Uruguay in need of Suarez to halt downward spiral
The group of death has become the game of death and, like England, Uruguay are under no illusions what will be the consequences of defeat on Thursday.
Unlike England, Oscar Tabarez's side do not even have the consolation of having played well in defeat.
The 3-1 humbling by Costa Rica was a punch to their collective solar plexus. Seldom will they have had to rely on their traditional national characteristic of garra (grit) as they will in Sao Paulo. They will need it more than they need Luis Suarez.
"We have to win against England, it is as simple as that," said the Juventus defender Martin Caceres. "It is hard to explain what happened in our opening game. You go in a goal ahead at half-time and then a couple of minutes later, everything changes.
"We have had a bit of bad luck, we have lost our first game and now we are on the back foot. What is important now is that we make things better against England.
"You can look at the conditions [in Fortaleza] but the conditions were the same for both sides and we are not the sort of people who go round looking for excuses.
"The important thing now is to look at why we conceded those two goals in three minutes but not to dwell on it too much that we don't look ahead positively – that has always been our strength." Tabarez will have to make one of the calls of his career in Sao Paulo. He is in the same position as England manager Ron Greenwood found himself in the 1982 World Cup, when his best player, Kevin Keegan, was stricken with a back injury. The striker came on as a late substitute in their final game against Spain and missed a glaring chance that might have sent them into the semi-finals.
"If Suarez comes back against England, it would give us a boost," said Cacares, who will be given the task of facing Wayne Rooney if the England forward keeps his place.
"Everybody knows what a great player he is for us. It was a pity we couldn't call upon him in the first match but it is a difficult sort of injury that he has and you'd not want to risk him falling behind in his recovery. I hope he will be back for the next game but will he start? I really don't know."
Tabarez's first task will be to reshape a defence that was badly exposed by Costa Rica's Joel Campbell and which will be without Maxi Pereira. It is likely he will start with Diego Forlan and Edinson Cavani up front in Sao Paulo, with Suarez a wild card to throw into the game if Uruguay need it.
However, even if the striker does appear, Steven Gerrard might like to remind the England dressing room, some of whom voted for Suarez as Footballer of the Year, just how many goals he scored in the games that decided the Premier League title – those against Arsenal, Manchester City and Chelsea. The answer is none.