The first wave of the COVID-19 pandemic was devastating in Peru, which suffered a high death rate and severe economic disruption. These results occurred despite ambitious response measures, revealing widespread institutional weaknesses across the country's levels of government. We analyze responses across the four levels of government, with emphasis on local governance in rural areas, to understand how institutions and contexts shape crisis management outcomes. We focus on the Arequipa region, drawing from 44 interviews with officials and community members. We found that the crisis provoked a reversion to the norm across multiple scales, though with significant differentiation. The national government fell back on a centralized, militarized approach that effectively reclaimed power but was ineffective in confronting the pandemic. Counter the overarching recentralization trend, in rural peripheries where state power was always partial, norms of informal local governance were reinforced and intensified. The de facto autonomy in rural areas elicited a mix of paralysis and improvisation, with outcomes that varied widely from place to place and over time. These bifurcated results in the face of crisis reveal important weaknesses in Peru's governance structures and institutions and show how pre-existing habits and norms were reproduced in the face of crisis, rather than reformed or transcended.