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Using an ecosyndemic lens, which draws on a multi-disease hazard context of place, this commentary highlights the importance of El Niño as a major factor that not only may aggravate COVID-19 incidence in the future, but also the broader health problem of ecosyndemic vulnerability in Latin America.

Latin America has emerged as an epicenter of the COVID-19 pandemic. Brazil, Peru, and Ecuador report some of the highest COVID-19 rates of incidence and deaths in the region. These countries also face synergistic threats from multiple infectious diseases (that is, ecosyndemic) and quasi-periodic El Niño-related hazards every few years. For example, Peru, which is highly sensitive to El Niño, already copes with an ecosyndemic health burden that heightens during and following weather and climate extreme events. 

The results show that :

• although it was initially argued that climate (for example, seasonality) could possibly constrain the spread of COVID-19 (for example, Sajadi et al. 2020), the emergence of Latin America, particularly South America, as an epicenter of COVID-19, suggests that equatorial regions are also at great risk, as some preliminary research shows (O’Reilly et al. 2020), particularly in places with limited health systems (Merow and Urban 2020).
• Thus, examination of COVID-19 within a broader scope of ecosyndemic vulnerability including quasi-periodic El Niño-related threats may provide new insights for prevention and disaster risk reduction strategies that address COVID-19 and the broader public health problem of multi-infectious disease vulnerability in the region.