Chapter 1

Hindsight 2020

The COVID-19 pandemic has provoked a collective, global trauma driven by rising deaths, accelerating unemployment, inequality, political instability, stalled economies, and widespread suffering and fear. We are on the cusp of a possible global depression. The death toll directly attributable to the virus could prove to be minuscule relative to its cascading effects and the impact on public health arising from social and economic deprivation.

While current global numbers continue to rise, with over 1 million deaths and 34 million infected individuals and counting, the projected caseload in the low-income countries outstrips available mechanical ventilators and oxygen by a factor of 25x. According to Imperial College in London, this number is itself a gross underestimation. In Africa alone, where 600,000 tests have been administered to date, estimates point︎︎︎ to the need for 5 million in the next 100 days. Higher levels of poverty and inequality, limited access to basic resources, poor living conditions, demographics relating to population growth and ageing, and the overall health systems’ capacity to deal with the subsequent epidemic waves︎︎︎, all suggest an increased mortality rate in low-income countries. Imperial College’s latest report︎︎︎ on the impact of COVID-19 on low- and middle-income countries indicates that this rate may be 4-times higher than current estimates suggest︎︎︎.

Grand Central Terminal, New York. Empty.
Photo by Alec Favale on Unsplash
In terms of the economic impact, the International Monetary Fund (IMF) estimates︎︎︎ contraction of the global economy by 3%. This is far worse than the 2008-9 financial crisis, pushing an additional 40-60 million people into extreme poverty︎︎︎, resulting in the first increase in global poverty since 1998. Collapsed distribution chains and export markets, coupled with diminishing demand, have affected Bangladeshi garment workers, Ethiopian coffee farmers, Kenyan flower producers, Sri Lankan tea growers. These are all people who need to work in order to eat. The International Labour Organization (ILO) indicates︎︎︎ that 81% of the global workforce – that is, 3.3 billion people – have seen their workplace partly or fully closed as a result of the pandemic. Over 200 million jobs are at risk of loss – a figure that does not account for the informal sector that is prevalent in low- and middle-income countries. The incomes of 150 million Africans︎︎︎, or ⅓ of the total labour force, are at risk, with an estimated 60 million jobs already lost. The World Bank projects a decline of $110 billion in remittances this year, roughly ⅕ of the 2019 figure. Massive debt, a shrinking public purse, plummeting oil costs, and a reliance on external finances increase the likelihood︎︎︎ of political instability and conflict in countries already suffering from economic, political, and other crises.

The social costs of the pandemic are equally grim. The number of acutely hungry people is expected to double︎︎︎ from 135 to 265 million, with a potential 30 million deaths︎︎︎ in the coming months. More than 117 million children will miss out on vaccinations over the next few weeks, leading to an expected increase in illnesses and deaths︎︎︎ from preventable diseases such as polio, cholera, and measles. The pandemic is having a disproportionate affect on women, with the United Nations Fund for Population Activities (UNFPA) indicating a likely 20% increase in domestic violence during an average 3-month lockdown across all 193 UN member states, as well as 2.7 million unsafe abortions and 11,000 pregnancy-related deaths︎︎︎.

Next: Normal was a problem in the first place ︎

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