Covid-19: How Uruguay shifted from Latin America’s exception to having the highest rate of new cases

RIO DE JANEIRO, BRAZIL – “We are inexorably losing our privileged position. We must restrict our mobility and physical contact to slow the spread of the virus,” tweeted Julio Medina, a professor of infectious diseases at the University of the Republic (UDELAR), on November 29th of last year.

Less than four months later, the country’s situation has taken a turn for the worse.

Uruguay passed Brazil on Sunday as the Latin American nation with the highest number of new Covid-19 cases per million inhabitants, according to Our World in Data’s 7-day rolling average.

While positions in this ranking may vary from one day to the next, experts are concerned about the Uruguayan situation. On Sunday, the country recorded its highest number of daily infections, active cases and patients in intensive care since the start of the pandemic a year ago.

With an average of 33.51 cases per 100,000 people in a week, Uruguay is in the red risk zone according to Harvard University parameters (from 25 cases). “We are at the worst moment of the epidemic in our country and the next few weeks are going to be very difficult,” Medina predicts.

“Prisoners of our own success”

Uruguay is still doing better than several of its regional neighbors on a few pandemic indicators. With fewer than 3.5 million inhabitants, the country counted 712 Covid-19 deaths by Monday, according to the Johns Hopkins University database.

Its Covid-19 case death rate (1%) is one of the lowest in Latin America and lower than that of nations with similar populations, such as Costa Rica, Panama and Paraguay, according to Our World in Data.

Uruguay also has one of the lowest records in the region for Covid-19 deaths per million inhabitants.

To date, the Uruguayan health system has never been overwhelmed by the pandemic. And although it was one of the last countries in the region to be supplied with Covid-19 vaccines, in late February, it is now the Latin American country with the second-most doses administered per 100 people (5.9), well behind Chile (34.5).

Uruguay drew attention since last year for having implemented a unique strategy against the pandemic, with no compulsory confinements. President Luis Lacalle defined this approach as one of “responsible freedom”: he urged the population to remain at home, but rejected other countries’ police controls.

As the population heeded the advice and the virus was under control, the government in April 2020 began to gradually reopen activities it had closed at the start of the pandemic: construction, trade, schools, and restaurants.

But the first wave of infections began to surge at the end of the year in Uruguay and experts believe that what they are currently experiencing is a rebound. Part of this phenomenon is being attributed to people’s behavior, who are interacting more on their return from the southern hemisphere’s summer vacations.

“Sometimes it is a result of one’s own success: the country had done very well and people relaxed their measures, that explains a good part of what is now occurring,” says Professor Medina.

He adds that the other possible explanation for the increase in cases is that the Brazilian variant of the virus – known as the P.1 and more transmissible – has entered Uruguay through its land border with Brazil.

Although the Lacalle government has ordered a partial border closure, this is difficult to accomplish in cities bordering Brazil, where only one street marks the binational boundary.

“We are convinced that the P.1 must be in the country, we just haven’t been able to prove it yet,” says the infectologist.

And he maintains that, should this be confirmed in studies being conducted, “it means that the measures the country has been employing to contain the epidemic are no longer as efficient and they will need to be stricter.”

The hare and the tortoise

The Uruguayan government analyzed the health situation on Tuesday in a cabinet meeting. For the time being, it has decided to request Parliament to renew a limit imposed on the right of assembly to prevent crowds, local media reported.

Until last week, President Lacalle was opposed to introducing more restrictive measures, such as a traffic ban.

However, the Honorary Scientific Advisory Group (GACH), formed by experts such as Medina, which advises the government on the pandemic, suggested in February to limit social or family gatherings and non-essential commercial activities.

And on Monday, several experts publicly called for more measures. “Unlike the fable of the race between the hare (virus) and the tortoise (us), here it will not go to sleep alone. We have to block it now, lowering mobility with new measures, and thus reach the finish line,” tweeted Gonzalo Moratorio on Monday, a virologist at the Pasteur Institute in Montevideo.

Nephrologist Oscar Noboa argued on the same network that “every minute without measures has very high costs for the sick and their contacts.”

“The reality no longer allows us to be optimistic. It is a race between the surge in cases and the very good vaccination rate. This month (between now and mid-April) the finals will be played. Tough measures need to be implemented, even if they are not liked,” tweeted Oscar Ventura, professor of Chemistry at UDELAR.

Uruguay has also adopted a unique vaccination schedule, not starting with the older population as other countries did because they are a risk group. This is because, according to local experts, the first vaccines the country received, from the Chinese Sinovac laboratory, lacked sufficient clinical trials in people over 60 years of age.

On Monday, the government announced that it will start immunizing people aged between 50 and 70. But the exact date for inoculating people between 70 and 75 with doses from other laboratories is not yet known.

Medina stresses the key role of vaccinating against Covid-19, but points out that without other measures, even a high inoculation rate would have little impact at this point in the country. “This is not going to help us at this stage of accelerating epidemic,” he warns. “It’s going to help us later on.”

Source: El Pais