Exceptionally low mortality despite widespread COVID-19 infection among Indigenous Tsimane and Moseten of Bolivia

Lucia Paola Inchauste Jordan, Xavier De Lamballerie, Stéphane Priet, Maguin Gutierrez Cayuba, Juan Copajira Adrian, Daniel Eid Rodriguez, Raul Quispe Gutierrez, Sarah Alami, Jacob E. Aronoff, Kenneth Beutow, Daniel K. Cummings, Bret A. Beheim, Caleb E. Finch, Margaret Gatz, Suhail Ghafoor, Thomas S. Kraft, Amanda J. Lea, Wendy Mack, David E. Michalik, Katherine Sayre, Edmond Seabright, Jonathan Stieglitz, Gregory S. Thomas, Randall C. Thompson, Benjamin C. Trumble, Hillard Kaplan, Michael Gurven and Paul L. Hooper
Additional contact information
Lucia Paola Inchauste Jordan: UVE - Unité des Virus Emergents - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale
Xavier De Lamballerie: UVE - Unité des Virus Emergents - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale
Stéphane Priet: UVE - Unité des Virus Emergents - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale
Maguin Gutierrez Cayuba: Gran Consejo Tsimane, San Borja,
Juan Copajira Adrian: Tsimane Health and Life History Project, San Borja, Bolivia
Daniel Eid Rodriguez: UMSS - Universidad Mayor de San Simón [Cochabamba, Bolivie]
Raul Quispe Gutierrez: UMSS - Universidad Mayor de San Simón [Cochabamba, Bolivie]
Sarah Alami: School of Collective Intelligence, Mohammed VI Polytechnic University, Morocco.
Jacob E. Aronoff: ASU - Arizona State University [Tempe]
Kenneth Beutow: ASU - Arizona State University [Tempe]
Daniel K. Cummings: Chapman University
Bret A. Beheim: Max Planck Institute for Evolutionary Anthropology
Caleb E. Finch: USC - University of Southern California
Margaret Gatz: USC - University of Southern California
Suhail Ghafoor: ASU - Arizona State University [Tempe]
Thomas S. Kraft: University of Utah
Amanda J. Lea: Vanderbilt University [Nashville]
Wendy Mack: USC - University of Southern California
David E. Michalik: Medical School, University of California, Irvine School of Medicine, USA.
Katherine Sayre: UC Santa Barbara - University of California [Santa Barbara] - UC - University of California
Edmond Seabright: UM6P - Université Mohammed VI Polytechnique, Rabat Campus
Jonathan Stieglitz: IAST - Institute for Advanced Study in Toulouse, TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - Comue de Toulouse - Communauté d'universités et établissements de Toulouse - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement
Gregory S. Thomas: Division of Cardiology, University of California, Irvine, Orange
Randall C. Thompson: Department of Cardiology, Saint Luke's Mid America Heart Institute, Kansas City
Benjamin C. Trumble: ASU - Arizona State University [Tempe]
Hillard Kaplan: Chapman University
Michael Gurven: UC Santa Barbara - University of California [Santa Barbara] - UC - University of California
Paul L. Hooper: Chapman University

Post-Print from HAL

Abstract: We report on the prevalence of and mortality from SARS-CoV-2 among the Tsimane and Moseten, two Indigenous subsistence groups in Bolivian Amazonia, and show that they evidence the lowest infection fatality rate ever reported. These populations have minimal access to medical care, a history of high parasite and pathogen exposures, and upregulated immune responses compared to industrialized populations. Between July and December of 2020, and again March - May of 2021, 85.4% of the Tsimane population aged 17+ were interviewed, and 42.0% provided blood samples. Among the Moseten aged 17+, 38.3% were interviewed and 38.6% provided blood samples. Blood samples were analyzed for SARS-CoV-2 antibodies with a mix of point-of-care IgG/IgM and ELISA with seroneutralization. The pandemic experience of these groups during the initial 2020 wave contrasts sharply with that observed in more industrialized contexts: while 71% and 63% of the Tsimane and Moseten populations were infected with SARS-CoV-2, mortality was minimal, with infection fatality ratios of 0.009% and 0.095%, respectively. The mortality rate for the Tsimane is 1/23rd the expectation based on rates observed elsewhere in the world. Disease severity—as measured by length of illness, ELISA antibody titers, and virus neutralizing test titers—did not increase markedly with age. We propose that low fatality, despite high transmissibility and non-negligible severity, may be due to a more vigorous and effective immune response to infection, with implications for future global pandemics.

Keywords: Infectious disease; Bolivia; Indigenous health; Pandemic; COVID-19 (search for similar items in EconPapers)
Date: 2026-09
References: Add references at CitEc
Citations:

Published in Social Science and Medicine, 2026, 404, pp.119493. ⟨10.1016/j.socscimed.2026.119493⟩

There are no downloads for this item, see the EconPapers FAQ for hints about obtaining it.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-05668298

DOI: 10.1016/j.socscimed.2026.119493

Access Statistics for this paper

More papers in Post-Print from HAL
Bibliographic data for series maintained by CCSD ().