Peru, Ecuador: health systems in intensive therapy for coronavirus

Text by: Eric Samson

Neighboring and culturally close countries, Ecuador and Peru faced the pandemic a few weeks apart. If the health crisis has placed their health systems in a state of intensive therapy and deconfinement looks risky, Peru has better managed the crisis, thanks to an intensive policy of tests. Last night, he passed the 2,000 death mark.

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From our correspondent in the region

When the first cases of coronavirus were announced on December 31, 2019 in China, the threat is still considered distant by the Ecuadorian and Peruvian authorities. Little by little, it draws closer, without the discourse actually changing. In public opinion, it is common to hear people talking about a “  big flu  ” that does not deserve as much media hype. However, the epidemic is not far away, geographically speaking: a first case was confirmed, on January 21, in the United States , the preferred vacation spot for many well-to-do Ecuadorians and Peruvians.

The arrival of the first cases is only a matter of time, recognize the authorities of the two countries, whose borders remain open. Temperature controls and biosecurity measures are not systematic at airports, as noted by the RFI correspondent in the region, during a Lima-Quito flight on January 29.

The first cases

The first confirmed case of coronavirus was officially announced on February 29 by the then Ecuadorian Minister of Health, Katalina Andramuño. It is an Ecuadorian, 71 years old, who did not show any symptoms when she returned from Spain on February 14th.

Presented as the "patient zero", this woman, then her sister, will be among the first deceased victims of the pandemic. However, this patient "  was probably not the real zero patient  ," notes journalist and university professor Paul Mena Mena, who specializes in Big Data analysis . "  New information made public indicates that at least 31 people had symptoms compatible with Covid-19 in Guayaquil, as of mid-February  ".

At the time, the authorities were slow to ban public demonstrations. A soccer match for the Libertadores Cup even takes place, in a packed stadium, between the Ecuadorian Barcelona and Independiente del Valle, a club in the capital.

Peru had a little more time than Ecuador to prepare for the arrival of the pandemic. The first case of coronavirus was diagnosed on March 5. He is a pilot of the airline Latam, returning from vacation in Europe, now fully recovered.

The first death of Covid-19 was reported in Peru on March 19, three days after the declaration of the state of emergency. He is a 78-year-old man with high blood pressure who died of severe respiratory failure in the Air Force hospital.

Slow progression

The progression of the pandemic is initially slow in both countries. On March 1, five new cases are detected in Ecuador, while the authorities try to isolate the 177 people who have been in contact with the patient zero. The concern is not yet general, but nearly 90,000 people have already contacted, on this date, the digital platform reserved for Covid-19. As of March 8, Peru still officially has only seven cases of Covid-19, all imported. However, management errors will cost their post to the ministers of health of the two countries, Katalina Andramuño and Elizabeth Hinostroza.

The two neighbors diverge quickly, however, regarding their testing policy. Peru is multiplying them, while Ecuador lacks tests, reagents and laboratories to analyze them. As of May 11, nearly 505,000 people have been tested in Peru, for a population of 30 million, and 67,307 cases have been confirmed, for a total of 1,889 deaths.

On May 8, Ecuador was only 82,312 tests for a population of 17 million, including 28,818 positive, 32,242 negative and 21,252 pending results. "  A quarter of people tested still do not know if they are positive ", regrets Paul Mena for whom " the Ministry of Health was not ready to manage such a health emergency  " .

Dramas in Guayaquil and Iquitos

As of March 10, Ecuadorian President Lenin Moreno announces economic measures to deal with the crisis. He declared a state of health emergency the next day after the World Health Organization declared a state of pandemic.

In Peru, President Martin Vizcarra does the same for 90 days. The state of national emergency will be declared on March 15. Social confinement becomes compulsory and the country's borders are closed. It is, for the time being, extended until Sunday, May 24.

On March 12, massive public events are banned, on the eve of the death of the patient zero in Ecuador. The country closed its borders on March 14 and suspended its national football championship. Thousands of tourists are then stranded, awaiting humanitarian flights. In mid-March, the Minister of Health recognized "  the existence of community transmission  ".

In April, the pandemic hit the economic capital of Ecuador with unprecedented violence. With more than 60% of cases officially registered in the country, Guayaquil and the province of Guayas become the epicenter of the country's health crisis. The health and funeral services are completely overwhelmed by the influx of thousands of corpses. The images of bodies abandoned in the streets go around the world.

The vital statistics register 10,000 additional death certificates in March and April, compared to the historical average of deaths in the province of Guayas. "  Not everyone died from the Covid, but this figure reflects the impact of the pandemic,  " notes Paul Mena. A figure that is not taken into account in the official balance sheet which, as of May 12, 2020, spoke of 2,327 confirmed deaths and 1,544 probable.

With a delay of a few weeks, the Peruvian cities of Lambayeque, Piura, Tumbes and, above all, Iquitos are also severely affected. Capital of the Amazonian province of Loreto and largest city in the world without terrestrial communication, Iquitos sees its already weak health system put to the test. Due to a lack of beds, oxygen, medical staff and intensive care units, the corpses accumulate and the situation gets out of hand.

Indiscipline

In both countries, authorities are struggling to enforce compliance with the containment rules. The vast majority of people living in informal work cannot afford to be constantly at home. He has to go out to sell anything and everything on the streets. "  Without sales, there is no food on the table,  " says a neighbor in the La Ferroviaria district of Quito.

The relaxation intensified at the end of April. In the streets of central Quito and near the markets, municipal police, trying to displace street vendors and confiscate their goods, are taken to task, sometimes attacked. Since Monday, the Peruvian government has intervened in 36 markets considered to be centers of infection, while waiting to verify 344 others. In Peru, Interior Minister Carlos Moran imposed “civil death”  on April 15 on all those who had not paid the fines on time for failing to comply with the confinement rules. All administrative procedures are impossible for them until payment of the fine.

While the two countries have started a cautious deconfinement, Peru clearly has the backbones to start again. Economy Minister Maria Antonieta Alva has set up an ambitious economic support plan of $ 26 billion, equivalent to 12% of national GDP, while Ecuador is still trying to pass a humanitarian law in the National Assembly, has no available monetary reserve and has seen its oil exports collapse with the fall in crude oil prices on the international market.

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