For Ecuador's Guayaquil, Tides of Death and Disappearance
Comment of the Day

April 24 2020

Commentary by Eoin Treacy

For Ecuador's Guayaquil, Tides of Death and Disappearance

This article by Lise Josefsen Hermann for Undark may be of interest. Here is a section:

And yet the official numbers have been a matter of some dispute. According to public health officials, in the first two weeks of April alone — a period where the region might see 1,000 people die for any number of reasons, natural and otherwise — Guayas province registered more than 6,700 deaths. As of this week, however, Ecuador has only been able to officially confirm, through testing, that 537 people have died due to Covid-19. Another 952 are considered probable Covid-19 deaths, with the victims having shown symptoms, but without definitive testing.

But just how many of the nearly 6,700 deaths in this one province are ultimately attributable to Covid-19 is impossible to know — and may well remain so. As has been the case in Italy, Spain, and other nations where health care resources have collapsed beneath the weight of illness and death, several reports have surfaced of people dying of non-Covid-19 causes that would have, or should have, been preventable. But authorities — widely criticized for being slow to act amid the gathering crisis — insist that they now have the matter well in hand.

“It is true, that in the beginning, this got out of control,” Juan Carlos Zevallos, the health minister of Ecuador, said in an interview. “But we are handling the situation now.” He was referring to the bodies. The region had become so quickly overwhelmed by the number of deaths that no resources were available to deal with them. Hundreds of corpses and cardboard coffins accumulated in tidy rows in the streets, while in homes across the province, the dead bodies of loved ones, mothers, fathers, children — whether they perished from the coronavirus or not — lay for days on sofas and in bedrooms and across floors. And with temperatures pressing past 85 degrees (30 degrees Celsius), an almost unbearable smell rose up across Guayaquil.

It was the smell of a Covid-19 situation out of control.

Eoin Treacy's view

Let’s put to rest the belief the virus cannot spread in hot countries. Ecuador sits on the equator. I’ve been to Guayaquil, it’s hot and sticky a lot of the time. That means everywhere is going to have to deal with the impact. No testing does not mean no infections.

Young populations, lower population density, fewer multi-generational homes, more developed healthcare systems, stronger governance and stronger formal economies versus black markets will also influence how different regions and countries are affected.

The least discussed statistic is the easiest to come by. How many people died in April relative to March and on a year over year basis. The explanation for the difference can then be divided between those who died from the absence of access to care and those who died from the coronavirus.

From deaths, a number for infections can be arrived at. South Korea’s 0.7% mortality rate is perhaps the most accurate because they have done the most work to test the population. The more tests done, the lower the mortality rate. If countries only test symptomatic people, who turn up at hospital, the mortality rate tends to be sharply exaggerated.

The significant lag between infections, symptoms and either recovery or death suggest there is a delayed reaction in how emerging markets are reporting how badly affected they have been. This event is going to throw up wonderful buying opportunities in the emerging markets but we are probably not yet at the point where enough visibility of recovery can inform a buying decision.

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