It’s Covid code red in Latin America with no signs of peaking

When a top World Health Organisation official this week declared Latin America the new epicentre for Covid-19, few experts in the region needed to be persuaded. The data are overwhelming – and overwhelmingly dreadful.

The number of regional cases stands at 1.17 million. Demographic giants Brazil and Mexico are posting among the fastest growth rates and logging daily death records. Viral illness is also rising in Peru, Colombia, Chile and Bolivia.

“The curve is steepening – the sky is the limit,” Julio Croda, an infectious disease specialist and former Brazil Health Ministry official, said about the trajectory in his home nation. “The current data show no signs of stabilisation.”

One of the most urbanised and unequal regions in the world with the slowest growth and a history of profound public mistrust of government, Latin America, with its 650 million inhabitants, is now a grim laboratory of viral pandemic.

With insufficient public assistance, the social distancing and stay-at-home orders that have been issued are increasingly unsustainable. Residents are returning to the streets – many never left – in search of work or aid, even as Covid-19 explodes. It will not be long before Latin America, with 8% of the world’s population, accounts for a majority of new coronavirus deaths. It’s now at almost 44 percent.

It’s easy to point the fingers at governments that were slow to lock down – some still haven’t – or leaders who prioritised jobs over health. But for most of the region, perhaps more so than other emerging markets, self-isolation is a luxury few can easily afford.

No safety net

“Even if people want to follow the recommendations, it’s often difficult, or perhaps impossible, to do that,” said Ana Diez Roux, dean and distinguished university professor of epidemiology at the Drexel Dornsife School of Public Health in Philadelphia. “There’s no safety net and it’s very hard to stop working.”

In South America, 83 percent of the population live in cities, according to UN-Habitat, with many packed into slums and multi-generational homes that can turn into hotbeds for infection. More than 30% of the urban population of Mexico live in poverty. In Brazil, it’s at least 15 percent.

Without social distancing, “the virus will continue to spread – that’s almost a biological fact,” Amesh A. Adalja, an infectious disease physician and senior scholar at Johns Hopkins Center for Health Security, said by phone from Pittsburgh.

On Thursday, Brazil reported a record 1,473 fatalities, plus some 1,000 more on Friday, for a total of over 35,000. It passed Italy to become third globally in number of deaths and is likely days away from catching up to the UK. Peru’s case count is nearing 200,000, and Chile and Mexico each have had more than 110,000 infections.

Beyond overcrowding and poverty, other factors playing a role include health systems that were on the verge of collapse before the virus struck, economies dragging along for years and political instability.

Heading into the pandemic, the US was capping its biggest economic boom ever while Latin America was mostly going backward. Argentina and Ecuador were on the verge of default (the former has since taken the plunge; the latter is scrambling to avoid it). Mexico had slipped into recession, while Brazil in 2019 logged its fourth straight year of unemployment above 10 percent. And then there’s Venezuela, whose collapse has sent a diaspora of millions across its borders.

Off-the-books

Drive along most any thoroughfare in Latin America in regular times and it’s common to see street vendors hawking bottles of water or power cords for mobile phones. Buses are packed with day cleaners and nannies who travel long distances to tidy up after the wealthy. In Brazil, a common occupation for men is “faz tudo” – “does everything” – cleaning up construction sites, gardening and painting.

They’re part of a massive off-the-books labor force with little or no savings and few bank accounts. According to the Inter-American Development Bank, more than half the workforce, or about 140 million people, work under-the-table. For them, not working can mean not eating.

The formal economy isn’t all that much better off. Industries that are getting pumped full of fiscal stimulus elsewhere, from airlines to small businesses, have so far been left largely to fend for themselves. So have their workers, although Brazil handed out some cash to the poor and Mexico is offering cheap loans to small businesses. (Peru is an exception, firing off billions in stimulus back in April.)

In Brazil, Latin America’s economic powerhouse, standing in the way of a coordinated government response is a political drama that could be called farce if the consequences weren’t so dire. President Jair Bolsonaro has burned through two health ministers after clashing over the need for social distancing and the use of controversial drug chloroquine. He and state governors have argued publicly over whether the economy or public health should take priority.

Mixed messaging

Amid all the mixed messages, conspiracy theories are running rampant. In a working paper published last month by the US National Bureau of Economic Research, Brazil and Mexico showed the third- and fourth-highest levels of respondents in 58 countries saying they don’t trust their governments to keep them safe.

Unreliable government data is a large part of why many health professionals likely weren’t surprised when Carissa Etienne, WHO director for the Americas and head of the Pan American Health Organisation, this week called Latin America the new epicentre.

“I see a lot of difficult weeks and months ahead,” Ashish Jha, director of the Harvard Global Health Institute, said Friday at an Infectious Disease Society of America briefing. “What will cause the number of cases to peak and start coming down? It’s hard for me to say.”