ObjectivesAccurate civil registration and vital statistics (CRVS) systems are the primary data source to measure the impact of the COVID-19 pandemic on mortality. This study assesses how the pandemic impacted CRVS system processes in Loreto region of Peru, one of the worst affected countries globally.DesignQualitative study.SettingLoreto, a remote region, which had the highest reported mortality rate in Peru during the pandemic.ParticipantsSemistructured individual interviews and documentary analysis were conducted between September 2020 and May 2021 with 28 key informants from eight institutions involved in death certification. Key informants were identified using a purposive sampling strategy commencing at the Health Directorate of Loreto, and the snowball method was used where a participant suggested another organisation or person. Information from key informants was used to compare business process maps of the CRVS system before and during the pandemic.ResultsDuring early May 2020, there were seven times more registered deaths than in earlier years, but key informants believed this underestimated mortality by 20%–30%. During the pandemic, families had to interact with more institutions during the death certification process. Several issues disrupted death certification processes, including the burden of increased deaths, the Environmental Health Directorate often removing a body without the family’s express agreement, the creation of COVID-19 cemeteries where no death certificate was needed for burial, greater participation of funeral homes that often used outdated paper forms, and closure of civil registry offices. There was increased use of the online National Death System (SINADEF) but many users had problems with access.ConclusionsThe pandemic substantially disrupted CRVS processes in Loreto, making death certification more difficult, placing greater burden on the family and leading to more participation from unregulated organisations such as funeral homes or cemeteries. These disruptions were impacted by limitations of the CRVS system’s processes before the pandemic.

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Objectives: To evaluate the survival of health workers infected by SARS-CoV-2 in the context of the vaccination process against COVID-19 in Peru. Methods: A survival analysis was performed using data from national health databases. Data from people between 18 and 59 years old infected with SARS-CoV-2 as evidenced by molecular or antigenic tests were included. Kaplan Meier graphs were produced to compare the survival of health workers and the rest of the population during 2021 and health workers during the first and second wave of mortality in Peru in 2020 and 2021, respectively. Results:Data from 998,295 people were included. The average age was 41.2 years (SD 15.8) and 485,167 (48.6%) were women. A higher level of survival of health workers after vaccination was found compared to the general population and to the population of health workers before vaccination. It was evidenced that, at the beginning of the second wave, the risk of dying for health workers was twice that of the first wave (HR = 2). After vaccination (in the sixth month of the second wave), the risk of dying decreased to 87.5% less than in the first wave (HR = 0.125). Conclusions: A positive change has been evidenced in the level of survival of health workers infected by SARS-CoV-2 during the context of vaccination against COVID-19 in Peru.

Introduction COVID-19 infection is a major public health problem in the world and reinfections are becoming more frequent. Our main objective was to describe the epidemiological, clinical and genomic characteristics of the confirmed cases of reinfection by SARS-CoV-2 in the capital of Lima and Callao, Peru. Methods We searched in the Peruvian laboratory information system from April 2020 up to May, 2021, looking for cases having 2 positive molecular tests for SARS-CoV-2 with more than 90 days between them. We performed genomic sequencing to the available pairs of samples and described the clinical characteristics, epidemiological and genomic of the confirmed reinfections. Results There were 1,694,164 people with a positive diagnostic test for SARS-CoV-2 in Lima/Callao during the study period. Of these, 1,695 had 2 positive molecular tests with more than 90 days between them. 211 had both samples available for genomic analysis according to our selection criteria, these were retrieved and submitted to sequencing. 30 were confirmed to be SARS-CoV-2 reinfections having 2 different lineages in the 2 episodes. The variant Lambda (C.37) was the most common during the second infection, accounting for 19 (63.3%) of these. Conclusions We report 30 cases of confirmed SARS-CoV-2 reinfections. The Lambda variant was the most common cause of the second infections, in concordance with its predominant circulation during Peru´s second wave. This report describes the largest series of confirmed reinfections by SARS-CoV-2.