond the walls of his cemetery. “My sister called the ambulance and they told us directly that there was no place to take him, that if they picked him up, they would most likely return him dead,” he recalls. They asked at a private hospital, but the price of 150,000 pesos (7,400 dollars) for admission, plus 100,000 per day (almost 5,000 dollars) for intensive therapy deterred his family, which belongs to a country where the average salary is 7,000 pesos per month ($ 350). Finally, after a few days, Ernesto died at home and was buried in the civil pantheon for residents of the municipality in San Lorenzo Tezonco.

When finding a bed in a hospital is a pilgrimage with no guarantees of success because of the 72% occupation in the capital, the costs increase. Private care in a private hospital can vary, but does not go below 130,000 pesos per admission and per day, according to the doctors consulted for this report. The amount includes the cost of care for each day the bed is used, the fees of the doctors who attend to the patient, medicines to alleviate the effects of the coronavirus, the use of devices such as respirators or oximeters and even hemodialysis in the necessary cases.

Ernesto Martínez, who took maximum care of his contacts to avoid becoming infected, infected his father and uncle before he died. In just 15 days, Gloria Martínez assures that she has paid 40,000 pesos (almost 2,000 dollars) just for her father’s treatment at home.

In the most extreme cases, where a patient needs care in a private hospital for several weeks, the bill can reach 3 million pesos (almost 150,000 dollars). A doctor who collaborates in several private hospitals in the city, and who gave his testimony on condition of anonymity, assures EL PAÍS that there are families who come to sell cars or properties in an attempt to save their loved ones. “It depends a lot on the hospital, but in particular they are charging a million”, he explains. “Imagine that after all that the patient dies and you are left with a millionaire debt,” he says, and narrates how, during this second wave, they have left bodies abandoned. “The bad thing is that there are no refrigerators for them and they accumulate.”

The magnitude of the excess of deaths has exceeded any logistical forecast, private or public, and this has reached even the most elementary step to process a death: obtaining a death certificate. Santiago Reynaga Ávila barely had time to look for a funeral home when his father passed away. “I kept calling, but everyone told me there was a four-day wait, what am I going to do with my body for so long?” At the death certificate services, necessary to start the burial or cremation procedures, there was a queue of almost a week. Before the pandemic, obtaining this document required only a few hours and was a procedure that did not cost more than 1,500 pesos. “An acquaintance offered us the service of a friend of his who would get us the document for 12,000 pesos. It seemed like too much to us, but the second we found it we raised it to 15,000 ”, he recalls.

David Vélez, president of the Association of Owners of Funeral Homes and Embalmers, explains that during the second wave of covid-19 there was a shortage of the official numbered paper of the certificates in the State of Mexico. Also, coffins became scarce. Even so, he assures that funeral services remain at 10,000 pesos. Gloria Martínez adds that many private companies exceed those prices. “The cheapest you find is 18,000 pesos, but there are those who come to pay for the same 31,000,” he details.

Vélez explains that there is also no regulatory mechanism for funeral prices. Unlike other services of the pandemic that must benefit from a fixed rate to avoid opportunism – such as the price of oxygen tanks – funeral rates respond to the law of supply and demand of the market at all times, and in a year pandemic requests have skyrocketed. Even so, Vélez assures that in the second wave the rate for funeral homes fell by 40% due to the shortage of coffins, one of the most expensive pieces of the entire ceremony. “By burning the bodies directly in the bag, the coffin is dispensed with and the price goes down,” he explains.

The pantheons that Martínez directs in Iztapalapa are preparing for the arrival of two Covid victims that will be buried in a tomb within its 120 square hectares. The popular mayor’s office of Iztapalapa, which with 1.8 million inhabitants has lost 4,000 residents to the virus – more than some entire states – receives bodies from other states where there is no room left. The graves that the gravedigger Gustavo Mendoza has dug are in addition to the more than 85 that he has opened in the last day. And there are still more than 50,000 holes.