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.

(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].

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].

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]✪.

⇑ 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 ⇓

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’)