Poor countries weigh easing lockdowns as cases continue to rise
Many developing countries are easing restrictions on their economies while new infections and deaths are growing
Car factories are starting back up in Brazil and Mexico. Train service is restarting across much of India. Mining companies are reopening in Peru.
The world’s largest developing nations are following recent steps in West to ease restrictions aimed at slowing the growth of the coronavirus pandemic in order to spare further pain to their battered economies.
There is, however, a crucial difference: Poorer countries are starting to reopen while new infections and deaths are growing, rather than slowing. Health experts say the timing risks an explosive rise in cases and deaths in crowded slums across the developing world.
“The number of people who could eventually die in places like Brazil and the rest of South America could far exceed what we’re seeing in the US,” said Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine in Texas.
Already, daily death tolls are surging across the developing world, and in some cases now rival the worst days of the pandemic in Europe. Brazil this week joined the US as the only countries where more than 1000 people are regularly dying each day from the pandemic. Mexico now ranks third in the tally of daily deaths behind the US and Brazil and ahead of Britain.
When scenes of Italy’s overcrowded hospitals in late March were beamed around the world, startled governments in poorer countries began to worry about their own ill-prepared hospitals and ordered stay-at-home measures and other steps to slow the spread of the new coronavirus.
The steps, which for many nations came at an earlier stage in the epidemic than in Europe or the US, allowed some governments to shore up their capacity to treat the ill and test for the virus and slowed the spread of the highly contagious pathogen.
That persuaded some, including presidents from Brazil to Mexico to Tanzania, that pandemic fears were overblown. In late April, Mexico’s President said his country had tamed the virus.
The US Centres for Disease Control and Prevention says economies shouldn’t start to reopen until there is a decline in overall cases or positive tests over a 14-day period.
Dilemma for leaders
Across swathes of the developing world, however, containment measures haven’t reversed the epidemic’s course, but merely slowed the pace of growth. And as countries prepare to open up, the virus has grown to a point where it threatens to overwhelm their populations.
Still, governments argue that many of their people, especially the estimated 1.6 billion across the world who toil in the informal sector, are suffering more from containment measures than from the virus itself. Hundreds of millions of people have lost their jobs and poverty rates across the world are soaring.
“We looked into all the scenarios, including total lockdown, but to be honest we can’t afford it,” Egyptian Information Minister Osama Heikal said in a television interview last week.
Pakistan’s top court last week ordered all stores to be allowed to open, arguing that the government was focusing too much on stopping the spread of the pandemic.
While leaders in wealthier countries face similar trade-offs, the dilemma for leaders in developing countries is especially stark: Each week that the reopening is postponed creates more poverty, increasing chances of social unrest and violence. But reopening too soon may cause new outbreaks.
Last week, hundreds of people protested food shortages in Santiago’s poor El Bosque neighbourhood, clashing with Chile’s militarised police. On Wednesday, people protested in Santiago’s La Pintana district, holding signs saying “Manalich killer,” referring to Health Minister Jaime Manalich.
In Lebanon, protests erupted last month with demonstrators setting fire to banks, venting anger about the country’s dire economic straits.
In Lima, Peru, where a two-month lockdown has left more than a million people unemployed, residents are increasingly defying stay-at-home orders. Crowded markets have become a hotbed for the spread of the virus.
In Mexico City, some homes in the poor suburb of Ixtapaluca have put up signs next to their homes: “At home, but without food.” construction worker Gregorio Tapia, 35, who lost his job at the end of March, says he, his wife and three children are getting by with help from friends and relatives.
“We have been eating vegetables, rice and prickly pears. I don’t have enough to buy milk, eggs or meat,” says Tapia.
The balancing act governments are trying to strike is clear in Nigeria, Africa’s most populous nation. There, the government has begun to relax a five-week lockdown even as cases surge. The stores and markets in the streets of the capital Abuja and Lagos, Africa’s largest city with an estimated population of more than 20 million, are bustling again.
Adedoyin Adeyemi, who owns a clothing boutique in Abuja, said if the government didn’t ease the lockdown, his business would have folded within weeks.
“Of course I’m afraid, but I need the money to survive,” he says through a face mask.
Lack of testing
Public-health officials and doctors say an uncontrolled reopening could spark a disastrous increase in new cases and deaths, forcing governments to resume lockdowns and creating more economic pain.
“Lockdown was never supposed to be permanent, it was supposed to buy you time to get ready to do mass testing and have enough hospital space ready,” said Carlos del Rio, an epidemiologist at the Emory Vaccine Center in Atlanta.
But many poorer nations are doing little testing, limiting their ability to locate new hot spots of infection as their economies reopen. Mexico has said it won’t do mass testing or contact tracing, tools used by South Korea and Germany. Nigeria has carried out 34,000 tests in a country of 200 million.
“Many countries haven’t prepared. What will happen? I’ll give you two words: death and suffering,” says del Rio.
In the northern Nigerian city of Kano, gravediggers are running out of space. Salisu Musa says so many corpses are arriving each day that he is burying bodies in the tiny spaces between existing graves in Kano’s Dandolo graveyard.
“Some families who have lost many people are being buried together in single graves,” he said, adding he has gone from burying three people a day to about 45. “We are all exhausted and many of us have fallen sick. It is something we’ve never seen before.”
One reason so many countries are risking a reopening is that for some, the spread hasn’t turned out to be as bad as predicted. South Africa, with a population of 57 million, has seen 429 confirmed deaths from COVID-19 as of Sunday, and Colombia 705 deaths.
A lack of testing could be one reason. Still, the lower numbers gave confidence to some policymakers and leaders.
“We’re doing well because we’ve tamed the epidemic,” Mexican President Andres Manuel Lopez Obrador said on April 26. “Instead of it growing quickly, like it did in many parts of the world, here the growth has been more horizontal and that’s allowed us to prepare ourselves very well.”
Since then, the number of cases and deaths in Mexico has quadrupled. Mexico plans to allow some 300 towns across the country to reopen on June 1.
India imposed a strict nationwide lockdown that slowed the spread of the virus. Some of its steps included stopping train service that prevented tens of millions of workers who work in a different part of the country from returning to their hometowns.
But even then, the virus continued to make inroads. The country’s average level of new cases now tops 6000 a day, and daily deaths are climbing. Much of the growing toll is in Mumbai, where four in 10 people live in tightly packed slums.
In the Dharavi neighbourhood, featured in the 2008 film Slumdog Millionaire, only about one-fifth of households have their own toilet, with the rest of the population sharing 225 public facilities, says Vasant S. Nakashe, a community leader and resident of Dharavi.
The slum is also the temporary home of workers who are from elsewhere in India but weren’t allowed to return home under lockdown. Now, as the lockdown eases, some 250,000 migrant workers from Mumbai are trying to head home to villages across India, many of them on trains arranged by the government to transport them.
Migrant worker Sharvesh Kumar, who had been living in one of the Mumbai slums, recently managed to get home on one of the trains.
“Near my house in Mumbai, at least four people reported positive for the virus. There are hardly four toilets for around 200 people to use. I didn’t want to risk my life,” says Kumar.
The Wall Street Journal
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