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The horror story of Covid-19 in Ecuador and the cautionary tale for developing countries


Ecuador is the country with the highest number of reported deaths by Covid-19 in Latin America per capita, closely followed by Panama and the Dominican Republic. In recent days there have been multiple horror stories in the city of Guayaquil, the most populous city and an economic hub in Ecuador.

There are many reports of hundreds of dead bodies that have not been collected by the emergency services in and around the city of Guayaquil. This city has a tropical climate all year round, and high temperatures in the last month has accelerated the decomposition of these uncollected bodies adding to the distress for their families. This has also resulted in people covering the bodies of their loved ones with plastic or abandoning them on the street, sometimes for days.

In an article in the newspaper El Comercio, they show the picture of a body abandoned on a bench on a street in Guayaquil, covered with a blanket and an umbrella on top. Next to it a placard that reads ‘We called 911 and there is no help’ as a sign of protest. This newspaper also reported that 300 bodies have been collected in this city, however once they have been collected some of these bodies did not arrive to their intended destination and no one has been able to find them. Refrigerated containers have been promised by the Municipality of Guayaquil to ease the pressure in morgues.

It is not clear that all the bodies are victims of Covid-19. Given the collapse of the health system in this city, this could have resulted in other patients dying due to unrelated reasons. For instance, in some areas of Italy and Spain excess deaths double or even tripled those attributed to Covid-19. Fear has also played a factor, with some doctors and nurses not feeling protected and funeral homes rejecting any dead bodies deeming them unsafe.

The province of Guayas, and its capital city of Guayaquil, has 69% of the cases of Covid-19 in Ecuador. Like many other coastal regions this area ended their school year in early February, and it was reported that many people, especially from Spain, travelled back from abroad to be with their families during the holiday period, however Ecuador has many migrants residing mainly in the USA and Italy as well, two hotspots of the pandemic.

The government was slow to react, since according to the BBC it dismissed videos and suggestions of the tragedy in Guayaquil, or any criticism, as a pro opposition propaganda, even framing early reports of the events in Guayaquil as a ploy by the ex-president Correa to topple the government. Added to this atmosphere is the fact that elections are due to take place early next year and there is a sense of deep political division in the country.

The struggles in Guayaquil continue as the government is attempting to undertake a body collection effort. They have dismissed their earlier idea of using common graves in favour of single graves. Furthermore, the government has also promised transparency about the situation in Guayaquil. The vice president has now apologised and called for unity.

The vice-president also indicated a ramping up of tests to 2,500 per day and 2,000 extra doctors. In 2018 the number of doctors, nurses and auxiliary nurses in Ecuador was around 82,000, which together with the extra doctors could mean testing only this sector once would take 33 days, that is without including the rest of suspected cases and their epidemiological circle. The case for testing, as well as tracing and isolating, is vital in the fight against coronavirus, especially since it is estimated that at least 59% of cases are asymptomatic.

In Guayas province, which is the worst affected in Ecuador, the vice-president indicated that the Teodoro Maldonado hospital is equipped with only around 200 ICU (Intensive care unit) beds, with no details about the number of ICU beds in other hospitals. A low number of ICU beds could be hugely problematic since in the UK it was estimated that 4.4% of infected cases could require hospitalisation with 30% of those in intensive care, with a median hospitalisation time of 10.4 days.

If Moreno's government is seeking help with testing, medical staff and personal protective equipment from developed nations, this task has been made more difficult in recent days. The USA government invoked a Defence Production Act, demanding USA companies to provide equipment and blocking their exports from now on. In addition, most European nations are dealing with their own lack of equipment.

The Ecuadorian government has put in place a house lockdown on its citizens, however it has been sometimes ignored. In a country where job insecurity, unemployment, low wages and informal work affect over 60% of the population some could be tempted to break the lockdown due to economical reasons. In fact, a New York times article indicated staying at home is a luxury, where people in the top 10% of income in the USA were able to stay at home for longer and even many days earlier from the start of their lockdown than the bottom 10%.

A government handout of $60/month to those that earn under $400/month has been promised, however in Ecuador the basic basket of goods per family costs $501/month, and this handout may not be enough to persuade people to stay indoors. The Ecuadorian government ordered that the national police be the security entity that monitors compliance with the lockdown, however there have been reports of abuse and heavy handedness from the National Police.

Other worrying reports indicate that people are being laid off, and one of the government strategies to halt these has been to offer microcredits at low interest rates, which again may not persuade all businesses to take up debt to subsist.

Ecuador was in fact predicted to have a better prepared health care system for the pandemic, compared to the rest of Latin America. However, the early contagion in the country has projected the country as a possible scenario for what could be in store for the region and perhaps in other developing nations around the world, especially since the country is still at the early stages of this epidemic.


What are my sources?

President Moreno, scolds those that have not stayed at home (In Spanish)


Spanish, immigrant groups, stats (In Spanish)

Ecuador’s government $60 per month help initiative for two months

Coastal regions in Ecuador end their academic school year on the 4th of February

John Hopkins University, Covid-19 tracker

Ecuador basic and vital basket of goods prices

Extra number of deaths, double or triples in some areas of Italy and Spain those from Covid-19

Story of a poor family who had to cover two of their loved one with plastic for days

Government dismissing reports as fake news and blaming ex president

BBC reporter describes the early lack of response, political context
https://www.bbc.com/mundo/noticias-america-latina-52161539

Guayaquil crisis, picture of dead body on a bench and a protest sign

USA tells 3M not to export to Canada and Latin America

Story of a family who covered two dead family members with plastic for days

Number of doctors, nurses and auxiliary nurses in Ecuador

The vicepresident apologises and number of promised tests

Employment in Ecuador

Staying at home is a luxury
https://www.nytimes.com/interactive/2020/04/03/us/coronavirus-stay-home-rich-poor.html

Report that influenced UK's response, number of beds and ICUs needed
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

Majority of cases asymptomatic
https://www.nature.com/articles/d41586-020-00822-x
https://science.sciencemag.org/content/early/2020/03/24/science.abb3221.full?fbclid=IwAR2Sz23SA-IRTRhS8HiuwbA3X5DyaPtLxXueNnqNmdAb94d_Gaj178_6ySE



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