Gonzalo Alvarez, a player in Uruguay’s premier basketball league, started feeling the symptoms a few days after a game: fatigue, headaches, lower back pain, loss of taste and smell.
In the early days of the pandemic, Uruguay was a global model. Leaders in the progressive, stable, high-income nation united behind science-based measures to contain the spread of the coronavirus. Low case counts enabled it to reopen schools and businesses before many of its more virulent neighbors.
But now the nation of 3.5 million is trending in the wrong direction. For several days in April, Uruguay had the world’s highest daily case count per capita. More than 92,000 people were diagnosed with covid-19 during the month, 42 percent of the country’s total since the start of the pandemic. Authorities reported 1,642 deaths, more than four times the toll in March.
The country, wedged between Brazil and Argentina on South America’s Atlantic Coast, has been unable to avoid the deadly wave now engulfing the continent. South America leads the world in new cases and deaths per capita, and Uruguay leads South America in both.
Analysts blame a range of factors, from a breakdown in social distancing to the arrival of the P.1 variant, spawned next door in Brazil. The popular sportscaster Alberto Sonsol died in April, as did a pregnant woman — a first for the country — and then another.
“The situation is dramatic,” said epidemiologist Jacqueline Ponzo, who serves on an interdisciplinary panel that studies coronavirus data. “I don’t usually like to use adjectives to explain these things, but it really is fitting.”
The government has been adding hospital beds to meet the surge, but the health system is struggling to staff intensive care units, and the primary care system, where most coronavirus patients are treated, is showing signs of saturation.
“We are having an increase in mortality which is probably tied to how stressed the health-care system is,” Arturo Briva, professor of intensive care medicine at the University of the Republic, said at a virtual conference organized by the university. “Our health-care system is able to take care of 650 very ill patients. … If I have 800 patients coming in, they are going to be admitted, they are going to be cared for and the staff will do their best, but the system is not able to do something that is not within its capabilities.”
The P.1 variant, now the predominant strain in Uruguay and other South American nations, is believed to be more transmissible than other strains. It is not known whether it is deadlier.
“We are at a time when intensive medicine has to ask the rest of society to humanize itself,” Briva said. “To not remain indifferent to the fact that every day they are telling us that 40, 50, 60 Uruguayans are dying from a disease that is preventable if we cut community transmission.”
Authorities have resisted reimposing lockdowns. In March 2020, at the outset of the pandemic, they closed the borders, shut down schools and appealed to Uruguayans’ sense of duty. The motto was “Libertad responsable” — responsible freedom. But 14 months later, the spirit has unraveled as people gather in parks, drink in reopened bars and board crowded buses to go to work.
The economic implications of a harsh lockdown are not lost on Uruguayans, who remember the dark days of the 2002 economic crisis. The economy contracted nearly 6 percent in 2020; 100,000 people fell below the poverty line.
A presidential advisory panel found that Uruguayans perceive the risk has grown since February. But their study also showed the people were still reluctant to give up activities such as small social gatherings.
“I have this feeling that we haven’t fully grasped the situation,” said Alejandra López, a psychology professor at the University of the Republic who led the study. “I’m worried about normalizing, that we will get accustomed to 70, 80 or 90 deaths a day.”
Uruguay is vaccinating rapidly — more than a third of the population has received at least one shot, and a quarter are fully inoculated — but not rapidly enough. Analysts have warned of the dangers of pursuing a vaccination campaign amid high levels of contagion.
“When you have community transmission, it’s an optimal scenario for the appearance of dangerous variants,” Ponzo said. “We are completely exposed to the appearance of a ‘Uruguayan variant.’ But if we also add to that that the virus is in contact with our immunity, which is in full motion, the probability that this virus will develop strengths to attack us more severely increases.”
She stressed that vaccines alone will not end the pandemic — they should be accompanied by continuing measures to contain community spread.
The early days of May have seen a slight reduction in cases; in-person classes are resuming in stages.
Alvarez, the basketball player, is slowly regaining his sense of smell; his sense of taste is almost fully back. Now his girlfriend has started to show coronavirus symptoms. They tried to be careful, staying away from each other while she cared for their 2-year-old son.
“But she could have caught it anyway,” he said. “We will see.”
Coronavirus: What you need to know
Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. New federal data shows adults who received the updated shots cut their risk of being hospitalized with covid-19 by 50 percent. Here’s guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.
New covid variant: The XBB.1.5 variant is a highly transmissible descendant of omicron that is now estimated to cause about half of new infections in the country. We answered some frequently asked questions about the bivalent booster shots.
Guidance: CDC guidelines have been confusing — if you get covid, here’s how to tell when you’re no longer contagious. We’ve also created a guide to help you decide when to keep wearing face coverings.
Where do things stand? See the latest coronavirus numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people. Nearly nine out of 10 covid deaths are people over the age 65.
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