Responses to COVID-19 in five Latin American countries

Abstract

Background: COVID-19 reached Latin-American countries slightly later than European countries, around February/March, allowing some emergency preparedness response in countries characterized by low health system capacities and socioeconomic disparities.

Objective: This paper focuses on the first months of the pandemic in five Latin American countries: Brazil, Chile, Colombia, Ecuador and Peru. It analyses how the pre-pandemic context, and the government's responses to contain and mitigate the spread together with economic measures have affected the COVID-19 health outcomes.

Methods: Extensive qualitative document analysis was conducted focused on publicly-available epidemiological data and federal and state/regional policy documents since the beginning of the pandemic.

Results: The countries were quick to implement stringent COVID-19 measures and incrementally scaled up their health systems capacity, although tracing and tracking have been poor. All five countries have experienced a large number of cases and deaths due to COVID-19. The analysis on the excess deaths also shows that the impact in deaths is far higher than the official numbers reported to date for some countries.

Conclusion: Despite the introduction of stringent measures of containment and mitigation, and the scale up of health system capacities, pre-pandemic conditions that characterize these countries (high informal employment, and social inequalities) have undermined the effectiveness of the countries' responses to the pandemic. The economic support measures put in place were found to be too timid for some countries and introduced too late in most of them. Additionally, the lack of a comprehensive strategy for testing and tracking has also contributed to the failure to contain the spread of the virus.

Keywords: COVID-19; Chile; Colombia; Deaths; Ecuador; Effects: Brazil; Health; Latin America; Measures; Pandemic; Peru; Response.

Fig. 1

Timeline with the main mitigation and containment measures by country.

Fig. 2

Evolution of the containment stringency index for each country and COVID-19 cases (new cases and positivity rate) , , , , , .

Fig. 3

Timeline for economic measures by country

Fig. 4

Evolution of economic stringency index and COVID-19 trends , , , , , .

Fig. 5

Growth in the average of new cases (by day of first symptoms) post and pre-quarantine (%) . Note: For each county growth is defined as the variation (%) in the average of daily new cases on the week number 2 after quarantine declaration (week 0) and the average of new cases in the 2 weeks before quarantine was implemented. The average of new cases is corrected by the number of tests taken each week. Pink bars correspond to the counties that increased the daily average of new cases. Blue bars, those that decreased it.

Fig. 6

Evolution of daily tests conducted per 100,000 population (7 days average) , , , . Note: No public data for daily numbers of tests realized in Brazil.

Fig. 7

Evolution of positive cases [[32], [33], [34], [35], [36],75].

Fig. 8

ICU COVID-19 patients [33,34,36,76,77].

Fig. 9

Evolution of the death toll [[32], [33], [34], [35], [36], [75]].

Fig. 10

Comparison between excess of deaths and official report of deaths , , , . Note: C19: COVID-19. Two values of cumulative deaths are presented for Ecuador. The lower value is from data on the official daily report. The higher one is the one presented in the website of coronavirus Ecuador and includes deaths defined as COVID-19 probable. * In the case of Brazil the excess and difference is calculated for five cities: Fortaleza, Manaus, Recife, Rio de Janeiro and São Paulo. C19 report also include deaths only in that cities (from The Economist).

Fig. 11

Evolution of unemployment (%) , , , . Note: There is no public data for unemployment after December 2019 for Ecuador.

Fig. 12

Evolution of economic indicators , , , , , .

Fig. A1

Daily cases and deaths and rates per 100,000 hb. until June 10th, by state .

Fig. A2

Evolution of Covid-19 cases in Chile, by region .

Fig. A3

Evolution of Covid-19 in Colombia, by department .

Fig. A4

Evolution positive Covid-19 cases and deaths, cumulative and per 100,000 hb., per province .

Fig. A5

Evolution of Covid-19 cases in Peru, by region .

Fig. A6

Emergency admissions in Chile (112).

Fig. A7

Respiratory diseases Colombia (Bogotá) (113).

Fig. A8

Coverage of notifications of diseases with mandatory notification (Ecuador) (114).

Fig. A9

Immunizations (Peru) (115).