Ruben Vazquez lives in fear of dying before he gets a new kidney -- just one of thousands of organ transplant operations put on hold in Mexico due to the pandemic.
The 60-year-old retired accountant hopes that mass immunization against the coronavirus will enable him to finally undergo the surgery that he had been preparing for when the outbreak began in February.
"I live in constant anguish. Sometimes I think I'm going to die before the vaccine arrives," said Vazquez, who suffers from chronic kidney disease.
Mexico has officially recorded more than 100,000 coronavirus deaths -- one of the world's highest tolls.
The government advised public hospitals dealing with an influx of Covid-19 patients to suspend organ transplants between March and September to reduce the risk of infections.
Although some have since slowly resumed the operations, many have not, including Hospital Juarez in Mexico City where Vazquez was supposed to undergo surgery.
By the time the pandemic struck, he had already undergone numerous examinations, some of them very painful, such as the procedure to obtain images of his urinary tract.
- 'Thought I'd die' -
Mexico's National Transplant Center had 23,370 people registered on the waiting list for organ donation in the second quarter of 2020, including 17,418 in need of a kidney.
Vazquez worries that his own donor -- one of his friends -- might back out.
"When I knew that transplants would be suspended, I thought I'd die," he said by telephone.
"I can't go to hospital if I get seriously ill. They all have Covid patients," he said.
Two months after the government announced the resumption of organ transplants, Hospital Juarez has yet to set a date for restarting the procedures, which severely weaken patients' immune systems.
"X-rays, hospitalizations, beds, operating rooms -- everything's focused on Covid patients," said Andres Bazan, who heads the hospital's transplant program.
"It's impossible for us to mix immunosuppressed patients with highly infectious patients," he said.
- 'Activity collapsed' -
Only one kidney transplant operation was carried out in Mexico in the second quarter of this year, in a private hospital in the southeastern state of Tabasco.
That compared with 744 in the same period of 2019, according to the National Transplant Center.
Things improved slightly in the third quarter with 36 kidney transplants.
"Donation and transplant activity collapsed in most of the hospitals," said the director of the National Transplant Registry, Jose Andre Madrigal.
"Budgets are definitely being used to deal with Covid," he said.
The suspension of transplants was the results of fears that the health system would be overwhelmed, according to doctor Rodrigo Lopez, president of the Mexican Society of Transplants.
He urged the authorities to designate certain hospitals for the exclusive care of patients in need of new organs, especially those with kidney failure.
About a third of the 102,000 people killed so far by the coronavirus in Mexico had hypertension or diabetes, which can lead to kidney disease.
No figures are available on the number of patients who have died while awaiting transplants during the pandemic.
The risk of infection from the coronavirus makes it impossible for people with kidney disease to attend consultations, making it "harder to know when a patient dies on the waiting list," Madrigal said.