The COVID-19 Fallout: What Happened in Latin America and the Caribbean?

By Bas B. Bakker and Carlos Goncalves

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While there’s talk of ‘life after the pandemic’ in some of the world’s wealthiest countries, in several Latin American and Caribbean countries, daily COVID-19 deaths are still near pandemic heights.

Unlike the United States and Western Europe, the death toll in the region has steadily increased since the onset of the pandemic—there were no big waves. Latin America locked down early and has a much younger population than the other regions; so why did deaths continue to mount? 

Our research shows that the timing of the lockdowns, high levels of informal employment (informality), and weak institutional capacity played an important role in limiting the effectiveness of lockdowns in the region.

The real impact

The official COVID-19 death toll (per million) in Latin America and the Caribbean is similar to the United States and Western Europe, despite a much younger population and COVID-19 hitting relatively late, which gave countries time to prepare.

The official death toll may not be all that accurate, however. The number of “excess deaths”—a measure of how many more people are dying than would be expected in a normal year—suggests the true death toll in many Latin American countries is well above the official death toll. Peru is a case in point. Its official death toll almost tripled after a recent review of its medical records, on account of the large discrepancy between excess deaths and official deaths.

The region's response to COVID-19

Countries in Latin America and the Caribbean were hit later, which gave them time to lock down before the disease had spread. The lockdown was also stringent—the declines in mobility in the spring of 2020 in some Latin American countries were among the highest in the world. This had a big impact on economic activity. In April, economic activity in the region had fallen by 20 percent from the year before.

But the early and stringent lockdowns did not reduce the daily death toll. Our research shows that while the growth rate of new deaths in the region slowed, the number of new deaths continued to rise slowly but steadily, peaking in early 2021. This was very different from the United States and Western Europe, where daily deaths declined rapidly during the second quarter of 2020.

Why didn’t lockdowns in the region reduce the daily death toll?

One reason may have been the high levels of informality and lower levels of institutional capacity in the region. The higher the level of informality, the less impact lockdowns have on the growth rate of new deaths, in part because people with informal jobs cannot afford to stay at home. We find a similar result for governance and other indicators of institutional capacity. Lockdowns delivered better results in countries with higher measures of government effectiveness, presumably because government effectiveness is a proxy for the quality of the health care system.   

Another reason was locking down too early. When the lockdowns started, the number of infected persons was still very low, which meant the susceptible population was very high. This made it much harder to stop the pandemic.

Finally, government policies became less stringent and less impactful, leading to increased mobility as cases went up. Western Europe also saw increased mobility in the summer of 2020, but this was when new cases had fallen to low levels.  

Limited vaccines and new variants

In late 2020, there were two further game-changers—the arrival of vaccines and the arrival of new, more contagious variants. The region has been hit hard by the latter, including the infamous P.1 variant in Brazil.  The percentage of the population that has been fully vaccinated is also relatively low in most countries. 

There are other factors that may have impacted the death rate that are more structural. For example:  

  • The number of hospital beds—more beds per capita led to fewer deaths.
  • Countries with a history of BCG vaccination (against tuberculosis) had a lower death toll than others.
  • Larger and more densely populated municipalities had more deaths per million (population density does not explain cross-country differences however).   

Lessons learned

  1. Timing is key. Locking down too late will cause the death rate to soar but a very early lockdown may not be sustainable and is unlikely to succeed in stopping the pandemic (with the notable exception of small islands).
  2. Higher levels of informality and weak institutional capacity limit the effectiveness of lockdowns.
  3. Rapid rollout of vaccines is critical. Countries most at risk of a sudden surge are those with a very high share of the population that is still susceptible. In Uruguay for example, the daily death toll surged from 63 in December 2020 to 4,700 in June 2021—its death rate is currently one of the highest in the world relative to the size of its population. As of early-June 2021, the rate of fully vaccinated people in the five most populated countries (Argentina, Brazil, Colombia, Mexico, Peru) ranged between 4 percent (Peru) and 11 percent (Brazil), compared with 41 percent in the United States. With many countries in the region struggling to acquire or buy vaccination doses, vaccine access remains a major priority.