The city of Guayaquil has become the epicentre of coronavirus transmission in Ecuador. The country has been unable to manage new infections and deaths, pushing the healthcare system to collapse while the true scale of the disaster remains unknown.
Entering Guayaquil, in Ecuador, the sight of coffins immediately strikes you. Cars, pick-up trucks and vans loaded with coffins, coffins on the streets, everywhere. Rows of coffins outside cemeteries. Families are forced to keep their loved ones' bodies at home for several days, and the terrible smell compounds the pain of loss. Funeral homes have run out of coffins and everyone needs one. The "corona-coffins". The municipality has had four thousand cardboard ones made in an attempt to meet demand. It is as though the entire city is breathing death and despair. Coronavirus has struck very hard the largest city in Ecuador, normally vibrant, now terribly silent.
Ecuador is one of the countries with the highest number of coronavirus cases in Latin America after Brazil and Peru, and has one of the highest per-capita mortality rates from the pandemic. 31,881 cases and 1,569 deaths have been recorded, but the authorities believe there are hundreds more deaths attributable to the virus. "The high level of migration in the country and contacts with countries such as Spain have probably contributed to the current situation," says Esteban Ortíz, a public health expert who is helping the Ecuadorian government with virus containment measures.
The first coronavirus case was announced by the government on 29 February: a 71-year-old woman who had arrived in Guayaquil from Madrid two weeks earlier stated that she had experienced fever and pain during the journey, but was not examined by medical staff at the airport. She subsequently travelled to Babahoyo, a small town an hour and a half away, and two days later attended a family event. By the time the Ministry of Health identified her as patient zero, the woman had already travelled many kilometres, spreading the virus.
President Lenín Moreno declared a health emergency on 12 March, and the following day patient zero died, becoming the first Covid-19 victim in Ecuador — without ever having known she had contracted the virus. The day after, one of her sisters also died from the virus.
The national infection rate rose dramatically from 17 March, when the number of infected people almost doubled compared with the previous day: from 58 to 111.
Over seventy per cent of the epidemic is concentrated in the Guayas region, where Guayaquil is located. Health experts expect between 2,500 and 3,500 deaths linked to the virus in this region alone over the coming months. The healthcare system collapsed within a matter of days and the authorities are doing everything they can to ensure victims receive a dignified funeral. The situation is indicative of how the health emergency has unfolded: patients are not tested in time, many die in hospital corridors and others simply die at home. Deaths are so high that the authorities cannot manage them. The city has reported more Covid-19-related deaths than entire nations in Latin America, and Ecuador has been identified — including by El Salvador's president Nayib Bukele — as the worst possible example of the consequences of poor crisis management.
On 9 April, Interior Minister María Paula Romo announced an extension of the lockdown and the closure of all workplaces for at least ten days. Schools will also remain closed for the entire month, and the suspension of all international travel and travel between provinces remains in force. All large-scale events have been suspended for the months of April and May. The authorities have also imposed a fifteen-hour daily curfew in the worst-affected regions, Guayas and Pichincha, where the capital Quito is located. Romo also announced that from 13 April the situation in each province would be assessed and some restrictions could be eased using a "traffic light" system, with certain areas classified as green, yellow or red according to the spread of infection in that area. Indeed, as announced at a press conference on 24 April, from 4 May Ecuador too moved from the isolation phase to that of social distancing, with the exception, however, of the city of Guayaquil itself, where lockdown will remain in force.
Staying at home is a very difficult challenge for the majority of people working in the informal sector: "This is a population that depends on what it earns each single day, so staying at home is not an option," says Olga Sarrado, UNHCR spokesperson for Venezuela, because hunger does not disappear with the arrival of coronavirus. The situation is similar across the rest of Latin America, where inequality rates are the highest in the world.
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The state was slow to react in Guayaquil and the population took a long time to grasp the gravity of the situation, which deteriorated vertiginously and is now out of control. Moreover, there is a widespread mistrust of public information, because the population perceives a discrepancy between the official figures and everyday experience — people see families forced to keep bodies at home or leave them on the street. "Everyone has at least one family member, a friend or a relative who has died in recent days or recent weeks," says Billy Navarrete Benavides, executive secretary of the Permanent Committee for the Defence of Human Rights in Guayaquil.
"From the outset the figures were not reliable — many people with Covid-19 symptoms were not tested and died. All those people were not counted, so it is not even possible to come close to knowing the true scale of the disaster." Concerns have also been raised over the misuse of public resources in the procurement of medical supplies, and the police are investigating the situation to assess whether there have been cases of corruption, which has further damaged public confidence in the way the crisis has been handled.
According to data up to 11 April, eight journalists covering the situation in Guayaquil had died from coronavirus, eleven had officially contracted the virus and sixteen were in isolation. As of today, it has also been announced that 1,569 people in Ecuador have recovered from Covid-19. In general, many people appear to be dissatisfied with the way the government has handled the emergency, and the question arises naturally: what went so wrong as to cause so many cases in Guayaquil? "One possible explanation for the speed of the spread lies in Ecuador's very weak healthcare system, a situation shared with other countries in Latin America," explains Ortíz. Furthermore, "the region is in the midst of a dengue epidemic," which has further complicated the response.
It is only a matter of time before the economic collapse, and a consequent rise in crime rates is expected. On 2 April, the World Bank announced that it would grant Ecuador a loan of 20 million dollars for the purchase of medical supplies and equipment for intensive care and isolation wards. Furthermore, in the midst of the epidemic, on 21 March the then Health Minister Catalina Andramuño resigned, stating that the country does not have the financial resources needed to deal with the situation — a claim subsequently denied by the authorities.
The minister's resignation revealed not only the enormous financial gap, but also a general crisis of governance, which is also evident in the diverging approaches adopted by Moreno's national government, by Quito mayor Jorge Yunda, and above all by the leadership of Cynthia Viteri, the mayor of Guayaquil. From the outset, Yunda took a stricter approach, while in Guayaquil the situation became very serious before the authorities reacted. In reality, Guayaquil is still struggling to act and to enforce restrictions such as staying at home and wearing face masks (now a compulsory measure).
Beyond the alarming situation in Guayaquil, there are other segments of the population that are particularly vulnerable to the onset of the syndrome caused by Covid-19, such as the thousands of homeless people and the approximately 350,000 Venezuelan refugees, many of whom live in precarious conditions and often without a home. Even the most basic preventive hygiene measures, such as handwashing, can be a challenge in these conditions, explains Serrado from the UNHCR. As a result, the coronavirus has generated a xenophobic response towards Venezuelans in Ecuador and across the region. "The coronavirus does not discriminate, anyone can be infected," says Serrado, "the difference lies in the consequences it can have for the people who fall ill."
Another concerning prospect concerns the spread of coronavirus into the Amazon, particularly in areas inhabited by uncontacted indigenous tribes. In general, native populations are more vulnerable to virus-borne diseases due to high rates of malnutrition and limited access to healthcare infrastructure. For this reason, in early April several indigenous organisations representing the Waorani people in Ecuador banned members living in urban areas from accessing certain areas of the jungle.
Read also: Ecuador, la resistenza dei popoli indigeni contro la pandemia
Gina Watson, the World Health Organization's representative in Ecuador, warned that there are no epidemiological surveillance protocols in the country to prevent the virus from spreading among indigenous populations as well — a worrying scenario whose concrete consequences we have already witnessed in Brazil. On 9 April, news spread in the Amazon of the death of a fifteen-year-old Yanomami person who had tested positive for Covid-19. Moreover, shortly before, in March, there was a reported potential case near the Javari territory, where the majority of Brazil's (and the world's) uncontacted populations live. This news raised fears that a coronavirus epidemic could lead to the extermination of these populations.
In Peru, in the department of Loreto, part of the Amazon territory, the highest per capita case rate after the capital Lima is recorded, despite it being the area with the lowest population density. In Colombia, on 31 March the first cases among indigenous populations were confirmed, when two Yukpa people in the city of Cúcuta, on the border with Venezuela, tested positive. A widespread epidemic would be a disaster in these communities, also because it would be particularly difficult to contain.
In the meantime, a special task force has been set up in Guayaquil to collect bodies more quickly, and work has begun on the construction of a new cemetery. The whole world now has its eyes on the city, to learn from what is happening here, and to prevent a crisis of these proportions from being replicated in other cities in the region.
Translated by Elettra Tsikoudis