A bus stop in Athens, Greece, on May 4. | Aris Messins/AFP via Getty Images
The pandemic’s collateral damage, briefly explained
The world’s attention has been focused on the coronavirus pandemic for the past couple of months, and rightly so. The global death toll has hit 285,000, the economy is in shambles, and our day-to-day lives are completely transformed. It’s obviously a huge deal.
But as we all focus on that, what other problems are being neglected and growing worse? What sort of collateral damage is the world incurring?
The secondary impacts of Covid-19 — including a possible “hunger pandemic” and “poverty tsunami” — are worth taking seriously. The number of deaths they cause, experts caution, could easily outstrip the number of deaths from Covid-19 itself.
That’s not an argument for taking Covid-19 less seriously, relaxing social distancing, or reopening the economy; in the US, epidemiologists emphasize that we are absolutely not ready to do that safely.
Instead, the point is that we’d do well to adopt a wider-angle view on human suffering. When we think about this pandemic, it’s not just the direct effects we need to worry about, but also the secondary effects. In other words, while the coronavirus is a serious problem we need to pay attention to, these other issues are also serious problems that are neglected and that urgently require our attention.
Below are eight examples that are worth highlighting, though this list is by no means exhaustive.
1) Routine vaccinations are falling by the wayside
People are putting off getting vaccinations for themselves and their children because they’re afraid to be exposed to Covid-19. In many cases, even if people want to come in, hospitals and clinics are asking them to stay home.
“National immunization programs in more than two dozen countries have been suspended, which could also leave more than 100 million children vulnerable,” the New York Times reported.
If kids don’t get their shots, that puts them at risk of preventable life-threatening illnesses like measles, polio, and diphtheria. Experts predict that we’re going to see these illnesses pop up more in coming years because immunization rates are falling during the pandemic.
In addition, the World Health Organization warns that coronavirus-related disruption to anti-malaria programs in sub-Saharan Africa could cause deaths from malaria there to double this year.
2) People are avoiding going to the doctor, even for heart attacks and strokes
US doctors are alarmed to see a precipitous drop in the number of patients presenting with symptoms of heart attack and stroke. “Where are all of our patients? There’s nothing we’ve done overnight that has cured heart disease,” Martha Gulati, chief of cardiology at the University of Arizona, told STAT News. “My worry is some of these people are dying at home because they’re too scared to go to the hospital.”
For people experiencing heart attack or stroke symptoms, it’s crucial to seek treatment immediately. The earlier a patient is treated, the better chance there is of mitigating damage to the heart and brain and reducing the risk of paralysis.
Experts are also concerned that we’re going to see surging rates of sexually transmitted infection (STI) and that the fight against HIV will probably take a hit because people are not going in for testing. “We are seeing a complete disruption to STD prevention here in the United States,” David Harvey, executive director of the National Coalition of STD Directors, told The Hill. “We expect to experience even higher STD rates as a result.”
3) “Elective” procedures — including cancer surgeries and organ transplants — are being postponed
When you think of elective procedures, you probably think of nose jobs or hip replacements — things that can be deferred without putting anyone’s life in danger. But as ProPublica explained, the category extends far beyond that: “Elective surgery is, by definition, any surgery that is scheduled. That means cancer surgery, organ transplants, and other lifesaving procedures, all of which are now put on hold.”
That’s in part because many hospitals have a shortage of personal protective equipment, and they’re trying to preserve it all for doctors and nurses treating Covid-19. They’re also trying to keep ventilators and ICU beds free for Covid-19 patients, particularly in areas that have been hit hard by the virus.
The American College of Surgeons has found itself in the position of having to recommend that removal of cancerous colon polyps be delayed for three months and breast cancer surgery be postponed if hormone therapy can help in the meantime.
Many heartbreaking stories have emerged as a result. To pick just one: Zach Branson is a 33-year-old in Colorado who was born with a rare disease and therefore needed a new liver. After a long wait, he was finally told he’d get a transplant on March 25. But then the coronavirus came along, and the surgery was canceled. His doctor told him he might only have 30 to 45 days left to live. And yet the hospital considered the surgery that would get him his liver from his willing donor to be “elective.” His family called this “a death sentence.”
Branson ultimately did receive a new liver in April, after the hospital reversed course. But many others who need transplants or surgeries haven’t been as lucky.
4) A “hunger pandemic” and “poverty tsunami” may be coming
The Covid-19 pandemic may be dragging another disaster behind it — what David Beasley, the executive director of the UN World Food Program, calls “the looming hunger pandemic.” He warns that “we could be looking at famine in about three dozen countries” and that “WFP’s analysis shows that 300,000 could starve to death every single day for the next three months” if we don’t keep humanitarian aid flowing in the face of border closures.
What’s more, the coronavirus economic crisis will exacerbate global poverty. According to a new analysis out of King’s College London and Australian National University, it could push an additional 8 percent of our planet’s population into poverty — some 500 million people. That would effectively wipe out three decades of economic development. “We were surprised at the sheer scale of the potential poverty tsunami that could follow Covid-19 in developing countries,” said one of the authors.
5) The risk of a bacterial pandemic is growing
Covid-19 may fuel yet another disaster: a potential bacterial pandemic, spurred on by a worsening of the antibiotic resistance crisis.
“Even though Covid-19 is a viral illness not affected by antibiotics,” Wired reports, “early data from hospitals shows that very high proportions of patients — more than 90 percent in some cohorts — are being treated with those drugs to cure or protect against secondary infections during respiratory illnesses or hospitalization.” In addition, many people are taking antibiotics on their own in a misguided effort to protect against the coronavirus.
This overuse could worsen antibiotic resistance, which is when bacteria evolve and adapt so that our antibiotics can no longer kill them. It’s already a huge crisis: One person in the US dies every 15 minutes because of an infection that antibiotics can no longer treat effectively. Globally, this accounts for about 700,000 deaths per year. If we’re not careful now, that number will mount.
6) The coronavirus crisis is taking a very unfortunate toll on research
The Covid-19 pandemic has stalled clinical trials for pretty much everything other than Covid-19. To patients who are desperate for new treatments for stubborn or rare illnesses, it’s devastating and potentially life-threatening to have this research put on hold.
At the same time, keeping immunocompromised patients enrolled in clinical trials right now could also be life-threatening because it would put them at increased risk of exposure to Covid-19. It’s not easy to know how to strike the right balance.
Meanwhile, a lot of research is being put on hold for an altogether different and very annoying reason: Women seem to be submitting fewer academic papers during the pandemic than before it because they’re saddled with the lion’s share of child care duties now that schools and day cares are closed.
Even as the number of submissions from women is decreasing, the number of submissions from men is increasing — more than 50 percent, by some counts.
This reality threatens to derail the careers of brilliant women academics. When they come up for tenure in a post-pandemic world, it’s not clear whether their evaluators will believe them when they say, “Don’t punish me for not publishing as much as you expected — it’s just that I suddenly had three kids to take care of full-time!”
7) Vulnerable populations are getting hit even harder than usual
Far from being an equalizer, the Covid-19 pandemic has been exposing and amplifying preexisting disparities. It’s precisely the populations that were already worse off — girls and women, LGBTQ people, people experiencing homelessness, and people of color — that are feeling the harshest effects of the current crisis.
We’ve all been told to stay at home, but for millions of people, home is dangerous. “Every year, more than 10 million Americans experience domestic violence, and experts fear that the pandemic and the isolation necessary to combat it could drive those numbers even higher,” Anna North wrote for Vox in March. “The National Domestic Violence Hotline is getting reports of abusers using the coronavirus as another excuse to isolate and harm family members.”
In France, reports of domestic violence have jumped 30 percent during the pandemic. Calls to hotlines have increased by 30 percent in Cyprus and 33 percent in Singapore. And UNHCR, the United Nations’ refugee agency, warns that refugees, internally displaced people, and stateless people are especially vulnerable to physical and sexual abuse. Being stuck at home while economies are failing and emotions are running high is a recipe for increased intimate partner violence, the agency says.
LGBTQ people have also suffered under stay-at-home orders. As Katelyn Burns reported, some don’t have the luxury of returning to their families’ homes when, say, their college residences are shut down. And the trans community is having to grapple with a health care system that marginalizes them to dangerous effect.
And then there are people experiencing homelessness. As the New York Times explained, they’re at higher risk of contracting and dying from Covid-19. They often live in cramped quarters in under-resourced shelters, and many have underlying health conditions like chronic respiratory infections. The lack of accessible and affordable health care, coupled with a lack of handwashing stations on the streets, compounds the risk for the more than half-million homeless people in the US.
This is a global problem, and it’s perhaps nowhere more glaring than in India. When that country suddenly instituted the largest lockdown ever attempted on Earth, the Times reported that “hundreds of thousands of migrant laborers have begun long journeys on foot to get home, having been rendered homeless and jobless.” In other words, the homeless population surged precisely as having stable housing became even more crucial than usual. “This may have been a good decision for the wealthy,” one laborer told the Times, “but not for those of us with no money.”
What’s more, there is clear evidence that people of color are bearing the brunt of this pandemic. Covid-19 is disproportionately taking black lives. In Louisiana, for example, black people accounted for more than 70 percent of deaths; the state is only about 33 percent black. To anyone who understands how systemic oppression works, this won’t come as a shock.
As Fabiola Cineas wrote for Vox, “Hundreds of years of slavery, racism, and discrimination have compounded to deliver poor health and economic outcomes for black people — heart disease, diabetes, and poverty, for starters — that are only being magnified under the unforgiving lens of the coronavirus pandemic.”
8) Millions of animals are being killed
Even as Americans obsess over the possibility of a meat shortage, millions of animals are being killed on farms and going completely to waste. Their barns are being filled with a foam that suffocates them to death. All these animals are dying for nothing; the meat will never make it to anyone’s plate.
The reason for this horrific mass killing: Many farmers have nowhere to send their animals for slaughter because some major meat processing plants have been forced to close after becoming hot spots for Covid-19 transmission.
“People might think, ‘Well, if [these animals] go to the slaughterhouse, they’re going to die anyway. Who cares?’ But it’s a big difference in terms of the amount they suffer at their death,” said Leah Garcés, the president of Mercy for Animals. “And it’s also crazy wasteful — the fact that all these animals went through a factory-farmed, horrible life, only to be foamed to death and then disposed of.”
The pandemic has exposed the flaws in our factory farming system, just as it has exposed the brokenness in our systems for warehousing human beings — such as nursing homes and prisons. Hopefully, the coronavirus crisis will prompt us to change these systems, which were a crisis of their own long before Covid-19 came along.
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