Table 2.
Initial response to the COVID-19 pandemic in eight selected Latin American countries: what worked well and what has hampered the response
| What worked well? | What has hampered response? | |
|---|---|---|
| Argentina | Rapid application of quarantine measures, which made it possible to strengthen the capacities of hospital services; training of human resources, mainly in intensive care management; widespread communication to the population from the Ministry of Health of the nation; effective coordination between federal and provincial levels; effective coordination between the public and private sectors in health | The national health system had suffered severe deterioration between 2016 and 2019, which required significant recovery efforts. This affected the economic situation of small and medium businesses, which implied strong orientation and negotiation efforts |
| Brazil | Strong epidemiologic and health surveillance system and online case notification system | Capacity constraints for large-scale molecular and antibody testing and ICU beds |
| Rapid construction of field hospitals and conversion of existing hospital beds to create surge capacity | Political tensions when the Minister of Health was relieved of his position by the president because of public disagreement on the nature of restriction measures on commercial businesses | |
| Chile | Chile has achieved relatively low death rates and established a “dynamic” quarantine. Hospital beds, including intensive care beds, have been available | The quarantine and lockdown measures have not been on a national scale, and local and regional policies have varied. The number of health workers infected has increased because of insufficient personal protective equipment |
| The delay between testing, results, and medical leave for symptomatic cases poses risks for transmission. There is a need for more PCR testing in at-risk populations | ||
| Colombia | Rapid scale-up of laboratory and testing capacity and capacity of ICU beds | Political tensions due to the lack of coordination for quarantine orders between the national government and mayors and governors, which generated confusion among the population |
| Opposition of the national government to curfews introduced by some mayors and governors | ||
| A national fund established by civil society and different organizations to support low-income populations, the unemployed, and those working in the informal sector with precarious earnings | ||
| Social distancing, isolation, quarantine, and other voluntary restrictions are not consistently observed in some populations | ||
| Costa Rica | The Ministry of Health has played a political, strategic, and technical role through the response to formulate and articulate interventions with explicit agreement between the public and private sectors. Financial support for those experiencing job losses has mitigated the economic and social impacts of the epidemic | Restrictions create major challenges for people looking for jobs and generating income for their households |
| Supply shortages for testing kits, respirators, personal protective equipment, and hospital capacity | ||
| Increase in social pressure on the government to ease restriction measures from citizens experiencing “behavioral fatigue” | ||
| Ecuador | Introduction of a national emergency coordination of the pandemic led by the vice president of the republic with technical experts and the autonomous decentralized governments | Strong economic problems due to a recessive and dollarized economy, government management characterized by improvisation, and budget cuts for investment in health. A free trade agreement with the European Union from 2016 deepens the crisis |
| Mexico | The appointment of an undersecretary of health with strong technical–scientific skills for management of the pandemic, who is also directly involved in communications about the pandemic’s progression on a daily basis (press conferences) | The pandemic has coincided with major health reforms to replace Seguro Popular, which provided health insurance for low-income groups, leaving gaps in health services |
| A large proportion of the population, who have informal employment with precarious income, have not been able to follow social distancing, isolation, and stay-at-home orders in the absence of income support and welfare measures | ||
| Levels of crime and violence, generally against women and health personnel, have increased since the restrictions were introduced | ||
| Political tensions due to contradictory messages related to the pandemic response from the General Health Council, federal health authorities, state governments, and the president | ||
| Peru | Leadership of the president to prioritize the health of the nation and introduce a rapid national response. Economic and financial support to lessen the socioeconomic impact on low-income groups. Introduction of rapid serologic tests allowed the scale-up of testing not only to symptomatics and contacts but also to other populations (military, police, health workers, and even people at markets). This led to a rapid increase in the number of “infected” people, including those positive on rapid serologic or molecular tests, which is hard to compare with other countries with more restrictive definitions of “confirmed cases of COVID-19,” which usually includes only those positive on molecular tests | Weak and fragmented health system with low capacity for molecular testing, isolation, and contact tracing, as well as ICUs and problems with oxygen availability |
| High rates of informality and poor housing conditions with overcrowding | ||
| Lack of a disease prevention and control communication plan | ||
| Migration from urban areas like Lima, where the majority of Peru’s cases have been reported, to other regions and rural areas | ||
| Mortality reported by Peru is not comparable with other countries because it includes deaths with any positive test to COVID-19, either molecular test or a serologic test |
ICU = intensive care unit.