The tragedy of Guayaquil and what it tells us about the coronavirus pandemic

By David Morrill

On March 26, local news media reported the first bodies on the sidewalks of Guayaquil. Within the days, the international media, including the New York Times, the Guardian and the Washington Post were in town to share the lurid images with the world, revealing, they said, what impoverished Latin American countries had to look forward to from the Covid-19 pandemic. Guayaquil, the Washington Post said, was a “harbinger of things to come.”

An angry Jose Valencia, Ecuador’s foreign minister, fired off letters to publishers and news directors claiming the media had sensationalized a tragic situation, claiming that Ecuador was working hard to control the virus. “In particular, I resent the report that there were hundreds of bodies in the streets when in fact there were never more than 10,” he wrote.

Two days later, Jorge Wated, commander of a joint military-police task force that was responsible for transporting bodies to morgues, told a television reporter that the number of dead in Guayaquil was only 20 to 30 percent more than normal and that the delay in removing bodies was the result of funeral homes refusing to handle the work.

Workers carry a coffin to a Guayaquil cemetery. (El Universo)

A week later, on April 16, Wated was back on tv to announce that official Guayas Province civil registry records showed there were 5,700 more deaths than usual during the first two weeks of April — 6,703 instead of the average of 1,000. “I am stunned by these numbers but am making them available under the directive of President [Lenin] Moreno to offer full transaprancy about everything related to the coronavirus,” he said. “The new information tells us that the disease is much more prevalent than we previously believed although we cannot be certain of the causes of all the deaths.”

The next day, the Guayas Medical Association announced that the real number of additional deaths was probably closer to 8,000. They pointed out that Covid-19 began to spread in the province in early March and that March deaths as well as April deaths should be considered. “Medical professionals in Guayaquil were aware of the state of affairs weeks ago and now the country is learning too,” said association president Javier Carrillo. “There has been a great failure here, first in the testing program and then in the treatment.”

In her press conference on April 18, Interior Minister María Paula Romo said she was shocked by the Guayas death count but, like Wated, said it was impossible to say they were all the result of Covid-19. “I am saddened and very disturbed but we will have to examine the data before we can make a definitive statement. Until then, it’s obvious that the virus was responsible for most of these deaths.”

Like Vice President Vice President Otto Sonnenholzner, Romo has gone to great lengths to paint a picture of two Ecuadors, Guayas Province and the rest of the country. “Despite the tragedy in Guayas, we must not forget that the health emergency measures we took in mid-March have been very effective in the rest of the country in controlling the outbreak.”

She also blames the high numbers in Guayas Province on the disregard of stay-at-home and curfew orders. “Whereas compliance has been good in most of Ecuador, this has not been the case in Guayas and, in my opinion, this has led to the spread of the virus,” she said.

Medical pesonnel in a Guayaquil hospital.

Carrillo and other medical officials call such statements by Romo and Sonnenholzner an effort to “shame” Guayaquil and Guayas Province. “This is grossly unfair,” says Carrillo, who suggests that the government was late in ordering restrictions on personal movement in the province and understaffed in its testing. “Covid-19 arrived here weeks earlier than it did in the rest of the country and the ministry of health was aware of it. “We have the largest international airport and largest seaport in Ecuador so it is natural that the virus would be established here sooner. The government was late and inadequate in its response.”

Carson Stevens, a doctor and former U.S. Peace Corps volunteer who lives in Guayaquil, says he is “fighting mad” about the suggestion that Guayaquileños are responsible for the high death toll. “It pisses me off when they suggest we are to blame for what’s happening,” he says. “Everyone knows that Guayaquil has the worst slums in Ecuador and the worst poverty and the vast majority of cases are in the slums. This is where you saw the pictures of the bodies in the streets, not in the gated communities were the upper class folks live.”

Stevens also considers it an insult when government officials say the locals should have followed lockdown restrictions and stayed indoors. “March and April are the hottest months of the year and poor people don’t have air conditioning. Most of the slum housing has tin roofs so when it’s 93 and 94 degrees outside you can imagine how hot it is inside. To tell people they should shelter in place is the same as telling them to roast in place.”

Hernán Urgilez, Immunology Director at Hospital de los Ceibos in Guayaquil, says the discrepancy between the confirmed cases and the actual cases is a systemic failure, not just of testing. “Officially, they count about 6,000 Covid-19 infections in Guayas but the real number may be 150,000 or even 200,000. They say that 200 people have died but it is really 8,000,” he says. “I don’t blame the government for the lack of tests. This is a poor country with limited political influence so it is very hard for us to acquire the testing kits we need. Right now, we have thousands of completed tests that cannot be processed because we don’t have the reagents.”

According to Urgilez, there is a silver lining to Guayaquil’s numbers. “We are building the herd immunity that the rest of the world will need before there is a cure or vaccine for the virus. When more than 50 percent of the population has contracted the disease and recovered, the infection rate will drop substantially.”

What is happening in Guayaquil is happening around the world, Urgilez adds, “We are being taught a lesson in humility, discovering the depths of our ignorance about disease, and are having to change our understanding about Covid-19 on a day-to-day basis,” he says. “I have an epidemiologist friend at Stanford University in the U.S. who has been in the news with his theory that Covid is no worse than traditional influenza. I talked to him yesterday and he told me that he has changed his opinion based on new information, and says the disease is more infectious and more fatal than he previously thought.”

Urgilez added: “My dearest hope is that because we started earlier with the infection, Guayaquil will finish sooner.”