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Oliver Lamb explores the havoc coronavirus is likely to wreak throughout poorer war-torn countries, and discusses whether certain countries have made sensible choices in already releasing their lockdown measures. This article further explains the meaning of the so-called "R" number, and considers the likelihood of contact tracing apps.
The coronavirus pandemic continues to spread. At the beginning of Saturday 25 April, worldwide confirmed cases stood at 2,828,000 with 200,000 deaths. A week later those figures had risen to 3,398,000 and 239,000. The United States now accounts for 1,131,000 of all cases; Spain and Italy have over 200,000 each, and the UK, France, Germany, Turkey and Russia over 100,000.* Many of these places, however, are past the peak.
Meanwhile, the pandemic is accelerating elsewhere. Confirmed cases are rising rapidly in countries as diverse as Canada, Peru, India, Ecuador, Saudi Arabia, Mexico and Pakistan. Medical officials in five Brazilian cities, including Rio de Janeiro, warned on Saturday that their health systems were close to collapse, and some hospitals are already turning away patients. Manaus, the largest city in the Amazon, is digging mass graves.
When the virus hits poorer countries, the situation will be even worse. Perhaps nowhere is more vulnerabe than Yemen. In 2014 it was already the poorest country in the Middle East; since then, it has been ravaged by civil war, which has pushed ten million to the brink of starvation and left twenty million without access to healthcare. It has been called the world’s worst humanitarian crisis. There are currently six confirmed cases of coronavirus and two deaths, but the UN warns of a “very real probability” that the disease is spreading undetected. Yemen’s only saving grace is that approximately 3% of its population is over 65, with 46% under 18. Nevertheless, an outbreak will be difficult to contain and its impact on a weak and sick population may be devastating.
Perversely, many stock markets are surging, with American indexes enjoying their best month since 1987. That belies the disastrous economic impact of the lockdowns that have been imposed globally. On Wednesday the International Labour Organisation reported that the world’s two billion informal workers have seen their incomes fall by an average of 60% during the first month of the outbreak in their region. 400 million businesses are at risk of severe disruption. On Thursday, it emerged that the eurozone economy shrunk by 3.8% in the first three months of 2020, its largest quarterly drop since records began. Since lockdowns were imposed only in March, that figure is likely to pale in comparison with those for the second quarter.
Alarmed by these numbers, governments are turning their attention to easing lockdowns. Several European countries as well as ten US states are reopening non-essential shops and services. However, it is a delicate balancing act: move too quickly or too aggressively and the virus, which is still very much present, will rebound. That might necessitate a second lockdown.
The key is a single number called the R0. The R0, or reproduction number, is the average number of people infected by each person with the virus. Above 1, and a disease spreads exponentially; below 1, and it gradually dies out. The natural R0 of Covid-19 is estimated to be around 3, meaning that each person with the virus infects three others. However, in many places lockdowns have reduced the R0 to below one. Since Germany lifted certain restrictions, its R0 has risen slightly to 0.76, and there has been a small uptick in infections. Despite this, on Thursday the government announced that museums, galleries, zoos and playgrounds could soon reopen, and religious services resume.
An alternative route to lifting lockdown is to allow those who have recovered to return to work. This assumes that infection confers immunity. On Saturday, however, the World Health Organisation warned that there is no evidence you cannot be reinfected, and that use of ‘immunity passports’ risks a surge of cases. Nevertheless, the Chilean government plans to press on with issuing virus-free certificates.
Essential to preventing a second wave will be testing and tracing. Once the lockdown has brought daily new cases to a low level, it will be possible to track down and isolate those who have come into close contact with them. To make this endeavour easier, countries including the US, the UK, France and Australia are developing contact tracing apps of the kind that have been successful in China, South Korea and Singapore. Whether citizens in the more libertarian-minded West will accept such an incursion into their privacy remains to be seen, but many will surely see it as an acceptable price to pay for their health and the return of their freedom.
Meanwhile, the search for a treatment continues. A vaccine is still months away, but on Friday the US Food and Drug Administration approved emergency use of remdesivir: an anti-viral drug which has been shown to shorten recovery times for seriously ill people. However, it has only a small impact on survival rates.
* statistics taken from https://www.worldometers.info/coronavirus/
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