ASUNCION (Reuters) - As a global coronavirus pandemic spread around the world, landlocked Paraguay did not wait, imposing a strict lockdown in early March, before neighboring countries. The result: the fewest cases in the region.

The grains producer with a population of around 7 million people has just 159 confirmed cases and seven deaths. Just three of the infected people are hospitalized, with one in intensive care, health ministry data shows.

That compares with over 2,000 cases in Argentina, 10,000 in Peru, almost 8,000 in Chile, and 25,000 in Brazil. Smaller neighbor Uruguay has almost 500 confirmed cases while Bolivia has 354.

Luis Alberto Escoto, representative of the World Health Organization in Paraguay, told Reuters the country’s success was due to aggressive social distancing measures.

“Their best result can be attributed to adoption of these and the attitude that the population has despite living in a difficult context, of inequality and poverty,” he said.

Paraguay’s government shut schools and suspended large events in the second week of March. Shortly later, it closed its borders, airports and ordered a total quarantine of the population with very few exceptions.

Police and military watch the streets and shops and have punished more than a thousand people for violating restrictions.

The South American nation, however, also has one of the lowest test rates for the virus, with 26.2 tests per 100,000 inhabitants, according to the WHO and Pan American Health Organization. It has shortages of tests and a lack of qualified personnel.

It has also had trouble getting ventilators and protective equipment for medical personnel, part of the reason President Mario Abdo extended the quarantine on Monday.

Escoto, however, said this was not masking a hidden crisis, while local lawmakers emphasized the country’s health system - though under-funded - was not buckling under the strain.

“There is a certain under-reporting that exists. But the absence of mortality or serious cases saturating the system suggests there is not exponential community transmission yet,” said Senator and former Minister of Health Esperanza Martínez.

“The fear is that when these measures are lifted without having a rapid test strategy,” she added, “Paraguay may get the sort of peaks that have occurred in other countries.”