Introduction
A
year ago, on 2019 New Year's Eve (NYE), China's health authorities
notified the World Health Organization (WHO) that they had identified
a cluster of cases of "pneumonia of an unknown cause" in
the city of Wuhan. A year later, the streets of Wuhan were packed
with crowds of people celebrating 2020 NYE, while billions around the
world were left stranded inside their homes, in an attempt to curb
the rapidly spreading SARS-CoV-2 virus that cause the COVID-19
disease. As 2020 comes to an end, we reflect on the lessons learned
so far regarding this health pandemic.
2020
was an unprecedented year that saw the novel coronavirus spread from
Wuhan, where it was originally detected, to reach each continent and
corner of the globe, including Antarctica. According to Johns
Hopkins University, by the end of the year, SARS-CoV-2 had infected
83 million people, and caused the deaths of 1.8 million
individuals.[1] The USA, with a population of 332 million people, had
the most infections and deaths, 20 million cases and 346,000 deaths.
With less than five percent of the world's population, the USA had close to a quarter of the world's total number of coronavirus cases
and deaths from COVID-19. The USA had more coronavirus cases than the
next three countries combined (India, Brazil and Russia).
Compared
to the USA, India with four times the population (1.3 billion), had
half the number of cases and deaths, 10 million cases and 148,000
deaths. And, China, with even more people (1.4 billion), had even less
cases and deaths, 87,000 cases and 4,600 deaths. The figures from the
USA, India and China show that the impact of the SARS-CoV-2 has been
unequal. Why is the USA figure so high, and what do these numbers tell us about this deadly virus?
Where
Did SARS Originate?
Before
we can start analyzing the unequal toll from the disease, it is
important to consider some basic questions, and sum up the lessons
learned so far. The first set of questions relate to the origin of
the crisis - where did SARS-CoV-2 come from? Does the origin of
SARS-CoV-2 have anything in common with the the SARS virus that
appeared in 2002? What are the chances of a third severe acute
respiratory syndrome (SARS) virus arising in the next decade? The
constant mutation of SARS viruses are also troubling. In the final
weeks of 2020, there was two significant SARS-CoV-2 mutations, the
UK’s B.1.1.7 and South Africa’s 501.V2. Both are more infectious
than their progenitors. If we understand what is causing SARS
pathogens to materialize and mutate, then we can try to prevent
future pandemics from this coronavirus.
Destruction
of Nature
The
UN and World Health Organization suggest that, in general, pandemics result from the destruction of nature. Environmental scientists
also argue that less biodiversity will eventually lead to more disease. We know that the state of biodiversity is bad, but what
can we do to turn things around? For one, destructive development
projects are often subsidized by governments and international
monetary organizations, so this form of socialized capitalism has to
end. To preserve biodiversity, it is critical to restore and respect
indigenous land rights. Also, an important economic lesson that
business owners in urban areas should learn is that investing some of
their profits in preserving nature, forests and ecosystems will
enable them to remain in business in the long run. This is because
protecting biodiversity can help to prevent future health pandemics
and economic crises that can result in loss of market and business
failure.
Are
Animal Wet Markets to Blame?
In
addition to the general cause of pandemics, it would be useful to
know if there was a specific vector that caused SARS-CoV-2? Did this
infectious virus originate in a food animal wet market or on a
particular factory farm? The exact cause of transmission is yet
unknown, but if food animal production is to blame, then reducing
demand for animal products has to be part of the SARS solution.
However, governments and banks are expending billions of dollars to
subsidize factory farms and promote carnism as part of economic
growth. This funding of future pandemics has to stop. Just like we have to de-fund fossil
fuel companies to stop global warming, in order to decrease the
chance of more SARS pandemics arising, funding agencies must
recognize that industrial animal agriculture has to be curtailed.
Failure
of Herd-immunity
One
vital lesson of 2020 relates to the failure of an open economic
policy and trying to develop natural immunity to a SARS virus in the
general population. Sweden (pop. 10 million) followed a herd-immunity
plan with little official restrictions. By the end of the year, this
national approach resulted in 437K infections and 8,700 deaths from
COVID-19. Sweden's neighbors had much lower COVID-19 death figures in
2020. For example, there were only 450 deaths in Norway, and 1,400 in
Denmark. In comparison, Australia (pop. 25 million) with double the
population of Sweden, implemented strong lockdown measures, like
business and school closures and mandatory mask-wearing. By the end
of the year, Australia's response resulted in far lower infections
and fatalities, 28K cases and 900 deaths from COVID-19. Sweden's
policy was irresponsible since it resulted in 15 times the number of
SARS-CoV-2 cases and 10 times the number of COVID-19 fatalities as
Australia. This shows that trying to achieve natural herd-immunity is
a poor response to SARS viruses, with deadly consequences.
Strong
Lockdowns Work
An
important lesson learned in 2020 relates to the effectiveness of
strong lockdown policies. To stop infections from getting out of
control, it is important to immediately address the problem by
shutting down the economy and halting the movement of people.
Countries that had the most success in limiting the number of
SARS-CoV-2 infections in 2020, like China (87K), Australia (28K), New
Zealand (2,181) and Taiwan (812), did so with strong lockdown
measures.[2] And, regions that had the least success in limiting the
rise in SARS-CoV-2 cases by the end of the year, like Europe, North
America and South American, implemented limited lockdown measures,
with fewer business and school closures.
Another
lesson learned from 2020, is that as SARS-CoV-2 spreads in a country,
it becomes increasingly deadly. This is evident in the nationally
reported figures on COVID-19 deaths. Although countrywide levels of
testing and transparency vary, we can learn a lot by looking at
COVID-19 fatalities per million people in 2020.[2] The number of
deaths in the European Union (EU), US, Mexico and South America are
far beyond the figures in Asian countries that have managed to limit
the spread of the virus. Let's examine the numbers.
In
Depth: European Union
Many
Western European countries experienced an infection surge in the
Spring, and implemented strong lockdown measures. Most states were
fully reopened a few months later after flattening the SARS-CoV-2
curve. But, after the Summer lull, cases began to rise again with
deadly consequences by the end of 2020. For example, France (pop. 67
million) had 2.6 million total SARS-CoV-2 infections and 988 deaths
per million people from COVID-19. At one point during the Spring
peak, France had around 975 deaths per day. But this number dropped
during the Summer to as few as 8 deaths per day. At the end of the
year, the fatality rate was back up, and above the Spring peak. The
UK (pop. 66 million) had 2.7 million cases in total, and a fatality
rate of 1070. Italy (pop. 60 million) had 2.1 million infections and
1217 deaths per one million people. Italy was among EU countries with
the highest fatality rate from the virus. And, Spain (pop. 47
million) had 1.9 million cases and a COVID-19 fatality rate of 1084
by the end of 2020.
Most
Central and Eastern Europe states avoided the worst of the first
coronavirus wave in the Spring. However, at the end of 2020, these
nations were experiencing some of the most rapid spread of SARS-CoV-2
in the world. For example, Slovenia (pop. 2 million) had a total of
150 COVID-19 deaths as of October 1st, but then, over the next 10
weeks, that figure jumped to over 2,000. As the year closed, the
country had 125K infections, 2.8K deaths, and a high fatality rate of
1,365 deaths per million people.
Compared
to these high SARS-CoV-2 case numbers and morbidity rates, some EU
countries maintained preventive measures throughout the Summer and
Fall, which resulted in less infections and deaths. For example,
Germany (pop. 83 million) had 1.7 million cases and a fatality rate
of 396 deaths per million people. Denmark (pop. 6 million) had 170K
cases and a fatality rate of 216. And, Norway (pop. 5 million) had
51K infections and 80 deaths per million people from COVID-19.
Germany, Denmark and Norway implemented stronger lockdowns measures
for longer periods of time, which reduced their numbers, compared to
EU countries with higher fatality rates. This trend suggest that more
open policies results in more deaths from this pandemic.
In
Depth: North and South America
During
this unprecedented year, in general, countries in North and South
America remained mostly open with limited lockdowns, which resulted
in higher COVID-19 fatality rates. For example, the USA (pop. 330
million) had 20 million SARS-CoV-2 cases and a COVID-19 fatality rate
of 1034 deaths per million people. Brazil (pop. 210 million) had 7.7
million infections and a fatality rate of 912. Columbia (pop. 50
million) had 1.7 million cases and a death rate of 843. Argentina
(pop. 45 million) had 1.6 million cases and a fatality rate of 961.
Mexico (pop. 126 million) had 1.4 million cases and a death rate of
968. Peru (pop. 32 million) had 1 million infections and a fatality
rate of 1139. And, Bolivia (pop. 11 million) had 167K cases and 783
deaths per million people.
Fatality
rates in the Western Hemisphere are as high as those in the worse EU
countries, but there are a few exceptions. Like Germany, Canada (pop.
37 million) took strong lockdown and preventative measures, which
resulted in 610K cases and a fatality rate of 410. The states with
the first and second highest number of total COVID-19 deaths are both
in the Western Hemisphere - the USA (350K) and Brazil (195K).
Tellingly, the machismo leaders of both countries downplayed the
SARS-CoV-2 pandemic and resisted lockdowns. Their inaction show that
doing little to slow the spread of SARS viruses leads to more deaths.
In
Depth: Asia
In
the East, where SARS-CoV-2 supposedly originated, COVID-19 fatality
rates are far lower than those in the West. Asian countries have more
experience in dealing with infectious disease, compared to the West.
For example, a SARS-associated coronavirus, originated in China in
2002, and killed more than 800 people around the world by 2003. Asian
countries have prior experience with the SARS virus, so there is more
health compliance, like avoiding contact, mask-wearing and isolation.
One exception is India, which has the third highest COVID-19 deaths
(178K). With 107 deaths per million people, India also has the
highest COVID-19 fatality rate in Asia. One main reason is that
India's strong lockdown policy triggered a mass migration of laborers
from urban areas that spread the virus to rural areas. Better
planning and support for workers could have limited the spread, but
India's death rate is still almost 10 times less than that of the UK
and US.
Although
Asian countries have larger populations, their SARS-CoV-2 case and
morbidity numbers in 2020 were much lower than countries in the West.
For example, the Philippines (pop. 106 million) had 475K cases, 9K
deaths, and a COVID-19 fatality rate of 84 deaths per million people.
Indonesia (pop. 267 million) had 770K infections, 22K deaths and a
death rate of 80. Nepal (pop. 28 million) had 262K cases, 1.8K
deaths, and a fatality rate of 63. Myanmar (pop. 54 million) had 126K
infections, 2.7K fatalities, and a rate of 48 deaths per million
people.
In
Bangladesh (pop. 161 million), there were 516K cases of SARS-CoV-2,
7.5K deaths from COVID-19, and a fatality rate of 45. Pakistan (pop.
212 million) had 490K infections, 10.5K deaths and a fatality rate of
46. Japan (pop. 126 million) had 243K cases, 3.5K fatalities and a
rate of 25 deaths per million people. South Korea (pop. 51 million)
had 64K infections, 1K deaths and a fatality rate of 17, and China
had 3 deaths per million people. In Oceania, the rates of death from
the virus are lower still. Australia's COVID-19 fatality rate was 35,
and New Zealand (pop. 5 million) had 2.1K infections, 25 deaths and a
fatality rate of 5 deaths per million people. These figures show that
lockdowns and preventive measures were effective in reducing morbidity rates in the East.
In
Depth: West Asia and Africa
West
Asia was slow to implement lockdown measures in 2020, and many
restrictions were not followed or enforced. There is an uneven
distribution of COVID-19 fatality rates per million people across the
region. For example, in Iran (pop. 82 million), there were 1.2
million infections of SARS-CoV-2, 55K deaths from COVID-19, and a
high fatality rate of 650 deaths per million people. Turkey (pop. 82
million) had 2.2 million cases, 21K deaths, and a fatality rate of
250. Saudi Arabia (pop. 33 million) had 363K infections, 6.2K deaths,
and a fatality rate of 175. In Egypt (pop. 98 million), there were
143K cases, 7.8K deaths, and a low fatality rate of 76.
Lockdowns
and restrictions were uneven in Africa as well. And fatality rates
per million people vary widely on the vast African continent, from
high to low. For example, South Africa (pop. 58 million) had 1.1
million SARS-CoV-2 infections, 30K deaths from COVID-19, and Africa's
highest fatality rate at 472 deaths per million people. Tunisia (pop.
12 million) had 144K cases, 4.8K deaths and a fatality rate of 390.
Morocco (pop. 36 million) had 430K infections, 7.5K deaths and a
fatality rate of 199. In contrast, Kenya (pop. 51 million) had 95K
cases, 1.5K deaths, and a fatality rate of 31 COVID-19 deaths per
million people. And Ghana (pop. 30 million) had 55K infections, 335
deaths and a fatality rate of 10 deaths per million people. Unlike
West Asian states, most African countries have managed to limit their
number of infections and deaths. Many African countries have decades
of experience dealing with infectious disease, like hepatitis, HIV,
Ebola and cholera, so there is greater health compliance, like
mask-wearing and isolation.
Comorbidity
Factors
A
third basic question from 2020 relates to comorbidities and other
issues that can lead to higher COVID-19 fatality rates. The Center
for Disease Control (CDC) state that some pre-existing health
conditions can increase the likelihood of illness and death from the
disease.[3] For example, cancer, chronic obstructive pulmonary disease,
heart disease, chronic kidney disease, and severe obesity can lead to
more severe symptoms and outcomes. Age and sex are factors important
as well. The length and amount of exposure to the virus is
significant, and the weather is a key driver, as colder Winter
temperatures have resulted in higher transmission and morbidity
rates.
Higher
GDP Equals More Deaths
One
other lesson we can learn about the difference in the death rates per
million people in countries and regions across the globe is that
Western and developed nations have higher death rates than Eastern
states and those that are less developed. This is shown is a chart
comparing death rates and gross domestic production (GDP). On the GDP
chart, the countries with higher fatality rates skew towards the
top-right, consisting of high GDP states in the EU, like Belgium,
Germany, Ireland, Denmark, and France, plus the USA and Canada. On
the other hand, countries with lower death rates per million people
skew towards the bottom-left, consisting of low GDP states in Africa
and Asia, like Liberia, Ghana, Afghanistan and Vietnam.
Is
this GDP and morbidity difference similar to the distinction between
higher fatalities in Western states and lower fatalities in Eastern
countries that have more experience with infectious diseases and
compliance to health regulations? On the chart, many Asian countries
are on the right in terms of GDP and in the middle in regards to
mortality, for example, Japan, Malaysia and Singapore. These Asian
countries are more similar to Western states than lower GDP countries
in Africa with lower fatality rates per million people.
Carnism
and Comorbidities
The
co-relation between higher GDPs and higher fatality rates per million
people is surprising. Higher GDP countries have advanced medical
resources and care, with more doctors, nurses, ICU beds, ventilators,
etc., than lower GDP states. So the death rates in rich nations
should be lower, not higher. One explanation for the higher death
rates relates to diet. Specifically the over-consumption of animal
products in higher GDP countries leads to obesity and comorbidities
that increase the risk of more severe illness and death from
COVID-19. For example, the CDC state that over 40% of adults in the
US are obese. The UN FAO chart on meat consumption show that
countries with higher food animal consumption are countries with
higher GDP, like the US, Canada and the UK. The USA is the top consumer of food animals, and it also has the most COVID-19 deaths.
Conclusion
Food
animal consumption is linked to the origin of deadly SARS viruses,
and also to higher fatality rates. Yet, there no calls to reduce
animal consumption. If the over-consumption rates of the wealthiest
nations are not curbed, this will lead to increasing obesity and more
COVID-19 deaths. There is little evidence that food animal
consumption is slowing, and average GDP countries are starting to
follow the same trend as high GDP nations in terms of diet and
disease.
Moses
Seenarine is the author of Meat Climate Change: The 2nd Leading Cause
of Global Warming (2016). Xpyr Press, 348 pages ISBN: 0692641157
http://amzn.to/2yn7XrC
[1] Staff. 2020. Coronavirus Resource Center, Johns Hopkins University of Medicine. Dec. 31.
https://coronavirus.jhu.edu/
[2] Staff. 2020. Our World in Data. Global Change Data Lab, University of Oxford.
https://ourworldindata.org/
[3] Ogden, Cynthia. 2015. "Prevalence of Obesity Among Adults and Youth: United States, 2011–2014." CDC. November
