Guayaquil has 2.7 million people over 122 sq. miles of land. Population density 22,000/sq. mile. At 13 feet above sea level, there is not much UV sunlight. The poor neighborhoods have 50,000+ per square mile. That allows an average of 12 feet between people. Any travel requires you to get less than 6 feet from the nearest person. Walking one mile in the Guayaquil ghetto would put you within 6 feet of 850 different people. Ecuador - 456 dead (whole country) of 17 million. 26 deaths per million people. Compare to New York State - 901 deaths/million. New York City - even higher.
OTOH, Hong Kong reports just 4 deaths in 3 months. 7.5 million people on 1,060 square miles. Masks, gloves, and social isolation.
You’re probably right about a combination of poor habits and poor people causing a lot of problems. I have been checking out Cuenca because a lot of expats live there and they aren’t having anything close to the problems Guayaquil is.