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Bolivia was mired in political turmoil when the pandemic hit. The response was chaotic. And the surge in deaths that followed was among the worst in the world, according to an analysis by The New York Times. So many people were dying that the government’s numbers couldn’t be accurate. Calls to pick up bodies were inundating Bolivia’s forensic office. By July, agents were gathering up to 150 bodies per day, 15 times the normal amount in previous years, said the country’s chief forensic official, Andrés Flores. The demand on his office suggested that the official tally of Covid-19 deaths — now just over 4,300 — was a vast undercount, Mr. Flores said. But with limited testing, scarce resources, and a political crisis tearing the country apart, the extra lives lost were going largely unrecognized. New mortality figures reviewed by The Times suggest that the real death toll during the outbreak is nearly five times the official tally, indicating Bolivia has suffered one of the world’s worst epidemics. The extraordinary rise in death, adjusted for its population, is more than twice as high as that of the United States, and far higher than the levels in Italy, Spain and the United Kingdom.
About 20,000 more people have died since June than in past years, according to a Times analysis of registration data from Bolivia’s Civil Registry, a vast number in a country of only about 11 million people. Tracking deaths from all causes gives a more accurate picture of the pandemic’s true toll, demographers say, because it does not depend on testing, which has been very limited in Bolivia. The mortality figures include people who may have died from Covid-19 and from other causes because they couldn’t get health care. “This is a very cruel situation that we’re living through,” said Mr. Flores, who heads the Institute of Forensic Investigations. “We’ve been left completely exposed.”
With a bare-bones health system, a decentralized government and poor infrastructure, Bolivia struggled to contain infectious diseases such as dengue even before the coronavirus arrived, said Virgilio Prieto, an epidemiologist at Bolivia’s Health Ministry. But its ability to respond was undermined by a contested election that led to the ouster in November of the then-president, Evo Morales, a socialist. An interim president, Jeanine Añez, a conservative, stepped in with a promise to govern until elections could be held. Since then, Ms. Añez has announced that she is running for the office — and asked the electoral board to postpone the new vote, saying the pandemic made it unsafe for the population to go to the polls. The rescheduling of the vote from May to October has enraged opposition groups, who see it as an attempt by the caretaker president to cling to power. “She is not recognized as a legitimate leader, which makes it extremely difficult to coordinate a complex response that the pandemic requires,” said Santiago Anria, a Bolivia expert at the Dickinson College in Pennsylvania. Ms. Añez’s decision to run for president herself antagonized the opposition lawmakers and regional officials on whom she depended to mobilize health care resources, said Mr. Anria, leading to a disorganized, ineffective effort.
