You may think you understand where we stand in this pandemic, but you don’t. No one entirely does. Scientists are taking in new information and giving guidance to politicians and bureaucrats who then decide what to do with it, even as demagogues and hucksters claim special understanding to take advantage of the public’s hunger for answers and an end to the suffering.
It was satisfying to see one of these hucksters get called out, as Rand Paul was by Dr. Anthony Fauci at a Senate hearing this week: "You do not know what you're talking about." But for the most part the anti-vaxxers and science-loathers and faux libertarians and con artists who have left a trail of death and suffering are still spreading an infodemic (a word I coined in a Washington Post article in 2002 in response to the disinformation and panic surrounding the SARS epidemic in Asia) that’s compounded the consequences of the epidemic.
One thing that we do in fact know is that there are two kinds of countries in the world: rich countries with the means to bring the virus under control where it is nonetheless resurgent, and poor countries that have never gotten the virus under control, in large part because those rich countries did not adequately share the vaccines needed to do so, and that will pay a price over generations.
In the U.S. right now, whereas the seven-day average of new cases was lower in June than it has been since the start of the pandemic, it is now rebounding. The average number of new cases has almost tripled in the past 30 days and hospitalizations and deaths are up by around a quarter over the same period. This surge however, is primarily limited to those who have not taken advantage of the free vaccines available across the country. Almost all new deaths are coming within this group. It is what Center for Disease Control Director Rochelle Walensky last week called “a pandemic of the unvaccinated.” Rates among those who have not heeded President Biden’s repeated admonitions to get the protection the vaccines afford are in some states at rates last seen before the winter surge the country experienced. A small group of states with low vaccination rates are responsible for a disproportionate share of the new cases—including Arkansas, Florida, Louisiana, Missouri and Nevada. The situation has become so dire that even some of the people who created the disinformation problem in the first place—the talking heads at Fox and GOP leaders like Mitch McConnell—are belatedly starting to urge people to be vaccinated.
But whereas the U.S. has effectively encountered a pandemic of choice—since plenty of vaccine has been made available across the country—other countries are not so fortunate. Africa is effectively unvaccinated. Much of Latin America has very low vaccination rates with only 44 percent of Brazilians having had at least one shot of the vaccine, only 29 percent of Mexicans and Colombians achieving that level of immunization, and in Central America and Bolivia, Peru and Venezuela rates lower than that. Neither Honduras nor Guatemala have immunized even 1 percent of their people. Twenty-three percent of Indians have had one shot, 15 percent of Indonesians, 9 percent of Filipinos, 5 percent of Iranians, and just 22 percent of Russians. World Health Organization chief Tedros Adhanom Ghebreyesus attributed the gap between rich and poor countries to “greed.” (Canada is at 70 percent, the U.K. at 60, the U.S. is nearing 60 and much of Europe in the mid-50s or above.) His assertion is that more prosperous nations are hoarding vaccines and not sharing as much as possible with the emerging world.
The consequences have been catastrophic. The Washington, D.C.-based Center for Global Development (on whose advisory board I once served), has estimated that the death toll in India may be as much as 4.7 million, more than 10 times higher than the official toll of approximately 400,000. Latin America is seeing a new surge of cases with Argentina, Colombia, and Cuba setting new highs and increases across the region. Like in India, experts believe the death tolls in countries like Mexico and Brazil, respectively approximately 240,000 and 545,000, understate a much grimmer reality.
The new circumstances are rattling governments unsure how to deal with the crisis. Early on, the crisis revealed extraordinary leadership failures in many of the world’s largest countries including China, India, the U.S., Brazil, Mexico and Russia. Today, confusion persists. In the U.K., even as the new wave of cases surges, the Boris Johnson government declared this past Monday “Freedom Day” and eliminated virtually all COVID restrictions. In the U.S., red state governors continue to resist Biden administration efforts to help protect their people. In France, President Emmanuel Macron has instituted a new set of measures placing restrictions on the unvaccinated which produced howls of protest… and a surge in vaccinations. In Japan, the head of the Tokyo Olympics did not rule out cancelling the games at the last minute in response to surging COVID rates in the host country. Global institutions are mobilizing now to provide vaccine to nations in need but much belatedly and much too slowly. WHO Director General Tedros Adhanom said, “The pandemic is a test. And the world is failing.”
With all this confusion and a history of missteps and twists marking the history of this pandemic to date, it is difficult to predict its future (as it always is). Certainly, a failure to distribute vaccines and the likelihood of further, more virulent mutations suggest it will be with us for a long time to come. In some countries, unrest has been rising. In places like Cuba, Haiti and Colombia, for example, it is hard to sort out how much the pandemic and its resulting economic stresses are fueling dissent but we do know that when people turn out in the streets in these situations, the virus spreads.
A generation of students across the developing world have been out of school for a year and a half. It is unclear when they will go back. It is unclear whether some will ever go back. Certainly, inequality worldwide resulted in the haves being the ones to be vaccinated and well cared for while the poor and the disenfranchised suffered and died with the disease at higher rates and struggled economically to a much greater degree. It remains to be seen if this will lead to new waves of unrest or simply extend the economic plight of developing regions more broadly. Either way, many have suffered and many, many more certainly will. And with China as the top investor and trading partner in much of the developing world, many of these countries may grow more dependent on the Chinese.
Markets this week showed how easily rising COVID could rattle them. Another series of lockdowns would be a brutal blow that few predicted. A resurgence or continuation of the pandemic may also result in leaders seeking to distract their people the old fashioned way, by finding scapegoats and through nationalism. Countries like India and China are already facing a stand-off along their border, this may exacerbate that. Iran and North Korea are vulnerable. In other words the effects of the lingering pandemic may be immediate, may produce geopolitical disturbances over the medium term and may result in lasting economic and social scarring that retards development.
The Biden administration has shown how quickly a nation can mobilize and address much of the challenge posed by the disease. While domestic political divides remain a problem, it is clear that wealthy nations with competent governments and the will to act can produce worldwide progress. Those wealthy nations need to realize the national security threat as well as the humanitarian costs of prolonging this global crisis.
The IMF has estimated that the cost of vaccinating everyone worldwide would be approximately $50 billion. As Oxfam noted, that’s a fraction of the combined wealth gains of the 10 richest men in the world during the pandemic (estimated then at $540 billion). The world spent nearly $2 trillion on defense spending in 2019; 2.5 percent of that would pay this price.
In other words, it’s affordable. It’s not a matter of whether we have the resources. It’s a question of will and of conscience.
As Dr. Peter Hotez noted in The Daily Beast, we must combine an organized global effort to contain the pandemic with a similar, major campaign to contain the infodemic. And here in the U.S. and around the world, the calamity of COVID requires not just introspection but investigations and accountability. Over 900,000 Americans are likely dead of this disease, many of them because of the incompetence, self-serving politics and venality of the last administration.
If we don’t investigate where we went wrong—and other countries do not do the same—we will be ill-prepared to more successfully contain the next such threat when it arises. And among the few certainties currently associated with this pandemic is that it will surely be followed by others in the years to come.