it has been estimated that there were over 9,000 excess deaths in guyaquil in the months of march and april. the chaotic conditions in hospitals had led to misidentification of the deceased with many bodies of the dead going missing. may 2020 on 4 may, the number of confirmed cases had reached over 30,000, with 31,881 cases reported, 1,569 reported deaths and a further 1,336 possible deaths caused by the virus. by 15 may, the situation in guayaquil appeared to have stabilized, although it still had 55% of the total 31,467 cases in ecuador. however, increasing numbers in quito were reported, with 2,400 coronavirus cases and 181 deaths registered in the pichincha province. the financial times estimated that between january and mid-may, there were over 19,200 excess deaths in ecuador, 12,000 of which were from guayaquil alone. june 2020 on 13 june, a major laboratory involved in testing for coronavirus was forced to close and stop its tests due to a lack of basic lab equipment. july 2020 on 23 july, quito surpassed guayaquil in the number of cases, becoming the epicenter of the disease in ecuador. august 2020 on 11 august, the pichincha province surpassed guayas as the province with the highest number of cases. on 21 august, confirmed positive cases were reported in all 24 provinces, with quito being the hardest-hit area. according to "compassion ecuador," the indigenous population is particularly vulnerable. statistics nationwide show cumulative tests show cumulative cases by province show provinces with > 100,000 confirmed cases show provinces with > 20,000 confirmed cases show provinces with < 20,000 confirmed cases daily cases show daily tests show daily cases show daily deaths current number of cases by provinces confirmed covid-19 cases and confirmed and probable deaths 2020 provincesconfirmed casesconfirmed deathsprobable deaths azuay25,37451944 bolívar6,73811123 carchi8,7512843 cañar6,03013722 chimborazo8,569530141 cotopaxi11,572580129 el oro21,8301,099256 esmeraldas8,94639285 galápagos1,4691012 guayas65,8862,7571,918 imbabura15,32942428 loja17,160567160 los ríos12,712493424 manabí32,2342,5511,183 morona santiago6,146609 napo3,5831094 orellana3,4949623 pastaza3,3198719 pichincha165,8543,197386 santa elena4,418428281 santo domingo de los tsáchilas11,684697142 sucumbíos5,4601736 tungurahua14,459619376 zamora chinchipe2,93410014 ecuador463,95116,0205,688 vaccine on 16 december 2020, the ecuadorian medical authority arcsa granted emergency use of the pfizer–biontech covid-19 vaccine. vaccination is planned to start in january 2021 for senior home residents and medical workers, with mass vaccination beginning in march. economic impact the government is paying informal workers $60 per month to stay at home. an estimated 500,000 venezuelan migrants in ecuador are especially vulnerable because they do not have access to the stimulus payments. the country was already in economic difficulties before the pandemic, but the covid-19 pandemic and fall in oil prices during the pandemic had led to severe economic problems in the country. all government officials and teachers had been asked to take a pay cut, a number of national companies such as the national airline tame were liquidated, and ecuador was unable to pay its foreign debt. the budget deficit for 2020 is expected to be at least $12bn, which is about 11 per cent of ecuador's gross domestic product. a law to make labour law more flexible was also passed. government announcement of cuts has led to protests by demonstrators. the poverty rate reached 32.4 percent in december 2020 (up 7.4 percentage points from december 2019) according to government data. the recession in 2020 is estimated at 10 percent.