What Past Global Health Crises Can Teach Us About COVID-19

It has been less than three months since the World Health Organization announced the official name of COVID-19, the mystery respiratory illness originating from central China in early 2020. In this seemingly short period of time, the novel coronavirus has upended nearly every country in the world, and has caused the global economy and migration to halt. As I write this article, there are over one million confirmed cases and over 50,000 deaths worldwide- a majority in North America, China and European countries.

While the infection spreads like wildfire in first world countries, the global health community has begun to spark major concerns about the lasting impact of the virus in developing countries, as well as the 70.8 million displaced persons living in vulnerable and high-risk environments. Currently, over three-quarters of the global population lives in developing countries, where millions of people die of preventable, communicable diseases such as Tuberculosis: a disease that has less than 10,000 annual cases in the US. So, how will this new virus, with no cure and no vaccine, impact the world’s most vulnerable? Lessons from past and current global health crises may help us understand the gravity of the issue.

It will greatly impact the urban poor

The UN estimates that over half of the world’s population now lives in an urban environment, compared to less than a third in 1960. Evidence suggests that we will eventually expect to see 90% of the global population living in cities by 2050, as rural populations move into urban areas to pursue employment and other opportunities. This has proven to be a large global health issue. Many people living in cities and developing countries lack running water and proper infrastructure that would allow them to practice good hygiene and access adequate healthcare. In fact, more than 2.6 billion people do not have access to proper toilets or clean, running water.  One could only imagine the challenges of ‘social distancing’ when you have little space of your own, and no running water or soap to kill viral germs on your hands.

It will greatly impact refugees and internally displaced people

Communicable disease accounts for the most health-related deaths in humanitarian emergencies. In conflict, factors attributing to respiratory illness, cholera outbreaks, and diarrheal disease are incredibly difficult to manage due to lack to infrastructure and the dangers and challenges of providing adequate healthcare. The humanitarian health community experienced this most recently in the 2018 Ebola outbreak in the Congo, where conflict and internal displacement allowed the virus to persist for nearly two years. The new virus, COVID-19 is said to have an infection rate (or, RO) of 1.5 to 3.5, which is considerably more than Ebola. It will take a huge amount of coordination among the humanitarian and international community to be able to contain the virus in conflict and in refugee camps, where many are immune-compromised and lack access to healthcare.

It may effect younger populations in developing countries

Recent data has told us that while everyone is susceptible to contracting the novel coronavirus, the case-mortality rate for older populations is the highest. While this could be positive news for many developing countries ( over 50% of the population in countries in Africa are below the age 24), many young children also have weaker immune systems. Poor sanitation claims 1.6 million lives each year, and also contributes to childhood stunting and a myriad of other complications that could compromise the immune system of a child. Because of the huge differences in access to health resources, quality of nutrition, and sanitation in many developing countries, we simply will not know how these younger, more vulnerable populations will fight COVID-19 until it is too late.

How can you help?

Given the severity of this global pandemic, everyone is incredibly worried for themselves and their loved one. I certainly am too. I encourage anyone reading this to consider those who do not have the luxury of social distancing in their own homes/apartments, who may not have soap and water to wash their hands, or a primary care doctor to contact when they have an onset of symptoms.

Sundara is working with Gabriel Project Mumbai, running an emergency fundraiser to increase access to our sanitation and hand washing efforts in slums that will be especially hard hit around Mumbai.  Your support and donation made here would mean so much to us. If you have a favorite health-related charity helping those who are most at-risk (both at home and abroad), now is a critical time to give your financial support. This may be a once-in-a century event for those of us in North America, but health emergencies like this happen all too often to many men, women and children in the developing world.



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