Once in crisis, Ecuador city now helps others battle virus

Ecuador's biggest city, Guayaquil, was a pandemic hellscape of makeshift morgues, hundreds dying at home, bodies left in the street.

That was in March and April, when the country's economic hub on the Pacific coast suffered as much as anywhere in the world from the new coronavirus and the disease it causes, COVID-19. Guayaquil later stabilized, sending medical teams and equipment elsewhere in Ecuador and taking in virus patients from outside the city.

Guayaquil officials partly attribute the turnaround to a strict lockdown and the adaptability of a population that, through history, endured epidemics of malaria, yellow fever, dengue and bubonic plague in a place whose tropical climate, crowded neighborhoods and exposure to foreign travelers seemed geared for infection.

Some medical experts caution against seeing Guayaquil as a model for others, even if authorities adjusted well after initially being overwhelmed.

“The contagion was so massive, so rapid,” and so many people died, that the number of people who are particularly vulnerable to the coronavirus in Guayaquil is much lower today, said Dr. Esteban Ortiz, research director of a health program at the Universidad de las Américas in Quito, Ecuador’s capital.

Additionally, Ortiz said, the more rigorous use and implementation of “respiratory masks, facial masks, facial shields, social distancing and hand washing” slowed contagion there.

So far, Ecuador's health ministry lists more than 1,600 COVID-19 deaths in Guayas province, which includes Guayaquil. That's nearly one-third of the official death toll nationwide from the disease, a figure widely acknowledged to be an undercount.

Other Guayaquil data indicate the number of daily deaths recorded in parts of March and April was hundreds higher than for the same days in past years, suggesting many were coronavirus-related. Thousands certainly died of COVID-19 in the city of 2.7 million, and some relatives still don't know exactly where their dead were buried in that chaotic period.

Guayaquil promises to punish anyone who violates health guidelines. The city warns of $60 fines for people who don't wear masks on public transport, and bus drivers who let passengers ride without masks can get $200 fines as well as points docked from their licenses.

Hotels and restaurants are banned from hosting parties. Gatherings for baptisms and weddings are out. The city's Veradero beach remains closed while beaches open up in other parts of Ecuador.

The city helps citizens with food handouts and mobile clinics. The private sector got involved in aid efforts. Military and national health authorities assisted, though municipal officials say the government in Quito lagged in providing resources and sharing information.

“Given the tremendous burden Guayaquil felt during March and April, I believe that they learned a lot, both from their successes and their shortcomings," said Bernardo Gutiérrez, a researcher at the Universidad San Francisco de Quito. He wrote in an email to The Associated Press that “the merits of Guayaquil specifically lie in their efforts to organize and coordinate efforts between the local government and different civilian actors" to implement health measures.

But Gutiérrez said there is no guarantee that Guayaquil's particular protocols would work elsewhere because of the unpredictability of any outbreak and the fact that “the specific situation of a city will be very different from others."

With its crisis abating, Guayaquil sent doctors to several areas including Quito, which is experiencing its own COVID-19 surge. Guayaquil accepted virus patients from other regions, to the point where Mayor Cynthia Viteri, herself recovered from a light case of COVID-19, has warned that available ICU beds are again scarce.

On July 25, Viteri marked Guayaquil's foundation by Spanish colonizers in the 16th century with an emotional speech on Carmen hill, which overlooks the city.

“We were simply left to our fate" at the pandemic's peak, she said. But, the mayor said, Guayaquil residents got back on their feet.

The small group of invited guests — masked, their chairs spaced well apart — clapped.