Intended for healthcare professionals

Letters Covid-19 in Peru

Covid-19 in Peru: from supervised walks for children to the first case of Kawasaki-like syndrome

BMJ 2020; 369 doi: (Published 22 June 2020) Cite this as: BMJ 2020;369:m2418
  1. Jaime A Yáñez, professor1,
  2. Aldo Alvarez-Risco, professor2,
  3. Jaime Delgado-Zegarra, director3
  1. 1Universidad Peruana de Ciencias Aplicadas, Facultad de Educación, Carrera de Educación y Gestión del Aprendizaje, Avenida Prolongación Primavera 2390, Los Álamos de Monterrico, Santiago de Surco, Lima 15023, Peru
  2. 2Universidad de Lima, Facultad de Ciencias Empresariales y Economicas, Carrera de Negocios Internacionales, Lima, Peru
  3. 3Universidad San Martin de Porres, Facultad de Ciencias Administrativas y Recursos Humanos, Instituto de Consumo, Lima, Peru
  1. jaimeayanez{at}

Godlee appraises the UK government’s response to covid-19.1 Peru is among the countries with the most covid-19 cases globally,2 reaching 178 914 cases on 3 June.3 Regardless of this, on 18 May the Peruvian government started allowing supervised walks for people under 14 years old,4 following the Spanish measure implemented on 26 April.5 We have previously expressed our concern for this measure6 because it could lead to a rise in cases in children, who typically exhibit milder symptoms.7 Criticism led to the publication of an epidemiological alert prohibiting supervised walks in most of Peru because of the high risk of contagion.8 By that point, however, thousands of people had already been out with children, as shown in the media.

In Spain this measure caused an increase in cases in children under 10 from 0.31% of total cases on 26 April to 0.36% on 13 May and from 0.9% to 1.03% in 11-19 year olds.9 Similarly, in Peru the cases in children under 11 increased from 1.9% of total cases on 12 May10 to 2.6% on 26 May11 and from 1.1% to 1.6% in 12-17 year olds. This happened as Kawasaki-like cases with prolonged fever, rash, and hyperinflammatory shock in young children started to be reported in Europe12131415 and the United States.1617 On 14 May, this syndrome was called multisystem inflammatory syndrome in children (MIS-C).18 In Peru on 1 June, three children with covid-19 were reported to have Kawasaki-like symptoms,1920 and two days later a 3 year old girl with covid-19 became the first case of MIS-C in Peru.21

Even though the link between MIS-C and covid-19 needs to be determined,22 we must be cautious in Peru, where there is a precarious health system, cases keep increasing in small children, paediatric hospitals are saturated with adult patients, and public policies are not necessarily following the global epidemiological alerts.


This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.