Ecuador and COVID-19: the "Guayaquil Effect" in contrast to Quito

The repercussions of COVID-19 are different throughout the world due to an assortment of aspects that distinguish some countries from others regarding the structure and response of health systems, the socioeconomic conditions of the population, the activation of emergency committees and contingency plans, and the coordination between central and sectional governments. Even among cities, regions and states of the same country, the pandemic presents a different face. In Ecuador, the effects in Guayaquil contributed to its being catalogued as the Wuhan of Latin America. This article sheds light on the social determinants that explain the consequences in Guayaquil, in contrast to what happened in the capital, Quito.