DAVID GREENE, HOST:
All right, COVID-19 has become the leading cause of death in parts of Latin America. The region has been particularly hard-hit, and that's because of a combination of health, social and economic factors. Here's more from NPR's Jason Beaubien.
JASON BEAUBIEN, BYLINE: In Peru on All Saints Day, people traditionally visit the graves of loved ones, particularly loved ones who've recently passed away. They bring flowers, food and loaves of specially baked bread to their graves. This year, however, things were different. At La Balanza cemetery on the outskirts of Lima, lines of police and soldiers in riot gear blocked the entrance to the graveyard. Peru has the highest death rate from COVID in the Americas. And as the pandemic continued to spread in late October, the local mayor, Raul Diaz Perez, told residents not to come to visit their deceased loved ones.
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RAUL DIAZ PEREZ: (Speaking Spanish).
BEAUBIEN: Standing in front of lines of police outside the cemetery, Mayor Diaz said on a video posted on his Facebook page that entry to the graveyard is prohibited.
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DIAZ: (Speaking Spanish).
BEAUBIEN: "We have been hard-hit," he said, "and these measures to avoid crowds are to reduce the spread of the virus."
The fact that COVID has hit Latin America harder than other regions isn't a fluke. The continent had all the ingredients to ignite a pandemic - crowded living conditions, poverty, social discord, poor governance and fragmented, underfunded health systems.
CARISSA ETIENNE: Latin America is one of the most unequal regions of the world.
BEAUBIEN: That's Carissa Etienne, the head of the Pan American Health Organization, the WHO's regional office for the Americas.
ETIENNE: And COVID-19 exacerbated these inequalities.
BEAUBIEN: Etienne says the pandemic has highlighted and exploited longstanding problems in the region. The virus swept through dense urban metropolises like Mexico City, Bogota and Sao Paulo, where physical distancing was difficult, if not impossible. And many people have jobs that they simply can't do from home.
ETIENNE: The many millions who rely on the informal economy for their livelihoods didn't have the option to stay home.
BEAUBIEN: The region has high levels of obesity, diabetes and other underlying chronic health conditions that during this pandemic have made the virus far more deadly.
Jeremy Veillard is a senior health specialist with the World Bank specializing in Latin America.
JEREMY VEILLARD: In Peru, which is one of the countries where you have had the highest number of excess deaths from COVID-19, during the summer, 85% of the people who died from COVID-19 were in overweight or obese.
BEAUBIEN: Another factor in Latin America is a hodgepodge of ways that people access health care. Some go to private clinics and hospitals. Some rely on government programs. Some only visit a doctor and a pharmacy once they're sick. These siloed systems offer dramatically different levels of service to residents based on what, if anything, they're able to pay. Frederico Guanais, the deputy head of the health division of the Organization for Economic Cooperation and Development, says in the midst of a national health crisis, it's hard to get all these different health systems to work together. And there's also often mismatches in resources.
FREDERICO GUANAIS: In Brazil, the SUS - right? - the publicly funded health system, has roughly 40% of the ICU beds.
BEAUBIEN: The majority of Brazil's ICU beds are in private hospitals, which serve less than 25% of the population.
GUANAIS: And this is in the system that is supposed to be a universal system like the National Health System (ph) of England.
BEAUBIEN: These structural inequities in Brazilian health care can mean that for the masses with limited resources, a severe case of COVID could be potentially fatal while if they had money or they lived somewhere else, they might survive. And this is part of why COVID is now a leading cause of death in the region.
Jason Beaubien, NPR News.
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