If you live in the United States, you could be forgiven for thinking the novel-coronavirus pandemic is almost over. New infections, hospitalizations and deaths are down, way down, thanks to one of the world’s most aggressive vaccination campaigns.
But beyond the borders of the U.S. and a few other wealthy countries, the situation couldn’t be more different. Lots of people are still getting sick and dying—in record numbers in some places—and there’s not nearly enough vaccine to halt the pathogen’s spread.
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“The places where we are able to implement high-quality vaccines and seeing declines, there’s this palpable sense that the worst is over and life is coming back to normal,” Chris Beyrer, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, told The Daily Beast. “That is not what it looks like in Central and South America, in East and Central Asia, in South Asia, in much of the world.”
More than 3.7 million people all over the world have died of COVID-19 since authorities in China registered the first infections back in December 2019.
That’s the official count. Owing to the inability, or unwillingness, of many governments to accurately count and attribute deaths, the real number is undoubtedly much, much higher, experts told The Daily Beast. Beyrer for one estimated as many as nine million people have already died.
And barring some dramatic improvement in the global distribution of the best vaccines, millions more will die before the expanding immunity cuts off the virus’ transmission pathways, experts said. Inoculating enough people to achieve worldwide immunity could take another two years at current rates, Beyrer said.
If it takes longer—a distinct possibility as the novel-coronavirus continues to mutate into more dangerous variants—the death toll could swell even higher.
No one can predict for sure what the final toll might be, especially considering authorities have never accurately counted COVID-19 deaths. But some experts have given it their best shot. Beyrer would only say that millions more deaths are likely on top of the up to nine million he believes have already died.
The computational biologists at the Institute for Health Metrics and Evaluation (IHME) in Seattle crunched COVID-19 stats from all over the world, charted the trends and concluded that as many as 9.7 million people could die by late September. If the trend line continues, COVID-19 could kill 20 million by 2023, according to IHME’s model.
The IHME, like Beyrer and many health-data brokers, assumes that the current official death toll of 3.7 million represents a major undercount. After looking at death rates in many countries and U.S. states and comparing them to previous years’ death stats, IHME concluded that 8.1 million people have died of COVID-19 so far. American authorities have been undercounting COVID-19 deaths by nearly 60 percent, according to the group.
Still, it’s a safe bet the United States and other well-off countries will be okay moving forward as long as their vaccines continue to work. Chances are, poor countries are going to bear the overwhelming brunt of the suffering as the 18-month-old pandemic enters its likely middle. The inequity is deeply baked in.
More than two billion doses of COVID-19 vaccine have been administered worldwide, according to Johns Hopkins University’s authoritative coronavirus tracker. But look at where those doses are concentrated. Eight of 10 shots have been in rich countries.
The United States with its 328 million people has administered 299 million doses—most of them the gold-standard, two-dose messenger-RNA jabs from Moderna and Pfizer. That’s enough to at least begin inoculating 51 percent of Americans. Only a few countries—the United Kingdom and Israel, for instance—are better vaccinated.
Check out the trend lines in those three countries. The United States registered just 15,000 new COVID-19 infections a day last week (32 per 100,000 people), matching the low rate of fresh cases the country counted in late March 2020. And whereas the trend was upward a year-and-a-half ago, the trend now is downward.
The situation is similar in the U.K., with 3,300 new cases a day (42 per 100,000 people)—and Israel with 20 new cases a day (1 per 100,000 people).
Now consider what’s happening in India, where a devastating spike in infections—nearly 400,000 new infections a day in early May (74 per 100,000 people)—is finally subsiding despite a flagging vaccination campaign that relies heavily on the middling AstraZeneca jab.
Or what’s going on in Brazil, where a total lack of national leadership—and stubbornly low vaccine-uptake—has allowed a third surge in infections.
Brazil’s uncontrolled transmission (74 fresh infections per 100,000 people per day) has not only produced a new and more dangerous variant of SARS-CoV-2, it has also made the country a major exporter of the pathogen. Smaller, poorer countries bordering Brazil, including Paraguay and Uruguay, have some of the highest rates of new cases in the world. 274 per 100,000 people in Paraguay. A staggering 694 per 100,000 people in Uruguay.
The uneven distribution of vaccine helps explain the disparity. The United States has administered 85 doses per 100 people. In South America, countries have administered only 25 doses per 100 people, on average. India only recently cracked 10 doses per 100 people. African countries are still below five shots per 100 people, on average.
The quality of the vaccines is uneven, too. In the developed world, the best vaccines from Moderna, Pfizer and Johnson & Johnson are readily available. But the developing world, outbid for the most effective jabs, has had to make do with the less-effective AstraZeneca vaccine—or, worse, weak Chinese- and Russian-made shots that don’t even have solid data behind them.
Taken together, the data point to a pandemic that’s ending (or at least pausing) in the richer part of the world… and raging on, or even getting worse, everywhere else. Beyrer for one said he dreads the day SARS-CoV-2 spreads across rural Central Asia. There, authorities don’t even have the means to accurately count deaths. “With these enormous populations, the deaths are going to go up and reporting is going to go down.”
The longer the virus has free rein across more than half the planet, the worse the inequity could get. If America and other rich countries reopen their economies, resume travel and trade and move on to other challenges while poor countries continue to struggle against a lethal virus, the rich could get richer while the poor get even poorer.
“Inequality in vaccine rollout, both within countries and between them, already displays a strong income-related pattern, which suggests there exists a risk of letting inequities undermine the global pandemic recovery,” Paul Caesar von Chamier, a researcher at New York University’s Center on International Cooperation, told The Daily Beast.
Needless to say, poorer countries lack the same tools richer countries possess for addressing the pandemic. The United States can afford to pay workers’ stimulus checks and encourage them to stay home. Malaysia, for example, can’t.
If a developing country can’t pay for the full range of non-pharmaceutical interventions and lacks access to adequate supplies of the best vaccines, it’s doubly vulnerable to the virus.
Ultimately, that’s bad news for everyone. “The same underprivileged communities that have been hotspots of SARS-CoV-2 infections can become a fertile ground for the virus to develop new strains,” von Chamier said.
With every day that passes, the likelihood grows that the virus will evolve into a variant that can evade even the best vaccines.
If that happens, the vaccine-induced protection that the U.S. and other industrialized countries currently enjoy could collapse virtually overnight. A vaccine-evading mutant would be a great leveler. It could reset the world back to where it was in late 2019: defenseless against a fast-spreading, lethal pathogen.
Which is why the sense of security you, a resident of a rich country, feel right now is a false one. America bought, at a cost of tens of billions of taxpayers’ dollars, early protection from the novel coronavirus. Other advanced countries could afford the same protection.
But the protection is fragile. COVID-19 continues to rage across the portion of the world that couldn’t buy itself a pharmaceutical wall against the disease. And if the novel coronavirus travels far enough, for long enough, it just might revisit the developed world in a brand new and far more dangerous form.
Mechanisms exist for the developed world to buy vaccine for the developing world and, in so doing, help to safeguard everyone. Foremost, the international COVAX consortium. The administration of President Biden has recently upped its support for COVAX.
At the G7 summit in Cornwall last week, the leaders of the United States, the United Kingdom, Canada, France, Germany, Italy, and Japan pledged to donate at least a billion vaccine doses to the developing world. The U.S. contribution, 500 million jabs, is by far the biggest.
But the developed world—and America, in particular—could and should do more, experts said.
Ali Mokdad, a professor of health metrics sciences at the University of Washington Institute for Health, urged converted action by rich countries. “Increase production of vaccines now, distribute them equally and fast, support some failing economies to avoid instabilities and migration due to food shortages and disease outbreaks.”
Even leaving aside our shared humanity, it’s in the interest of the world’s rich countries to do everything they can to protect the world’s poor countries. And fast.
Because the virus moves fast, too.
