Virus Gains Steam Across Latin America

MEXICO CITY — By late March, the Mexican government calmly predicted that its coronavirus outbreak would peak in April.

A few weeks later, it changed its prediction to mid-May.

And then to late May. And then to June.

Now, with new infections surging and the government facing growing anger, even ridicule, over its constant guesswork, many Mexicans have drawn their own conclusion: No one really knows.

“Obviously, prediction is not a guarantee of precision,” Hugo Lopez Gatell, the federal health official in charge of the nation’s virus response, has acknowledged.

Mexico, like the rest of Latin America, has quickly become a focal point of the pandemic, a worrisome frontier for a virus that has claimed the lives of more than 460,000 people and infected more than nine million worldwide.

Credit…Henry Romero/Reuters

The coronavirus was always going to hit Latin America hard. Even before it arrived, experts warned that the region’s combustible blend of inequality, densely packed cities, legions of informal workers living day-to-day and health care systems starved of resources could undermine even the best attempts to curb the pandemic.

But by brushing off the dangers, fumbling the response, dismissing scientific or expert guidance, withholding data and simply denying the extent of the outbreak altogether, some governments have made matters even worse.

Months have passed since the pandemic struck Latin America, but unlike in parts of Asia, Europe and the hardest-hit cities in the United States, the virus is only gaining steam across the region. Deaths have more than doubled across Latin America in a month, according to the Pan American Health Organization, and the region now accounts for several of the world’s worst outbreaks.

In recent weeks, Brazil has often recorded the world’s highest number of new infections and daily deaths — and shows no signs of slowing down. Peru and Chile now have more cases per capita than the United States. Cases continue to climb in Mexico, which recently became one of the few countries anywhere to hit 1,000 deaths or more in a single day.

Credit…Victor Moriyama for The New York Times

In many ways, the faltering, scattershot approach to the pandemic in parts of Latin America resembles the disorganized approach in the United States — with some presidents in the region questioning how dangerous the virus is, championing unproven, baseless or even dangerous remedies, clashing bitterly with state governors and refusing to wear face masks in public.

And as the virus storms through Latin America, corruption has flourished, the already intense political polarization in some countries has deepened, and some governments have curtailed civil rights. In El Salvador, thousands of people have been rounded up, many for violating stay-at-home orders, despite the Supreme Court’s demands that the detentions end.

Economies already stretched thin before the virus lie on the precipice of ruin. Millions are out of work, with millions more at risk. The United Nations has said the pandemic could result in a drop of 5.3 percent in the regional economy — the worst in a century — forcing some 16 million people into extreme poverty.

“In a matter of months, we could lose what we have gained in 15 years,” said Julio Berdegué, the regional representative for the Food and Agriculture Organization of the United Nations.

In Brazil, where President Jair Bolsonaro spent months downplaying the threat of the virus — calling it a “measly flu” and railing against shutdowns imposed by governors — epidemiologists say the death toll could surpass the total in the United States to become the world’s highest by late July.

In Mexico, where President Andrés Manuel López Obrador has suggested that a clean conscience helps ward off infection — “no lying, no stealing, no betraying, that helps a lot to not get coronavirus,” he recently told reporters — the country has already suffered three times as many deaths as officials first predicted.

Not all is dire in the region. Nations like Uruguay and Costa Rica seem to have avoided the worst so far, while an almost military-style health care intervention in Cuba has left the island nation in better standing than most.

But in much of Latin America, the worst may still be on its way.

Colombia is entering its harshest recession since record-keeping began more than 100 years ago. Venezuela has tumbled into free-fall. Ecuador is facing a debt crisis and a return of mass social unrest. Peru has gone from projecting the region’s fastest economic growth to one of its worst contractions.

In some South American nations, such as Chile and Colombia, the cases are just beginning to surge.

In Argentina, which enforced strict, successful quarantine measures, a fresh outbreak, largely in the Buenos Aires metropolitan area, has troubled officials. The number of cases has more than quadrupled in the past month, while deaths have more than doubled.

“We’re doing well because of everything we did, but there is a real possibility that the increase in cases will turn into a problem that is difficult to manage,” said Ginés González García, Argentina’s health minister.

Credit…Juan Ignacio Roncoroni/EPA, via Shutterstock

Latin America has a vast array of distinct politics, cultures, geographies and histories. But some commonalities may help explain why, despite at least a month of advanced notice that the virus was on its way, many countries struggled to buffer the blow.

Regionwide, 53 percent of workers are estimated to toil in the informal sector, selling food on the streets, working part-time construction jobs or cleaning the homes of wealthier families. Many live in densely crowded parts of the region’s largest cities, in neighborhoods where sanitation is poor and access to fresh water is limited. By and large, they have no paychecks, no pensions, no insurance, no benefits.

For many, to quarantine is to starve.

“If I can’t work, I can’t eat, it’s as simple and plain as that,” said Mario Muñoz Cruz, a shoe shiner in Mexico City. “If the doctors and experts tell me to stay home, I would ask them, ‘What do I eat then?’ ”

While there is a seemingly democratic quality to the virus -— it can infect anyone, including leaders like the president of Honduras, Juan Orlando Hernández —- it follows and exploits the disparities that already divide the region.

Risk factors like diabetes, hypertension and obesity are generally higher among the poor. And while the wealthy can afford private hospitals, the poorest rely on public health systems plundered by years of neglect. On average, nations in the region spend about a quarter of what developed nations spend each year on health.

Even in nations where the response was arguably exemplary, like Peru, endemic poverty overwhelmed the best intentions. Now the country is fighting one of the world’s worst outbreaks — and the economic consequences.

Delmira Vasquez, 36, moved to the capital, Lima, in early March, like many Peruvians from poorer provinces who have seen their hopes vanish in the pandemic.

Her husband, a construction worker, found a job within a week of arriving in Lima, but lost it the week after because of the strict national lockdown that shut down most activities.

  • Frequently Asked Questions and Advice

    Updated June 22, 2020

    • Is it harder to exercise while wearing a mask?

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      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

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      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

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      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

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      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

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      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

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      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

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      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

“Now we only eat because our neighbors take pity on us,” Mrs. Vasquez said from the one-room shack on a hillside shantytown that she shares with her husband and three children.

Rural areas have hardly been spared, either. In the small Colombian city of Leticia, along the Amazon River, the recorded death rate is nearly 28 times as high as for the country as a whole, according to government data.

Credit…Tatiana De Nevo/Agence France-Presse — Getty Images

“The situation is incredibly grave,” said Doctor Mauricio Diaz, who works in Leticia and described his hospital as “a parody” of a hospital. A few days ago, he said, four ventilators arrived. But the hospital’s wall outlets are broken, and “we haven’t been able to use them,” he said.

The degree of suffering endured by some nations was not inevitable, experts say, pointing to Brazil, Mexico and Nicaragua for particularly poor leadership during the crisis.

In Nicaragua, President Daniel Ortega rejected measures adopted worldwide to curb the spread of the virus, saying that most Nicaraguans were too poor to not work under a shutdown. Schools and businesses remained open, though hundreds of doctors across the nation urged the government to acknowledge the virus was proliferating.

In open disregard of the risks, the government organized a rally, held in solidarity with countries going through the pandemic. It was dubbed “Love in the Time of Covid-19,” and was held while other nations ordered or urged their citizens to stay at home.

As the virus was tearing through Brazil and stirring widespread anger at Mr. Bolsonaro, the president, his administration made a decision that shocked health experts: It simply stopped reporting the total death toll. And while his health ministry was urging people to stay home, Mr. Bolsonaro encouraged mass demonstration and shook hands in public.

Mexico’s president, Mr. Lopez Obrador, also mocked the virus early on, continued to hug and kiss his supporters, and encouraged Mexicans to patronize restaurants until the end of March. Even his coronavirus czar, Mr. Lopez Gatell, claimed that the president’s “moral authority” would protect him from the virus, and until last month, he dismissed the utility of face masks.

Credit…Daniel Berehulak for The New York Times

“One of the fundamental lessons that is coming out of this pandemic is that governments make a difference,” said Octavio Gomez Dantes, a researcher at Mexico’s National Institute of Health. “The evolution of a pandemic depends in an important way on the responses of various governments.”

With fewer than 1,000 confirmed cases and 24 deaths, Uruguay is a standout in the region.

The tiny country of 3.4 million quickly enacted a system of contact tracing and, when it had only four confirmed cases, it closed borders, suspended schools and called on the population to stay home. Uruguayans listened.

“We have been able to succeed thanks to the citizens who understood the urgency and the importance of taking care of themselves and each other,” explained José Luis Satdjian, sub-secretary of Uruguay’s Health Ministry.

Credit…Matilde Campodonico/Associated Press

The relative success has extended the honeymoon period for President Luis Lacalle Pou, who had been in office just two weeks when the nation confirmed its first Covid-19 outbreak in mid-March.

“Uruguayans believe the government has handled this situation well,” said Mariana Pomiés, executive director of Cifra, a local polling firm. “The government has benefited from the pandemic.”

Reporting was contributed by Julie Turkewitz and Jenny Carolina González in Bogotá, Colombia; Manuela Andreoni in Rio de Janeiro; Pascale Bonnefoy in Santiago, Chile; Letícia Casado in Brasília; Mitra Taj in Lima, Peru; and Paulina Villegas in Mexico City.