Poverty, precarious work, and the COVID-19 pandemic: lessons from Bolivia

Abstract

Bolivia is one of the poorest countries in Latin America with a gross domestic product of around US$3500 per capita, health spending of approximately $220 per capita, a labour market dominated by informal work, and a weak health system. However, in the response to COVID-19, Bolivia has fared better than other health systems in the region and provides insight with regard to the implementation of subnational nonpharmaceutical interventions and supporting workers without social protection.The Bolivian Government confirmed the first case of COVID-19 in the country on March 10, 2020, and responded quickly by cancelling events, closing schools and borders, and implementing a national lockdown on March 22, 2020. However, the Bolivian Government was under pressure to open the economy in an election season. In response, the Bolivian Government shifted responsibility for most non-pharmaceutical interventions to departmental and municipal governments on June 1, 2020. The Bolivian Government maintained a mask mandate, school and border closures, and a nightly curfew, while allowing departmental and municipal governments to set workplace, social gathering, population mobility, and public transit policies. Daily deaths from COVID-19 increased markedly from 20 on June 1, 2020, to 96 on Aug 1, 2020. 1 Subnationally, the first outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in the wealthy, politically conservative department of Santa Cruz, followed by the poor, politically moderate department of Beni in May, 2020. These two departments maintained strict confinement policies in June, 2020, to manage outbreaks. Strict policies were also maintained in the wealthy, politically conservative department of Tarija, while the other six departments relaxed restrictions quickly in June, 2020, and subsequently a surge in cases was observed. In response to an increase in deaths in June and July, 2020, Chuquisaca and Cochabamba reinstated some restrictions and the other departments shifted to a policy of isolating municipalities with outbreaks. Daily deaths began to decline in August, 2020, decreasing to 35 per day by Sept 15, 2020. 1 We declare no competing interests.

Evaluating Social Distancing Measures and Their Association with the Covid-19 Pandemic in South America

“…For example, in Bolivia, the lockdowns were combined with income supports directed to informal workers, considered successful in the context of the pandemic, although problems, such as crowds formed at the benefit distribution locales, have been reported, increasing the risk of contamination. Faced with a large population of informal workers and employees mainly in the agricultural sector, the national government expanded benefits for existing cash transfer programs in order to protect these workers and contain Covid-19 which was rapidly spreading among the poorest population, achieving good social and public health outcomes [84].…”

A Tale of Two Pandemics: Economic Inequality and Support for Containment Measures in Peru

“…While our article focused on Peru, other studies and journalistic accounts confirm that throughout Latin America the poor suffered disproportionately from the effects of lockdowns and were less likely to comply with stay-at-home orders (Ioris, 2020;Levy Yeyati and Malamud, 2020;Sandin, 2020). For instance, Hummel et al (2021) show that labour informality and economic inequities in Bolivia led to a relaxation of stay-at-home orders and more severe COVID-19 outbreaks in the poorest departments. In a similar vein, Bennett (2021) demonstrates that quarantine compliance and effectiveness was lower in poor areas in Chile.…”

“…Second, this article provides some individual-level evidence of public opinion towards quarantine measures that complements existing studies showing that poor communities were hardest hit by the health and economic consequences of the pandemic. In recent studies, scholars have argued that one of the reasons for the ineffectiveness of lockdowns in low-income communities was the economic and social inequalities that affected how poor and rich experience the pandemic (Bennett, 2021;Hummel et al, 2021). For instance, Hummel et al (2021) show that poor departments in Bolivia had worse health outcomes and relaxed stay-at-home orders earlier.…”

Seroprevalence Canine Survey For Selected Vector-Borne Pathogens of and Its Relationship With Poverty in Metropolitan Pereira, Colombia, 2020*

“…Poverty has been linked as a determinant to multiple disease groups, especially infectious diseases [30,31,32]. Among the infectious diseases linked to poverty, tropical diseases and vector-borne diseases, such as malaria [33,34,35,36] and dengue [37,38,39], have been well documented.…”