Beyond The Count: A Closer Look Into Venezuela's COVID-19 Data

This investigation explores how COVID-19 data was collected, managed and reported in Venezuela.

It also uses independent data collected directly from major public hospitals to provide a clearer picture of the pandemic’s impact on an already precarious healthcare system.

COVID-19 arrived in Venezuela in early March 2020.

Unlike other countries, there are specific factors that make it difficult to understand the pandemic data and its impact on the country:

Hospitals across the country were already facing significant challenges to supply basic care.

Years of underinvestment and inadequate public policies have left Venezuela’s public healthcare system in a critical state, struggling to meet even the most basic needs.

In 2019, the year before the pandemic, Human Rights Watch (HRW) along with the Center for Public Health and Human Rights at the Johns Hopkins University’s Bloomberg School of Public Health published a report detailing some of the significant challenges hospitals across the country face daily.

Then, at the beginning of 2020, the Encuesta Nacional de Hospitales (ENH), an independent organization monitoring 40 hospitals nationwide, published their report with data collected from the health centers over the past year:

the government has a history of not being transparent with any sort of data.

A culture of opacity has been integrated into Venezuela’s public administration raising significant doubts about the reliability of official statistics in any sector, including health.

economics

The Central Bank of Venezuela stopped publishing key macroeconomic statistics between 2015-2019, the same period where the country was submgerged into hyperinflation and one of the worst financial crises in its history.

public spending

The International Budget Partnership has consistently assigned Venezuela a score of 0 since 2019—indicating a complete refusal to disclose public spending data.

elections

International organizations, such as the UN and the Carter Center, have repeatedly criticized Venezuela’s lack of transparency in both the 2019 and 2024 presidential elections.

On the Ministry of Health:

Since 2015, it has withheld essential national health statistics, making it nearly impossible to track trends or plan interventions.

A telling moment occurred in 2017, when then-Minister of Health, Dr. Antonieta Caporale, briefly resumed publishing health statistics after a two-year hiatus:

The data revealed alarming increases in maternal and infant mortality rates, as well as an increase in malaria cases.

Dr. Caporale was fired from her position the very next day, sending a clear message about the government’s unwillingness to communicate and acknowledge the healthcare crisis.

venezuela’s 2016 health stats vs. similar countries

data: venezuela’s epidemiology bulletin (2017) / unicef colombia / world malaria report (2016)

On the COVID-19 data:

The Ministry of Health initially set up an online platform to provide pandemic-related information, similar to efforts in other countries.

However, the platform became inaccessible for months, leaving researchers and the public unable to verify official statistics.

As a result, this investigation relies on third-party sources that previously gathered and replicated the government’s data.

With all of this as background,
the pandemic struck Venezuela.

The first two cases were reported on March 13th, 2020.

Four days later, on March 17, the government imposed a nationwide strict lockdown that remained until June 2020.

The first two cases were reported on March 13th, 2020.

Four days later, on March 17, the government imposed a nationwide strict lockdown that remained until June 2020.

Then, a new system called “7x7” was introduced: one week of strict lockdown and one week of eased restrictions.

The goal was to balance controlling the virus’s spread while allowing for some economic and social activity to resume.

This the official count of COVID-19 cases in Venezuela, based exclusively on postive PCR tests.

However, until July 21st only one lab in all the country was allowed to process the tests.

This the official count of COVID-19 cases reported in Venezuela, based exclusively on postive PCR tests.

which, among other things, brings us here:

The official data and its methodology has been called out and questioned.

PCR tests were identified by the World Health Organization (WHO) as the most accurate tool for diagnosing COVID-19, making them essential for tracking the virus' spread and guiding public health decisions.

However, Venezuela’s PCR testing strategy and the data derived from it have been widely questioned by institutions such as Venezuela’s National Academy of Physical, Mathematical and Natural Sciences (Academy of Sciences, for short) and the Johns Hopkins School of Medicine.

In the first four months after COVID-19 was detected in Venezuela, all PCR tests were processed at the National Institute of Hygiene (INH), a government-run laboratory under the Ministry of Health in Caracas

Experts estimated that the INH’s processing capacity was limited to around 100 tests per day.

Venezuela
‍(100 tests / day)

In contrast, Colombia had established 38 laboratories capable of processing approximately 2,550 tests daily as early as April 2020.

colombia
‍(2.5K test / day)

While private health centers and academic institutions across the country offered to help process PCR tests, the government delayed authorizing additional facilities.

It wasn’t until late July 2020 that a second laboratory—also near Caracas—was allowed to process tests.

By the end of 2020, the Venezuelan government had authorized only five laboratories to process PCR tests, three of them near Caracas.

Even before reaching the (very few) labs, there were already limitations in the PCR testing strategy that directly affected the subsequent data reported:

Until mid 2021, PCR testing was only allowed at specific health centers and limited to symptomatic patients.

Therefore, not ensuring effective testing was available to all and leaving asympotatic people out of any official statistic until very late in the pandemic.

After patients were tested, regional epidemiology agents would collect samples from the health centers and send them to one of the authorized labs (again, very few and centralized in Caracas), whom would then report results directly to the government’s pandemic task force.

This centralized and bureaucratic approach caused significant delays in both processing the PCRs and reporting the results.

By September 2020, the Academy of Sciences argued that the average wait time for PCR results was 8 days (± 5 days).

Considering the virus’s incubation period of 5–6 days, and the requirement that testing only occurred after symptoms appeared, the reported data lagged behind the actual situation by 8–18 days, varying by region.

delays in pcr testing protocols (september 2020)

data: academy of sciences: covid report II

Acknowledging the underreporting of active cases, the Academy of Sciences used an epidemiological model to estimate the real number of infections.

The model, designed for a population divided into subgroups, accounted for local transmission dynamics, interregional movement, and the continuous influx of people—mainly from Colombia—introducing new cases.

It was assumed that the epidemic spread primarily through local transmission + symptomatic individuals did not travel, while asymptomatic or healthy individuals continued to move between regions.

By late August 2020, official reports reported an average 900 new daily infections.

official reports
(900 new cases / day)

The Academy of Sciences’ model estimated that by that same time, Venezuela had approximately 7,000 new daily cases — almost eight times the official count.

academy of sciences’ model
‍(7K new Cases / day)

1 circle = ten cases

data: academy of sciences: covid report II

The limited testing capacity, delays, and restrictive protocols also contributed to the underreporting of COVID-19 deaths in Venezuela.

Official protocols required a positive PCR test to certify COVID-19 as the cause of death.

By late August 2020, neighboring countries reported COVID-19 mortality rates of 2–3%.

Based on the official count of 900 daily new cases and according to that mortality rate, there should have been between 18 and 27 daily deaths by COVID-19 in Venezuela by that same period.

Yet only seven deaths were reported on average each day.

Using the Academy of Sciences’ estimate of 7,000 daily cases, the expected number of fatalities would have been between 140 and 210 daily deaths during the same period.

The Encuesta Nacional de Hospitales (ENH) monitored key metrics throughout the pandemic, including deaths attributed to Acute Respiratory Infections (ARIs).

Unlike official figures, the ENH’s data included all patients who died in surveyed hospitals from severe respiratory conditions, regardless of their PCR test results.

By late August 2020, the ENH reported an average of 27 daily deaths from ARIs, aligning with the 2–3% mortality rate observed in other countries for confirmed COVID-19 cases.

data from WEEK 35, 2020
(aug 24 - 30)

data: venezuela’s government. sourced through JHU CSSE COVID-19 Data / enh

ENH data consistently shows that deaths by ARI accounted for 2–3% of confirmed COVID-19 cases, comparable to regional mortality rates.

In contrast, official Venezuelan data reported a COVID-19 mortality rate of no more than 1.2%.

This discrepancy makes sense when considering the protocols.

PCR tests were only conducted in hospitals to symptomatic patients. Of those, the severely ill would remain in observation under an ARI diagnosis until their PCR results came back.

If any of these patients died, the ENH would record them as ARI-related deaths in the hospitals they monitored, regardless of PCR confirmation.

In contrast, a positive PCR result was required for a death to be officially classified as COVID-19.

As previously noted, significant delays in the official protocol, caused by limited capacity and centralized testing, likely led to patients with COVID-like symptoms dying in hospitals before receiving their PCR results. Therefore, these deaths would not be included in the official statistics.

data from WEEK 35, 2020
(aug 24 - 30)

data: venezuela’s government. sourced through JHU CSSE COVID-19 Data / academy of sciences: covid report II

This is as far as the official data goes.

The government only reported daily new cases and COVID-19 deaths, with only the fatalities segregated by state.

These figures were published on an official government website, which, like many others, is no longer accessible.

There was never any clear information on the number of tests performed and processed daily, nor was a positivity rate ever released—both of which were recommended by the WHO as key indicators for shaping public health policies.

Likewise, no official data was provided on the public healthcare system’s capacity, including hospital occupancy, availability of supplies, or healthcare personnel, as had been the case even before the pandemic.

This is as far as the official data goes.

In contrast, the Encuesta Nacional de Hospitales (ENH) tracked key metrics daily from the public hospitals they survey regularly.

One of the key indicators tracked was the weekly ICU bed occupancy for patients with severe Acute Respiratory Infections (ARIs), by state.

The chart below highlights the weeks when ICU capacity was either fully saturated or exceeded, meaning there were more patients in need of an ICU bed than available beds.

Both Miranda and Zulia experienced persistent ICU saturation, likely due to the fact that they are the two most densely populated states in Venezuela.

These factors increase transmission rates, leading to a higher number of patients requiring critical care in ICU.

Itt is possible that patients from other states were transferred to Miranda or Zulia, as these states have greater hospital capacity and resources compared to the rest of the country.

Regardless of the contributing factors, the chart clearly shows that ICU beds in Venezuela’s two main states remained at critical levels for an extended period, underscoring the strain on the healthcare system throughout the pandemic.

Mechanical ventilators played a life-saving role during the pandemic, as severely ill COVID-19 patients with respiratory failure often depended on them for survival.

Given that COVID-19 could cause Acute Respiratory Distress Syndrome (ARDS), ventilators were essential to ensure that critically ill patients could receive adequate oxygenation when their lungs could no longer function properly on their own.

The ENH tracked the availability and usage of mechanical ventilators in the hospitals they surveyed by patients with ARDS during the pandemic:

The data once again highlights Miranda and Zulia as the states with the highest saturation of ventilator use, likely for the same reasons as ICU bed saturation—higher population density, increased transmission, and larger hospital capacity, which may have attracted referrals from other states.

However, this chart also reveals a nationwide surge in ventilator demand, especially throughout 2021, with significant peaks in the final weeks of the year.

In Miranda, for example, the need for ventilators reached a critical point, with demand exceeding availability by a factor of five.

This shortage underscores how the strain on Venezuela’s public healthcare system further complicated patient care and survival rates in the most critical moments of the pandemic.

Recognizing the severity of COVID-19's spread and the critical importance of protecting healthcare personnel, the ENH also monitored the availability of three indispensable supplies: face masks, gloves, and hand sanitizer.

Only 19% of surveyed hospitals had an uninterrupted supply of face masks, meaning these were available every day without interruption. Conversely, 7% of hospitals virtually never had face masks available.

Only 24% of hospitals reported consistent availability of gloves throughout the monitoring period.

While just 7% of hospitals had a continuous supply of hand sanitizer, while nearly 36% experienced a complete lack of the supply.

availability of covid-19 supplies in ENH’s surveyed hospitals

data: ENH’s covid report

available 90% or more of reported days

available some days (10.1% - 88.9%)

available less than 10% of reported days

The shortage of essential medical supplies was not just a logistical failure, It was a direct consequence of the same systemic issues that plagued Venezuela’s entire COVID-19 response (and overall healtcare system).

The COVID-19 pandemic in Venezuela exposed critical failures in healthcare infrastructure, data transparency, and resource management.

Also, the data reported by the Venezuelan government does not reflect the true scope of the pandemic.

Instead of providing a reliable picture of the crisis, the numbers were shaped by bureaucratic bottlenecks, limited testing, and structural inefficiencies.

In this case, we are able to investigate where these failures occurred because alternative data sources like the Encuesta Nacional de Hospitales offered insight into what was happening on the ground.

Through it, we can see hospital shortages, supply deficits, and a wider picture of the pandemic's influence in Venezuela, its healtcare system, and its people.

However, the lack of transparency in Venezuela’s public data is not new. For years, experts and civil society organizations have warned about the government’s increasing opacity in reporting key health, economic, and humanitarian statistics.

This lack of accessible, accurate data prevents effective crisis response, hides the severity of public health issues, and ultimately puts lives at risk.

The COVID-19 pandemic is just one example of the consequences of information suppression, where the cost is measured not just in distorted numbers but in the real human impact of a system built to obscure rather than to inform.

a project by julio simón
in collaboration with the encuesta nacional de hospitales