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Why Uruguay Lost Control of Covid

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Why Uruguay Lost Control of Covid News in focus is the country’s geography, researchers say. South America is currently reporting some WHY URUGUAY of the highest rates of weekly COVID-19 deaths per capita in the world. Uruguay is wedged LOST CONTROL between two of the region’s hotspots — Argen- tina and Brazil — where infections have been OF COVID driven in part by a highly transmissible variant of SARS-CoV-2 called P.1, or Gamma. Some Uru- Once a pandemic success story, the country couldn’t guayan cities, such as Rivera, press against the border with Brazil, making travel restrictions withstand the surge now rocking South America. between the countries ineffective there. In February, less than 15% of all viruses By Luke Taylor URUGUAY’S SURGE sequenced in Uruguay were the Gamma The country managed to keep COVID-19 under control variant — but in Rivera, that figure stood at for most of 2020, but infections and deaths began to nce looked to as a global model for rise late in the year, and skyrocketed in March. 80%, says Rodney Colina, head of the molec- how to respond to the COVID-19 ular-virology laboratory at the University of 4 pandemic, Uruguay has in recent the Republic in Salto, Uruguay. months lost its grip on the corona- virus SARS-CoV-2. It’s now one of Relaxed vigilance Oseveral countries in South America struggling 3 But the Gamma variant is only one part of the to control a wave of infections. equation, Uruguay’s scientists say. Paradoxi- Uruguayan scientists say a mix of com- cally, the country’s early success in containing placency — fuelled by the country’s early 2 the pandemic probably played a part in the loss success at controlling the virus — and the of control in 2021. challenges posed by a particularly transmis- “National authorities claimed victory too sible SARS-CoV-2 variant are to blame. 1 early,” says Moratorio. “Fear of the virus was “We were a model in 2020,” says Rafael Radi, lost because of all the good things we had a biochemist at the University of the Republic cases (thousands)* Daily COVID-19 done.” in Montevideo. “Unfortunately, things are not 0 When case numbers surged, Uruguay following the same path in 2021.” Mar May Jul Sep Nov Jan Mar May should have locked down to bring them back SOURCE: OUR WORLD IN DATA OUR WORLD SOURCE: *Seven-day rolling average 2021 For all of last year, the 3.5-million-person to manageable levels, says Zaida Arteta, sec- country recorded only about 19,100 cases of other nations. So the researchers developed retary of the Medical Union of Uruguay and a COVID-19, and 180 deaths from the disease. their own, and achieved one of the highest test- member of the Uruguayan Interdisciplinary But this year, it has already reported more ing rates per capita in Latin America. Thanks COVID-19 Data Analysis Group, which moni- than 346,000 infections and 5,300 deaths, to widespread testing and an aggressive con- tors the pandemic. according to the online publication Our tact-tracing system put in place by Uruguay’s The office of the Uruguayan president and World in Data, maintained by researchers at Ministry of Health, the country was able to the Ministry of Public Health did not respond the University of Oxford, UK (see ‘Uruguay’s break transmission chains before they could to Nature’s queries about why they chose not surge’). On several occasions in May and June, grow exponentially (P. Moreno et al. Preprint to follow the GACH’s recommendations to Uruguay recorded the world’s highest number at medRxiv https://doi.org/gksc; 2020). enact restrictions the second time around. of COVID-19 deaths per capita. Government officials weren’t the only In the past few weeks, however, new infec- “We were a model in 2020. ones to let their guard down when it came to tions and deaths have dropped, thanks to the COVID-19. Researchers say that compliance country’s swift vaccine roll-out, says Radi. Unfortunately, things with social-distancing recommendations Uruguayan scientists and representatives are not following the waned in 2021 because Uruguayans were confi- attributed the country’s early success at same path in 2021.” dent in how the pandemic had been managed, keeping the pandemic in check to govern- and in the COVID-19 vaccines. The first shots ment officials following the advice of the were administered in Uruguay on 1 March. Honorary Scientific Advisory Group (GACH), But all of that changed in 2021. COVID-19 Research published by the GACH that month a team of 55 multidisciplinary science experts cases began climbing in December. The GACH found that, although the majority of Uruguay- led by Radi. In March 2020, after the country once again recommended restrictions, such as ans think that COVID-19 is a severe disease, confirmed its first COVID-19 cases, the gov- border closures, but government officials did only one in three thought they themselves ernment swiftly shut down businesses and not implement all of them. For instance, they would get infected within the next six months. schools, and restricted travel at the borders, did not close restaurants because it would have So far, about 43% of Uruguayans have been on the basis of the group’s recommendations. harmed the economy, says Radi. fully vaccinated, and 63% have received at “We got many things right,” says Radi. “The As the number of infections continued to least one dose of a COVID-19 vaccine. For coupling of health, science, government and grow, Uruguay’s test, trace, isolate (Tetris) pro- those who have been vaccinated, admissions society in 2020 was almost perfect.” gramme faltered. Once more than 4% of tests to intensive-care units have dropped by more At the same time, scientists — including come back positive, says Moratorio, Tetris than 92%, according to a study by Uruguay’s Gonzalo Moratorio, a virologist at the Pasteur cannot identify and isolate COVID-19 cases Ministry of Public Health. Institute and the University of the Republic, quickly enough to contain the virus. So experts remain cautiously hopeful. “It’s both in Montevideo — realized that Uruguay “This really persistent first wave we are not over yet,” says Arteta. “But the vaccine would need COVID-19 tests to identify peo- suffering is way beyond the Tetris strategy,” roll-out is one of Uruguay’s strengths. They ple who are infected, and that the country says Radi. are efficacious, and we are vaccinating very couldn’t rely on purchasing those kits from Another reason for Uruguay’s recent spike well and quickly.” Nature | Vol 595 | 1 July 2021 | 21 ©2021 Spri nger Nature Li mited. All rights reserved. .
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