Reports of mass graves as Latin America becomes new pandemic epicenter

As deaths from the COVID-19 pandemic begin to plateau and slowly decline in some parts of Europe and the United States, the devastation is reaching a fever pitch in Latin America.

Death tolls in cities and areas of Brazil, Peru, and Ecuador are reaching alarming levels—in some places five times higher than normal death rates—according to an analysis by The New York Times.

While some of the official death tolls from the pandemic remain low, a review of mortality data by the Times reveals significant increases. The death counts include those directly from COVID-19 and also those from other causes—which in some cases may be due in part to people not being able to receive a standard level of care while health systems are overwhelmed during the pandemic.

In the last two months, deaths in Lima, Peru, doubled over historical averages. In Manaus, the capital of the Amazonas in Brazil, deaths for April reached about 2,800—three times the historical average. Gravediggers in the city reportedly stacked coffins three layers deep into mass graves to try to keep up with the body count.

In the port city of Guayaquil, Ecuador, deaths spiked to five times the average—an increase comparable to the spike in deaths seen in New York City during the worst of its outbreak. Residents in Guayaquil were reportedly forced to leave dead bodies in cardboard boxes on the streets for days.

SARS-CoV-2, the new coronavirus that causes COVID-19, was slow to make its way to Latin America. But despite its delayed arrival, many areas have struggled to prepare. Guatemala and Haiti have only around 100 ventilators between them, according to an article last month in The Lancet Infectious Diseases. Mexico, the article also noted, has high rates of hypertension, obesity, and diabetes, which are risk factors for severe disease.

“It is a very difficult situation,” Alfonso Rodríguez-Morales, from Colombian Association of Infectious Diseases, told the journal. “Obviously the healthcare systems are not trained for coronavirus; we had a little extra time to get ready for the arrival of the disease but some places are really going to struggle.”

There’s also been issues with messaging. In February, Mexican President Andrés Manuel López Obrador said that COVID-19 was “not even as bad as the flu.” Brazil’s president, Jair Bolsonaro, had been dismissive of the death toll and the need for social distancing. When asked recently about the country’s mounting death toll, he responded, “So what? I’m sorry. What do you want me to do?” according to the Times.

Nicaragua, meanwhile, has refused to impose social-distancing measures, and there are media reports that the government is covering up the extent of its outbreak. So far, only 25 cases and eight deaths have been reported in the country of roughly 6.5 million. The figure is likely a vast underestimate.

Even without accurate figures, the overall picture is not looking good. “We are deeply concerned with how rapidly the pandemic is expanding,” Dr. Carissa F. Etienne, Director of the Pan American Health Organization, Regional Office for the Americas of the World Health Organization (PAHO/WHO), said in a press statement May 12. She continued:

In South America, health systems in large urban centers like Lima and Rio de Janeiro are quickly becoming overwhelmed. We are also witnessing a similar impact of COVID-19 on big cities across the Amazon basin.

When transmission is high in areas that function as regional hubs, neighboring areas are then quickly affected—as people move through roads and rivers—impacting smaller towns and remote communities, including indigenous areas, where access to health care is challenging.

PAHO continues to coordinate the response across countries, but we call on national and local health authorities to work even more closely together to contain the spread of the virus and support health systems capacity.