April 26, 2020
Alexis Sierra is a geographer, Professor at CY Cergy Paris University and treasurer at the Institut des Amériques
On March 6, Colombia documented its first Covid-19 case, a student returning from Italy. The media title "Llegó el coronavirus" ("The coronavirus has arrived").
However, the crisis has already been palpable for several days. Wearing a mask is generalized and controlling the temperature of travelers arriving at the Bogotá International Airport customs is quasi systematic. These emergency measures, absent at that time in Paris, show a very strong response by the local authorities, as well as in Perou and Ecuador. They bring up the significance of the notion of crisis itself, largely used to the point of dulling it, in combination with the notions of risk and disaster. Analyzing public action in these three countries shows that the crisis is less defined by the presence of a disruptive element, here the SARS COV 2 virus, than by a diagnosis of the situation, at a given time, according to a pool of knowledge including an understanding of the spread of the disease in Europe, but also that takes the specificities of the region into account. This diagnosis then leads to the creation of a risk that justifies radical and early measures which immediately impacts the population with force and unequally, launching the start of a "crisis" phase.
THE CRISIS: DIAGNOSIS AND CREATION OF A MAJOR RISK UPSETTING THE SOCIETY
Confronted with the COVID-19 pandemic, the Colombian, Peruvian and Ecuadorian governments reacted the same way and almost simultaneously: suspension of flights from main international clusters, then school closures, confinement (quarentena) and curfew. Their reactivity to the spread of the epidemic singles them out since the measures were taken at the same time as those in Europe where the virus was already widespread, and earlier and more generalized than those taken by regional powers (United States, Mexico, Brazil) though closer geographically. So, Colombia, Perou and Ecuador have the distinctive feature of experiencing the crisis even before the spread of the epidemic.
It is true that the official statistics that are based on tests that are not systematic or totally reliable certainly do not show the full extent of the epidemic, but they are the only ones the agents can use to justify the emergency measures. Yet, according to these, the governments of Perou, Colombia and Ecuador anticipated.
By anticipating, the governments are not managing a public health disaster, but rather its perspective, in order to avoid it. In other words, the measures demonstrate risk management. If, according to available statistics, the virus is still not circulating much (the "crisis" with respect to health issues was therefore not present), the diagnosis establishes a major risk against which most of the inhabitants must rally around and which provokes an unprecedented disturbance in national life: a crisis is fomented to avoid another.
Etymologically, the Greek krisis means the point at which a judgment is made that leads to a decision, so the diagnostic moment. By derivation, a crisis means a turning point in the disease, that critical moment (word that has the same origin) when diagnosis of its evolution is possible. It then gained ground in the psychology field to summarize a deep distress, then in the 19th century acquired a public, economic and social dimension as a sudden time of depression and disorder. The Andean situation is proof of its original significance and its shifts in meaning. The crisis (i.e. the decisive moment) here has anticipated the epidemic wave. It's by interpreting the different elements (so, a diagnosis), that the authorities have identified a risk justifying the upheaval of daily life even before the spread of the virus. The measures chosen, specifically the confinement, are the cause of a real disturbance in the economic and social life of the inhabitants in such a way that the remedy seems worse than the ailment when it comes to keeping homebound populations that are not covered by health insurance and depend on the "informal" sector day to day (a situation found in Colombia and Mexico).
A DIAGNOSIS THAT SHOWS INSUFFICIENT HEALTH RESOURCES
This strong response is not new in this particular region: on July 4, 1997, even though the scientists hadn't wholly confirmed the arrival of El Niño (a periodic meteorological phenomena bringing rain and floods on the South American pacifique front), the Ecuadorian government had declared a state of emergency, a constitutional provision in case of catastrophy. So, a risk situation, anticipating a potential disaster, is defined politically here as a crisis situation. It is true that in those days the disturbances were limited and really helped the president muster exceptional resources. However, expecting a disaster was really a time for evaluating the potential consequences of the phenomena on agricultural production, tourism, infrastructures and services to the population. The study of prior situations, such as Perou, shows how crisis and disaster do not often overlap and that provoking the first one is usually anticipated for fear of not being able to handle the other.
In a pandemic, the risk that legitimizes this unprecedented disturbance in national life is determined by evaluating the ability to treat the sick. The number of hospital beds and doctors is clearly insufficient to handle a sudden influx of seriously sick people. Whereas the World Health Organization recommends a minimum of 2.7 beds per 1000 inhabitants, Colombia has 1.7 , Perou 1.5  and Ecuador 1.4 . This ratio is even smaller for services specializing in respiratory illnesses and intensive care.
Furthermore, the global hospital capacity is all the more reduced in these countries where local epidemics strain the health system. When the Covid-19 epidemic started, Perou was already in a public health crisis because of the dengue (more than 4000 cases at the end of January). In this country, intensive care units in the public sector were already at 90 % of their capacity before the arrival of SARS-CoV-2, while simultaneously revealing a huge unequal access to healthcare.
The threat then that provoked the crisis beginning of March is the crash of the health system. Aware of this weakness, the public health authorities chose to mobilize governments and populations so that something that hadn't even started yet (as opposed to Europe), effectively didn't happen. An exercise such as this is difficult and subject to controversy and only works if there is a minimum of trust (or fear). The perception of risk was therefore created using information that came from Europe and was narrated. Therefore studying crises in Andean countries, as a diagnostic and decision making period, is a heuristic way of grasping the power struggles and the weaknesses of these societies.
 OCDE 2019
 MINSA 2018
 Ministerio de Salud Publica, 2018
Alexis Sierra is a geogrpher, Professor at CY Cergy Paris University and treasurer at the Institut des Amériques. A specialist in risk and crisis management in Latin-American cities and their impact on urban fringes, he has analyzed the geopolitical issues of "natural" risks in Ecuador and Perou. He has worked on a number of research projects around urban issues at IRD and with the Centre National de la Recherche Scientifique (CNRS).