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Der Spiegel ranked Uruguay’s pandemic response #11 in the world. So what have I been grateful for every day of the pandemic?

The Uruguay border is about to open on November 1. It was closed to all but citizens and residents for the last eighteen months. So how has it been living in Uruguay?

The German paper, Der Spiegel, ranked Uruguay #11 in the world for its pandemic response. It was the only country in Latin America to be included in the top 21 countries. The article didn’t elaborate on the situation in Uruguay. So here are some of the things that many of us living here, including myself, have appreciated.

Coronavirus balance sheet of 154 countries (page 1 of 10), overall grade. Source: Der Spiegel

1. No lockdown ever

Uruguay has never had a mandatory lockdown. Instead the government called on citizens and residents to exercise ‘responsible freedom’ (‘libertad responsable’). For the first six weeks or so, anyone that could stay at home did and businesses closed voluntarily. Mandatory measures, such as mask wearing in enclosed public places, were put in place. This approach worked throughout almost the entirety of 2020. There were a total of 180 deaths nationwide. In 2021, cases numbers began to increase significantly. The reasons can be disputed but include proximity and dry borders with Brazil and Argentina (both pandemic hotspots), pandemic ‘fatigue’ and belief that once vaccination campaign started the battle was won. Despite that, we have had privileged freedom of movement, city dwellers respected mask mandates and the uptake for vaccines was strong.

2. A Covid response based on science and technology

Within a month, a committee of experts was brought together to advise the government on its management of the pandemic. Known as the GACH (an acronym pronounced gatch), the independent group of 50 scientists was an essential reference for the government. For the first year of the pandemic, recommendations made by the GACH were adopted by the government pretty much 100%. “The coupling of health, science, government and society in 2020 was almost perfect,” said the leader of the GACH. However, as the vaccination campaign got underway, the government began to pick and choose from recommendations, leading to some tension. Despite that, the sincere effort by both sides—scientists and the government—to seek the best for the country was palpable. The GACH disbanded in June and a ceremony held in recognition of their immense dedication to protecting the health and wellbeing of the population. In the meantime, scientists like “coronavirus hunter” Gonzalo Moratorio were recognised internationally.

Uruguay has a long tradition of good health care and over a century of mass vaccination campaigns. The previous government (2005-2020) had reformed and invested in the health sector so the system was in good shape when the crisis hit. Not only was the vaccine roll-out well managed but studies were carried out to monitor the efficacy of the three vaccines available to Uruguay, comparing stated clinical trial results elsewhere with the reality that vaccinated Uruguayans were living.

In 2020, Uruguay became the only country in the world to use its airport as a storage, preparation and distribution centre, according to Pharma Aero. * The video below is promotional but definitely an informative watch.

3. Steady political leadership

Remarkably a new government had come into power on March 1 2020, just thirteen days before the first Covid-19 cases were announced in Uruguay and two weeks before they decided to close the borders of Uruguay to the world. During the first few months the new president and members of the cabinet gave nightly briefings in the form of press conferences. They answered the questions that were on all of our minds with common sense and plain language. The politicians were careful never to lock themselves into action or obligations by a particular date. Instead they referred to stages: for instance, once case numbers reach ‘x’ stage, then ‘y’ can change. So there was no backpedalling on dates or decisions. Whether they had voted for the government or not, approval ratings showed that most people felt that the country was in steady hands—and that we were being treated as adults.

4. A monitoring app within seven days

It still seems incredible to me that within just one week there was an application to download onto our telephones which showed us cases recorded each day, deaths and the situation of case numbers in different parts of the country. “The Uruguayan government needed a digital relationship with every citizen — it was like a war situation,” said one of the brains behind the app. It worked. The level of detail and transparency of the data was reassuring. The application was later updated and now shows us the rate of vaccination—the numbers of people getting vaccinated (first dose, second dose, second dose plus 15 days (ie fully vaccinated) and now the third booster) update on an hourly basis before our eyes. The same application can be used to request a PCR test and shows our vaccination status. It’s really quite remarkable. Hats off to the developers who worked around the clock to get it out.

5. One of the fastest vaccine campaigns in the world

Uruguay has regularly been in the top five countries rolling out vaccines to their population most quickly, alongside nations like Israel, the UK and USA. On August 24, the eve of anniversary of Uruguay’s Declaration of Independence, seventy percent of the population became fully vaccinated against Covid-19.

This is particularly noteworthy when considering that, as a small country with limited bargaining power, there were problems initially getting hold of vaccines. Uruguay was the last country in Latin America to receive supplies of the vaccine at the end of February, months after more developed nations. In the meantime, Uruguay went ahead and organised wait lists. We used the Coronavirus app to book our spot in a waiting list. Once vaccines became available for our age group we were given a slot for our first vaccination and a slot with an identical time and place exactly one month later for our second dose.

The decision to acquire Coronavac was made because it was available in quantities that would allow vaccination to get started. The available doses of Pfizer were initially limited to emergency workers. Once Pfizer was readily available, booster jabs were offered, using the aforementioned waiting list.

6. Uruguayan willingness to get vaccinated

Once sufficient vaccines arrived, the health ministry’s original plan was to have 70% of the population immunised against Covid-19 by September vaccinating at a rate of 30,000 a day—around one in every 100 Uruguayans. However, after receiving a new consignment of shots, additional vaccination centres opened to respond to demand and the number of people signing up doubled.

The government had put all its chips on the vaccination campaign and needed the people to step up. Uruguayans traditionally are used to nationwide health campaigns and respond to them positively. Childhood vaccinations are obligatory and a requirement for schools and sports. There was a period of three months this year when the number of coronavirus cases and deaths was dire. From very low or zero daily deaths in 2020, a busload of citizens was dying each day between April and June 2021. Undoubtedly people had felt the effects of the virus on their family and friends. Whatever their motivation, Uruguayans signed up in droves to the vaccination waiting lists. Additionally they’ve entrusted their children. Uruguay is the first country in Latin America and one of the first in the world to vaccinate teens.

Today, as the borders open for the first time to the outside world in nineteen long months, 74% of the population is fully vaccinated, 34% have a booster third shot and 85% of 12-19 years olds have had at least one shot.

Eighteen months is a long time to be closed to the world. Children, older people, those of us in industries like tourism and those with lower incomes have been hard-hit by the pandemic. The consequences are still unknown and covid cases, while under control, can still rise. However when I compare the reality here, to the experiences of friends and family in the US and the UK, there is much to be grateful for. I still feel as I did over a year and a half ago, in April 2020, when I wrote in Medium.com there is no place I would rather be in a pandemic than Uruguay.

Photo of the author on the rambla in Montevideo by: Alfonso C Cuchman

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