Uruguay Emerges as a Rare Pandemic Winner in Latin America
Despite the border with hard-hit Brazil, the coronavirus is well under control in the country.
Uruguay doesn’t often find itself on the international stage, save for wine and soccer. Yet despite sharing a border with Brazil, the country second-worst-hit by COVID-19, this small nation is managing to successfully combat a virus that has brought global giants to their knees.
Latin America is currently one of the regions most affected by the COVID-19 pandemic. Argentina and Brazil, the countries bordering Uruguay, are seeing increases in cases daily. In Argentina, despite strict measures taken by the government, COVID-19 has claimed more than 2,200 lives, and the number of cases in the country is over 100,000. In Brazil, the situation is so drastic that the Latin American country is considered the second-most-affected in the world after the United States, with more than 140,000 deaths and almost 2.2 million confirmed cases.
The situation in Uruguay, however, could not be more different. As of July 20, Uruguay has only 1,054 total confirmed cases, 33 deaths, and more than 920 patients recovered—with only 99 active cases.
Although the government’s approach has not been without missteps, given the crisis-ridden nations next door the relative success is a credit to the public and the administration. With close ties through border cities such as Rivera, where you can cross the street and suddenly be in Brazil, the Uruguayan government has had to shoulder not only its own situation but also that of a country whose response to the pandemic has been disastrous.
That success has paid off with the public. In a survey carried out by Ipsos, the Uruguayan management of the pandemic had the highest rate of public approval out of any Latin American country. “I feel very cared for,” said Carlos Leguísamo, a former director of the Uruguayan station Radio Colonia. “Science was respected, and so were individual freedoms. Instead of totally isolating the virus, Uruguay made every effort to find the first case of each contagion and then isolate the entire chain of contacts. And that was the main difference we had with the rest of the world.”
Uruguay’s success in coping with COVID-19 is not only a result of immediate actions, but also rooted in institutional strengths that the nation has been growing for years. In addition to being among the countries with the least poverty in Latin America, Uruguay is one of the few countries in the region where the population has full access to basic services, such as running water and electricity, as well as high rates of internet connection.
With more than 88,000 coronavirus tests conducted since March 13, when the first cases were detected in Uruguay, the country is among the top performers in the world in terms of testing by population—which has been widely available even to people without symptoms.
The smallness of the country, which has a population of 3.5 million to Brazil’s over 200 million, enables rapid and effective contact-tracing, which has also meant targeted, random testing. That has allowed the targeting of specific groups who play a key role in supply chains and can be inadvertent superspreaders, such as construction workers or distributors and transporters.
“I think that without a doubt scale is something that plays in our favor,” said Diego Irazábal, the governor of Flores. “The health authorities can have a more direct control of the situation, and it can control the people infected and their contacts at a much more personal level.”
The exhaustive control of cases is complemented by one of the largest scientific deployments ever inside the country, augmented by existing investments in education.
“In the years [when the opposition was in government] there was a transfer of resources and the University of the Republic, Uruguay’s top university, has seen its budget increase enormously,” said Liliam Kechichián, a former minister of tourism and senator from the Broad Front, the main opposition party.
“This has been really useful, because today it allows us to have the test kits without depending on anyone, which was a problem at the beginning of the pandemic,” she added.
Even before COVID-19 was not yet a clear threat on the continent, scientists from the Pasteur Institute in Montevideo, alongside researchers from the University of the Republic, began to manufacture kits to detect the coronavirus using molecular technology. This not only reduced the cost of testing but also established the country as a leader in the region, enabling it to sell kits to Argentina, Chile, and Paraguay, and helping to test the population in the cities bordering Brazil.
“Uruguay has developed a national integrated health system that not all countries have, and that bets a lot on primary care,” said Jorge Mota, a former director of departmental health for the department of Colonia, which borders Argentina.
“Preventive interventions are carried out on the entire population, from babies to the elderly, and this means that people will be monitored even if they are healthy,” he said. The doctor added that in emergency situations, such as the current pandemic, the entire management of the system falls to the state, allowing greater coordination and control.
By the end of February, the health system was already preparing to deal with the situation. Not only was a plan created to strengthen both public and private health centers, but the government also sought to increase and coordinate the joint work of the country’s various institutions. At the beginning of March, when the pandemic still seemed somewhat distant and the first cases were confirmed, the decision was taken to expand the number of beds in the intensive care units and increase the amount of specialized equipment and respirators in its facilities, something that allowed the system to be prepared in case the situation got out of control.
As the world has rapidly learned, solutions for COVID-19 aren’t just about lab work, but also social psychology.
The health control exercised by the state was accompanied by the same social distancing measures that have proved to be effective in other countries, but—unlike in many other nations—in Uruguay compulsory quarantine was never decreed. Nor were sanctions applied to those who did not comply with the guidelines suggested by the government.
“All the measures were taken on time, the necessary measures expressed in the first sanitary emergency decree, but always emphasizing the responsible freedom of the people,” Irazábal said, adding that in Uruguay, unlike elsewhere, these measures have been obeyed practically to the letter. The country’s high rates of connectivity and lack of extreme poverty meant that people were more confident that social distancing wouldn’t prove an economic disaster for them or an educational disaster for their children. The government has used individual freedom and civic rights as one of the main points of its strategy—and this has been generally accepted by citizens who, faced with the option to choose, chose to preserve the safety and health of their fellow citizens.
Other earlier steps ended up helping prepare the country for the pandemic. The Ceibal Plan, established in Uruguay over a decade ago, delivers tablets and computers to children. Another government scheme, the Ibirapitá Plan, delivers tablets to the elderly, an important measure in a period when keeping people physically separate but informed and in touch with others—especially among at-risk populations—can be the difference between life and death. The government has also taken steps such as designating a special COVID-19 fund, providing social baskets, and increasing one-time social assistance cards for the most vulnerable.
Some have called for stronger action. “No measures were actually applied here,” said Juan Raúl Ferreira, a senator from the Broad Front.
“Except for the interruption of classes, and now the use of face masks on public transport, all the other measures that have been taken have had no coercive value. They are suggestions, recommendations, appealing to the responsibility of the population,” he said. Ferreira argued that, given the proximity of Brazil, stronger measures were needed and that the lack of border closures early on had been a failure by the government.
But despite the lack of enforcement, social distancing has been common. “We took rapid social isolation measures and closed universities, high schools, and shopping malls,” Kechichián said.
“There were decrees from the executive branch that suspended all kinds of activities,” Irazábal added. “A lot of public activity was completely frozen, without the need for mandatory quarantine”
Despite the country’s successes, it has not emerged unscathed.
Although Uruguay’s economy was able to stay on course in several areas, it suffered a major blow due to the total paralysis of tourism, one of its most vital economic activities.
Tourism, which represents 9 percent of the country’s GDP and is directly linked to 100,000 jobs in different areas, is, according to Kechichián, in a “dramatic situation,” indicating that the government has done little to minimize the impact of the pandemic on the sector. “I believe that the measures taken by the executive branch in relation to tourism activities have been practically nil, beyond postponing the payment of some taxes by public entities,” the opposition legislator said, adding: “There is a special unemployment insurance, which can be evaluated as positive, but we have not seen concrete support for small business.”
The impact on the economy also has a direct effect on the most vulnerable sectors of the population, and the opposition says that more could be done to alleviate the situation. “At a time when Argentina was saying that they don’t pay for electricity, water, or gas, in Uruguay they increased the rates,” Ferreira said, referring to the rate increase carried out by the government after taking office earlier this year.
“The country had credits set up for contingencies of this kind, which from our point of view should have been used more massively to assist the unemployed, small and medium business,” Kechichián said.
But successful control has allowed for other parts of the economy to continue strongly. “Agriculture continued to go on, which is the basis of our exports,” said Irazábal, explaining that in an area like Flores, where the main income base is in the agricultural and livestock industry, “this has allowed us to cushion the social costs.” He also mentioned the large number of public posts and the maintenance of contracts as important factors in the country’s economic sustainability.
The border with Brazil remains a huge concern. “Uruguay knows that it has a very complex land border with Brazil, so nothing has been won yet,” said Ricardo Planchón, a deputy of the ruling National Party from the department of Colonia. Sporadic outbreaks in the country, with the exception of the first outbreak, have been concentrated in four of the five border departments, Uruguay’s regional units.
In addition to closing borders, restricting movement, and setting up checkpoints, Uruguay has also collaborated in testing the inhabitants of the border cities on the Brazilian side. In a country like Brazil where testing is scarce and the health system is overwhelmed, this collaboration is important not only to avoid contagion on the Uruguayan side, but also to assist a country where the situation is already out of control. Like other successful small countries from Taiwan to Georgia, Uruguay has implemented pandemic control and landed in a surprisingly strong position despite economic pain. As Latin America picks up the pieces of a devastating epidemic, Montevideo may emerge as an unlikely diplomatic leader.
Milagros Costabel is a visually impaired freelance writer and disability rights advocate living in Colonia, Uruguay.