The November 2019 ouster of President Evo Morales, followed by the interim government’s harsh crackdown on his supporters, plunged Bolivia into a political crisis just as the COVID-19 pandemic arrived with devastating effect. The interim government’s haphazard response was marred by corruption scandals over procurement of medical supplies. After several delays, a general election was finally held in October 2019. Luis Arce, the presidential candidate of Morales’s Movement Toward Socialism, won decisively. But Morales’s subsequent return from exile signaled that the struggle over his legacy would continue.

Bolivia had a tumultuous year starting in November 2019, when President Evo Morales was ousted in what most observers saw as a coup. An interim government stepped in. Although tasked only with calling elections, this administration revealed itself to be both corrupt and brutal—and, once the COVID-19 pandemic hit, incompetent.

Morales, both celebrated and vilified for having held power for fourteen years, was Bolivia’s first Indigenous president. He steered the country to the left with a bold redistributionist agenda. But his bid for a fourth term, based on a court ruling that overturned constitutional term limits, led many to question the vote from the outset. He was toppled amid allegations of electoral fraud, street protests, a police mutiny, and a suggestion from military leaders that it was time for him to resign. He complied and left the country. Just a few days after the interim government took over, two protest marches were met by troops with gunfire that killed twenty unarmed civilians. Widespread persecution of former Morales administration officials began, and many were jailed.

Then, on March 10, 2020, COVID-19 arrived with two Bolivians returning home from Europe. Twelve days later, a national quarantine was put in place. Through much of 2020, Bolivians were confronted with what many now call the double pandemic: a repressive government and a deadly virus. When elections were finally held in October 2020, Morales’ Movement Toward Socialism (MAS) party, led by presidential candidate Luís Arce, won in a landslide. MAS reclaimed a majority in the legislature along with the presidency. Although the pandemic has not gone away, Bolivia’s simultaneous passage through COVID-19 and the coup is a remarkable testament to the country’s commitment to democracy and its unbreakable human spirit.

By most measures, the interim government did a bad job in dealing with the pandemic. Bolivia, with a largely poor population of 11 million, certainly faced infrastructural challenges, even though the Morales government had invested heavily in public health over recent years. Morales had used revenues from natural gas exports to expand the public sector, invest in infrastructure, and launch several cash transfer programs to alleviate poverty. In addition, Morales tripled the budget for health between 2006 and 2019. Indices of infant mortality, hunger, and care for expectant mothers all improved. A universal health care system was launched in 2010 and was set to expand starting in March 2019.

But Morales had a running political feud with the organization representing professional physicians. Doctors in Bolivia work in both public and private clinics. The latter are invariably better equipped and, of course, more expensive. The result is health segregation: those who can afford it enjoy access to private clinics, and those who cannot are consigned to underfunded, understaffed, and overcrowded public facilities. Even in public clinics, doctors often charge patients extra for equipment, treatments, and drugs.

The expanded national health program was intended to improve the public sector situation, but it threatened the private interests of doctors. In the lead-up to the 2019 election, they opposed not only its implementation, but Morales himself, joining the coalition of groups that demanded his ouster after the disputed vote. With Morales out and the new health program not yet fully implemented, COVID-19 arrived at a point of acute political and institutional instability that increased the likelihood of an inadequate response.

The lack of preparation for the virus was not entirely the interim government’s fault. Yet this administration, seen by many as illegitimate, did not instill confidence. Indeed, it did not really seem to care that much about the poor majority of the country’s people.

The new president, Jeanine Añez, was a senator from a right-wing party that had little national support, garnering only 4 percent of the vote in the disputed election. After Morales and his vice president had fled and others in the line of succession had resigned, Congress elected Añez, the second vice president of the Senate, to the presidency in a procedure lacking a quorum and of dubious legality.

As president, Añez had one job: to call new elections. But she soon declared herself a presidential candidate and set about using her grip on the state to build political alliances, campaign, and distribute patronage jobs.

Alongside rising political tension and repression, the interim government’s actions revealed a troubling lack of knowledge about the virus. In one telling example, in the early days of the outbreak, Añez and her close circle of advisers were seen wearing “virus shut out necklaces,” said to emit a disinfecting cloud of chlorine dioxide that protects the wearer. Hucksters hawk them on the Internet and on the streets of New York City, but the US Environmental Protection Agency has banned them. When Bolivia’s new leaders fell prey to such a scam, it was a harbinger of what was to come.

COVID-19 arrived at a point of acute political and institutional instability.

The interim government was politically aligned with the doctors, but nobody seemed very sure what to do about the pandemic. The Añez administration made clumsy efforts to inform the population and enforce a quarantine. Yet its primary goals seemed to be persecuting figures from the previous government and repressing lingering discontent over the coup. Rather than a logic of care, the government operated with a mindset reminiscent of the Cold War years when Bolivia was ruled by a succession of military dictatorships preoccupied with national security

Critics of the government were deemed “seditious” and “terrorists.” The police and the army were designated as the primary actors in the “war” against COVID-19. People said to be possibly infected were deemed “suspicious cases.” Those who did not obey quarantine orders or wear masks were labeled “infractors,” a term used for criminals. Under cover of the quarantine, or in its name, the government jailed a number of Morales sympathizers. One was imprisoned after police interrupted a dinner party at her house. Public protests were treated as both a security and a health threat, drawing heavy-handed police responses.

The interim government exacerbated tensions with its barely-masked racism toward Indigenous people, who comprise the majority of the Bolivian population. Representatives of the interim government, largely made up of lighter-skinned Bolivians from the old-guard elite, referred to the darker-skinned protesters as “hordes.” Añez herself described Morales supporters as “savages.”

The government’s attempts to educate people about the virus also took on an aggressive tone. Administration officials berated community leaders, blaming them for the virus’s spread. After a national quarantine was declared in mid-March, those who broke it faced criminal charges, and hundreds were jailed.

As with the “shut out” necklaces, repression could abruptly give way to parody. At one point, the minister of public works, tasked with educating the public, came to a press conference armed with action figures of the Avengers and the villain Thanos. Holding them up to stage a mock battle, he explained to the viewers (whom he evidently presumed to be child-like) that Thanos, like the virus, was evil and had to be fought. He was widely ridiculed on social media.

This incompetence tinged with racism was compounded by Bolivians’ economic reality. Almost 80 percent of the economy comprises the informal sector, where people work as street merchants, day laborers, market vendors, and the like. This is a population that largely has no formal contracts, salaries, benefits, job protections, or even a fixed place of work. For them, working from home is not difficult—it is impossible. A massive government aid program might have alleviated the pressure of the lockdown. In the absence of such aid, people had no choice. They went out in the streets to work, while the government complained of unruly and disobedient citizens. People from the privileged classes were also out and about, but the government was mainly concerned about segments of society it deemed a risk to itself.

Among these was La Paz’s sister city, El Alto. The city’s largely Aymara Indigenous population was at the core of opposition to the interim government. When its residents spearheaded protests back in November 2019, the army killed ten civilians (one of two mass killings that month). The interim government responded to the perceived political threat of El Alto by deeming the city an unruly public health risk and enforcing harsh lockdown measures. At one point, a coliseum was used as a giant holding pen for “infractors.”

A second target was the tropical region known as the Chapare, Morales’s primary base of support. Among a range of other threats to “cordon off” and “contain” the region, the minister of government (equivalent to an interior minister), Arturo Murillo, Añez’s main enforcer, warned that anyone trying to “escape” would be treated as a criminal. Backed by a draconian decree on the health emergency, he threatened those who broke quarantine with ten years in prison. Murillo vowed to declare a state of siege and impose martial law if people did not stay at home.

The health emergency decree also directed threats against anyone who “generated uncertainty” among the population, an ill-defined phrase that could apply to almost any form of speech. The US-based nongovernmental organization Human Rights Watch denounced the decree as a thinly veiled political attack on freedom of speech and called on the government to suspend it. Just two weeks after the decree was issued, the government announced that it had detained 67 Internet activists, opponents of the government who were alleged to have “generated uncertainty.”

By the end of March, the national electoral commission called for the suspension of political campaigns. It seemed reasonable, given the pandemic. Yet the lack of public confidence in a government that many considered illegitimate led some to see this as a bid to stay in power.

Meanwhile, the police appeared to be the only effective arm of the state. In one April weekend, they announced 839 arrests for lockdown violations, followed by similar figures over the ensuing weeks. But this seemed counterproductive, since Bolivia’s prisons were already notoriously overcrowded and were becoming COVID-19 hotspots. Detaining more people verged on the absurd. For their efforts, police officers were among those worst affected by the virus, with many deaths in their ranks.

As the government tried to put on a more serious face, Añez formed a “scientific committee” of advisers in April. Many of them were not actually scientists, though much attention was given to one young man, Mohammed Mostajo. Said to be a close friend of the president’s daughter, he was a US-based Bolivian scientist who flew in to join the effort. Añez also named a new health minister, pulmonologist and surgeon Marcelo Navajas. Yet the scientific committee seemed to be focused more on postponing the elections than on fighting COVID-19.

The elections originally scheduled for May were first postponed indefinitely due to the pandemic. On May 2, the MAS-dominated Congress passed a measure calling for elections within 90 days. Añez refused to sign it and tried to delay it with a court challenge. By mid-May, protests and road blockades to demand elections had spread throughout the country.

In June, after a dialogue that included representatives of the United Nations, the European Union, and the Catholic Church, Congress passed another law postponing the election date to September 6. By July, the virus was spiraling out of control; Añez herself, along with five cabinet members, reportedly tested positive. Despite the protests of the MAS, the electoral commission postponed the vote a final time, to October 18.

Meanwhile, there was growing instability in the government: the interim president’s decision to become a candidate herself led to a reshuffling of cabinet members and ruptured the unwieldy coalition that had backed regime change. Corruption scandals were rife. Ministries saw the arrival of new personnel aligned with the coup regime, but with little real experience. The health minister who preceded Navajas had been given the post as a reward to the doctor’s association for supporting the putsch.

Navajas himself did not come with a gleaming reputation. He had been accused in the past of selling overpriced chemotherapy treatments. His scheme was to buy the drugs in Chile, falsify receipts, and then resell them at a markup to his patients in Bolivia. He declared his innocence, and Añez affirmed her confidence in him. Shortly after he took office, he advocated a policy of herd immunity, announcing that everyone was going to catch the virus anyway. The only thing to avoid, he said, was the collapse of the health system. Yet it seemed as if the collapse was already well under way, if not complete.

As more and more Bolivians contracted the virus and the death toll rose, bodies started appearing in the streets. Morgues were filling and mortuaries were backed up. Domestic violence was on the rise. Some cities and towns deemed hot spots were subject to “encapsulation,” cordoned off for ten to fourteen days. In these areas, police and health workers went from house to house to seek out infected patients. The military was also deployed in some places to reinforce these operations. The government issued yet another decree, expanding the definition of pandemic-related misinformation and increasing the punishments for alleged perpetrators. Human Rights Watch, the Inter-American Human Rights Commission, and Bolivian rights organizations all declared it another attack on the press and free speech.

Meanwhile, with great fanfare, the government announced that soon the country would benefit from a new shipment of ventilators. Navajas’ office oversaw the purchase, financed by the Inter-American Development Bank (IDB). As details of the deal came to light, questions were raised. An expert who reviewed the contract said the ventilators were designed to address short-term emergencies rather than the longer-term intensive care that COVID-19 patients would need. Others raised questions about their high price, at $28,000 apiece, compared with the normal cost of around $7,000.

The government operated with a mindset reminiscent of the Cold War years.

Mostajo, serving as ambassador for science, technology, and innovation, tried to explain away the irregularities, claiming that oversight by the IDB ensured absolute transparency. Two days later, two high officials in the health ministry were arrested. The deal was exposed as corrupt, yielding huge kickbacks to various middlemen. Then two consultants working for the IDB were arrested, and Navajas himself was jailed. Mostajo quietly caught a plane back to the United States and has not resurfaced since. The ventilators were never put into service.

To add insult to injury, the government was using the pandemic as a smokescreen for other interests. With the backing of the powerful agroindustrial lobby, which had placed many representatives in the interim administration, Añez quietly tried to authorize the expanded use of genetically modified seeds—a highly contentious issue, given the problems associated with pesticides, herbicides, and threats to native crop species. Another decree authorized the highway department to award exceptional no-bid contracts, which clearly had no relevance to COVID-19 but allowed for public funds to be disbursed with little oversight.

A further scandal tied to no-bid contracts embroiled the national hydrocarbons company YPFB. In another case, the government transferred extra funds to the Ministry of Defense, ostensibly to buy more tear gas—apparently deemed a crucial resource amid the pandemic. The “ventilator affair” was soon complemented by the “tear gas affair,” since the chemicals were also allegedly bought at a fraudulent markup.

The interim government was less active when it came to making policy to ameliorate the pandemic’s effects. It delivered only a one-time direct cash transfer to families, of some 500 bolivianos (roughly $70). The payment was provided first to families with children in public schools, and later to households with children in private schools as well. While assistance was certainly welcome, the amount was minuscule. Furthermore, claiming the transfers required people to stand in long lines at banks, clearly raising the risk of the virus spreading. Critics were quick to point out that the government’s scientific committee had deemed elections too risky, but seemed willing to overlook the risks of lines outside banks in order to score popularity points with these micro-transfers.

Education was another area of contention. Students were kept at home without classes or any remote learning options, starting in mid-March. Once the quarantine was slightly loosened in June, the government declared that schools had the obligation to come up with their own plans for dealing with the crisis. The Defensoría del Pueblo (Defender of the People), a human rights oversight body, cried foul. UNICEF’s office in Bolivia tried to put together a proposal to create better conditions for virtual schooling, yet the government seemed unwilling to commit resources to such an effort.

At the end of July, with students still at home, the government simply declared the school year over. (It usually runs from February to November.) All students were automatically promoted to the next grade. There would be no remote schooling.

The Ministry of Education had made a few statements about plans for holding classes via radio and television, but there was no serious effort to organize such programs. Nor were schools or students equipped for such a contingency. About 40 percent of Bolivians own a computer, while only 10 percent have Internet access at home. The figures are even lower in rural areas, where barely 3 percent of households are connected to the Internet.

The public schools and teachers were unprepared and unequipped for online education, whether the students had Internet access or not. But private schools, generally catering to the wealthier urban classes, had the resources for remote schooling. The cancellation of the school year for the public system had a deeply unequal impact.

Once again, the government’s approach seemed to be as much about political control as it was about public health. Bolivian teachers have well-organized and often militant unions. They were quick to argue that the school shutdown was meant to keep them off the streets. To quiet such complaints, the government continued to pay teachers’ salaries for the rest of the year, even though they would not be teaching.

Civil society organizations challenged the decision to cancel the school year in court, arguing that the government was denying children the right to education. The court sided with the citizens and gave the ministry ten days to come up with a plan. Minister of Government Murillo, whose role was to defend all government decisions, shrugged it off. In his words, he would rather have children be ignorant than send them to school during the pandemic, and he was willing to go to prison if he had to. The schools stayed closed.

As has been the case in Brazil, Ecuador, Peru, and Colombia, Indigenous peoples, particularly in Bolivia’s lowlands and Amazon regions, were especially hard hit by the pandemic. Rural Indigenous peoples have less access to health care than urban Bolivians, but are often subject to higher contagion risks.

The case of the Guaraní, who comprise Bolivia’s third-largest Indigenous population, is illustrative. Rural farmers for the most part, the Guaraní are now surrounded by large natural gas extraction facilities. Some Guaraní communities were able to enforce their own kind of lockdown by blocking access roads, but in others, the influx of gas workers, who come and go from the cities and interact with local people in various ways, was a vehicle for the virus. Guaraní organizations demanded that drilling be halted to reduce such movement, but the gas operations continued, and outbreaks followed.

In parts of the Amazon, gold mining activities were the culprit. Gold mining, much of it financed by Chinese capital, involves dragging Amazonian rivers. The need for gasoline and other machinery means heavy movement of trucks and workers in and out of rural regions. Already destructive in environmental and social terms, gold mining operations brought the coronavirus from the cities into isolated regions. Mining activities initially slowed when the national lockdown was imposed, but as the quarantine weakened, they picked up again.

Since many Indigenous people work in the gold mining economy, they were exposed to this movement of people. In April, Indigenous organizations signed a joint letter demanding that all extractive activities, like mining and gas drilling, be suspended. In June, Indigenous and other civil society groups also wrote a joint letter to Añez complaining of their lack of access to regional health care infrastructures and asking for health personnel, protective gear, and treatment. The government did nothing in response to either letter. By October, even the most isolated Indigenous communities had felt the impact of the virus.

Against the backdrop of corruption, incompetence, and repression, there were bright spots. Some regional officials, like Santa Cruz health secretary Óscar Urenda, did yeoman’s work in marshalling resources and pushing the national government to do better. Much like US senior health official Anthony Fauci or New York Governor Andrew Cuomo, he drew notice by holding press conferences to provide public updates that were frank, sincere, and honest, clearly explaining why the quarantine was necessary. Sadly, he himself caught the virus not once but twice. After recovering from the first bout, he worked to open a new hospital and helped the neighboring state of Beni develop a strategic plan. Then, after coming down with COVID-19 again, he spent a month on one of the city’s few ventilators. The disease killed him on July 24.

Another glimmer of positivity emerged in the Chapare region. Although the government called them unruly and seditious, farmers in the Chapare collected surplus vegetables and fruits and formed “solidarity caravans” to deliver them to poor neighborhoods in the city of Cochabamba. There are surely thousands more such stories yet to be told about the time of the pandemic in Bolivia, where collective solidarity is deeply woven into the fabric of civil society. It was the interim regime, rather than the population at large, that was the major problem with the pandemic response.

As of late November 2020, official figures suggest that there have been around 145,000 cases and 9,000 deaths in Bolivia. In a country of 11 million, these numbers may not seem so high. But as the New York Times reported in August, the real numbers are likely as much as five times what the official statistics show. At its peak, Bolivia had “one of the world’s worst epidemics,” as the Times article put it. The Bolivian independent news website Muy Waso dug deeper, finding that between June and August alone, 20,000 more people died than in the same period the previous year—suggesting that Bolivia’s death rate per capita was up to twice as high as that of the United States.

Even the most isolated Indigenous communities felt the impact of the virus.

With widespread testing and treatment unavailable, an accurate count is impossible. Bolivia appears to have seen its worst peak in August, when its death rate ranked among the top ten highest in the world. As the hotter months of the Southern Hemisphere summer arrived, the virus seems to have stabilized at a lower rate, at least for the moment. Whether a second wave will come remains to be seen.

When the general election was finally held on October 18, 2020, the resilient spirit of Bolivia was put on display. In a massive turnout, citizens stood in line for hours to vote, waiting patiently and wearing masks. In the wake of the tumult that followed the 2019 election—the accusations of fraud, and the intervention of the police and military—most saw the 2020 election as a deciding moment for the country’s democracy.

Opponents of Evo Morales, divided into three major coalitions, hoped that Luís Arce, the candidate of Morales’s MAS party, would be forced into a runoff. Had this happened, the other parties might have unified around Carlos Mesa, the centrist candidate thought by many to have a fair chance at beating Arce in a head-to-head vote. Supporters of Morales believed that the country’s democratic process had been interrupted; they viewed the election, and a MAS victory, as the only clear path to its restoration. Tensions were high. Yet the election went off with only minor disruptions. As the vote count continued that night, exit polling data showed a clear MAS victory. Arce won 55 percent of the vote, avoiding a runoff.

The country had withstood a brutal and incompetent regime and faced down the virus. Now it had also demonstrated a deep commitment to the ballot box. Still wearing masks, jubilant crowds poured into the streets. As the newspaper El País in the southern city of Tarija later editorialized, not all of those who voted for Arce may have been enthralled with Morales or his party, but they had seen what kind of government they did not want, and voted to rid themselves of it.

The ex–health minister, Navajas, remains under house arrest pending the outcome of the “ventilator affair.” Murillo, the former government minister who threatened to jail anyone who broke quarantine, fled the country after the November 2020 election and is now a fugitive in the United States. Along with the former defense minister, now at large in Brazil, he is wanted on charges related to the “tear gas affair.”

Jeanine Añez, the former interim president, is still in Bolivia, though that may not last long. The new government has already arrested one military officer in connection with the killings of protesters. The Inter-American Commission on Human Rights is currently carrying out an investigation that may lead to criminal charges against Añez as well. The victims’ families have also been in discussions with Harvard Law School’s International Human Rights Clinic. The clinic represents Bolivian families who are using the US civil court system to sue former President Gonzalo Sánchez de Lozada, now living in Maryland, over an army massacre in 2003. Should Añez also flee Bolivia to avoid charges, she may think twice about going to the United States.

For his part, Evo Morales returned from exile on November 9, a day after Arce was sworn in as president. Throwing caution to the wind, Morales organized a two-day car caravan from the Argentine border back to the Chapare. At every town, city, village, and hamlet along the way, he stopped to greet jubilant supporters. Masks were not much in evidence, and the rallies looked like potential super-spreader events.

Now the COVID-19 emergency confronts a new government. The economic growth and stability of the past fourteen years are under threat. Natural gas prices are down, depleting government revenue. Arce says the country will need at least two years to get back on its feet after the pandemic and the coup. Although there are eager expectations of a return to the relative prosperity of the recent past, Arce pledged in his inaugural speech that his government will be an “austere” one. He will not enjoy the same bonanza of gas revenues that bolstered Morales for 14 years, and he has tried to dampen hopes that the boom will return. He will have to maneuver between both the centrist and the hard-line right-wing opposition, the MAS base, and Morales himself.

As of early November, the number of newly reported COVID-19 cases was low and stable, at around 100 per day. Despite the severe challenges of the past year, Bolivia had shown its commitment to the idea that a government should care for its people, not criminalize them. Wherever one stands on Evo Morales, there can be no doubt that Bolivians gave the world a lesson in democracy, amidst the tragedy of the pandemic.