(Para versión en español, haga click aquí)

As the coronavirus pandemic unfolds, international media has mostly ignored the experience of Latin American countries. And when news of the region reaches the rest of the world, it tends to be sensationalistic and pessimistic, like the reports of the macabre scenes on the streets of Guayaquil. Although it is difficult to generalize about what is happening across an entire continent, and despite the dynamic and unstable circumstances of the epidemic, nevertheless we venture to share our reflections on the pandemic in the Latin American context.

As a geographer (Carter) and a historian (López Campillay), we are united by an academic focus on the political and social history of health in Latin America. Specifically, in other work we have dealt with the development of health policies and health systems in Chile and Argentina. We also share a somewhat optimistic reading of this history. Over the long term, there has been concrete and measurable progress in health conditions in most countries of the region. Although political and health institutions sometimes fail, and while history is full of conflict and injustice, we maintain that the region's health systems are stronger than many outsiders imagine. Although nowadays the idea of ​​social progress is often questioned, in our opinion it is better for societies not to move backwards as a result of this pandemic.

Since the security, well-being, and health of Latin American countries are dependent on the international context, we will not limit ourselves to analyzing what is happening within the region. Our main focus is the dynamics between borders and identities. The fear and anxiety that accompany great epidemics often produce political and social reactions of isolation. Against globalizing currents, connections between countries are severed, with travel restrictions, quarantines, and intensified border control. How, and for how long, can such measures be sustained in our highly interconnected societies, ones where individual freedoms are presumably valued? In the next part of the essay, we address the social fissures that, while always present, have been accentuated by the pandemic. Then we take up the question of the economic impacts of the pandemic itself and the nearly global lockdown of commerce in its wake. The economic crisis spawned by Covid-19 is sure to be painful, deeply and widely felt across Latin America. Finally, we will examine whether the pandemic presents an opportunity to seek a fairer globalization, in a region where anti-globalist movements have widespread support.

Quarantines and the new bordering of international health

Recently a group of Argentine historians suggested that perhaps we are in the presence of a singular event: the quarantine, a medieval tool, is making a strong comeback in the second decade of the 21st century. As an isolation technique to confront large-scale epidemics, it was first used in advance of the Black Plague by the city-state of Venice in the year 1377. As Eugenia Tognotti maintains, the strategy has the virtue of standing the test of time. However, in countries that followed the path of industrial modernization, the idea of ​​quarantine fueled strenuous debates, especially among liberals (in the classic sense), who saw it as a coercion of individual and commercial freedom, and as a symbol of authoritarian governments, as the historian Erwin Ackerknecht has maintained.

The emergence of the coronavirus in 2020 reminds us of two facets of quarantine, each related to the sensitive balance among public health, social justice, and individual autonomy. First, it is clear that this traditional form of health surveillance generates friction with human rights law, one of the success stories of democracy in the 20th century. Indeed, voices are emerging today that warn of future tensions between the corpus of individual liberties and states that may opt for models of epidemiological surveillance with authoritarian overtones, such as the philosopher Byung Chul Han. Still, it is somehow hard to imagine Latin American governments having the capacity, interest, and public support for the kind of draconian surveillance policies carried out in countries like China, Taiwan, or Singapore to control the epidemic.

At the same time, the uneven acceptance of quarantines and similar measures in Latin American countries deserves attention. In particular, the manifest lack of understanding of many citizens, leading to non-compliance with the isolation regulations, has been the subject of discussion in the press. Certainly, it is not easy to interrupt vital social processes such as educational and administrative activities, entertainment services, or informal economic activities, such as street trade, which in Latin America is the source of daily income for almost 140 million people. This multitude faces the dilemma of choosing between protecting their health or their earning capacity for daily family support; sheltering in place is hard to manage for people with no savings, no government protection, and the need to work on the streets on a daily basis.

If we add the questionable leadership of politicians like López Obrador (Mexico), Ortega (Nicaragua), and Bolsonaro (Brazil) , who have questioned the seriousness of the pandemic, the scenario in the region becomes even more complex for the application of the health strategies suggested by the WHO, in a continent that has health systems that reflect ingrained historical inequities. In short, quarantine is a technique whose effectiveness today is conditioned by the political situation prevailing in Latin America. As history shows, it can be applied for only a limited time, and the social and economic insecurity of much of society leads to mounting pressure to relax or suspend such orders.

The pandemic as a social catalyst: stigma and discrimination

Throughout history, major infectious disease epidemics tend to strengthen and harden national identities and lead to discriminatory and racist reactions. In the environment of fear and confusion of a pandemic, when a country feels "attacked" by a foreign force, latent prejudices are activated against groups that are perceived as originating or carrying the infection.

It is not surprising, then, that something similar has happened with the coronavirus. Because of its origin in the city of Wuhan, China, it was labeled the "Chinese virus" and incidents against people of Asian descent have arisen in many countries. There are also populist politicians who use racial logic in their discourse on the epidemic, notably President Trump, who continues to use the term "Chinese virus" despite the spread of a more accepted label (Covid-19).

Possibly, the reaction in many parts of Latin America is different. It cannot be denied that there is a lot of fear and confusion, which leads to hasty decisions (such as the decision by the mayor of Guayaquil, Ecuador, to prevent the landing of a plane from Spain on March 18) or improvised policies (such as prohibiting men and women from going outside on the same days of the week, as has been attempted in Panama and Colombia). It is true that there are demagogic leaders like Bolsonaro, who follows impetuously in the footsteps of Trump, and unfortunately there have been incidents against ethnic Chinese people, in countries like Chile and Argentina. And in the subterranean discourses that circulate on WhatsApp and other social media, people will say just about anything, as always.

But generally, the public discourse on the pandemic in Latin America has not been marked by a racist or nationalistic tone. Perhaps the region's strong cultural and economic links with Spain and Italy, the two European countries most affected so far, have produced another geographical imaginary of the pandemic, one not so focused on Asia. Furthermore, it is known — sometimes with great certainty, as in the case of Ecuador — that the first cases of Covid-19 in the region originated with travelers from Europe, not Asia.

And, if in past epidemics the culprits were sought among the humble classes, this episode we are experiencing presents a certain inversion of this class conflict. According to media reports, certain places where wealthy people gather for long vacations — cruise ships, ski chalets in the Italian Alps, luxurious parties in Connecticut — appear as hotspots for virus "super-spreaders." Unlike historical experience, many of the first cases of Covid-19 in the West have been relatively famous people, such as actor Tom Hanks, the First Lady of Canada and the Prime Minister of Great Britain.

The same is true in Latin America. Initially at least, "coronavirus in Mexico has been a problem for the elites," in the words of one journalist, with many of the first imported cases originating in the ski resorts of Colorado. In Chile, the identification of the upper-class neighborhoods of Santiago (Las Condes and Vitacura) as the focus of "pestilence" has been striking, and the "cuicos" labeled as the carriers of disease. For certain sectors opposed to the government of Sebastián Piñera, these are the people who travel the world and belong to the elite that has promoted a model of neoliberal development that has been deeply questioned in the last decade. In other words, according to this perspective, the wealthy are now responsible for the "importation" of a dangerous microbe, demonstrating once again that the most vulnerable populations will pay the costs of globalization.

With respect to invoking racialized scapegoats, possibly most of the region's national leaders prefer not to follow the example of Trump, who is scorned throughout the region. Such political maneuvers of a racist and demagogic nature would be obvious and probably rejected immediately. In any event, a leader like Piñera, while conservative, cannot become a populist overnight. Rather, he, like his peers in other countries, wants to use this episode to demonstrate the capacity of the state. It is not mere cynicism to point out that a crisis offers a priceless political opportunity to present a competent government that can maintain public security without falling into the errors of authoritarianism.

The wild card: What will be the economic consequences of the pandemic and the control measures? We believe that if the consequences are harsh, with a strong and prolonged recession, with deep unemployment and challenges in meeting basic needs, it would be even more logical to blame the upper classes as the very source of the crisis (and as those who suffer the least). In this context, the widespread feeling of social solidarity can quickly fade.

Health governance: weak institutions

The Peruvian historian Marcos Cueto, a renowned scholar of international health policy, has emphasized the reformulation of the political role of the WHO in the face of the profound repercussions that the planet is experiencing due to the coronavirus. Perhaps this event will inaugurate a new stage in the WHO's history after some episodes that, in recent decades, have given rise to questions about its mission.

In the 21st century, following the avian influenza outbreaks of 1997 and 2003, and SARS in 2003, the new International Health Regulations (IHR) were designed to prepare a collective response to an impending pandemic. This regulation is one of the key bases of the "global health security regime" (as characterized by anthropologist Andrew Lakoff ), and in theory serves as an appropriate instrument to govern and coordinate global health emergencies that could certainly arise, by strengthening the conditions that historically favored the emergence of a pandemic of an infectious nature. However, as Cueto has indicated, the advantages offered by this international norm could not be put into practice as a result of the little financial support that the IHR received, which turned into a political defeat for the WHO.

In the same sense, but from a different perspective, it is worth noting that the first decades of the present century have not been favorable to the multilateral will that characterized various western democracies in most of the twentieth century. It is not necessary to delve into the anti-globalization discourse of some new populist and nationalist leadership in Europe, the Americas, and Asia and that have seduced important sectors of the population who, burdened by the negative effects of hypercapitalist economic globalization, yearn for a new promise of security. Here we see another the weakening of the globalist ambitions of institutions such as the WHO.

Thus, it is possible to propose that the Covid-19 pandemic, while generating disturbing uncertainty, looms as an event that may favor the confirmation of existing certainties. On the one hand, those who wish to disassociate themselves from a globalization that they understand as an exhausted system, and who wish to return to the warm and comforting confines of national borders, will enclose and distance themselves from a strange and hostile world that has also become the source of a viral pandemic. But on the other hand, from a measured critique neoliberal globalization, a rejuvenation of social democratic ideas might emerge. Some of it can be felt in Latin America, perhaps. An international movement that calls fervently for the generation of global public goods, as Umair Haque, among others, has argued, is likely to find support in many quarters of Latin America. It is a discussion that at least deserves serious debate in regions where the pandemic will leave deep marks, and, incidentally, it is an issue on which WHO can strengthen its mission through planetary leadership.

Economic impacts of the pandemic and political responses to the coming crisis

As new disease control measures are imposed, the pandemic will have serious economic consequences. In the US, the government seeks to cushion the almost total collapse of domestic consumption and the unprecedented rise in unemployment. In Latin America, the situation is even more complicated. First, as countries dependent on hard currency earnings from exports and tourism, the region's economy is suffering from the collapse of demand in the world economy. These are circumstances beyond the control of Latin American governments.

Furthermore, pre-crisis conditions vary from country to country. In Peru, the government plans an injection of approximately US$26 billion which is equivalent to 12 percent of its GDP. The Chilean government has designed a package of economic measures for 11 billion dollars (4.7 percent of GDP), which is the largest fiscal injection since the "subprime" crisis of 2008-09. A constitutionally mandated 2 percent emergency reserve has been used to assist public health efforts. These neighboring countries have the advantage of a low percentage of public debt, in relation to their GDP level.

But for other countries, there may be less room for maneuver. The Argentine government, with the enormous weight of its external debt and inflationary trends in the economy, for now has limited its stimulus package to 1 percent of GDP, and seeks to negotiate again with the IMF to restructure its payments on external debt. Ecuador, having a dollarized economy, gives up much control of its monetary policy to the US central bank, and as an oil exporter, suffers from the simultaneous collapse of the price of this product. The economic crises in the United States and Europe are also affected by the loss of remittances from immigrants living in the Global North, which constitutes an important share of the income of many countries. It makes sense, then, that the IMF would project an alarming 6.6% decline in Mexico's GDP for 2020, due to this country's dependence on US consumer demand, petroleum exports, tourism, and migrant remittances.

The role of the International Monetary Fund is yet unclear. Having promoted a neoliberal package of economic reforms since the 1980s, the IMF has a bad reputation in Latin America. However, the IMF exists precisely to face these situations, that is, to support countries that experience unforeseen and temporary economic emergencies. But does the IMF have sufficient resources to dedicate to Latin America, when almost the entire world asks for help? And, would the renewal of relations with the IMF mean, in the long term, another submission to neoliberal concepts? IMF director Kristalina Georgieva is confident that the fund can address the needs of all of the countries asking for assistance, as long as pandemic-related restrictions on economic activity are lifted soon, and she also asserts that only a handful of countries would be required to submit to IMF restructuring conditions to receive loans. According to Joseph Stiglitz, a new generation of finance ministers in the region learned, during the 2008 financial crisis, to adopt a more flexible and pragmatic stance, discarding the orthodoxy of the neoliberal school. The current crisis will surely test these new perspectives and economic policy tactics.

Conclusion

It is possible that one reason that may explain the reactions that Latin America has shown in the face of this pandemic is the absence of a memory of epidemics. Recently, historians are once again discuss the perplexing loss of historical memory that followed the Spanish flu of 1918. In this sense, we can understand that many people still do not understand the need for restrictions in their daily lives, since they do not have memories of the profound and dramatic changes that define a pandemic event. Therefore, the present reflection is part of a task that is more than necessary to generate a link with the experiences of our ancestors that at the beginning of the 20th century faced a planetary viral storm, influenza, which made patent the mutual dependence between social development and health.

However, our analysis aims to open discussion about the processes of global relations, democracy, and the welfare state, to find new approaches to the large-scale challenges that we have ahead. The various sciences have demonstrated their ability to influence policy based on the evidence they can provide, while the global bewilderment generated by the COVID-19 pandemic is conclusive proof of the need to redefine roles (for example, of the WHO), analyze new social development paradigms, and take seriously a comprehensive notion of health. Even more ambitiously, can we rethink our planetary civilization? Or turn our backs on that very notion, as nationalist movements would have it?

Clearly, there are dark days ahead for Latin America, as in the rest of the world. We ardently hope to have a coronavirus vaccine that alleviates the immediate cause of this pandemic. However, we should be mindful that such a technical solution would neglect the deeper causes that generated this crisis, which not only leaves us vulnerable to the next global calamity, but also allows us to continue tolerating everyday suffering and despair.

Eric D. Carter is a geographer at Macalester College in Minnesota, USA. His research is interdisciplinary, at the nexus between medical geography, environmental history, and the social and political history of public health.

Marcelo López Campillay is a historian of health and medicine, at the Catholic University of Chile. His research areas include social epidemics, health politics, global health, and health humanities pedagogy.