Latin America

Latin America had time to prepare for the coronavirus. It couldn’t stop the inevitable.

RIO DE JANEIRO — For a time, early in the pandemic, when Latin America was mostly a spectator watching outbreaks in China, then Europe, then the United States, there was hope that when the coronavirus arrived here, things would be different. The climate was warmer. The people were younger. The governments had more time to study the mistakes made elsewhere, and to prepare.

Weeks later, more than a million people have been infected, tens of thousands are dead, and those hopes are gone.

The warmer weather did little to slow the disease as it devastated tropical metropolises in Ecuador and Brazil. Youth has not protected Mexico or Peru. And despite early and aggressive government action in many cases, Latin America has been unable to avert what now appears to have always been inevitable.

The disease has been a disaster in Brazil, now second only to the United States in reported cases, with more than 31,000 dead, but it’s not the only country in the region in the full grip of the virus. Peru has now confirmed twice as many infections as China. Mexico has suffered more than 10,000 deaths. Officials in Chile, now in the throes of one of the world’s most explosive outbreaks, warn that the hospital system in Santiago is teetering at capacity. The World Health Organization has declared Latin America the new epicenter of the global pandemic.

People in face masks hold boxes of food distributed by the government during a lockdown on the outskirts of Quito, Ecuador. (Dolores Ochoa/AP)

“The situation is very uncertain, and what is the plan?” asked Óscar Contardo, a prominent Chilean journalist. “The government response has been very weak for the magnitude of this situation.”

In the end, Latin America’s efforts to stall the disease were undone by a familiar cast of foes. Poverty, inequality, corruption, plunging faith in institutions — many of the societal problems that predate the pandemic are now being magnified by it. Countries that tried to enforce complete lockdowns haven’t been able to maintain them for long as hunger mounts, misinformation spreads and distrust grows.

The crisis is interacting with structural problems that Latin America has had for a long time, and these structural issues are exacerbating the effect of this health shock,” said Luis Felipe López-Calva, the Latin America director of the United Nations Development Program. “People saw this coming. There were plans.”

Jarbas Barbosa da Silva Jr., the assistant director of the Latin American office of the World Health Organization, flew throughout the region this year to meet with health ministries. In early March, Barbosa said every country was making plans. Cases were then very low — not a single instance of community transmission had been registered in Latin America — but everyone appeared to be taking the disease seriously.

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The region, he said, had some built-in advantages. Many countries aspire to provide universal health care, and though reality might fall short of ambition, the poor can usually seek treatment without fear of being turned away for lack of money. The region had more-recent experience in dealing with infectious 

diseases than Europe or North America. Public health infrastructure built during the Zika outbreak that raged through South America in 2016 was still in place.

“The capacity to respond has improved, and this is an advantage,” Barbosa said at the time. “We can see that there is an important commitment. . . . They are concentrating all efforts on using containment strategies.”

The region became a laboratory for such strategies. Witnessing what was happening in Europe and the United States, officials imposed quarantine practices long before cases began to spike. Chile issued a 90-day national emergency declaration within days of its first cases, restricting freedom of movement and banning public gatherings. Argentina closed its borders. In Peru, President Martín Vizcarra imposed perhaps the strictest measures in the region, allowing people to leave their homes only to buy food and medicine.

The sense was the same nearly everywhere. Outbreaks had brought much of the developed world to its knees. Leaders in Latin America, with their poorer health systems, had to do what they could to stop the virus from making similar inroads here. In countries where presidents were lax in preparing — principally, Brazil — governors stepped in to impose social distancing measures and build field hospitals.

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But despite the diversity in approaches — from the draconian in Peru to the laissez-faire in Brazil — many countries are ending up in roughly the same place: watching cases surge, with little political or institutional capacity to flatten their ascent.

I have tears in my eyes and goose bumps on my skin,” said Alexandre Kalache, one of Brazil’s leading doctors. “I’m grateful that my children are far away in England. I’m not seeing a future for this country for years to come.”

How it got to this point has been a case study in the difficulties of controlling a pandemic in the developing world. Policies such as social distancing and isolation — which must be maintained for weeks to have any effect — have proved simply untenable in countries where many people live crowded in urban slums and must work every day to survive.

Here people are calling it the Peruvian paradox,” said América R. Arias Antón, country director of Action Against Hunger in Lima. “The correct measures for the incorrect country.”

For containment policies to succeed, analysts say, they need both public support and robust aid for the poorest. But in much of the region, both elements have been lacking. In Brazil, what little aid the government offered — around $110 per month for informal workers — has for many been either laughably insufficient or blocked by an inscrutable application process. Peru has paid the poor less than the minimum wage. Many laborers still have to leave their houses to get by.

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Now, as exhaustion after 10 weeks of isolation settles in, trust in both policies and government officials is falling. In a region marred by corruption scandals and other 

breaches in public confidence, few have faith in public institutions. Today only half of Latin Americans support democracy, surveys show. Confidence in the media has plummeted lower.

The worldwide media and the local media is dominated by the left,” said Aluizio Montelo da Silva, 63, who lives in the northern Brazilian city of Belém. “It’s a biased media. It’s an activist media. There’s no way you can believe in a media like this.”
For weeks, his clothing shop has been closed to c

omply with containment measures — and for what? It didn’t stop his city from suffering a devastating outbreak. The hospitals still became overwhelmed. People are still dying. So much sacrifice, and so little to show for it.

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His frustration has given way to distrust. He believes officials are using the pandemic to bilk the system. Leaders are being accused of fraud and corruption from Panama to Rio de Janeiro, where the state governor is now embroiled in scandal. The people, Montelo said, are being played for fools. So he now leaves the house whenever he can — to protest the quarantines and show support for President Jair Bolsonaro, who has repeatedly played down the disease and called on the country to reopen immediately.

Leaders are being accused of fraud and corruption from Panama to Rio de Janeiro, where the state governor is now embroiled in scandal. The people, Montelo said, are being played for fools. So he now leaves the house whenever he can — to protest the quarantines and show support for President Jair Bolsonaro, who has repeatedly played down the disease and called on the country to reopen immediately.

“I never believed the stories,” Montelo said. “I’m not someone who blindly follows the media.”

As cases in Brazil surge and the hospital system buckles, the country is losing the political will for more quarantines. The streets are filling once more. Officials in Rio de Janeiro and São Paulo barely even talk anymore about harsher containment measures.

“I know my country,” said Margareth Dalcolmo, a researcher at the Oswaldo Cruz Foundation. “There are 2 million people who live in the favelas in Rio, and to talk about social distancing is ridiculous. It’s pathetic. It’s empty rhetoric. It doesn’t mean anything.”

The Pan American Health Organization last week urged a recommitment to social distancing in Brazil to avert a calamity. Its projections showed that 88,000 people could die by August. Researchers at the University of Washington put their death toll still higher — around 125,000 by August.

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“It is still not the time to relax restrictions or to reduce preventive strategies,” said Carissa Etienne, the organization’s director. “It’s necessary to remain strong and vigilant, and implement aggressive and proven measures of public health.”

But the following day, João Doria, the governor of São Paulo, the heart of the outbreak in Brazil, announced what he described as a “conscious reopening.” Cases continued to climb, and there’s no vaccine, but the country is trying to force its way back to normal.

“All of the government decisions in relationship to covid-19 have been based on science and medicine,” he said. “There is no guessing here.”

Heloísa Traiano contributed to this report.

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