AWAITING THE WORST
CORONAVIRUS IS ONLY NOW BEGINNING TO BARE ITS FANGS IN THE WORLD’S SLUMS
As the world slowly comes to grips with the worst pandemic since the Spanish influenza of a century ago, the most disturbing scenario of what lies ahead involves the prospect of SARS- COV-2 raging through the densely packed cities of Africa, Asia and South America, and the tent cities and the crowded camps where the planet’s 70 million refugees are gathered.
In the world’s poorest countries, the coronavirus pandemic has been slow to arrive and take hold. It’s only now beginning to bare its fangs in the great slums of the “Global South,” where the movements of SARS- COV- 2, the virus that causes the COVID-19 sickness, are particularly unpredictable and difficult to track.
Pakistan, for instance, didn’t register its first case of COVID-19 until Feb. 26. It took a month for the number of confirmed cases to reach 1,000. But it only took a week for the tally to reach 2,000, and then five days to reach 3,000, and only three days later, on Tuesday of this week, the count was up to 4,072.
In neighbouring India, which is seven times as populous as Pakistan with 1.4 billion people, the coronavirus got a head start, showing up a full month earlier, on Jan. 30, only five days after Canada’s first confirmed case. But as of Tuesday, India was reporting only 4,789 cases — a count only slightly higher than Pakistan’s. But that’s still twice as many as only two days earlier — along with 149 COVID-19 deaths, compared with Pakistan’s 58.
Iran is a special case. Strictly speaking, it’s a middle- income country of about 84 million, but it’s a theocratic police state run by a government that ruthlessly suppresses independent journalism and routinely traffics in conspiracy theories. By Tuesday of this week, Iran’s official COVID-19 count was 67,000, with more than 4,000 deaths. As many as 500 more people have died from drinking methanol, owing to a viral rumour that it’s a coronavirus miracle cure.
Iran’s Supreme leader, the Ayatollah Ali Khamenei, has refused help from the global NGO Doctors Without Borders on the grounds that the doctors are spies, and has also turned down help from the United States, insinuating that the Americans developed SARSCOV-2 as a biological weapon and that any medicines coming from the United States might be laced with the virus.
A number of factors have contributed to Iran’s high infection and death rates. The main reason is almost certainly the intense diplomatic and commercial traffic between the Khomeinist regime and China. For almost two months after the pandemic broke out in the central Chinese city of Wuhan, Mahan Air, owned and operated by the Islamic Revolutionary Guards Corps, was running 55 profitable flights a week between Tehran and Beijing, Shanghai, Guangzhou and Shenzhen. Iran ended up being a critical vector for the virus in its journeys around the world. Several of Canada’s first coronavirus cases were connected to travellers from Iran.
In the Western Hemisphere, Nicaragua is the second poorest country, after Haiti. Its Sandinista government is as authoritarian as the regime in Tehran, and its response to the pandemic has been “perhaps the most erratic of any country in the world to date,” according to a recent editorial in the British medical journal, the Lancet. President Daniel Ortega has been absent from public view for weeks, but Rosario Murillo, Ortega’s wife and vice- president, is calling on Nicaraguans to join in “Love in the time of COVID-19” parades.
Nicaragua’s Central American neighbours, all of whom have instituted social- distancing measures comparable to Canada’s, are increasingly concerned that if the virus takes off in Central America, Nicaragua will be the reason why. Authored by several public health specialists, the Lancet assessment concludes: “If the government’s senior leadership continues to ignore calls for strong mitigation efforts, the fragile public health infrastructure could collapse under the pressure of widespread infection.”
With only 166 confirmed cases and seven deaths as of Tuesday, Venezuela has so far dodged what might yet be a crisis it has absolutely no capacity to handle. Unlike Nicaraguans, Venezuelans have been subjected to draconian quarantines and curfews. But more than five million Venezuelans have fled the country in recent years — Venezuela is more or less a failed state — and its hospitals are dank and dysfunctional places, where basics like soap and water are at a premium.
Like the Khomeinist regime, Nicolas Maduro’s Bolivarian government blames American sanctions for its troubles. But with most of the world’s democracies refusing to recognize the legitimacy of Maduro’s authoritarian regime, the International Monetary Fund has refused his request for a $ 5- billion infusion to help cope with a possible outbreak.
The world’s largest concentration of refugees is now the vicinity of Cox’s Bazar, in Bangladesh, where nearly a million Muslim
Rohingyas have been driven from their homes in Myanmar, which the United Nations has tentatively determined to have engaged in acts of genocide. An analysis undertaken by the John Hopkins Center for Humanitarian Health reckons that a single carrier of the coronavirus entering the camps in Bangladesh would likely lead to a massive outbreak and an initial toll of up to 2,109 deaths.
The million or more Syrians recently displaced by Bashar al- Assad’s barrel bombing runs and the depredations of Vladimir Putin’s air force — dozens of hospitals and clinics have been destroyed in recent weeks in the Syrian governorate of Idlib — are similarly at risk. In refugee camps, and in “internally displaced persons” camps, the kind of social- distancing measures governments are taking to contain the spread of the virus are logistically and physically impossible to put in place.
This week, the humanitarian agency World Vision released an analysis of the United Nations’ survey of the 24 most fragile and coronavirus- prone countries. Based on the impacts of the 20152016 Ebola outbreak, World Vision concludes that as many as 30 million children are at risk of disease and death, just from the “secondary” impacts of the pandemic.
“We are wrong if we think this is not a children’s disease,” says Andrew Morley, World Vision International’s president. “Experience tells us that when epidemics overwhelm health systems, the impact on children is deadly. They are the most vulnerable as other diseases and malnutrition go untreated.”
To some extent, the UN’S appeals for help are starting to be heard. Canada, for instance, has stepped up with a contribution of $160 million, announced last week by International Development Minister Karina Gould, to support international efforts to deal with the pandemic. Sensibly, the funds are not being concentrated in the hands of the widely discredited World Health Organization.
Half the funds will be allocated to a consortium of agencies including the WHO, the World Food Programme, UNICEF, the UN High Commissioner for Refugees, the Red Cross and Red Crescent organizations and the UN Office for the Coordination of Humanitarian Affairs. The remainder will be spent mostly on the Coalition for Epidemic Preparedness Innovations — for COVID-19 vaccine research and development — and country- specific requests for assistance.
That last bit — the vaccine research — is the piece of the puzzle that’s necessary to complete a picture of what recovery from this global crisis will look like.
And it’s expected to be at least a year away.