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ABSTRACT: In 2020, Mexico confirmed 1.5M cases of COVID-19, with 128,000 deaths — an 8.8 percent fatality rate that is among the highest worldwide. The positivity rate for those tested is 42 percent (WHO target = 5 percent). The pandemic is likely to become the main cause of death in 2020, and in 2021— even with the vaccine —mortality is expected to rise. Almost half of the Mexican population receives its medical care from the Mexican Social Security Institute (IMSS). Our team from UCB, IMSS, and UNAM aims to harness the massive patient-level clinical and socio-demographic data from the IMSS to better predict susceptibility to infection and serious complications among those who are infected. The advantages of working with the IMSS are clear – the disadvantage is that it has taken many months to get approval from the relevant human subjects and research committees. The IMSS comprises many poorly integrated data systems, so there is significant work involved in relating the disparate databases to each other. We now have 2.5 years of utilization data (outpatient visits [>300M], hospitalizations, prescriptions [almost 500M], and COVID tests). We will study variability by employer, by state and neighborhood, by household structure, by clinic, by provider (and provider behavior), by current and prior health conditions, by degree of control of chronic health conditions, by any drugs that they have been prescribed, as well as by the usual demographic and socioeconomic characteristics. The priority will be to identify modifiable factors that the IMSS can use to reduce population risk. Stefano M. Bertozzi is Dean Emeritus and Professor of Health Policy and Management at the University of California, Berkeley School of Public Health, and Interim Director of University of California systemwide programs with Mexico (UC-MEXUS, the UC-Mexico Initiative, and Casa de California). Previously, he worked at the Bill and Melinda Gates Foundation, Mexican National Institute of Public Health, World Health Organization, UNAIDS, World Bank, and the Government of the Democratic Republic of the Congo. He recently co-edited the Disease Control Priorities (DCP3) volume on HIV/AIDS, Malaria & Tuberculosis, has served on governance and advisory boards for the East Bay Community Foundation, HopeLab, UNICEF, WHO, UNAIDS, Global Fund, PEPFAR, NIH, Duke University, University of Washington, and the AMA, has advised NGOs and ministries of health and social welfare in Asia, Africa, and Latin America, and is a member of the National Academy of Medicine. Juan Pablo Gutierrez is Professor at the Center for Policy, Population, and Health Research, National Autonomous University of Mexico (UNAM), Chair of the Technical Committee of the Morelos’ Commission on Evaluation of Social Development, and Member of GAVI Evaluation Advisory Committee. His research focuses on comprehensive evaluation of social programs and policies, universal health coverage and effective access, and social inequalities in health. He has been responsible for the evaluation of social and health programs in Mexico, Ecuador, Guatemala, Dominican Republic, Honduras, and India, as well as several population-based health surveys both in households and facilities. He is a member of the National Observatory on Health Inequalities in Mexico and has authored or co-authored more than 60 papers in peer-reviewed journals.
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