Beyond the hotspots of Brazil and Mexico, the coronavirus is threatening to overwhelm Latin American cities stretching from Chile to the Colombian Amazon in an alarming sign that the pandemic may be only at the start of its destructive march through the region.
More than 90% of intensive care beds were full last week in Chile's capital, Santiago, whose main cemetery dug 1,000 emergency graves to prepare for a wave of deaths.
In Lima, Peru, patients took up 80% of intensive care beds as of Friday. Peru has the world's 12th-highest number of confirmed cases, with more than 90,000. We're in bad shape," said Pilar Mazzetti, head of the Peruvian government's COVID-19 task force. This is war.
In some cities, doctors say patients are dying because of a lack of ventilators or because they couldn't get to a hospital fast enough.
With intensive care units swamped, officials plan to move patients from capitals like Lima and Santiago to hospitals in smaller cities that aren't as busy running the risk of spreading the disease further.
Latin American countries halted international flights and rolled out social distancing guidelines around the same time as the US and Europe, delaying the arrival of large-scale infection, said Dr Marcos Espinal, director of communicable diseases at the Pan American Health Organization.
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Latin America was the last wave, said Espinal, who previously worked at the World Health Organization.
He warned that authorities need to maintain anti-virus restrictions even as the US and Europe reopen. Some of the hardest-hit cities, like Lima and Santiago, imposed strict, early lockdowns.
But officials have struggled to enforce them, whether among the wealthy who are used to flouting regulations or lower-income people who depend on day labor or selling things on the street to feed their families.
Latin America is the world's most unequal region, a reality that Espinal said made it difficult to balance health and economic growth, with millions facing increased poverty during quarantines, curfews and shutdowns.
A month after swamping the Ecuadorian coastal city of Guayaquil in one of the first serious blows to Latin America, COVID-19 is sickening thousands in the capital of Quito, where 80% of intensive care beds were occupied as of Friday.
In terms of intensive care, we're stripped bare," city health secretary Lenn Mantilla said.
Quito has more than 2,400 confirmed infections, and Health Minister Juan Carlos Zevallos said he expected the peak to come toward the end of June.
He assured citizens that the city was prepared and would avoid the fate of Guayaquil, where hundreds died at home, left in living rooms for days before overworked coroners could retrieve the bodies.
Those who perished in hospitals in coastal cities were put in chilled shipping containers that served as makeshift morgues.
The number of deaths in Quito jumped alarmingly over the weekend, from 114 to 209, and doctors said they dreaded the coming days.
I have a 26-year-old woman next to me who walked in. Three hours later, she's suffocating because we don't have a respirator available,'' said an intensive care doctor, who spoke on condition of anonymity because he was not allowed to speak to the media.
I think we're getting to the point that you saw in Europe, where people died for lack of respirators."