TARIJA, Bolivia – So many people died that the government's figures could not be accurate.
Calls to retrieve bodies flooded Bolivia's forensic office. In July, agents collected up to 150 bodies a day, 15 times the normal number in previous years, the country's chief forensic officer Andrés Flores said.
The claim in his office suggested that the official number of Covid-19 deaths – now just over 4,300 – was a massive under-figure, Mr Flores said. But with limited testing, scarce resources, and a political crisis tearing the country apart, the extra lives lost were largely unrecognized.
New death figures reviewed by The Times suggest the actual death toll during the outbreak is nearly five times the official number, indicating that Bolivia has suffered from one of the world's worst epidemics. The extraordinary increase in population-adjusted deaths is more than twice as high as in the United States and much higher than in Italy, Spain and the United Kingdom.
According to a Times analysis of Bolivian Civil Registry records, about 20,000 more people have died since June than in previous years, a large number in a country of only about 11 million people.
Tracking all-cause deaths gives a more accurate picture of the pandemic's true toll, demographers say, because it doesn't rely on testing, which was very limited in Bolivia. The death rates include people who may have died from Covid-19 and from other causes because they could not receive health care.
"This is a very cruel situation that we are going through," said Mr. Flores, head of the Institute of Forensic Investigations. "We are completely exposed."
With a bare health system, decentralized government and poor infrastructure, Bolivia struggled to control infectious diseases such as dengue even before the coronavirus arrived, said Virgilio Prieto, an epidemiologist with Bolivia's Ministry of Health.
But her ability to respond was undermined by a controversial election that led to the impeachment in November of then-president, Evo Morales, a socialist. An interim president, Jeanine Añez, a conservative, stepped in with a promise to rule until elections could be held.
Since then, Ms. Añez has announced that she is running for office – and has asked the electoral board to postpone the new vote as the pandemic made it unsafe for the population to go to the polls. The reshuffle of the vote from May to October has infuriated opposition groups, who see it as an attempt by the temporary president to remain in power.
"She is not recognized as a legitimate leader, making it extremely difficult to coordinate a complex response required by the pandemic," said Santiago Anria, a Bolivia expert at Dickinson College in Pennsylvania.
The decision of Mrs. Añez's becoming president herself has thwarted opposition lawmakers and regional officials on whom she depended to mobilize healthcare, said Mr. Anria, which led to a disorganized, ineffective attempt.
Her response was also bogged down by corruption scandals, including the arrest of her health minister in May after investigators accused him of using money from international donors to buy hospital fans at twice the real cost.
Ms. Añez defended her approach to the outbreak, saying her decision to implement a quick lockdown would prevent an even greater loss of life. She also blamed Mr. Morales party for mismanaging the health care system during her 14 years in office and suppressing her plans to boost government spending in the pandemic.
"We have done more in three months than what has been done in this country's health care history," she wrote in a Twitter post this month.
More than 100 roadblocks by unions and Mr Morales' supporters have paralyzed an already weakened economy, leaving the government with fewer resources to import urgently needed medical supplies. The shortage of oxygen and other equipment caused by the roadblocks resulted in the deaths of at least 30 patients, the government said in a report to the Organization of American States.
With hospitals running out of drugs and coronavirus tests, Mr. Morales' allies in Congress passed a law permitting the medical use of a bleach, chlorine dioxide – one unproven and potentially dangerous coronavirus treatment popular among Bolivians.
"The pandemic has put us in a very precarious situation, with an inexperienced government and heightened political tensions," said Franklin Pareja, a political scientist at San Andrés Major University in La Paz. "This political deadlock is costing human lives."
In Bolivia's political center, the La Paz region, five times as many people died in July as in previous years, according to data, a percentage comparable to that of Madrid during its worst month. In the tropical plains of Beni, more than seven times as many people died as normal, a number that surpassed Bergamo, Italy, during its peak.
The Corona Outbreak>
Frequently Asked Questions
Updated August 17, 2020
Why does it help to stand six feet away from others?
- The coronavirus mainly spreads through droplets from your mouth and nose, especially when you cough or sneeze. The C.D.C., one of the organizations using that measure, bases its 6-foot recommendation on the idea that most of the large droplets that people expel when they cough or sneeze fall to the floor within 6-feet. But six feet has never been a magical number that guarantees complete protection. For example, sneezing can launch drops much further than six feet, according to a recent study. It's a rule of thumb: you should be safest when you're standing two feet apart, especially when it's windy. But always keep a mask on, even if you think you are far enough apart.
I have antibodies. Am I immune now?
- As of now, that seems likely, for at least several months. There are frightening reports of people suffering from what appears to be a second attack from Covid-19. But experts say these patients may have a long-lasting course of infection, with the virus taking a slow toll for weeks to months after initial exposure. Usually people are infected with the coronavirus produce immune molecules called antibodies, which are protective proteins made in response to an infection. These antibodies can remain in the body only two to three months, which may seem worrisome, but that's perfectly normal after an acute infection clears, said Dr. Michael Mina, an immunologist at Harvard University. It may be possible to get the coronavirus again, but it is very unlikely that it will be possible in a short time from the first infection or that people will get sicker the second time around.
I am a small business owner. Can I get relief?
- The stimulus bills passed in March are helping the millions of American small businesses. Those eligible for support are businesses and nonprofits with fewer than 500 employees, including sole proprietorships, independent contractors, and freelancers. Some larger companies in some industries are also eligible. The assistance provided, which is managed by the Small Business Administration, includes the Paycheck Protection Program and the Economic Injury Disaster Loan program. But many people haven't seen any payouts yet. Even those who have gotten help are confused: the rules are draconian and some are tied to money they don't know how to use. Many small business owners get less than they expected or hear nothing at all.
What are my rights if I am concerned about going back to work?
What will the school look like in September?
- Many schools are unlikely to return to a normal schedule this fall, requiring online learning, impromptu daycare and stunted workdays. California's two largest public school districts – Los Angeles and San Diego – said on July 13 that instruction will be remote only in the fall, citing concerns that rising coronavirus infections in their areas pose too great a risk to students and teachers. Together, the two districts enroll approximately 825,000 students. They are the largest in the country so far having left plans for even a partial physical return to classrooms when they reopen in August. For other districts, the solution is not an all-or-nothing approach. Lots of systemsincluding the largest in the country, New York City, are devising hybrid plans where they spend several days in classrooms and other days online. There is no national policy on this yet, so check with your municipal school system regularly to see what is happening in your community.
While Bolivia's official statistics show a severe spike in deaths from July, the closure of government offices during an April lockdown meant almost no deaths were recorded that month. Bolivian Civil Registry officials, who issue death certificates, warned that at least some of the deaths that occurred in April could have been recorded in later months, potentially skewing the death rate.
However, the magnitude of the mortality peak is confirmed by the overwhelmed crematoriums, cemeteries and bodies of bodies in Bolivia.
The spike in deaths had collapsed Bolivian hospitals and forced local authorities to expand their crematoriums and open new cemeteries. At the municipal cemetery of La Paz, residents and hearses had to queue in front of the entrance last week to bury their loved ones.
In Bolivia's capital, Sucre, local health authorities said they had to pile up dozens of corpses in morgues, hospitals, and even the local university, until they were able to install a new crematorium furnace to meet demand. And in the central city of Cochabamba, families had to keep the bodies of their loved ones at home for days because local funerals and crematoriums couldn't cope with the increase.
"The health system is saturated," said Department of Health chief epidemiologist, Mr. Prieto. "We don't have enough capacity, equipment or the required intensive care units."
Despite the crisis, some regional governments, under pressure to reboot the economy ahead of elections, are reopening gyms and restaurants, fueling fears that the death rate will continue to rise. The Ministry of Health estimates that the country will not reach the peak of the pandemic until September.
And in the meantime, the population will continue to bear the brunt of Bolivia's ineffective response.
When Josué Jallaza, a 24-year-old taxi driver in Cochabamba, fell ill with coronavirus symptoms, his family called for a doctor three times, but no one ever came. After he passed out, his family took him to a hospital, "but they didn't want to take us in," said his brother, Marcelo Jallaza.
& # 39; They kicked us out like a dog, & # 39; said Mr. Jallaza.
They then took him to a private clinic, where "a doctor came out, looked him in the eye and said," He's already dead, there's nothing we can do, "Mr. Jallaza said.
The family took the body home and tried to bury it for four days. After tearfully begging at cemeteries, they were eventually given a grave.