Tracking the spread and outcome of the coronavirus in Ecuador: Updated for Tuesday, January 27, 2021

Last week we shared information from the El Universo newspaper that outlined the rate with which the coronavirus was continuing to spread throughout the country. The numbers at that time were alarming, and there was little good news to offer.

Unfortunately, this week continues that trend with even more alarming figures. On Sunday of this week, the county reported 3,060 new cases in one day. Prior to that, the daily number of new cases was consistently running at about 1,000.

This huge jump in new cases would normally be extremely troubling, but we have to be cautious about this because in fact, there is no consistent testing program going on in the country, and therefore daily spikes have no baseline to be compared to.

The country continues to test people who show up at the health centers and is randomly testing throughout the provinces. But with no consistent, uniform method of testing that ensures that the population as a whole is getting tested, the number of new cases is almost meaningless.

We’ve made this point before, and if you recall, several weeks ago it appeared that the government was beginning to catch up on its backlog of tests and was having a large increase in sampling and test completion. Had this continued, the number of daily cases would have offered some value from an epidemiological perspective.

Government seems to have given up and awaits vaccine

Unfortunately, as the numbers below show, the government has fallen back on both sample collection and test completion, and for all intent purposes seems resigned to just struggle along until there is nationwide vaccination program in place.

This raises serious concern: if the government was unable to put a solid testing plan in place, how will it implement a vaccination program for approximately 10 million people (see below for the method used to come to that number) with a drug that needs to be handled with extreme care (i.e., the need for extreme cold storage in a country without the facilities to maintain the required temperatures)?

Also, there are elections scheduled for February 7, 2021, and a new presidential administration will be installed in May. This is shortly after the current administration says it plans to start a nationwide vaccination program. It would be unwise to assume that the program will be put into place perfectly by then, and that it would not stumble as the new administration is installed.

Some of the presidential candidates have said that regardless of the vaccination program, the country needs to develop a serious, intensive testing and contact tracing program, and they are correct. But most of the candidates have offered few concise answers as to how they will implement either a testing and tracing program, or the vaccination program.

At this point, we believe it is safe to predict that the vaccination of the general population will not begin in late March/early April as the current administration is saying. We say this for three reasons:

• Due to production issues, and other worldwide demands, the drug companies currently approved to dispense their version of the vaccine have failed to meet any delivery schedules, either in Ecuador or throughout the world. It’s unrealistic to expect that they will suddenly be able to ramp up production and meet the expectations of every country.
• Ecuador is already behind its “Phase 0” pilot program which was to cover first responders and elderly in nursing homes. This pilot will fall as far as three weeks (or more) behind.
• There has been little public information regarding the vaccination program; we do not know who the next group will be, what their demographics are, where they will receive their shots, or even when they will be vaccinated.

Without a public plan available, it is impossible to believe that the government will be able to begin a nationwide vaccination program in late March—it will only be receiving the bulk of its doses then (if all production and delivery schedules are successfully met).

Vaccine “plan”

With that said, here is what the government has shared regarding the vaccination program:

• “Phase 0” of the vaccination program began with 8,000 doses of the vaccine (as opposed to the expected shipment of 86,000 doses) on the 21st of January in Guayaquil, Quito, Cuenca and Manta. This is planned to be completed in 6 weeks.
• The government plans to inoculate 60% of the population.
• The government has ordered 18 million does to vaccinate 9 million of the 17.42 million residents of Ecuador.
  • 4 million doses ordered from Astra Zeneca and the University of Oxford (no confirmed delivery date)
  • 2 million doses ordered from Pfizer to be delivered sometime in March (are quest has been made to increase this order to 4 million doses, but this has not been confirmed)
  • 4 million doses have been acquired thru the Covaxx company, and
  • 8 million doses have been requested from the Covax initiative, run by the WHO
  • The government continues to negotiate with other companies with vaccines in development (e.g., Johnson & Johnson, Novavax and the Chinese version Sinovac)
• They will not vaccinate 6.1 million children, 900,000 nursing and pregnant women, 100,000 people with “catastrophic disease,” 240,000+ individuals who have already contracted COVID-19, or those women planning to get pregnant within the next three months or those people with severe food or drug allergies. Thus, they are planning for 10 million people to need the vaccine.
• The vaccination program is planned to be completed by “September or October.”
• The vaccines arrive in special thermal packaging from Pfizer to guarantee the “cold chain,” the Linde company, a producer of dry ice in Ecuador, will also be supporting the process of shipment and storage.
• Phase 0 will involve 43,000 medical personnel (includes nurses, assistants, orderlies, paramedics, among others) and the elderly who are in geriatric centers (and those who care for them).
• The distribution to the general population will begin at the end of March/early April.

The government has not publicly released the plan for how the “mass vaccination program” will happen starting in late March.

THE NUMBERS

While we feel that the positivity rate is the most important number to follow, there is still value in tracking the number of deaths, hospitals admissions and ICU census. With regard to the number of cases, the numbers this week are slightly better than last week, but again, of little value.

However, the number of new deaths more than doubled this week, and the number of provinces that saw an increase in the rate of new deaths is the highest it has been since September 6, 2020

New Cases

Only ten (10) provinces saw an increase in the number of new cases, but of course that relates to the rate of samples collected and the rate of tests completed, both of which fell this week.

There were 9,810 new positive cases this week, versus 10,412 last week.

It is important to repeat that on Sunday, there were more than 3,000 new cases recorded in one day.

The province with the highest increase in new cases was Pichincha, which went from 81,830 cases last week to 84,329 cases this week, or 3,199 new cases (this was however a 5% decrease in the rate of new cases).

By percentage, 10 provinces saw a rise in the number of new cases. Those were:

• Azuay – 4.7%
• Bolivar – 63.6%
• Cañar – 29.3%
• Carchi – 72.70%
• Esmeraldas – 20.0%
• Los Rios – 11.23%
• Pastaza – 29.0%
• Sucumbios – 184.4%
• Tungurahua – 6.7%
• Zamora Chinchipe – 26.67%

Overall, the positivity rate did fall slightly from 30.21% to 30.15%.

New Deaths

The number of new deaths across the country more than doubled this week, going from 14,319 to 14,623, or 304 new cases (versus 142 last week). This is a rise of 114.08%, versus an increase of 15.87% last week.

The province with the greatest increase in deaths this week was Guayas, which reported 60 new deaths, 15 times as many as last week (4). Azuay followed with 21 new deaths, which is 10.5 times more than last week.

No province saw a significant drop in the number of new deaths this week.

Provincial numbers

As is clear to see in the accompanying charts and graphics, there remains very little good news to report. To summarize:

• Ten provinces saw increases in the rate of new cases (4 significantly),
• Eighteen provinces saw an increase in the rate of new deaths (10 significantly),
• The overall rate of new deaths rose,
• The rate of new sample collection fell again,
• The rate of test completion fell again,
• The number of hospital admissions rose by almost 11.67%,
• The rate of discharge remained at approximately 2.3%,
• The number of people in ICU beds rose by 4.51%.

As for good news, statistically there is again little to report. There was an improvement in reducing the backlog of tests, but this happened in conjunction with a reduced rate of test completion.

TESTING

Ecuador’s test collection and processing pales in comparison to other countries

According to the official statistics, in October a large number of tests that had been in backlog were cleared; a total of 133,414 samples were tested. In December, however, only 91,342 were processed, representing a 32% drop between the two months.

So far January, the government has processed 90,546 tests, approximately the same number of samples it has collected over that time (90,098). So, its backlog remains at 45,695 tests.

Compared to the rest of South America, Ecuador’s testing program is a failure

With the exception of Bolivia, Ecuador continues to lag behind all of South America (Argentina, Bolivia, Brazil, Brazil, Chile, Colombia, French Guiana, Guyana, Paraguay, Peru, Uruguay, and Venezuela) in both the percentage of population tested and the number of tests given per million.

Based on the Ecuadorian Institute of Statistics and Censuses (INEC) population projections, Ecuador has only tested about 4.76% of its population. With 847,606tests completed, Ecuador has tested 47,632/1 million people, or 148thout of 215 countries tracked worldwide. This is dismal when compared to Ecuador’s direct neighbors.

Its neighbors Colombia, Peru and Chile (who’s population is size is closest to Ecuador at 19.18 million people) have tested 18.92%, 18.34% and 40.12% of their populations, respectively.

Colombia has tested 189,237/1 million people and ranks 95th on the list. Peru has tested 183,359/1 million people and ranks 97th on the list. Chile has tested 401,211/1 million people and ranks54th on the list.

[Chile only has 8.1% more people than Ecuador but has tested 9 times more people!]

Even Venezuela, who’s economy is considered to be in the worse shape in South America has tested 9.06% of its 28.4 million people. Argentina, who also has serious economic issues, has tested 13.03% of its citizens.

GRAPHICAL HIGHLIGHTS

Here is a quick review of the graphical highlights below (as of Sunday, January 24, 2021 at 8:00AM):

• 14,623deaths have been attributed to COVID-19.
• 846,027test samples have been collected.
• 241,292tests have returned positive (+).
• 559,040tests have returned negative (-).
• 45,695test samples remain “dammed” or backlogged in the testing process.
• 8% of the deaths have been among the ages 20 to 49 years old.
• 3% of the deaths have been among the ages 50 to 64 years old.
• Only 13.0% of the deaths have been among the ages 65 years and older.
• 4% of cases have been on males, 47.6% in females.
• Guayas province accounts for 12.8% of confirmed cases (30,849) and 24.78% (down from 24.89% last week) of the confirmed deaths (3,624).
• Pichincha province accounts for 34.9% of confirmed cases (84,329) and 16.36% (down from 16.41% last week) of the confirmed deaths (2,393).
• Azuay province accounts for at6.4% of confirmed cases (15,337) and 1.83%of the confirmed deaths (269).

HOW ACCURATE ARE THE NUMBERS?

The numbers from the government are only “accurate” as historical references, since they cannot guarantee that tests completed this week are from samples collected over the last seven days.

However, the graphic accompanying this article (it is provided by the government, but has been modified for easier readability), does offer some recent graphical dated information on four provinces, and at a national level.

The numbers and statistics below are based on all case data collected by the government as of 8:00 a.m. on Sunday, January24, 2021. More detail of all of the numbers is available in the graphics that follow.

The numbers in the graphic reflect the number of people who tested positive or negative for the virus, with both the polymerise chain reaction or (PCR) test which looks for antigens and identifies the presence of the virus in the body, and the “Rapid” test which looks for antibodies to the virus and identifies a person’s immune response to the virus. The PCR test gives an earlier identification of those who have been infected by the coronavirus and whether they have an active infection. Ecuador is now only reporting new PCR test results (however, prior Rapid tests are included in its report).

These numbers do not reflect the actual total number of people infected across the country or the number of deaths that can be attributed to COVID-19. The dates on the graphic are also adjusted back to when symptoms began, not when the positive test occurred.

For those who want a deeper level of information for a particular town or city, see: https://www.gestionderiesgos.gob.ec/coe-nacional/