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Data: European Centre for Disease Prevention and Control via Our World in Data; Chart: Naema Ahmed/Axios

Peru's coronavirus death rate is now the highest in the world, surpassing Belgium and exceeding even Brazil (7th) and the U.S. (8th).

Why it matters: Peru and Belgium illustrate the divergence between the world's two hardest-hit regions since the eye of the storm shifted from Europe to Latin America in the spring.

Zoom in: Belgium saw an incredibly sharp spike over a single month, from its first death on March 11 to a daily high of 321 deaths on April 9.

  • The post-lockdown descent was nearly as sharp. It has now been three months since Belgium last recorded more than 15 deaths in one day.
  • The trend is similar in other European countries, like Italy: a terrifying spike, a steady decline and consistently low death tolls even after the lifting of lockdowns.

The flipside: Peru was hit later than Belgium, and it imposed a lockdown in March before recording a single death. Death tolls climbed much more slowly, but over nearly three months rather than one.

  • On April 27, Peru’s daily death toll crossed 150 for the first time.
  • Since then, Peru (pop. 33 million) has recorded over 150 deaths nearly every day for four months.

Peruvian President Martín Vizcarra was initially praised for locking down early and hard, while passing a large aid package for workers.

  • But Peru's health care system has been chronically underfunded, its economy is largely informal, and social distancing is difficult in its densely populated slums and crowded food markets.
  • Hospitals struggled to cope with rising caseloads, while attempts to restart the economy caused further spikes.
  • Peru is facing the worst of both worlds. In addition to the world's highest death rate, its lockdown also caused the world’s deepest economic contraction in the second quarter, per Bloomberg.

Zoom out: Over the past week, the 10 countries with the highest population-adjusted death rates have all been in Latin America and the Caribbean (Peru is 5th).

  • Brazil and Mexico have grabbed international headlines for their high overall death tolls and COVID-skeptic leaders, but Colombia (1st) and Argentina (4th) are now recording among the world's highest death rates despite far stricter policies.
  • Buenos Aires has been under continuous quarantine for nearly six months, but it hasn't followed the trend of European cities like Milan or Madrid, where fast-growing outbreaks were eventually brought under control.
  • Latin America's economic downturn could be the most severe in the world, with the recovery stretching into 2023, per WSJ.

What to watch: While death tolls remain relatively low across Europe, cases have begun to spike dramatically in Spain and France while ticking upward elsewhere, including in Belgium.

  • Family gatherings and domestic travel have been cited as potential drivers, in addition to significantly higher testing rates.
  • In Spain, the median age of those testing positive has fallen to 37 from 60, per NYT.

The bottom line: Latin America was unable to match Europe's success in quickly suppressing the virus — but it remains to be seen if Europe can sustain it.

Go deeper: 9 things for the next pandemic

Go deeper

Cedar CEO: Consumers, employers drive change in health care pricing

Photo: Axios

Consumers and employers will drive changes in health care pricing and policy, Florian Otto, co-founder and CEO of Cedar, said on Tuesday at an Axios virtual event on the future of health care payments.

Why it matters: The U.S. spends more on health care than any other nation, but Americans do not enjoy better health outcomes. High health care costs affect how the country responds to major health crises — like the coronavirus — because people cannot afford to pay for testing or treatment, per the Washington Post.

Biden prioritizing schools, teachers in coronavirus playbook

Anthony Fauci appears via video on Tuesday with Vice President-elect Harris and President-elect Biden. Photo: Jim Watson/AFP via Getty Images

President-elect Biden's COVID checklist includes getting Americans to wear masks as a patriotic duty, vaccinating 50 million people and reopening the majority of schools by the end of April.

Why it matters: The remote learning adopted by many of America's biggest school districts has been a disaster for students and parents alike.

Dec 5, 2020 - Health

Dolly Parton's string of philanthropic hits

Photo illustration: Sarah Grillo/Axios. Photos: Bruce Glikas (FilmMagic), Jason Kempin/Getty Images

Dolly Parton is known around the world for her musical and acting talents, but the legendary performer recently made headlines for her contribution to science when she helped fund Moderna's COVID-19 vaccine.

Driving the news: Parton donated $1 million to Vanderbilt University for research toward a cure for the coronavirus. Her donation helped fund the university's research that contributed to the development of Moderna's vaccine, which has a reported efficacy of 94.5%