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Coronavirus-19 and The Unfolding Disaster in Southern Asia

A few days ago, the SARS-CoV-19 virus reached two hundred million cases, with over four million dead. We know these numbers are almost certainly under-estimations based on data collection limits and comparisons of death rates from previous years. It is with the benefit of hindsight that we now realise that the entire year of 2020 was, in fact, "the first wave" of increasing infections which did not peak until early January 2021 at close to 840,000 new cases a day, and its nadir in mid-February at a mere 400,000. Since then we have witnessed the rise of the new and more contagious and deadly Delta variant which peaked at the end of April with 875,000 new cases as it overwhelmed India. That peak declined to a low of around 300,000 new daily cases in mid-June, only to rise again as the variant spread to densely populated regions in South-East Asia; at the time of writing the daily new case numbers are at 688,000 and are on an upwards trajectory.

Significant media attention has been drawn to Indonesia which witnessed a stunning rise from 6,500 new cases at the end of May and then a sudden and rapid increase which peaked at 54,000 new cases on July 16. The daily cases have been on a declining trajectory since then, but at over 30,000 new cases a day the country is facing five to ten times as many cases per day compared to what it was used to in the latter half of 2020. The spike in new cases also has a similar trajectory in fatalities with some 1500-2000 people per day dying from the virus. Worse still for Indonesia is the very low numbers of tests that have been conducted; whilst Malaysia has almost three times as many cases per capita, it has conducted almost six times as many tests. The implication that there are significantly more cases in Indonesia "in the wild" should be obvious. The following metrics of regional countries, all in confirmed "per million" values as of August 7, illustrates the issue:

Malaysia has 37,313 confirmed cases, 310 deaths 579,275 tests
Indonesia has 13,039 confirmed cases, 376 deaths 99,777 tests
Myanmar has 5,890 cases, 205 deaths, 59,037 tests.
Thailand has 10,523 cases, 87 deaths 116,151 tests
Philippines 14,736 cases, 258 deaths, 153,766 tests
Singapore 11,118 cases, 7 deaths, 2,746,462 tests
Cambodia 4,761 cases, 90 deaths, 109,597 tests
Brunei 767 cases, 7 deaths, 349,662 tests
Laos 1,052 cases, 0.9 deaths, 43,178 tests
Vietnam 1,967 cases, 31 deaths, 120,960 tests
Timor-Leste 8,460 cases, 19 deaths, 70,936 tests

Thailand deserves special mention here, as it did so well through 2020. However, with an outbreak of the Delta and Delta Plus variants in April 2021 things have gone seriously wrong and are getting worse. This is not a typographical error: Thailand now has more than 100x the total cases and total deaths that it had at the beginning of the year, and the trajectory is truly horrific. The combination of the new variant, the highly privatised health system, and the general use of Sinopharm which is relatively ineffective against the variant has led to an unfolding and continuing disaster in that country. The élitist political and economic stratification in the country has led to allegations of hoarding (effective vaccines, oxygen) by the wealthy and well-connected whilst the poor simply die. In what is already a charged political environment, protesters have demanded the resignation of the ineffectual prime minister. With the head-of-state already conspicuously uninvolved from such mundane concerns, the potential of massive civil unrest amidst a health crisis is increasingly probable. Myanmar too, also faces this combination.

What is being witnessed in Southern Asia at the moment however is destined to be replicated throughout the poor countries of the world, of which the African and Mid-Eastern countries are terribly vulnerable. As Maria De Jesus, an expert in global health, has pointed out, about 10% of the global population has been fully vaccinated as of June 21st, almost all from wealthy countries, whereas less than 1% of people in low-income countries have received at least one dose. The main cause of this is wealthy countries overbuying vaccines; the U.S., has purchased 1.2 billion COVID-19 vaccine doses, or 3.7 doses per person and Canada has ordered 381 million doses, enough for everyone there to be fully vaccinated five times over. The problem is not supply, it is distribution. The inequality in the global distribution of effective vaccines will determine who lives and who dies between countries.

But it is not just between countries where this inequality exists, it is between countries as well. Even within wealthy countries, it is the welfare and working classes who have borne the brunt of this pandemic; it is they who have lost their jobs or have been forced to work in sites where the probability of transmission is high. These are no mere assertions, as the evidence as who contracts this disease and the that the transfer of wealth is from the poor to the wealthy. Government actions have often exacerbated this situation where the wealthy have been able to leverage their capital against the insecurity of working people. For example, in Australia employers rorted the JobSeeker program from the very start. What is starkly evident is despite the amount of money creatio ex nihilo, it has not matched gains in productivity. So much money has been created and spent and we have so little to show for it, whilst the proposals for a job guarantee have been ignored.

Such is the nature of our system; those who have the legal right to property will make use of their advantage and those who don't will pay the consequences, and often these days with their lives. Even in the realm of so-called "intellectual property" the same applies. Moderna is absolutely correct to suggest that people will require a third booster shot to overcome the Delta variant - even whilst the people of developing nations have not had their first dose. But, almost on-queue with making this announcement, they also took the opportunity to raise their prices, and not due to lack of supply, either. This is pure rent-seeking - deriving excess profits from the advantage of a monopolistic position, instead of a competitive profit which would see an equivalent reward to the effort that was put in.

From the very start of this pandemic, there have been both warnings and effective solutions. We knew that excess human exploitation of the natural world pushes the probability of zootonic diseases and that this is a direct function of land clearing, the increasing consumption of animal proteins, and land privitisation. All of this was known, but public health is an externality to private profit. We know that the most effective way to develop a vaccine is through a fixed reward system with public disclosure to allow for the production of generics, and the mass distribution of these according to need. But again, private profits get in the way of good public health policy. Whilst presenting the best information and our best knowledge on economics and health is necessary, it is insufficient. We still live in a political economy in which both individuals and institutions care about their positional advantage first, and the facts second, and that will not change through goodwill alone. It requires the force of public protest and public organisation; the very lives of people depend on it.