The Americas, Pandemic on the Back of Poverty: Peru and Ecuador; and a Southern Cone Contrarian

Posted on by E Curb Nottus
Environmental, Geography, Natural Environment, Public health,, Society & Culture

As Europe starts to pull itself out of the worst of the coronavirus outbreak, the Americas for the most part are still firmly mired in the devastating crisis of the pandemic…more worryingly, COVID-19 cases continue to rise and even accelerate in some countries as Latin America seems to be turning into “pandemic central”, the ‘new’ Europe❅. This is occurring despite the continent comprising only eight percent of the world’s population and having had the advantage of time to prepare for the virus which reached its shores some six weeks after ravaging Europe.

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(Source: www.maps-of-the-world.net)

Smallness helps
The picture of Central and South America is not uniformly bleak. Some of the smaller countries, such as Uruguay, Paraguay and El Salvador, have managed to restrict their nation’s outbreaks to low levels of infection and casualties. This last mentioned country was surveyed in an earlier blog entitled Courting Controversy in Coronavirus Country: Belgium and El Salvador – June 2020). Among the Southern Cone countries, Argentina and Uruguay stand in contrast to their neighbours Chile and Brazil. Argentina (population of >45 million)—its commendable performance vs the virus slightly tarnished by a recent upsurge following an easing of the lockdown—has a total of 39,557 COVID-19 cases and only 979 deaths, compared with Brazil (whose leader Jai Bolsonaro has taken a recklessly dismissive attitude towards the pandemic). Even on a per capita basis Argentina‘s figures are still a fraction of the human disaster befalling Brazil which has racked up 1,038,568 cases and 49,090 deaths (population: 212 million). The Argentine Republic’s results are also way better than Chile’s record of 231,393 cases and  4,093 deaths (from just 19 million) [‘Argentina’s president enters voluntary isolation amid coronavirus surge’, (Uni Goñi) The Guardian, 18-Jun-2018, www.theguardian.com].

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Brazil: COVID-19 mural message (Source: Getty Images)

Uruguay: Stellar success of an outlier
Uruguay has fared as well as anyone in Central/South America in avoiding a pandemic catastrophe on the scale of some of its neighbours. A tiny population (3.5 million) helps immeasurably but the sheer lowness of its corona numbers stands by themselves – just 1,040 confirmed cases and 24 deaths. This has been achieved despite a demographic profile that should have made it highly vulnerable to the disease: the largest regional proportion of  elderly citizens and a population which is 96% urban. And an outcome secured not by lockdowns and quarantines (allowing Uruguay to preserve its national economic health cf. the stricken economies of its large neighbours Brazil and Argentina), but by eliciting the voluntary compliance of its citizenry – and through the luxury of having a near-universal, viable health care system✺ [‘Why Is Uruguay Beating Latin America’s Coronavirus Curse?’, (Mac Margolis), Bloomberg, 30-May-2020, www.bloomberg.com].

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Uruguay (Photo: Daniel Rodrigues/adhoc/AFP via Getty Images)

Peru:   
Aside from Brazil the country in the region most in strife due to the pandemic at the moment is probably Peru. Peru’s statistics are stark – over 247,925 confirmed cases and 7,660 deaths in a population of 32 million. What is particularly troubling about Peru is that, unlike Brazil, at onset it seemed to be pulling all the right reins, implementing one of Latin America’s earliest and strictest lockdowns. Months of enforced lockdown have however failed to flatten the curve of infections. Peru finds itself in a demoralising “double whammy”, the public health catastrophe continues unabated❈ while the recourse to a tough national lockdown has further crippled the economy [‘Poverty and Populism put Latin America at the centre of the pandemic’, (Michael Stott & Andres Schipano), Financial Times (UK), 14-Jun-2020, www.amp.ft.com; ‘Peru’s coronavirus response was ‘right on time’ – so why isn’t it working?’, (Dan Collyns), The Guardian, 21-May-2020, www.theguardian.com]✪.

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⇑ Andean pabluchas patrol Cuzco streets to enforce social distancing and mandatory mask measures (Photo: Jose Carlos Angulo/AFP/Getty Images)

Indicators of the poverty trap
The economic predicament Peru finds itself stems from the country’s high reliance on an informal economy (reaching some 70%). What Peru has in common with Brazil—and has been exacerbated by the pandemic—is very high social inequality. The poorest Peruvians cannot afford to stay home, to isolate as they should. Many are without bank accounts and under the informal economy have to travel to collect their wages, those without home refrigerators also need to shop frequently – all of which makes them more vulnerable to be exposed to the virus [‘Latin America reels as coronavirus gains pace’, (Natalia Alcoba), Aljazeera, 15-Jun-2020, www.aljazeera.com]. Disease and impoverishment have converged in Peru to make the predicament more acute for those of the poor who need life-saving oxygen of which there is now a scandalous critical shortage – the situation being exploited by profiteering hit men (the sicarios) controlling the black market oxygen supplies [‘In Peru, coronavirus patients who need oxygen resort to black market and its 1,000 percent markups’, (Simeon Tegel), Washington Post, 18-Jun-2020, www.washingtonpost.com].

Ecuador and Guayaquil ⇓

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Ecuador:  
In Ecuador the pandemic epicentre is the western city of Guayaquil, the country’s largest city. This is thought to be due to a couple of factors, the city’s sprawling slums where “many residents live hand-to-mouth and routinely violate the government lockdown…in order to work”, and because many Guayaquil exchange students and migrant workers came back to the city from Spain and Italy in March [‘COVID-19 Numbers Are Bad In Ecuador. The President Says The Real Story Is Even Worse’, (John Otis), NPR, 20-Apr-2020, www.npr.org]. The unpreparedness and inability of the authorities to cope with the crisis has affected the woeful degree of testing done, the lack of hospital facilities for patients and even the capacity to bury the dead as the bodies of coronavirus victims were left piling up on the city’s streets. In the wake of the disaster the Guayaquil Council entered into a slinging match with Quito (the national government), asserting that the government has under-represented the city’s death toll by as much as four-fifths, that it failed to provide it with the health care backup demanded of the disaster, as well as calling out the corruption of public utilities which has accentuated the crisis (Alcoba). Ecuador currently has 49,731 confirmed cases and 4,156 fatalities in a population of 17 million.

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End-note: The hypothesis of virus protection at high altitude 
Among the multitude of worldwide research projects triggered by the pandemic, a multi-country study looking at Bolivia, Ecuador and Tibet has advanced the theory that populations that live at a height of above 3,000 metres have significantly lower levels of susceptibility to coronavirus than their lowland counterparts. The study attributes the capacity of high altitude to nullify the disease down to the fact that living at high altitude allows people to cope with hypoxia (low levels of oxygen in the blood), and that the altitude provides a favourable natural environment—dry mountain air, high UV radiation and a resulting lowering of barometric pressure—reduces the virus’ ability to linger in the air. The COVID-19 experience of Cuzco in Peru seems to corroborate this hypothesis, being lightly affected compared to the rampage elsewhere in the country – the high Andean city has had only 899 confirmed cases and three deaths. Similarly, La Paz, Bolivia, the world’s highest legislative capital, has recorded only 38 coronavirus-related deaths to date⊠ [‘From the Andes to Tibet, the coronavirus seems to be sparing populations at high altitudes’, (Simeon Tegel), Washington Post, 01-Jun-2020, www.washingtonpost.com].

 
<Þ> all country coronavirus counts quoted above are as at 20-June-2020

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❅ for week ending 20th June 2020, confirmed cases for Latin America represented half of all new coronavirus cases (Source: WHO)  
✺ a like-for-like comparison to Uruguay might be Paraguay – also a small population (6.9 million), only 1,336 cases and 13 deaths but at the cost of a draconian lockdown with an economy-crippling end-game. 
❈ even prior to COVID-19 striking, the Peruvian public health system was struggling due to “decades of chronic underinvestment” (eg, spending <$700 a day on health care) (Tegel, ‘In Peru’)   
✪ the strict lockdown has been less rigorous when removed from the urban centres…in outlying areas, in the northern coast and the Amazonas region (particularly bad in the Amazonian city of Iquitos) it was less “honoured in the breach than the observance” leading to the formation of new virus clusters (Collyns)  
⊠ other experts discount the study’s findings noting that most coronavirus infections occur indoors, negating the relevance of UV levels (Tegel, ‘From the Andes’)

Courting Controversy in Coronavirus Country: Belgium and El Salvador

Posted on by funambulator@live.com
Comparative politics, Media & Communications, Public health,, Science and society

As countries try to deal with an epidemic that is novel to the world of public health, with no tried-and-true templates to follow, there have been various quite differing approaches to the COVID-19 crisis. Some of these approaches have inevitably roamed into the realm of the controversial and polemical, polarising people at home and abroad. In previous blogs 7dayadventurer.com has sketched the go-it-alone path adopted by Sweden✱,〘Two Antithetical Approaches to the COVID-19 Crisis: A Controversial Outlier Versus a a Low-key Over-achiever (10-May-2020)〙and the denialist response of President Bolsonaro to the epidemic in Brazil〘Covid/Ovid 2020: Crisis (Mis)Management – How the World’s Leaders are Responding? (02-Apr-2020)  〙. 

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Belgium’s unenviable record – with an asterisk
This blog turns the spotlight elsewhere, on to an unlikely duo, two vastly dissimilar countries whose strategies towards the pandemic have proved controversial, each in it’s own way. Belgium, a small European state, has surprised and shocked many observers by its prominence on the table of world’s worst affected countries. The country has recorded 815 deaths per million of population (as at the 1st of June), easily the worst per capita toll in “First World” Europe (next closest Spain, 580/one million). Although Belgium has some distinguishable factors which contribute it its fatality rate—the country and especially the capital Brussels is the sixth-most dense in Europe, and Brussels has a very international and mobile population, a high number of Belgians reside in nursing homes (accounting for more than half of the disease’s victims)✬—there’s another (statistical) factor that goes a good way to explaining why there has been 9,580 recorded victims of the disease⊡. Belgium counts both the deaths confirmed as resulting from coronavirus and the deaths which are suspected to have been caused by the disease (most countries do not include this second category in their official COVID-19 counts)✪. (“Is Belgium the world’s deadliest COVID-19 country or just the most honest?’, (Bevan Shields), Sydney Morning Herald,  01-Jun-2020,  www.smh.com.au).

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🔺 Belgians returning home to a coronavirus-hit country

In defence of over-counting
Belgian virologist Prof Steven Van Gucht has deflected criticism of both Belgium’s numbers and its method of calculating corona casualties, commending Belgium for its honesty in selecting the more inclusive determination of the death toll. Van Gucht has argued that “public health shouldn’t be a political game or a contest on who is doing better than someone else”, adding that other governments not being honest with the public about the true scale of their outbreaks will be caught out on it later. Not everyone in Belgium applauds such transparency and honesty with the corona data, some within the kingdom’s business leadership have expressed alarm than the methodology used to ‘inflate’ mortality and morbidity numbers may have a deterrent effect on tourists returning to Belgium once the economy reopens (Shields).
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(Source: www.graphicmaps.com/)

El Salvador’s tough stand on lockdown transgressors part of a worrying authoritarian trend?
Pre-existing conditions in the Central American country of El Salvador have dictated the government approach taken to coronavirus. El Salvador’s high incidence of both gang activity and homicide prompted president Nayib Bukele (at 38 youthful and very social media savvy, eg, >1.9 M Twitter followers) to act hard and fast. Bukele’s government took a preemptive approach to the outbreak, schools and colleges were suspended and a state of emergence declared before the country had recorded its first confirmed case of the virus. Borders were closed, public gatherings in excess of 500 people banned, anyone caught driving cars without a sanctioned reason were detained at confinement centres for a 30-day period. Quarantine-breakers have been dealt with, summarily and harshly. Towns in El Salvador deemed to not be complying with the president’s strict lockdown orders have been cordoned off by the police, barring public egress [‘Savior or Strongman? El Salvador’s millennial president defies courts and Congress on coronavirus response’, (Patrick Oppman), CNN, 21-May-2020, www.edition.cnn.com].

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(Source: El Salvador Presidency via Reuters)

The new Salvadoran president has gone particularly hard on the country’s street gangs, the maras, who he fears would take advantage of the state of emergency to increase their criminal business activities when the security forces were busy policing the lockdown measures. Most controversial has been Bukele’s treatment of gang prisoners during the crisis –  shockingly dehumanising images have emerged of large numbers of half-naked convicts shackled and huddled together in tight-knit formation (with zilch regard for social distancing), resembling a great amorphous mass of  “human cargo” [’El Salvador’s president accused of using coronavirus to bolster autocratic agenda’, (Patrick J Mc Donnell & Alexander Renderos), Los Angeles Times, 01-May-2020, www.news.yahoo.com].

Recently Bukele has copped a lot of flak for the way he’s handled the crisis, including from labour organisations decrying the draconian quarantine measures as abuses of human rights. The legality of his actions has been questioned as has the increasing militarisation of the regime [‘One Year After Taking Charge, Nayib Bukele Faces Severe Criticism for Handling of COVID-19′, (Zoe PC/ Tanya Wadhwa), News Click, 03-Jun-2020, www.newsclick.in/].

El Salvador’s ‘hip’ president: taking a selfie before his speech at the UN 🔻

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Shades of  the White House
As an outsider—both as the son of an immigrant family from the Middle East and from a minor centre-right party which sits outside the political establishment traditionally dominated by the two main parties in El Salvador)—the president has deliberately attempted to work outside the mainstream including the National Assembly (NA) to achieve his aims. And he’s not adverse to employing military muscle to intimidate opponents⌽ while also reaching out to El Salvador’s impoverished with cash and food handouts (to buttress his personal popularity with the social base). Political opponents in the NA have accused Bukele of using the pandemic to consolidate an authoritarian regime, and of seeking to violate the national constitution (Oppman). The similarities seemingly extend to shared personal traits. President Bukele has disclosed his prophylactic use of hydroxychloroquine, while referencing Trump’s use and endorsement of the drug. The El Salvador authorities have managed to hold the death toll thus far to 53 (06-Jun-2020) at the cost of drastic restrictions on individual liberties.


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✱ Sweden‘s top epidemiologist has now conceded the government’s laissez-faire approach was seriously flawed – with a status quo of 43 fatalities per 100,000 people and Sweden finding its borders with its Scandinavian neighbours remaining firmly closed [‘Top epidemiologist admits he got Sweden’s COVID-19 strategy wrong’, (Bloomberg), National Post, 03-Jun-2020, www.nationalpost.com]
⊡ as at  06-Jun-2020
✬ some countries simply don’t count deaths occurring in nursing homes in their COVID-19 tallies, the UK only belatedly included them later in the crisis
✪ if Belgium applied the same criteria as most countries the recorded number of deaths by COVID-19 would be around half of what it is
⌽ such as deploying the army inside the Legislative Assembly as ‘bouncers’ [‘Nayib Bukele’s military stunt raises alarming memories in El Salvador’, (David Agren), The Guardian, 16-Feb-2020, www.theguardian.com]