As the pandemic hit hard early this month it overwhelmed Ecuador's business capital, Guayaquil, now the epicentre of coronavirus in Latin America. It became a medieval plague city.
Overcrowded hospitals turned away the dying, corpses were left in wheelchairs, on stretchers and on the floor in emergency and waiting rooms. Bodies were abandoned in the streets, and in the morgues hundreds of decomposing bodies were stacked in piles.
In the last week the death rate has fallen somewhat and an emergency task force has begun to clear the backlog of burials. Why Ecuador? Perhaps the many flights linking it with Spain. Indeed, the cruel irony is that the delayed surge of the pandemic in Latin America may now re-infect in a second wave those very countries which are beginning to talk of ending lockdown.
The iceberg-like scale of the pandemic in the impoverished country also provides a sharp warning to global health organisations. Although some 500 are reported officially to have died of coronavirus, and 11,800 been infected, a comparison by the New York Times of actual death rates with the numbers of those who would normally have been expected to die in the last two months reveals a staggering 7,600 “excess” deaths attributable to the pandemic but not recorded as such.
The absence of proper testing in Brazil also makes the real scale of the pandemic there deeply uncertain. To date more than 50,000 have officially been registered as infected with over 3,300 deaths, but the truth is exponentially worse
In São Paulo alone nearly 1,300 people have died of unidentified respiratory problems, compared with 50 people last year. A research team at the city's university thinks Brazil has 16 times more – as many as 711,000 cases.
Latin America's largest country is testing people at a rate far lower than any major nation. It tests 12 times fewer people than Iran, and 32 times fewer than the United States.
The absence of resources is compounded by Trump-like denialism at the highest level. Brazil's far-right president, Jair Bolsonaro, has dismissed the pandemic as a "fantasy" driven by "a little flu".
He claimed this month that the numbers "looked like the virus is starting to leave". Then, 10 days ago, he fired health minister Luiz Henrique Mandetta, who had publicly taken issue with his assessment and lack of urgency. Late last week, popular justice minister Sergio Moro resigned after clashing with the president.
Bolsonaro has joined demonstrators calling for an end to lockdown, even suggesting that a coup might be necessary to get around an obstructive parliament.
The vision of hell that was Guayaquil may yet be the nightmare future for a continent hobbled not only by this iceberg pandemic but crippling poverty and deeply dysfunctional politics.