A health system that was already been collapsing before: Coronavirus in Ecuador

“Only” about 3000 confirmed cases of coronavirus in Ecuador – the actual number is probably much higher. Ecuador is third of the most infected countries in South America after Brazil and Chile. The government is trying to prevent the spread of the disease through curfews, military and other measures. Most of the confirmed cases so far are centered in the city of Guayaquil. At least 120 deaths have been confirmed to have been caused by the virus in recent days and, together with deaths not caused by the virus, funeral homes are already overwhelmed by the situation. Sometimes the bodies of the deceased stay in the house for three days after dialing the emergency call.

But it is not only in funeral homes where problems arise. In an interview, I asked an auxiliary doctor about the situation of the health system in the country. He is working in a public hospital in the capital of Ecuador, Quito.

How reliable is the number of infected people in Ecuador?

Even with better organization and more testing possibilities, as for example in Germany, the number of people currently infected is only approximate. But here we have very limited possibilities to do tests.

What is the situation in Ecuadorian hospitals at the moment? How does the Coronavirus already affect the health system?

 Since the beginning of the Coronavirus our health system has had to adapt considerably. The problem is that it was already more than overloaded before the virus. There was not enough economic support for the hospitals and not enough medical staff. The waiting time for an operation was between 3 and 6 months, even if it was an actual emergency. In order to free intensive care beds for potential Coronavirus patients, operations have been cancelled – no matter if someone has been waiting for a long time for the appointment or is a cancer patient, for example. Only in the worst cases can we allocate beds.

Can you give approximate numbers of the available intensive care beds?

 In my hospital we have 40 intensive care beds. I cannot give an exact number of intensive care beds nationwide, I believe that we can only reach a maximum of 5,000 beds if we take precautions now. This will of course be far too little in an emergency. The president is currently talking about an expected number of 100,000 infected people.

Many countries also report a lack of adequate protective clothing for medical personnel. How do you deal with infected or suspected cases?

All those who are in contact with infected are still fully equipped. But we do not have enough protective clothing to equip doctors dealing with suspected cases. This is already a big problem. As auxiliary doctors still being students in the last semesters, we would have to be equipped with gloves and face masks by our university, which is not working out.  Also, there is reported a new case of corruption. Three persons in charge at the government institution for public health have sold face masks completely overpriced, in favor for themselves of course. They sold masks that would have cost 5 dollars in the local market for 12! Can you imagine that, in this situation? Of course, they have already been removed from their positions.  

Do you think that a so-called “flattening of the curve” is possible in Ecuador, especially in the province of Guayas, which has been most affected so far?

 There are enough reasons for me to believe that we cannot do this. Quarantines cannot be maintained, simply because of the economic situation of many people. Many have to leave home to work.

 “It’s more likely that my child will die of hunger than of the virus”

 many people report. I also believe that in provinces like Guayas the climate plays a major role. We are talking about temperatures above 30 degrees there. The majority doesn’t have an adequate home, that makes it possible for all members of the family to stay there all day under those circumstances.  Also, in my estimation, there is not yet enough awareness of the seriousness of the situation. Here in Quito there are programs, including online via social networks, and it is easier to convince people to stick to the restrictions. I understand the difficulties many people are facing. But gatherings in large groups and behavior, that plays in the hands of the virus, has to be stopped urgently. It should have had to be stopped before, I am afraid.