Objective:

To build a general index of vulnerability of the health sector and a specific index of vulnerability in pneumological diseases that identify the municipalities with the least capacity to respond to the pandemic caused by the SARS-CoV-2 virus.

Materials and methods:

To generate the indices, we rely on three components: infrastructure and available personnel, health demand, and the scope of social and health insurance, all using the Shapley decomposition method.

Results:

The municipalities that present a greater resilience capacity in the face of the pandemic are mostly capital municipalities, a fact that highlights the poor spatial distribution of health services. Besides, due to the socio-economic characteristics of the country, the municipalities of the southwest region (Oaxaca, Guerrero, and Puebla); of the Sierra Tarahumara (Chihuahua) and the Huasteca (San Luis de Potosí, Querétaro, and Hidalgo) are those that present a high index of vulnerability due to not having sufficient health resources and having a large proportion of the population sensitive to the pandemic. Another critical finding is that the capital municipalities, despite having a considerable number of hospital infrastructure and medical personnel, have a high demographic density, which causes them to be more exposed to the virus. Therefore, they are heading towards the total saturation of their population. Healthcare system: such is the case of municipalities such as Iztapalapa or Ecatepec who exceeded their hospital capacity after the second wave of the pandemic.

Conclusion:

The vulnerability of the health sector seen through the developed indices is aggravated if the specific capacity to care for respiratory diseases is analyzed, particularly in municipalities with high and medium exposure to the COVID-19 pandemic; the findings show the importance of developing targeted protection and mitigation policies for these municipalities.