A Virus for the Rich and for the Poor?

We do not know whether COVID-19 understands economy, but there is no doubt that it is destroying it. Without a vaccine that slows transmission, or a treatment that mitigates the risk of its most serious consequences, the only solution is to try to put barriers to slow its contagion. This is the current situation of those of us on this side of the world: sitting still, confined, trying to avoid as much as possible the number of contacts that spread the disease. It has been decades since something like this happened in the West, but we still have the testimony of other generations that suffered the ravages of diseases such as smallpox –already eradicated–, polio, measles or typhus, all of them now controlled thanks to the advance of vaccines.

Since then, the world has changed a lot, if not entirely. The economy has become globalized, science has discovered more and more advanced remedies, generating a protection barrier and at the same time allowing countries to develop. For everyone? No, most infectious diseases are on the other side of a border that divides the world map in two: those with resources and those without. COVID-19 has broken that border. For the moment, it is the exception- we do not know how long it will last. But we do know something that we have been saying for a long time: that the health and economy of a country go hand in hand. Perhaps it is easier to understand now that it affects us directly.

Most infectious diseases are on the other side of a border that divides the world map in two: those with resources and those without. COVID-19 has broken that border

We do not need to provide more information on the situation unfolding in the Northern hemisphere. The newspapers - their digital versions that bring us a world as virtual as the hugs these days - give a detailed account of the progress of the virus, as well as its social and, above all, economic consequences. But what is happening down there? The numbers of people affected in African countries are worrying. The first case was registered in Nigeria, by far the most populous country on the continent. Since that first positive case - an Italian who traveled to Nigeria-, 29 other African countries have already reported cases. While several days ago the spread of the virus across the continent was still uncertain, the current perspectives are not optimistic.

The virus cannot distinguish between rich and poor countries, even if the ratio is completely inverted to what normally occurs. In other words, the majority of cases so far have been registered in rich countries. Perhaps we can find some reasons underlying these differences. For starters, the average age of the African continent is 20 years, the youngest in the world, with only 3% of the African population over 65 years-old. Knowing that the disease is less severe among young people, it seems normal to think its impact will be lower. What is clear is that the disease is not being sufficiently diagnosed. Some countries have chosen to close their airspace and others are only screening passengers upon their arrival at airports, which is not very effective, taking into account the time between infection and symptom onset. There are not enough resources to test all those affected, which could hide some degree of sustained transmission in the community. For the moment, a substantial increase in acute respiratory diseases has not yet been detected among the community receiving HIV treatment.

Health and economy of a country go hand in hand. Perhaps it is easier to understand now that it affects us directly

Let's cross our fingers, because the fragility of health systems most of the continent’s countries can pose an insurmountable challenge. They do not have the capacity to respond to the most serious cases. To give just one example: Kenya, a country of over 50 million people, has only 130 intensive care beds. A real challenge.

If community transmission is extended in these countries, the situation will be worse than in Europe, although the number of infected people has to be considerable so as to become a greater public health threat than those already existing. In countries like Senegal, which has a higher income than many of its neighbors,11,000 children die each year before reaching the age of 5 as a result of preventable and treatable pneumonia.

The virus cannot distinguish between rich and poor countries, even if the ratio is completely inverted to what normally occurs. In other words, the majority of cases so far have been registered in rich countries

The deadliest diseases in Africa causes 3 million premature deaths every year. AIDS alone kills a million people, respiratory diseases take the same toll, and the diarrhea and malaria account in equal parts for the 3 million remaining. These global health emergencies impede the development of these countries, much as what is now happening with the coronavirus worldwide. We know that most health systems in Africa are not prepared to respond to the coronavirus, because they already have problems responding to the day-to-day health emergencies that punish their population so much.

These global health emergencies impede the development of these countries, much as what is now happening with the coronavirus worldwide

In any case, we should keep in mind that leaving SARS-CoV-2 unanswered in any region of the world is a threat to all others. The emergency situation in which we find ourselves must make us understand that, like the economy, health has to offer global responses because, although we tend to believe otherwise, viruses know no borders. COVID-19 is a global threat, unable to distinguish between rich and poor and, therefore, the solution will only be effective if it takes everyone into account.

Photo: Cheng feng on Unsplash