This Ain’t Our First Rodeo: What Can We Learn From Past Epidemics?

04/21/20 • 29 min

Since the first cases of the global pandemic of COVID-19 emerged in Wuhan in December of 2019, the world has watched with horror as the virus has spread from country to country, and cost over 100,000 lives. The developed world has not seen a pandemic of this scale since the 1918 flu pandemic. However, the same cannot be said for the developing world, where diseases such as cholera, tuberculosis and malaria remain the norm. Studying how nations in the developing world have reacted to these epidemic is valuable to understand how these countries will reach the developing world in full force, and so we can apply the lessons learned in the fight against infectious disease epidemic to the global fight against COVID-19. In part one, I will discuss how government under-funding of rural rat control has led to the plague becoming endemic to Madagascar. In part two, I will discuss how UN peacekeepers inadvertently brought cholera to Haiti, and how obfuscation by international agencies hindered the response to the epidemic. Finally, in part three, I will discuss India’s initial successes fighting malaria, it’s later failures, and the adaptations necessary to finally defeat malaria.

In 1898 black rats from a ship from India first brought plague bearing fleas to Madagascar, causing a series of devastating plague outbreaks that were only brought under control with the massive application of raticides by colonial authorities in the 1950s. Although we think of the plague as cataclysm from the middle ages, reservoirs of plague carrying rodents exist in the southwest United States and Tibet . The plague is no longer a major health concern because humans no longer live in close proximity to rodents, and antibiotics, if promptly applied can cure the plague. However, from the 1980s onward, Madagascar entered a period of economic decline, and Madagascar is the only nation to have seen per capita income decline since 1980 despite not suffering from a collapse of natural resource exports, civil war or revolution. As a result, the Departments of Agriculture and Health lost the funding in the 1980s to distribute free raticides to farmers, and coordinate rat population measures. Rat populations exploded, especially during the harvest season when rats would feast upon rice stores. The same rats would suffer from mass die offs during the r...

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Beggar Thy Neighbor, Literally: The Global Trade Collapse and Increasing Hunger in the Developing World

The global COVID-19 pandemic has caused the greatest economic contraction since the Great Depression, with global GDP expected to contract by 3% in 2019. A part of this economic contraction has been a near total collapse in international trade, with global trade volumes to come down by anywhere from 13% to 32%. Unfortunately, just as in the Great Depression and the US imposition of the Smoot-Hawley tariff, nations are responding to economic crisis with protectionism, only exacerbating an already desperate situation. In particular, given that global supply chains are breaking down and countries are faced with indefinite lockdowns, many nations have chosen to limit or block the exports of food products to ensure domestic food security for many of the same reasons people hoarded toilet paper at the beginning of the current crisis.

In 2018-2019, Russia exported 43.3 million tons of grain, more than any other nation in the world. For 2020, Russia will limit grain exports to only 7 million tons. Romania, which exported 12 million tons of grains in 2019, has completely banned the export of grain. Other nations such as Cambodia have moved to ban fish and rice exports, Turkey has banned lemon exports, and Serbia sunflower oil exports. Moreover, although most developing countries have not imposed export controls on food products, migration streams have collapsed. Cows in New Zealand are not being milked, and soy in American farms not harvested due to the effects of COVID-19. Not all nations have closed down food exports. For example, India and Thailand have decided to continue food exports, while Vietnam has lifted its ban on rice exports. The continuation of these exports should allow food import countries such as Saudi Arabia and the United Arab Emirates, with foreign exchange reserves of $500 billion and $110 billion respectively, have enough money to purchase needed supplies.

However, the situation is far more complicated for developing countries without those same reserves, such as the Philippines and Bangladesh. I am in particular worried about East African countries that have been hit by a series of unprecedented natural disasters. Mozambique, Malawi and Zimbabwe have faced massive floods caused by the most severe cyclone season in recorded history. Yemen, Somalia, Ethiopia, and Kenya currently face a locust infestation of biblical proportions, with 25 million hectares of land at risk. The collapse in global trade makes it impossible for these nations to both earn the foreign exchange, or buy the foodstuffs necessary to avert mass hunger. More broadly, the prevalence of undernourishment, after decades of rapid decline, has increased from 10.6% to 10.8% between 2015 and 2018. Trade in food plays a vital role in making it possible for food insecure nations to buy food necessary to stave off hunger. Any permanent shift to lower levels of food trade would also lead to a permanent increase in global hunger.

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Dog Bites Man: The Utterly Predictable Spread of Covid 19 in Singapore’s Migrant Dormitories

The city-state of Singapore gained international praise early on in the management of the Coronavirus pandemic. It was expected that Singapore, alongside other nations with close economic and cultural ties to China would be the hardest hit by the Coronavirus pandemic. It implemented its first measures against Covid 19 on January 2nd, checking temperatures on all people flying in from Wuhan. Singapore was quick to restrict travel from counties hit hard by the Coronavirus, and Public health authorities rapidly scaled test and trace programs using apps to keep control of disease spread. Singaporeans were able to maintain as semblance of normality in their day to day living. Although bars and night clubs were closed, most retail and schools remained open. The strategy seemed to initially be succesful, with the number of active cases at only 752 on March 31.

However, since late March, the number of Covid-19 cases has skyrocketed in Singapore. The number of active Coronavirus cases has increased from 752 on April 1st to 11,107 on April 23rd. The overwhelming majority of new Covid 19 cases come from migrant workers dormitories. Nearly 300,000 migrant workers live in cramped dorms where it is common for 12 to 20 men to share a single room. Covid 19 infected these dormitories en masse, and likely went undetected for some time as the Singapore government devoted limited resources to healthcare for migrant workers. Over 80% of all Covid 19 cases originate in migrant worker dormitories. The government of Singapore has rapidly scaled up test and trace in migrant worker dormitories, and two dormitories that house 20,000 workers have been put under complete isolation, with another 200,000 workers told to stay home from work. The migrants themselves find themselves in a desperate situation, as they are not working and thus not receiving pay, while at the same time not allowed to return home.

There are some signs that Singapore is finally getting a handle upon its current Covid 19 crisis. The number of new Coronavirus cases in Singapore has decreased of each of the last four days. However, similar crises have emerged in nearly every country with a substantial number of migrant workers. Saudia Arabia has 12,926, Qatar has 7,706 and the United Arab Emirates 7,407 active cases overwhelmingly concentrated in migrant worker dormitories. The situation of these migrants is increasingly desperate, with migrants blamed by many as the source of disease. However, migration plays a crucial role in developing the economies of wealthier nations and lifting the poor out of poverty. Limiting the spread of Covid 19 among migrant populations and overall society will require proactive action by public health authorities.