You’d see a woman standing in line just fall over—pum!—and die.

March 17, 2022 10:20 AM

Guayaquil likely had the world’s most lethal outbreak of covid-19 per capita. During that hellish stretch from late March to mid-April of 2020, hundreds [in one city] were dying each day. For more than a week in early April, the number was around seven hundred. In the evenings, she’d return home, but wouldn’t cross the threshold of the apartment before making sure that her mother, Loli, was in her own room, with the door closed. [Loli] was concerned, confined to the apartment, and eager to know what was really happening out there. How many patients came in, how many died, Loli would ask every night. Lots, Vélez would answer, always vague, trying not to worry her mother. After all, what good would it do to admit that she’d seen fifty people die that day?
posted by If only I had a penguin... (15 comments total)

For those (like me) who would otherwise have to look it up, Guayaquil is a port city in Ecuador with a population of about 2.7 million.
posted by heatherlogan at 10:42 AM on March 17, 2022 [13 favorites]

This article is so good. And so sad.
posted by subdee at 11:32 AM on March 17, 2022 [7 favorites]

.
posted by subdee at 11:33 AM on March 17, 2022 [2 favorites]

This was interesting:

The first patient was being treated at a private clinic when she tested positive, but she was soon transferred to Paola Vélez’s unit at Guasmo Sur. Vélez didn’t tell her mother for almost a week—she didn’t want to worry her—but in fact, Vélez admitted, it was exciting. She showed me photos from those heady early days: she and her colleagues in P.P.E. In some pictures, the masks have been removed, and they’re beaming. “From a professional standpoint, you feel that this is your moment, that you have to show that this is what you’ve trained for,” she told me. “Afterward, I was sorry and asked God for forgiveness for being so selfish. I had no idea what was coming.”

I feel like I understand that professional excitement she felt. And then the shame about it.
posted by Well I never at 11:50 AM on March 17, 2022 [29 favorites]

what a read. I have not quite finished (yet) but oh boy.
posted by supermedusa at 1:45 PM on March 17, 2022 [1 favorite]

The rate of deaths from Covid-19 hasn't really slowed down, we've just gotten more accustomed to it, and it's not the top story in the news anymore, even as the U.S. nears 1 million dead and the world passes the 6 million mark.
posted by TreeHugger at 3:23 PM on March 17, 2022 [7 favorites]

This is really excellent reporting about a specific time and place - the journalist took a risk to even go there to report this - it's not just about the rate of deaths from COVID in general.

You really should just read the article. It has all these touching stories from front-line defenders, and then alongside that, stories about how they've had five different health ministers since the pandemic began, about the former President diverting PPE and COVID testing kits to sell on the black market, and just the astonishing statistic that 65% of the whole population of Guayaquil got COVID in that first month from March to April.

What's striking is - this wasn't a total breakdown of order? They did a lot of things right there. In the article they mention that Guayaquil had the first specifically-for-COVID hospital ward in Latin America. There were a lot of people working hard and doing the right thing, and they are interviewed in the article. But they got unlucky with the timing of the first wave of the pandemic coinciding with the holiday and travel season, and then the government tweeted out stupid and sometimes contradictory things, like encouraging people to attend mass gatherings like a 20,000 person football match in March 2020 because "the only thing to fear is fear itself" etc etc.

It's a really sad story, and it's a cautionary story too, because this is how bad it could have been in so many other places. It's not like Guayaquil, alone, had corrupt government officials and understaffed hospitals. You know? When the system works as intended, it's invisible, but when it fails it fails spectacularly - and that's what happened here.

Anyway I don't want to summarize the article, which is also about the fact that people have gotten used to COVID and don't report on it any more even though it's still a concern - but not the same level of concern - and about the aftereffects of COVID, including the current surge in gang violence which is probably linked to the fact that students have been out of school for two years. It's just a really good article. That's all.
posted by subdee at 4:11 PM on March 17, 2022 [19 favorites]

This was also interesting:

I spoke with Esteban Ortiz again in January, on a day when Ecuador’s confirmed covid-19 infections topped those of any day in the pandemic. There was a note of resignation in his voice. Yes, the case count was growing once more, but the numbers, which were on the surface quite alarming, no longer registered as a crisis, at least not on the same scale as before. In any case, the front pages of the papers were all about the violence. “We’re not scared of covid anymore,” Ortiz told me. Hospitals weren’t overflowing, deaths remained low, just a few dozen a day, and Ecuador had one of the highest vaccination rates in the region—more than seventy-four per cent of the population is fully vaccinated—far higher than that of the United States. At the peak of its vaccination campaign, Ecuador had managed the highest per-capita daily vaccination rate of any country in the world. In December, it became the first country to require the covid vaccine for children as young as five. Ortiz grudgingly credited Lasso’s government for having overseen this success.

But the pandemic had made clear the limits of what one could expect from the state, a stark lesson that informed the reaction to this new explosion of violence. “If we haven’t died,” Ortiz told me, “it’s because we’re made of rubber.” ♦

When everyone in the country personally knows someone who died from COVID, the arguments against vaccination no longer hold water. And I'm sure the special level of the crisis there made vaccination a much much higher government priority.

BTW it alarms me that the news isn't about international vaccine sharing or differences in vaccine access between countries any more, is that because the issue's been solved or because we just aren't talking about it?
posted by subdee at 4:21 PM on March 17, 2022 [1 favorite]

A couple of things already noted that struck me:

1) That even when people were dying by the hundreds every day, the bureaucracy of death was not waived. You die at home, the coroner comes out to make sure you're dead. And if the coroner is busy, just sit tight a few days while your family keeps a terrified vigil.

2) I know this is petty and off-topic, but it said the doctor dressed up as Wonder Woman for Halloween. But Halloween isn't celebrated in Ecuador. I wonder if she dressed up as Wonder Woman on New Year's Eve (when many people do dress up), and if so, if she maybe kind of culturally-translated that as Halloween for the reporter so they would get it? Was she abroad on December 31 in a place that celebrates Halloween? Are there enough foreign doctors working at the hospital that maybe some of them organized a halloween event? What?

3)
When everyone in the country personally knows someone who died from COVID, the arguments against vaccination no longer hold water.

But it wasn't everyone in the country, it was just one city. I know an anti-vaxxer who has spent most of the pandemic in Ecuador (not in Guayaquil and has no family in Guayaquil as far as I know). Full-on anti-vax nuttery: vaccines cause infertility, microchips, the UN, Bill Gates, the whole thing, masks lower your oxygen, etc. etc. the whole thing. Her uncle died of covid (in Canada). Her parents (both recent cancer survivors) got Covid, probably because of her. Some people are too dumb to be reached.
posted by If only I had a penguin... at 5:56 PM on March 17, 2022 [3 favorites]

Oh, and one thing that was not mentioned in the article, that I heard from family was the role that poverty played. I do not have family in Guayaquil and my family is relatively privileged, so this is third hand info at best, but they were saying: It was so hot. Guayaquil is a very hot place and this was a hot time of year. And there are many people who live 7 or 10 people in a tiny house and the roof is made of metal and it's just impossibly hot inside the house in the daytime, especially if you fill the house with people.

And they told people "stay inside" or "stay home". Well who can stay inside or home? The people living in the nice air conditioned houses with the shaded and breezy central courtyard and the people in air-conditioned big condos, sure. But for the people in tiny crowded houses with metal roofs, it's not no do-able. They (disproportionately) went out. They (disproportionately) got covid. And many of them died.
posted by If only I had a penguin... at 6:14 PM on March 17, 2022 [9 favorites]

BTW it alarms me that the news isn't about international vaccine sharing or differences in vaccine access between countries any more, is that because the issue's been solved or because we just aren't talking about it?

subdee I would love to know this as well. News here in South Africa is that we're about to run out of the Pfizer vaccines that were donated. We still have J&J though.

But Halloween isn't celebrated in Ecuador.

If Equador is anything like South Africa in this regard: we don't celebrate Halloween either, but in recent years, because of social media, many more people have become aware of it to the point that a few years ago, we even had a few times when kids in our neighborhood would dress up and go trick ot treating. It didn't take, and doesn't happen anymore, but the impact of US culture on the rest of us is so profound that it wouldn't be surprising to me if a nurse here dressed up for Halloween, and most people would know why she was doing it.
Another example I find much more bizarre is that we now have black Friday sales here too. Will be interesting to see if that tradition lasts longer. I suspect it will, as it's not really a cultural phenomenon so much as a marketing tactic adopted by businesses.
posted by Zumbador at 8:48 PM on March 17, 2022 [2 favorites]

This was a stunning article-beautifully written and devastating. Thank you so much for sharing.
posted by purenitrous at 1:34 AM on March 18, 2022 [1 favorite]

When everyone in the country personally knows someone who died from COVID, the arguments against vaccination no longer hold water. And I'm sure the special level of the crisis there made vaccination a much much higher government priority.

My mom sent the article to my uncle in Ecuador (not in Guayaquil). He said "It's a lie." And he's not even anti-vax etc. etc. I don't know why, but people have astonishing power to rationalize whatever is they've decided to believe.
posted by If only I had a penguin... at 7:42 AM on March 18, 2022

I have slandered my uncle. He skimmed the article and thought it was saying Covid was out of control NOW and he was proud that Ecuador has things under-control-ish now with a high vaccination rate.
posted by If only I had a penguin... at 8:09 AM on March 18, 2022 [14 favorites]

BTW it alarms me that the news isn't about international vaccine sharing or differences in vaccine access between countries any more, is that because the issue's been solved or because we just aren't talking about it?

Well, it's not solved:

• "Africa CDC to ask world to pause Covid-19 vaccine donations" (not because they don't need vaccines but because they can't get them into arms fast enough due to "logistics challenges and vaccine hesitancy") - Politico, 22 Feb
• "COVID vaccine supply for global programme outstrips demand for first time" - Reuters, 23 Feb: "poorer nations are facing hurdles such as gaps in cold-chain shortage, vaccine hesitancy and a lack of money to support distribution networks"
• "Low vaccination rates in the Caribbean must be urgently addressed to stop the spread of COVID-19 says PAHO Director" - Pan American Health Organization press release, 23 Feb: "Out of the 13 countries and territories in the Americas that have not yet reached WHO’s 2021 goal of 40% vaccination coverage, 10 are in the Caribbean. . . . Vaccine hesitancy, a lack of vaccination centers in remote areas, insufficient staff numbers, and limited cold-chain infrastructure remain huge barriers to vaccination"
• "Timeline: Tracking Latin America's Road to Vaccination" - AS/COA, 28 Feb: "As of February 15, 63 percent of the people in the region were fully vaccinated. Still, 20 of the 35 countries in the Americas had yet to reach the World Health Organization’s (WHO) target of 40 percent vaccination coverage before the end of 2021."
• "WHO sees little impact on COVID-19 vaccine supplies to Africa from Ukraine war" - Reuters, 3 March: "Russia's Sputnik vaccines are part of an effort by wealthier countries to plug the COVID-19 vaccine gap in Africa, but so far they remain a minimal component of imports to the continent."
• "The Pandemic Is Following a Very Predictable and Depressing Pattern" The Atlantic, 4 March: "By epidemic we actually mean a pandemic that no longer kills people in rich countries," wrote Peter Sands, the CEO of the Global Fund, an international group that combats these diseases. "By endemic we actually mean a disease the world could get rid of but hasn’t. HIV/AIDS, TB and malaria are pandemics that have been beaten in rich countries. Allowing them to persist elsewhere is a policy choice and a budgetary decision."
• "The U.S. has shipped 500 million COVID vaccine doses globally, but there's work ahead" - NPR, 17 March

posted by joannemerriam at 10:02 PM on March 19, 2022 [3 favorites]