Featured image: Buenos Aires (Source: Santiago Sito via Flickr)
By Camila Otero
As the COVID-19 pandemic came into full swing, COVID-19 restrictions in Florida were far and few between. Only quite far along into the pandemic did Floridians receive some sort of strict quarantine—and such a quarantine was not in place for long. Nowadays, many Floridians and Americans in general have become exhausted and impatient with restrictions, claiming it to be an infringement of their rights. Masks are no longer mandated in Florida; unless a private business suggests the usage of masks, one can enter any space with other individuals completely maskless. People can also do so regardless of vaccination status, because Florida legislation now prohibits businesses or government entities from denying service based on this information. This was seen by policymakers as a way to protect Floridians’ personal liberties.
COVID-19 was spurring political debate not only in Florida, but throughout the entire United States. With responses to the pandemic increasingly politicized over time, it was difficult for there to be a serious and swift response. In reality, an adequate response never took place. According to the CDC, Florida became one of the states with the greatest number of total cases per 100,000 people, rallying in at number four (after Tennessee, North Dakota, and South Carolina) with a total of 16,770 cases per 100,000 people. This is significantly higher than the national average, in which there have been a total of 13,548 cases per 100,000 people since January 21, 2020. The number of deaths per 100,000 people in Florida is also remarkably higher than the national average: 262 compared to the nation’s average of 218 deaths per 100,000 people.
Many countries, particularly those in East Asia, took a starkly different approach to the pandemic, aiming to contain the virus from the beginning. The WHO received information of cases of pneumonia of an unknown cause from Wuhan, China on December 31, 2019, and on January 19, 2020, COVID-19 cases were first reported outside of Wuhan. Only four days were needed from this first case outside of Wuhan for the Chinese government to act. They implemented city lockdowns and mandatory quarantines to ban or limit traffic beginning January 23rd, as well as strategies that encouraged social distancing beginning January 28th and centralized treatment and isolation strategy beginning February 2nd. In locking down a population of 40 million people, many other countries criticized China for this heavy-handed approach for infringing on their citizens’ human rights. However, researchers such as Dr. Xi Chen, an associate professor of Public Health at Yale University, stated that “if China did not do that, I don’t think China would have been able to survive.” These strict measures were imperative, primarily because of the approach of the Spring Festival, widely considered the most important annual celebration in Chinese culture that prompts the largest regular migration of people in the world. In a normal year, around 15 million people would travel out of Wuhan during this holiday to visit their families. Thus, according to Dr. Chen, “if that were to happen without a lockdown of the epicenter (Wuhan), [COVID-19] would have spread very quickly.” These strict health policies, both at the national and local level, certainly paid off: it reduced the transmission rate and resulted in 1,408,479 fewer cases and potentially 56,339 fewer deaths.
South Korea, like China, reacted quickly after the first cases of COVID-19 were identified. Contrasted with the slow response of the U.S. government, there quickly became two different global strategies for tackling COVID-19. Both South Korea and the United States identified their first COVID-19 case on the same day. However, South Korea started massive testing shortly after this first case was identified, while the United States took 45 days to scale up testing and a whole 100 days to catch up with South Korea. Per Dr. Chen, “viruses often spread exponentially, hence the first 100 days may determine the future of [a] pandemic.” The United States’ delayed response to the pandemic reaped terrible consequences, and the necessity of early action can be seen in the stark differences in success of the United States versus South Korea, which managed to handle the pandemic much better from a public health aspect.
In Central America, Guatemala aimed to copy the model that East Asian countries like China, Japan, and South Korea implemented in stopping the spread of COVID-19 from the beginning. In particular, Guatemala wanted to utilize CT scans as a tool to stop the spread of COVID-19, like these countries were doing. Guatemala did not have enough PCR tests to test its entire population, diagnose the areas where the disease was coming from, and control its spread. At TechniScan, the largest diagnostic center in Central America that worked pro bono for the Guatemalan government during the pandemic, they investigated the use of CT scans for detecting COVID-19. Dr. Marco Cabrera, a radiologist at TechniScan, stated that their team “read an article that said that China was doing CT scans of the lungs, and because of the sensitivity of the CT scan in detecting COVID-19 in the lungs (being more sensitive than the PCR tests), [they] knew what to do in the pandemic.” They utilized CT scans as the main form of diagnosing COVID-19 and, as a result, did manage to prevent the spread of the disease in Guatemala at the outset of the pandemic.
According to WHO, the first cases reported in Guatemala were on March 9, 2020. The government acted swiftly, and within a matter of weeks implemented restrictions, including a mask mandate both indoors and outdoors, social distancing guidelines, travel bans, and a strict lockdown for about 6 weeks. Dr. Cabrera recounted that “at the beginning, for the first four months, we did OK. Our mortality rate was low, our community transmission rate was low, and I want to believe that the government was working side by side with the people.” The implementation of strict restrictions, although it involved the temporary sacrifice of certain “individual rights,” were effective in preventing the spread of COVID-19 and, as a result, kept a country’s population safe. However, such restrictions were not feasible for some countries, especially for countries with few resources and a large portion of the population living under the poverty line, like Guatemala.
According to the World Bank, 59.3% of the Guatemalan population lives below the poverty line, and 23% live in extreme poverty. Guatemala’s indigenous population, often living in rural areas, are acutely affected, with 79% of indigenous people in Guatemala living in poverty. This was the ultimate reason why Guatemala could not maintain its lockdown; many people needed to work in order to survive. In Dr. Cabrera’s words, “In rural areas of Guatemala, COVID was not the problem. The problem is food, the problem is poverty.” More wealthy countries, like Australia and New Zealand, instituted strict lockdowns but were able to prolong these lockdowns or implement one even after one had been previously lifted because of the financial stability and resources that these countries have. New Zealand, Australia, and many other countries, were able to provide their citizens with welfare checks in order to ensure that people could maintain their current standard of living. Guatemala did not have the resources to provide its citizens with money, and therefore the lockdown had to be lifted once people could no longer afford to continue living without work. After the lockdown was lifted, COVID-19 spread boundlessly all throughout the country, and Guatemala struggled with attending to all these people and trying to limit the spread of COVID-19 from there.
Regardless of countries’ limited pandemic responses and resources, almost every country’s economy suffered a negative impact as a result of the pandemic, particularly due to lockdowns and travel bans. Some countries, such as Argentina, suffered a similar fate as Guatemala; from March 19, 2020 to July 17, 2020, Argentina had a complete lockdown, like China and Guatemala. After July 17, restrictions were gradually lifted; more businesses were opened, and soon there was more economic activity taking place. However, masks and social distancing was put in place in order to compensate for the relaxation of the lockdown. The restrictions on borders were soon relaxed as well. In March 2021, the country opened its borders to new destinations, and now it is finally opening up to foreigners for travel and visiting purposes. According to Roberto Rojas, an economist who works as an executive for a large water and sanitation distributor in Buenos Aires known as ABSA (Aguas Bonaerense Sociedad Anónima), Argentina’s macroeconomic issues, high inflation, and external debts made opening the country a necessity for many people. One reason cited in support of this notion is that neighboring countries, like Brazil, had almost the same number of deaths but kept their country much more open (with less strict lockdown and travel restrictions) than Argentina. Regardless, as Rojas states, there are still many factors that must be taken into account when determining whether keeping the country open would have been a good move for Argentina or if it would have caused even more deaths and infections. These include factors such as proximity or remoteness to the equator, the type of climate, the type of food, and the average age of the population, among other things. Additionally, in the height of the lockdown, the government could not afford to issue money to the people, as its macroeconomic instability would generate more inflation.
However, in Argentina, it was the middle class that was the most affected. Rojas asserts, “We have around 8 million people living on public assistance in a population of 45 million, and public assistance was maintained (but not increased). An analysis says that those people had [economic] pressure, but it was not so strong. The real pressure in Argentina came from the middle class that is usually, for example, a dentist who has an office, lives very well, earns a lot of money in dollars and pesos, travels, and suddenly was forced to be eight, nine months without working, with which he went from having a very good income to having zero income. And the only program there was for that middle class, which is very broad in Argentina, was a program of a [one-time] subsidized credit of 150,000 pesos. That is nothing—it is approximately 1,500 dollars at the official exchange rate.” Thus, in Argentina, like in China, Guatemala, and the United States, the government “lacks the channels to reach [the vulnerable population] accurately and efficiently,” as Dr. Chen explains.
However, China, the United States, and other European countries with much stronger economies could afford to implement lockdown measures for extended periods of time, unlike Argentina, and especially unlike Guatemala. According to Dr. Chen, “If you have a big market like China has, then Zero Covid Policies may not be so bad because you still have a domestic economy on going, people have to have jobs, although the growth rate is reduced. But for many small countries it may become an issue, even for New Zealand because they rely on tourism.” Dr. Chen suggested a potentially better alternative to shutting down entire countries due to COVID-19 and similar pandemics that involves targeted travel restrictions: “Future policy design may utilize the history of economic activities and human migration data to model which city pairs need to be restricted and how many restrictions need to be imposed.” For example, these may include restrictions for cities in the epicenter of the pandemic (ie. Wuhan and nearby cities) and those that are major transportation hubs with strong links to the epicenter (ie. Beijing, Shanghai, and Guangzhou).
Similar to how many countries experienced issues with the economy and containing the spread of the disease, many countries encountered obstacles with vaccine distribution. Guatemala’s majority-Catholic population and mixed messaging from religious authorities throughout the pandemic have confused people on whether or not to get the vaccine. Dr. Marco Cabrera explained that about 48% of the population is Catholic, and this group has only recently begun to get vaccinated because of the Pope’s announcement to get the vaccine for the sake of humanity. In rural areas, however, there are small Christian churches that exist with essentially no rules or authority. Here, Dr. Cabrera said, “the pastors are saying that the vaccines are the mark of the devil, a sign of the Antichrist.” For this reason, these people living in rural areas, which make up a significant portion of the Guatemalan population, are refusing to get vaccinated.
A lot of this can be attributed not only to religion but to lack of education. According to UNESCO, only 81.29% of the population is literate, and there has been a growing trend in the number of out-of-school adolescents. 33% of indigenous adults, who make up the majority of people living in rural areas of Guatemala, cannot read or write. However, in the neighboring country of Costa Rica, the literacy rate is at 97.9%. Connecting this to the amount of people vaccinated, in Guatemala only a striking 25% of the population is vaccinated, and in Costa Rica 70-75% of the population is vaccinated. These numbers indicate a potential correlation between literacy rates and vaccination rates, and indicate the urgency in which Guatemala needs to address this issue and place education reform higher on its agenda.
In many countries, those living below the poverty line have seen the devastating effects of the pandemic, risking the possibility of contracting COVID-19 and their lives in order to put food on the table for themselves and their families. No country responded perfectly to the pandemic, but some responded better than others. It is disheartening to see that some countries, with all of the resources right at their fingertips, such as the United States, still managed to fail so horrendously in containing the disease and caring for their populations from the onset. Meanwhile, many other countries either had the resources and acted properly, or did not have the resources and tried the best they could to attempt to limit the disastrous effects of the pandemic. However, it is clear that policies put in place to help people during the pandemic failed to reach many populations, specifically minority groups and those living under the poverty line. Perhaps policymakers did have the right intention now during the pandemic, but their responses reflect the long-standing inherent corruption and injustice that characterize these governments, and that still continue to the present day.
Camila Otero is a first year in Saybrook College. You can contact her at camila.otero@yale.edu