This was the week when Peru crossed a psychologically significant frontier as the number of cases of Covid-19 rose above the 200,000 mark. As of Friday, 12 June, the figure stood at 220,749. Meanwhile the death toll continued to rise, passing the 6,000 mark to 6,308.

The numbers in hospital receiving attention was bordering on 10,000 with more than 1,000 in intensive care. The hospital system is at its limits in terms of being able to cope with the pressures put upon it.

Despite the length and severity of the lockdown in Peru, the country is still struggling to deal with the contagion, and the Vizcarra government (like others elsewhere) is striving to reconcile business and other pressures for a let-up with public health realities on the ground. On 10 June, Interior Minister Gastón Rodríguez refused to be drawn on a date for ending lockdown, saying that it would happen only when the government believes it the right thing to do.

Over the last week, the authorities trialled a new system, known as Operation Tayta, that seeks to identify the most vulnerable people living in a particular location (mainly the elderly), to oblige them to stay at home, and to provide daily food parcels to meet their needs for sustenance. The scheme was being piloted in a number of low-income districts of Lima which have witnessed the highest numbers of casualties in recent weeks.

For its part, the Ministry of Health believes that the worst may be over in the number of cases showing symptoms nationwide, emphasizing the differences between regions.

These differences have been clear from the early days of the pandemic. Those worst affected have been Lima, the coastal cities of the north and locations in the Amazon region (notably Iquitos and Pucallpa). The contagion has laid bare the weaknesses of Peru’s public health system, a sector given scant priority in government spending over recent decades.

A new study shows the degree of infection by districts per 100,000 head of the population for a given period between 25 May and 1 June. This identifies the worst affected areas (where the numbers of infected are more than 600 per 100,000 inhabitants) as ‘red’ areas. They are followed by those categorised as ‘amber’ (between 100 and 600 cases), ‘yellow’ (between 22 and 100 cases), and ‘green’ (less than 22 cases). Only in the last of these is contagion thought to be under control.

The figures suggest that the pandemic may be becoming less serious in the north of the country where, according to this classification, no districts are showing ‘red’. Previous hotspots, like districts of Piura and Lambayeque, are considered ‘amber’.

In Lima, only one district (Jesús María) is a ‘red’ zone, perhaps because of its relatively small population and the proximity of one of the major hospitals, the Rebagliatti. Most other areas are classified as ‘amber’, although there are a few districts classified ‘yellow’.

The ability of the authorities to reduce infection is limited by the lack of any procedures for identifying those who have been in recent contact with the infected (contact tracing). Testing, too, is patchy, making the accuracy of the numbers infected less than robust. The government gave up tracing early on in the pandemic. Tracing without testing makes little sense. And even if it had sufficient testing kits, Peru lacks the laboratories to analyse the results.

Although the situation may have improved a little in the north of the country, health officials worry that the virus will continue to expand in the south, and there is always the danger of a second wave.

A bit of good news is that the virus appears to be less virulent in attacking people living at high altitudes. The disparities between regions is notable, with Andean regions still much less affected than those along the coast or in the jungle. One theory is that increased ultraviolet light impedes propagation of the virus. Another is that Andean people living at high altitudes have less of the proteins that the virus uses to latch itself on to the human organism.

The lower rate of contagion in regions like Apurimac, Puno, Cuzco and Cajamarca squares also with the geographical spread of the virus in Bolivia and Ecuador where cases are also less common at high altitudes.

The Guardian provides a strong visual record of life under Covid-19 for the Shipibo of Cantogallo ‘island’ in Lima. Worth looking at.