The Pandemic In The Developing Countries-- Young People Are Dying

Russia is battling it out with Brazil for the number 2 spot behind Trumpland for the most cases of COVID-19. Right now Brazil has taken the lead. Though the U.S. seems untouchable in the realm of caseloads-- blowing through the 1,700,000 make yesterday (with 19,790 new cases Sunday), Brazil has been steadily pulling away from Russia over the past few days. On Monday, Russia reported 353,427 confirmed cases with 8,946 new cases, while Brazil reported 376,669 total confirmed cases and 13,051 new ones. Both are way past the old frontline countries like Spain (482 new cases), Italy (300 new cases), France (358 new cases), Germany (461 new cases) and Belgium (250 new cases). Only the U.K. is showing big new numbers (2,405). The real competition will be with India (7,113 new cases), Peru (4,205 new cases), Chile (4,895 new cases), Mexico (3,329 new cases) Pakistan (2,164 new cases)... The pandemic is spreading in le tiers monde-- and that's going to be really horrific... and not containable.

Washington Post reporters in Brazil, Terrence McCoy and Heloísa Traiano, wrote about the pandemic there Sunday. It really sounds pretty horrible. First of all, they wrote that "the narrative seared into the global consciousness in the early months of the pandemic-- that the virus spared the young and ravaged the elderly-- was not what she was watching unfold in Brazil. Younger people were being infected in Brazil and dying. "As the coronavirus escalates its assault on the developing world, the victim profile is beginning to change. The young are dying of covid-19, the disease caused by the novel coronavirus, at rates unseen in wealthier countries-- a development that further illustrates the unpredictable nature of the disease as it pushes into new cultural and geographic landscapes."

McCoy was part of a reporting team back in early April looking at the devastation starting to be wrought in third world countries. This is from nearly two months ago; it's much worse now:

Peru tried to do everything right. Officials declared an early national lockdown-- and backed it up with 16,000 arrests. Yet confirmed cases of the novel coronavirus are surging, up nearly 60 percent since last weekend.

In Egypt, observers say a repressive government is vastly undercounting the infected. In Brazil, where the president has dubbed Latin America’s largest outbreak a “fantasy,” numbers are skyrocketing.

...[E]pidemiologists and other public health experts say the coronavirus is poised to spread dangerously south, engulfing developing nations already plagued by fraying health-care systems, fragile governments, and impoverished populations in which social distancing can be practically impossible.

They warned of an amplified global crisis in the coming weeks, one striking nations that can least handle it at a time when wealthy countries are likely to be too preoccupied with outbreaks of their own to offer the kind of assistance they’ve extended during episodes of disease that were confined to the developing world. Add the extreme population density and poor sanitary conditions in vast urban slums, and experts warn that the pain of the pandemic is about to tilt quickly from richer nations to poorer ones.

“In three to six weeks, Europe and America will continue in the throes of this-- but there is no doubt the center will move to places like Mumbai, Rio de Janeiro and Monrovia,” said Ashish Jha, director of the Harvard Global Health Institute. “We need to be very worried.”

India, one of the first nations in the world to impose social distancing rules, has reported 1,397 cases of covid-19. Analysts say the health system would not be equipped to deal with larger numbers. The country has 0.5 hospital beds for every 1,000 people, according to the Organization for Economic Cooperation and Development. The United States has 2.8. South Korea has 12.3.

Experts say there’s no official count of intensive-care beds or ventilators. Mumbai anesthesiologist Atul Kulkarni, editor of the Indian Journal of Critical Care Medicine, has estimated there are about 67,000 intensive-care beds in the country of 1.3 billion. State-level resources offer a grimmer picture: One study found that Madhya Pradesh, home to more than 70 million people, had just 1,816 intensive-care beds.

A spike in infections would quickly overwhelm those resources. In a worst-case scenario, a group of epidemiologists and biostatisticians predicted, India could have 915,000 infections by May 15. To prepare, India has banned the export of goods that could be crucial in the fight against the coronavirus, including ventilators, surgical masks and the anti-malaria drug hydroxychloroquine, now being studied as a possible treatment for covid-19-- a decision that could complicate the ability of other developing nations to obtain such items.

Today, much of the fastest growth of the virus is in the developing world. These were the new cases since Saturday reported Sunday:

• Brazil- 16,220
• India- 7,113
• Peru- 4,205
• Chile- 3,709
• Mexico- 3,329
• Saudi Arabia- 2,399
• Pakistan- 2,164
• Bangladesh- 1,532
• Qatar- 1,501
• South Africa- 1,240
• Colombia- 998
• Egypt- 752
• Argentina- 723
• Afghanistan- 584
• Oman- 513
• Cameroon- 490

Egypt is starting to relax restrictions-- while reporting (Sunday) a new single-day record of 29 COVID-19 deaths, raising the death toll to 764 in the country-- as well as 752 new cases, bringing the total number of infections to 17,265. The nationwide curfew is being reduced from 13 hours to 10 hours as the government considers gradually reducing restrictions.





"In Brazil," reported McCoy and Traiano, "15 percent of deaths have been people under 50-- a rate more than 10 times greater than in Italy or Spain. In Mexico, the trend is even more stark: Nearly one-fourth of the dead have been between 25 and 49. In India, officials reported this month that nearly half of the dead were younger than 60. In Rio de Janeiro state, more than two-thirds of hospitalizations are for people younger than 49... Analysts say the emerging data suggests many of the problems that have long troubled the developing world-- intractable poverty, extreme inequality, fragile health systems-- are increasing vulnerability to the disease. In countries with more poverty and fewer resources, people who might have survived elsewhere are instead dying."

George Gray Molina, chief economist for the United Nations Development Program, said poverty is triggering “compounding effects.” Because population density is so much higher in much of the developing world-- and because so many people must keep working to survive-- a far greater share of the population ends up being exposed to the virus.

The virus then spreads through a population that’s less resilient. People in the developing world grapple not only with the diseases that have long been associated with it-- malaria, dengue, tuberculosis, HIV/AIDS-- but increasingly with those more closely associated with wealthier countries. Rates of diabetes, obesity and hypertension are surging. But treatment for many such illnesses is lacking.

When newly infected coronavirus patients already weakened by preexisting conditions seek treatment, they find hospital systems that are overwhelmed and unequipped to handle the deluge of patients.

“It all points to social economic status and poverty,” Gray Molina said. The positive benefits associated with the developing world, such as younger populations, are being “wiped out.”

“As this plays out,” he said, “we will see a balancing of the scales.”

When the coronavirus hit Brazil, it was an infection of the rich. Brought in by travelers to the United States and Europe, the coronavirus circulated primarily among the wealthy and connected. The Brazilian senate leader caught it. So did President Jair Bolsonaro’s press secretary. The Rio de Janeiro Country Club along Ipanema beach, one of Brazil’s most exclusive clubs, suffered a devastating outbreak.

Domingos Alves, a data scientist with the University of São Paulo, has been tracking the virus here since those early weeks. The pattern in Brazil at first mirrored that in the developed world: The dead were almost exclusively elderly. Coronavirus patients were flocking to private hospitals, and anyone who needed a hospital bed received one.

But by early April, as the virus began seeping into the favelas and slums of São Paulo and Rio, and the public hospital system started buckling, Alves noticed a sharp shift in the data. Younger people were being hospitalized at higher rates. People younger than 49 were dying. The disease was reaching lower into the demographic pyramid. The victim profile was changing.

...Bolsonaro, a global leader in minimizing the virus, repeats a mantra: Only the elderly are at risk. So the best policy is to isolate only them. He has called it “vertical isolation.”

“What has happened in the world has shown that the people at risk are older than 60,” he declared in a national address in late March. “So why close the schools?”

The contradictory messaging in Brazil-- between local leaders begging people to stay inside and a president calling people to return to the streets-- has fueled widespread confusion. As the virus explodes here, cresting 300,000 cases and 19,000 dead, people are increasingly ignoring isolation guidelines. The beach boardwalks in Rio de Janeiro are packed on weekends. The typical infected person infects nearly three others, according to researchers at Imperial College London, one of the world’s highest rates.

Pedro Archer, a physician at a public hospital in Rio, said his young patients have been stunned by their illness. Some had parroted Bolsonaro, who has repeatedly belittled the illness as a “gripezinha”-- a little flu. Until they got sick.

“I have people say to me, ‘I really had thought this was only a gripezinha, and now I see this is serious,’ ” Archer said. “I’ve seen people dying who have said the same thing.”

Others keep going out because they must. Government aid-- around $105 per month for informal workers-- has for many been either blocked by bureaucratic hurdles or woefully insufficient. Buses are still filled with people heading to work. Lines of people waiting for emergency funds have snaked around banks.

“Young people are dying at a higher rate because they are coming into contact with the virus many times more, because of their working and living conditions,” said Ligia Bahia, a public health professor at the Federal University of Rio de Janeiro. “Doormen are still working. Housekeepers are still working... Their viral load, their exposure, is greater.”

Sunday night, Trumpanzee kicked his fellow fascist Bolsonsaro where it hurts... when he was done. No one from Brazil, or even having visited Brazil in the last two weeks, can enter to the U.S. Expect other countries to start using that standard against Americans as Trumpland is seen to have become the fount of contagion for the whole world.

If the U.S. has the most fucked up people in the world-- in terms of classic idiocy-- the U.K. is close behind. Although their pandemic is worsening, they've picked an arbitrary date to reopen-- June 15. The World Heath Organization warned yesterday that "countries where coronavirus infections are declining could still face an 'immediate second peak' if they let up too soon on measures to halt the outbreak, the World Health Organization said on Monday. They recommended that the U.S., Canada and the EU counties should "continue to put in place the public health and social measures, the surveillance measures, the testing measures and a comprehensive strategy to ensure that we continue on a downwards trajectory and we don’t have an immediate second peak." Good luck with that!