Covid-19: The Next Phase

While some areas of Europe and the USA are beginning to see a flattening of the Covid-19 transmission curve and subsequent death rates, much of the rest of the world is still in the early stages of the pandemic’s first wave. Business lock-downs and population quarantines have become the widely accepted means of reducing the spread of infections across the globe. Governments — in countries both rich and poor — are now grappling with how to restart sagging economies without risking an overwhelmed healthcare sector.

Meanwhile, millions of workers in the informal economies of the developing world — who scrape together what they and their families need to survive on a daily basis — are becoming increasingly restless as insufficient government efforts fail to supply food to the neediest across the globe. Many governments in Latin America are facing the threat of medical worker strikes unless they can provide the personal protective equipment (PPE) desperately needed by staff.

As rich and poor countries compete for the same limited international supplies of PPE as well as ventilators for the most severely ill patients, a pattern is beginning to form. The developing world is being priced out of the very supplies necessary to fight the pandemic.

As infections and deaths continue to increase in the poorest regions of the world, indications are that social unrest will grow as well. This is especially true in countries such as Chile and Ecuador that saw weeks of protests, rioting and looting during last fall’s uprising against corrupt, institutionalized systems that have always favored the wealthy, leading to some of the world’s most dramatic economic inequality. Such raw feelings will be easily reawakened by the ongoing ravages of hunger, illness and death associated with Covid-19.

Here are some of the stories I followed for readers this week across Latin America and beyond.


Brazilian President Jair Bolsonaro speaking at a news conference. Bolsonaro has continued to deny the severity of Covid-19 in his country. Photo: Andre Borges/AP

Brazil’s President Jair Bolsonaro continues to deny the severity of the Covid-19 outbreak in his country, preferring to parrot Donald Trump’s early line that its a “little flu,”  and arguing that protecting the economy comes first. Again in lock step with Trump, Bolsonaro has placed hope in the use of unproven drugs like hydroxychloroquine.

In a further blow to the health of Brazilian citizens, this week Bolsonaro fired his country’s Health Minister, Luiz Henrique Mandetta, an orthopedist, who supported the promotion of broad isolation measures enacted by state governors. As is true in a variety of countries in the Americas at the moment, Bolsonaro has been at odds with local and regional leaders who know the situation on the ground and are taking the necessary steps to protect their populations.

A severe lack of testing — which provides information about rates of infection — makes it impossible for officials to institute effective strategies in their fight against transmission. According to data provided by the John’s Hopkin’s University coronavirus center, Brazil has more than 36,000 confirmed cases of Covid-19 as of April 18. Experts believe this is merely the tip of the iceberg because the country has tested just under 300 people for every million inhabitants. In the US, by comparison, this figure stands at 9,482 per million.


Workers construct burial vaults in the Angela Maria Canalis cemetery as Covid-19 overwhelms sanitary authorities in Guayaquil, Ecuador. Photo: Vicente Gaibor del Pino for Reuters.

The government of Ecuador has also been slow to respond to the unfolding health crisis in the rugged Andean mountain country. The southwest province of Guayas, which includes the country’s largest city and financial center, Guayaquil, has faced an unprecedented wave of deaths inside homes. Sanitation crews found themselves unable to cope with the situation causing many families to resort to placing the bodies of loved-ones on the streets (I am not sharing any of the photos) in an effort to stave off more infection within households.

Jorge Wated, director of a joint military and police task force recently charged with collecting and burying bodies, reported that there were officially 6,703 recorded deaths in Guayas Province from April 1 to April 15. The average of monthly deaths in Guayas is 2,000 and government officials are unable to account for the striking increase which has yet to be attributed to Covid-19.

Guayaquil doctor Gustavo Quinde is far more outspoken about the local virus death toll which he believes could number 4,000 or 5,000 in Guayaquil (a city of approximately two million residents) if the last weeks of March are included in the tally. According to Quinde, “We are suffering an extraordinary contagion that is not being reported.” [Note: The actual number of deaths attributed to Covid-19 in Guayaquil may fall somewhere between the Ecuadorian government’s estimate of several hundred and Quinde’s figure of 4-5,000.]

Ecuador’s government, headed by President Lenín Moreno Garcés, has shown itself to be incapable of taking positive steps to either contain the spread of the virus or adequately provide necessities for a population under quarantine. The president has authorized the distribution of US$60 per month to the neediest of families but this small sum is obviously insufficient in a country where the price of eggs (a staple of locals diets) recently doubled. Many families fear hunger — which they know all too well — more than contracting the coronavirus.


Red rags hang from doorways in Bogota’s poor southern neighborhoods, signaling that a family needs food or other basic resources. Colombia’s multi-week quarantine has hit the poor particularly hard. Photo: New York Times Reporter Federico Rios Escobar via Twitter on April 15.

Colombia’s national government reluctantly heeded the warnings of regional governors and the mayors of the country’s major cities and instituted a mandatory quarantine beginning on March 23. The country’s borders were completely sealed and all commercial airline passenger services ceased operation. While it’s believed that these strict measures have significantly slowed the spread of Covid-19, virus testing has been hampered by many factors, most recently due to the reported international shortage of testing reagents (enzymes) that are necessary for determining test results.

There are currently discussions surrounding how to reopen certain sectors of the economy as early as April 27, and indeed Colombia’s unpopular president, Ivan Duque, has already publicly announced such changes. However, this wouldn’t be the first time the country’s leader has walked back his proclamations in recent weeks. The Colombian medical establishment, fearing the collapse of the country’s underfunded healthcare system from even a modest epidemic, has been vehemently against any reopening of social or economic activity.

Government efforts so far to help those whose livelihoods have collapsed from the strictly-imposed regulations — particularly the informal workers who comprise as much as half of the working population in some locations — have been stymied by corruption and lack of coordination. According to the local English-language daily Colombia Reports, watchdog agencies stopped a government aid program after finding that the National Planning Department was sending emergency stipends meant for the poor to ghost accounts.

Since late March, thousands of Venezuelans have returned to their home country as their means of livelihood disappeared during Colombia’s Covid-19 quarantine. Photo: Colombia Reports

Thousands of Venezuelan refugees have returned to their home country over the past 3 weeks as the quarantine has taken away their means of making a living on the streets of Colombia’s major cities. This week there have been protests (along with looting) in poor neighborhoods of the country’s two largest cities, Medellín and Bogotá, due to the failure of food distribution programs. Surviving the near-future will require government agencies to redirect funds to feeding the hungry, which is already being done by individuals and local charitable organizations.

Positive Developments

Medellin medical engineer Mauricio Toro and his colleagues from Antioquia University pose with the low-cost mechanical ventilator they created. The open-source machines will go into mass production in Medellin beginning in late April. Photo: Mauricio Toro for Colombia Reports.

Despite the seemingly insurmountable challenges, there are also positive developments coming from joint ventures between Colombia’s universities and industry.

Medellin medical engineer Mauricio Toro, along with the local University of Antioquia, the CES University and local innovation institute Ruta N, have developed a low-cost, open-source mechanical ventilator that will go into production in Medellin beginning as early as next week. Besides freely sharing the plans and technology for these life-saving oxygen providing machines, initial mass production plans are to add 1,500 to the estimated 5,000 ventilators for adults currently in use in Colombia’s hospitals.

Final Words

I’ll leave you this week with a wacky photo from one of Bangkok, Thailand’s hospitals showing the lengths to which some institutions are going to ensure social distancing in situations that would have once seemed impossible. 🙂

peace and good health~henry

Header Image: New York Times Reporter Federico Rios Escobar via Twitter on April 15.




Categories: Covid-19, Health and Well-being, PoliticsTags: , , , , , , ,


  1. Some of these situations sound pretty tough. I appreciate this roundup. As you know, we don’t get a lot of South American news here in the U.S. Stay safe.

    Liked by 3 people

  2. We don’t get a lot of truth in the U.S. Our government is a joke, headed by an idiot. This situation points out, once again, the inequities between the haves and have nots and nothing will change. That’s the true horror story. Worse, no one rebels. This is a wonderful post. Thank you so very much.

    Liked by 4 people

    • Thanks @hitandrun1964. There is definitely a lot of misinformation being intentionally ladled out by governments these days. It doesn’t look as if there will be any quick or easy solutions to the crisis caused by the pandemic, so humans need to begin cooperating in a spirit that will bring mutual benefits. Thanks for the share and take good care of yourself!

      Liked by 3 people

  3. Thanks Henry, but I’m afraid this time I can only be pessimistic. Judging by what I hear and see, things will get worse when the virus spreads even further in poorer countries and both deaths and riots increase. The effects of this in those countries, how it will affect richer countries, and what changes this will cause in the way we see each other will be the determining factors for the shape of the new world the day after. I fear my faith in humanity doesn’t allow me to think positively.

    Liked by 3 people

    • Hi Marios,

      There is definitely plenty to make us pessimistic these days. I don’t see the future as a matter of positive or negative; it simply is. For those of us who’ve lived a relatively safe existence in richer countries up to this point, life is about to show us the grim realities that those living in many parts of the developing world have experienced for far too long. Take care and keep up your spirits.

      Liked by 3 people

  4. Thanks for the overview, Henry

    The situation in Ecuador us curious – I had a look at an expat website, Cuenca Highlife and it seems that some of the reporting about Ecuador may have been overstated by some of the media reporting (which seems to be somewhat of a general trend), unfortunately.

    “Like other officials, Zevallos said international news coverage of the situation in Guayaquil included glaring inaccuracies. “The number of bodies on the street was vastly overstated for impact and the fact that most deaths were the result of causes other than Covid-19 was not clarified. It is a tragic situation and this cannot be denied. The lack of response of the mortuary industry and misplacement of bodies in morgues is inexcusable. On the other hand, much of what has happened there is the result of fear that has spread far beyond the impact of the disease.” (Minister of Health Juan Carlos Zevallos) [See article on April 14, 2020]

    * And most likely this (the overstating in many cases) could be said about many countries as there are many inconsistencies in data collection, testing, recording, reporting, fact-checking, etc, etc. To the extent that its impossible to really know how bad the situation truly is. The biggest problem is a lack of comparative evaluation (this season compared to previous ones for each country). Also age groups affected – hardly ever mentioned.

    So, it is very hard (almost impossible) to do a clear analysis or evaluation of this situation. For example it seems some countries with mild restrictions do not have mortality rates much higher than countries with very strong restrictions. So, we would probably have a clearer picture only in a few more months or by next year . Personally I’m taking a wait and see approach in the meantime.

    Liked by 2 people

    • Hi Jean-Jacques,

      I agree with your assessment that the numbers of deaths due to Covid-19 in Guayaquil are in question, but it is up to the Ecuadorian government to organize and tally information in an effort to provide a clear and accurate picture of the situation in an effort to provide transparency which can go a long way toward easing tensions and worry. This is where the Ecuadorian government has completely failed. Without wide-spread testing and proper analysis, the true number of infections and deaths will never be known, nor can a clear strategy to fight the virus be implemented.

      As you say, even the world’s top epidemiologists are learning and adjusting their computer models day by day, so a clearer picture of the actual toll the virus is taking in each country is also constantly changing. I agree that it’s a wait and see game. Thanks for sharing your insights.

      Liked by 2 people

  5. Thanks for those updates. There is a lot of misery being felt all over the world by those who already felt down.

    Liked by 4 people

    • Hi Jim,

      There is definitely plenty of suffering to go around these days, but as is the case in most international crises, the poor are likely to experience the worst effects. Thanks for reading and commenting.

      Liked by 3 people

  6. Henry, thanks for the update of the situation across Latin America. Having lived in Northeast Brazil under some very tough times, I can well imagine the struggle of the working poor for survival.

    With regards to your comment: “The developing world is being priced out of the very supplies necessary to fight the pandemic.” This is why it’s so crucial for us to have a global response to this pandemic. Tragically, there is no global leadership coming from the world’s most powerful nation. Instead, American leaders have shot the W.H.O. in the knee by withdrawing its contributions. What shortsightedness in the face of a global pandemic that respects no political borders!

    Liked by 3 people

    • Hi Rosaliene,

      The US response to the current pandemic is truly shortsighted as all of Trump’s ‘America First’ policies have been. This is a critical time for world governments to unite and work together since – as you point out – the coronavirus (Covid-19) doesn’t respect international borders. The Trump administration’s protectionism and retreat from the world’s diplomatic stage will only end up biting all Americans, both economically and as it relates to health and well-being. Thanks for your insights as always!

      Liked by 3 people

  7. Thanks Henry – hope you’re keeping well.

    Liked by 1 person

  8. The next phase might be slow to come. A vaccine could take years to develop. Many vaccines take a decade or longer. And with some viruses such as AIDS, no vaccine ever resulted despite massively funded research worldwide. We can’t rely on necessarily getting a vaccine any time soon.

    As for herd immunity, that would require 60-80% of the population to become infected and develop antibodies. Testing shows some countries at around 10-14% of the population recovered so far with the next wave hitting in fall. It could take several repeats each season of many years before herd immunity is achieved. But at this point, we aren’t even sure how immunity works with this virus.

    Liked by 3 people

  9. Hi Benjamin,

    I agree on all counts. By next phase, I was referring to the impact the virus will have on the developing world which is personal for me since it’s where I’m living.

    Yes, there are so many unknowns about the virus that making any predictions is absurd. We are all in this for the long haul whether we like it or not. Thanks for sharing your insights!


  10. The only hope we have of curtailing this is anytime soon is with enough testing (far, far more than we have access to now) and good epidemiology with targeted quarantines. The trouble is there is no financial incentive for the pharmaceuticals (in the US anyway) to do this. Other than that, here in the Old US of A, we are looking at a year, I would guess, of some level of what we are currently experiencing.

    Liked by 2 people

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