The global Covid-19 gap is widening

The world is not safe so long as the emerging world continues to struggle to cope with the pandemic

Turkey's President Recep Tayyip Erdogan wearing a face mask to protect against the spread of coronavirus, speaks to the media in Ayder village in the Black Sea city of Rize, Turkey, Sunday, Aug. 16, 2020. Turkey's health minister says the number of new COVID-19 infections Saturday has hit its highest in 45 days and announced 1,256 new cases.(Turkish Presidency via AP, Pool)
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As warmer weather takes hold, the developed world has in recent days begun to relax public health restrictions and ease into a more comfortable, if still anxious, post-pandemic reality.

"Spring blossoms and vaccinations are bringing the city out of hibernation," The New York Times said last week, suggesting more than a dozen local restaurants where residents might catch up on their socialising and dining out.

The UAE is continuing to reopen after achieving a vaccination rate of more than one per resident last week. British pubs and restaurants are reopening, as the UK sees just 2,000 new cases per day, a sliver of its January peak. Then there's Israel, which achieved herd immunity weeks ago and is "partying like it's 2019", says The Washington Post.

But 2020 has returned with a vengeance in much of the world. India is chest-deep in a Covid-19 calamity: the country recorded nearly 350,000 cases on Sunday, the highest single-day total for any country since the start of the pandemic. The result is widespread terror, shortages of just about everything and countless deaths happening in real-time on social media.

Turkey is seeing the world's second-most new daily cases, at around 55,000, and hit several highs for new cases and deaths in the past week. The latter could also be said of Argentina, Iran and Peru. Ukraine has been locked down for five weeks, yet numbers remain near their peaks and last week the government extended the lockdown yet again. Brazil and Chile have also seen record highs this month, though they appear to have gotten their respective situations under control.

If it surprises you to know that 2021 is on pace to record more global Covid-19 deaths than 2020, I have a decent idea where you live. A year after its emergence, the pandemic's persistence is linked to GDP and global status. We knew all along it would happen, and now it's here: the Covid gap between the haves and have-nots. This is precisely why the World Health Organisation (WHO) a year ago launched an accelerator that included the Covax programme, to bring wealthier countries together to fund vaccine distribution in poorer states.

The programme has thus far delivered just 45 million doses of its target of 2 billion by the end of the year. Overall, of the 1bn doses delivered across the world, more than 82 per cent have been given in wealthier countries. That's right, less than one out of five global jabs has gone to the neediest. As a result, many influential voices have in recent weeks called on western countries, particularly the US, to support a patent waiver that would enable generic firms in poorer countries to produce vaccines.

The waiver is already backed by more than 100 countries, and seems a no-brainer. But flattening the curve is not just about getting vaccines. Turkey, for instance, has vaccinated about the same percentage of its population as Norway and France, which are seeing much fewer Covid cases. And the US state of Michigan has seen a sharp increase in cases this month, despite being part of a country winning plaudits for rapid vaccine roll-out.

The failures of some states seem to be as much about problematic governance and inadequate healthcare systems, as well as the spread of more transmissible variants. India's Covid-19 management in recent months echoed that of the US under former president Donald Trump last year, with election rallies, easing of restrictions and talk of beating the virus weeks before the country’s healthcare system buckled under the pandemic burden.

The failures in Turkey have been more subtle, though potentially just as troubling. The Turkish Medical Association (TTB) warned again this month that the country’s crisis could be more severe than official statistics suggest. TTB says the country’s health ministry has been dismissing WHO guidelines and registering many Covid-related deaths as “infectious disease/natural death”, keeping the numbers artificially low.

Many countries have under-reported death counts, but with Turkey the problem is particularly acute, in part because the government provides no data on excess deaths. “The numbers of deaths and cases are at least two times higher than the announced figures. I am saying this scientifically,” TTB Secretary General Vedat Bulut told Turkish news agency Bianet last week.

Last year, the Turkish Thoracic Society compared the January-April 2020 burial totals for Istanbul and Trabzon to those of the previous four years. They found a sharp increase in both cities in March-April 2020, a gap much greater than the number of reported Covid-19 deaths.

If we expand this reporting gap across the country and extend it over a year, it would represent tens of thousands of unreported deaths. This would help explain Turkey’s 0.8 per cent Covid death rate, among the lowest in the world. Russia and the UK have recorded roughly the same number of cases as Turkey, but about three times as many deaths.

Last October, Turkey admitted to only reporting symptomatic cases and altered its policy. But it never updated its overall case count with the missing three to four months of unreported asymptomatic cases. Even so, the world’s 18th-most populous country is set to pass Russia this week to rank fifth globally in total Covid cases.

To top it off, the government has generally ignored health experts, according to a report for the US National Institutes of Health: “Health‐related associations are prevented from actively participating in the fight against Covid‐19, data sharing by health professionals working in the field is considered a crime, and health associations that comment on the deficiencies of the Ministry of Health in the fight against Covid‐19 are marginalised.”

Hospitals are running low on vaccines and intensive care units are running short on beds. Turkey re-instituted restrictions in recent weeks and went into full lockdown over the long holiday weekend, a necessary but fraught move in a country facing persistently high inflation and unemployment, increased poverty and unstable financial markets.

Tourism and related industries represent 7-8 per cent of Turkey’s GDP, yet the main tourist period – from April to October – is again endangered. Russia has already suspended commercial flights to Turkey until June 1. In 2019, Turkey welcomed 45 million foreign visitors, including 7 million Russians. Last year, the total was just over 12 million, and 2021 may see similarly weak visitor numbers.

The knock-on effects of a Covid-19 spike are endless. Due to the pandemic-driven economic troubles in Turkey, for instance, Syrian refugee charity funding has fallen as much as 90 per cent. Market analyst Capital Economics warned in a report last week that fresh virus outbreaks in emerging markets would lead to further slowdowns and weigh on broader economic output. There’s also a geopolitical cost. Already, as the West has dragged its feet, Russia has stepped in to deliver Sputnik V vaccines to Argentina, Peru, Tunisia, Bolivia and beyond, boosting its reputation and influence.

India alone represents a sixth of humanity. Toss in all the other emerging markets dealing with a revived pandemic and we’re talking about a quarter or even a third of all people on the planet. As long as Covid-19 rages somewhere, people everywhere face an indirect health threat as well as continuing economic and political instability.

On the weekend, Aurelia Nguyen, the head of Covax, urged countries with excess vaccine supply to share with poorer countries, citing a "real and pressing need" a full year after the programme's launch.

What happens in India does not stay in India, and poorer countries should not have to fend off the virus on their own. Despite the re-opening some might be enjoying, we are a long way from the end of the pandemic. Getting there will require global action – the time is now.

David Lepeska is a Turkish and Eastern Mediterranean affairs columnist for The National