Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
INTRODUCTION: Between March and April 2020, the city of Guayaquil was a world epicenter because of the COVID-19 pandemic, this produced an excess of deaths and saturation of health services that the country had never faced before.
OBJECTIVES: To determine excess mortality associated with COVID-19 in the province of Guayas and the city of Guayaquil between epidemiological weeks 7 to 27 of the year 2020.
MATERIALS AND METHODS:
An observational, ecological, descriptive and analytical
study was carried out. General deaths in the province of Guayas between 2017-2020 were analyzed. The analysis was by epidemiological weeks with absolute values and percentages.
For the year 2020, the distribution by canton and its correlation with the total population and population density was determined. Finally, a timeline with events related to the COVID-19 pandemic was set.
RESULTS: Between epidemiological weeks 7 to 27 of the year 2020, a significant increase in general deaths was found. The highest number of excess deaths (1101 %) was found in week 14 compared to 2017-2019. The cantonal analysis showed a sudden increase in
deaths in Santa Lucia and Guayaquil, and then a decrease in their rates while neighboring cantons were increasing. Populations and population densities were strongly and moderately correlated with overall deaths (rho > 0.3).
CONCLUSIONS: Between the months of March and April attributable to COVID-19 there was a significant increase in excess deaths in Guayaquil. This increase was possibly
related to the scarcity of health resources, the high population burden, and the lack of an optimal epidemiological surveillance system.
1. Ellis R. WHO: 14.9 Million Died Because of COVID in 2020–2021. Medscape. 2022. [accessed 12 Sep 2022]. Available from:
2. Guerrero S. Coronavirus en Ecuador: Una Opinión Desde la Academia. La Granja. 2020 Aug 28;32(2):127–33.
doi: 10.17163/lgr.n32.2020.10 Disponible en: https://lagranja.
ups.edu.ec/index.php/granja/issue/view/176
3. León Cabrera J, Kurmanaev A. Ecuador’s Death Toll During Outbreak Is Among the Worst in the World. The New York Times. 2020. [accessed 15 Sep 2022] Available from:
https://www.nytimes.com/2020/04/23/world/americas/ecuador-deaths-coronavirus.html
4. Cuéllar L, Torres I, Romero-Severson E, Mahesh R, Ortega N, Pungitore S, et al. Excess deaths reveal unequal impact of COVID-19 in Ecuador. BMJ Glob Health. 2021 Sep 28;6(9):e006446. doi: 10.1136/bmjgh-2021-006446 Available from: https://pubmed.ncbi.nlm.nih.gov/34583975/
5. Ortiz-Prado E, Fernández-Naranjo R. Impacto de la COVID-19 en el Ecuador: De los datos inexactos a las muertes en exceso. Revista Ecuatoriana de Neurologia. 2020;29(2):8–11. doi: 10.46997/revecuatneurol29200008
Disponible en:
6. Santillán Haro A, Palacios Calderón E. Caracterización epidemiológica de Covid-19 en Ecuador. InterAm J Med Health. 2020;3(e202003020):1–4. Disponible en:
https://www.researchgate.net/publication 343421741_CARACTERIZACION_EPIDEMIOLOGICA_DE_COVID-19_EN_ECUADOR
7. Velasco Abad M, Hurtado Caicedo F. Desigualdades, impactos y desafios. La pandemía en el Ecuador. Quito; 2020 Oct. Disponible en:
https://ecuador.fes.de/news-list/e/la-pandemia-en-ecuador-desigualdades-impactos-desafios.html
8. Slattery G, Geist A. South America is Winning the Global Vaccination Race. Medscape. Dic. 2021. [accessed 12 Sep 2022] Available from: https://www.reuters.com/world/americas/south-america-battered-by-covid-19-now-winning-global-vaccination-race-2021-12-28/
9. Vandenbroucke JP. Covid-19: excess deaths should be the outcome measure. Ned Tijdschr Geneeskd. 2021; Sept 7; 165: D6219. Available from: https://pubmed.ncbi.nlm.nih.gov/34523848/
10. El Telégrafo. La Embajada de los Estados Unidos donó mascarillas, trajes de protección y desinfectantes al Ministerio de Salud Pública para hospitales en Guayaquil. Página Web Embajada de los Estados Unidos en Ecuador. Quito;
2020. [accessed 15 Sep 2022] El telegrafo. 16 de abril de
2020. Available from:
11. Vivanco J. Policías golpean a manifestantes en protesta por la Covid-19 en Ecuador. Human Rights Watch (Página Web). 2020. [accessed 15 Sep 2022] Available from:
12. León Cabrera J, Kurmanaev A. En Ecuador se acumulan los cuerpos y crece el temor a que la cifra siga en aumento. The New York Times. 2020. [accessed 15 Sep 2022] Available from:
https://www.nytimes.com/es/2020/04/15/espanol/america-latina/Guayaquil-coronavirus.html
13. Reuters Staff. Ecuador bajó muertes por coronavirus a unas 10 diarias, se está controlando pandemia: Ministro de Salud. Reuters. 2020. [accessed 15 Sep 2022] Available from:
https://www.reuters.com/article/salud-coronavirus-ecuador-idLTAKBN23F31G
14. Lozano D. Cientos de cadáveres sobre el asfalto de las calles de Guayaquil: ‘Estamos llenos de muertos por coronavirus’. El Mundo. 2020. [accessed 14 Sep 2022] Available from:
https://www.elmundo.es/internacional/2020/04 01/5e84d472fdddffd4618b45c6.html
15. El Heraldo Internacional. Guayaquil comienza a usar ataúdes de cartón para las víctimas del coronavirus. HERALDO. 2020. [accessed 14 Sep 2022] Available from:
https://www.heraldo.es/noticias/internacional/2020/04/05/
guayaquil-ecuador-comienza-a-usar-ataudes-de-carton-para-las-victimas-del-coronavirus-1368179.html
16. Secretaria general de comunicación de la presidencia del Ecuador. El presidente Lenín Moreno decreta Estado de Excepción para evitar la propagación del COVID-19. Pagina Web Secretaría General de Comunicación de la Presidencia.
2020. [accessed 14 Sep 2022] Available from:
17. Celi E. Así se propagó el Coronavirus en la provincia de Guayas. Primicias. 2020. [accessed 14 Sep 2022] Available from:
https://www.primicias.ec/noticias/sociedad/propagacion-coronavirus-provincia-guayas/
18. Ramirez Gallegos J, Ortega M. Desentrañando el desborde del coronavirus en Ecuador. CELAG (Página web). 2020. [accessed 14 Sep 2022] Available from: https://www.celag.org/desentranando-el-desborde-del-coronavirus-en-ecuador/
19. Alarcón F. El Gobernador de Guayas negó que el BSC vs. IDV fuera foco de contagio. Bendito Futbol. Guayaquil; 2020. [accessed 14 Sep 2022] Available from:
https://www.benditofutbol.com/nacional/gobernador-guayas-nego-barcelona-independientedelvalle.html
20. Sachs JD, Karim SSA, Aknin L, Allen J, Brosbøl K, Colombo F, et al. The Lancet Commission on lessons for the future from the COVID-19 pandemic. The Lancet. 2022 Sep; doi: 10.1016/S0140-6736(22)01585-9 Available from:
https://pubmed.ncbi.nlm.nih.gov/36115368/
21. Arciniegas Y. Italia ordena la restricción de movimiento en todo el país para detener el brote de coronavirus. FRANCE 24. 2020. [accessed 25 Sep 2022] Available from:
https://www.france24.com/es/20200309-italia-cuarentena-total-pais-brote-coronavirus
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2025 Medical-Scientific Journal CAMbios HECAM
