Battling the world's highest coronavirus infection rate as ambulances queue to deposit patients at hospitals bulging at the seams, Uruguay has gone from a shining example of Covid-19 control to a nation in pandemic crisis.

Last June, the government was toying with the idea of declaring Uruguay Covid-19-free after several days without any new infections.

The country of 3.5 million seemed an oasis in a world turned upside down by the worst pandemic in a century.

Fast forward to April 2021, and the picture could not be more different.

The Uruguayan government is placing its hopes for beating a world-record coronavirus infection rate on its vaccine campaign
The Uruguayan government is placing its hopes for beating a world-record coronavirus infection rate on its vaccine campaign AFP / Pablo PORCIUNCULA

AFP figures show an ever-climbing infection rate for Uruguay over the last two weeks of 1,390 per 100,000 inhabitants -- by far the highest in the world, with no other country breaching 1,000 per 100,000.

In absolute numbers, the country of 3.5 million, wedged between Brazil and Argentina, is registering about 3,000 new cases per day, and 50 daily deaths on average.

It also has the world's fifth-highest current death rate, with 20.64 per 100,000 people over two weeks -- the highest in Latin America.

Covid-19 has become the principal cause of death in Uruguay, though the country has had far fewer deaths per capita than neighbors Brazil and Argentina overall.

A new daily record of 79 coronavirus deaths was reported Thursday, for a total of 1,726, and more than 4,400 confirmed infections in 24 hours.

Uruguay has given at least one vaccine dose to almost a third of its population so far
Uruguay has given at least one vaccine dose to almost a third of its population so far AFP / Pablo PORCIUNCULA

Seventy-three percent of ICU beds are now occupied -- more than half of them by coronavirus patients -- and doctors complain of exhaustion.

In September last year, the BMJ medical journal declared: "Uruguay is winning against Covid-19."

Covid-19 cases and deaths per day in Uruguay, as of April 15, 2021
Covid-19 cases and deaths per day in Uruguay, as of April 15, 2021 AFP / Gustavo IZUS

It partly credited quick action by the government to temporarily close shopping malls, bars and schools, as well as the nearly 1,000-kilometer (620-mile) border with Brazil.

This gave the country with the oldest population in Latin America time to prepare its hospitals and testing system, said the journal.

Unlike most other countries, Uruguay never had a lockdown -- citizens voluntarily stayed at home in the initial phase of the pandemic and many businesses opted to offer delivery-only services to discourage people from mixing.

So what went wrong?

"Overconfidence and a loss of risk awareness were the two main factors that caused Uruguay to lose its best-in-class status," virologist Santiago Mirazo of the University of the Republic told AFP.

Despite ever stronger calls for action, Uruguay's center-right President Luis Lacalle Pou has steadfastly rejected a national lockdown
Despite ever stronger calls for action, Uruguay's center-right President Luis Lacalle Pou has steadfastly rejected a national lockdown AFP / Pablo PORCIUNCULA

During 2020, he explains, the government was quick to isolate outbreak pockets with effective testing and contact tracing.

But over time, a false sense of security took hold and the population became ever more lax with masks and social distancing.

Today, at the height of the pandemic, bars and restaurants are open, though schools and some non-essential government offices were recently closed, and festivals and concerts cancelled.

A major contributor to Uruguay's fast-spreading outbreak has been its proximity to northern neighbor Brazil, which has been battered for months by a new infection wave fueled by a new virus variant, P1, deemed more contagious.

In the capital Montevideo, some 400 kilometers from the nearest border point, some 60 percent of infections are now with the P1 variant.

Despite ever stronger calls for action, center-right President Luis Lacalle Pou has steadfastly rejected a national lockdown, with allusions to an undesirable "police state" in a nation allergic to any notion of authoritarianism since the end of its military dictatorship in 1985.

He stresses, instead, the importance of personal responsibility taken by individual citizens. "It is a matter of principle," he said last month.

But even the ruling National Party's coalition partners are starting to clamor for stronger action, without which, they say, a bad situation can only become worse.

According to a recent report by polling firm Factum, three-quarters of Uruguayans believe more restrictions are needed.

And GUIAD, a grouping of scientists keeping track of coronavirus data, said Monday that "only strict measures" will curb the infection rate.

The GACH scientific group, which advises the government, has suggested a halt to religious ceremonies and sports tournaments, as well as closing bars and restaurants.

It also suggested even stricter limits on people entering Uruguay -- its borders have been closed since March 2020 but with exceptions for nationals and some international travelers in specific circumstances.

These suggestions have been rejected by the government, which is putting all its hope on Uruguay's vaccination campaign.

In terms of inoculations, Uruguay is the second-most advanced in South America, after Chile, with almost a third of its population having received at least one vaccine dose since last month, and seven percent two jabs.

But many experts say this will not be enough, and Uruguayans will have to be compelled to stay at home.

"No country in the world, less so on the continent, can bend the infection curve without strict restrictive measures. This is the reality," said Mirazo.