Will Covid-19 Remain A First-World Disease?

Tuesday, 28 April 2020, 4:07 pm
Opinion: Keith Rankin

Predictions

It is dangerous to predict how pandemics will pan out. In Covid19 by the Numbers, Anatole Kaletsky (writing for Project Syndicate on 10 March 2020) used what looked like advanced analysis to conclude that at most 750,000 outside of China would contract Covid19. (He admitted he was wide of the mark in a subsequent March article, Averting Economic Disaster Is the Easy Part.)

The latest data shows a world tally of over three million known cases, which means about thirty million actual cases, mostly in Europe and North America. (If the eventual number of actual cases is 78 million, that would be one percent of the world's population. And if one percent of actual cases die, that would mean a final world tally of 100 Covid19 deaths per million (one per 10,000). Currently the official death tally is 27 per million, and is therefore probably about 40 per million given that many non-hospital deaths have not made the official statistics.

On Evening Report I have used charts – and accompanying conjecture – to make predictions and draw conclusions. On March 23 (and April 1),the day the 'lockdown' was announced, I predicted (optimistically, and based on by expectation that the restrictions would be effective) that the eventual case incidence in New Zealand would be "no more than" 25,000 and that deaths would finalise at about 100. (At the time people were projecting "tens of thousands" of deaths.) Later (April 9), too optimistically, I revised my prediction of deaths to ten. (The geometric mean of my two predictions – 100 and 10 – for New Zealand's final death toll is 32 deaths; that is looking likely at present!)

One of the most common projective statements about Covid19 is that, eventually, it will hit developing ('third-world') countries hardest, because in these countries physical distancing is almost impossible and healthcare systems would be less able to cope than those of first-world countries. A variation of this expectation is – that in countries including Italy and New Zealand – the final toll could be worse in the poorer parts of those countries.

In New Zealand, that means Māori-Pacific tolls would be worst in the event that those groups do not receive greater levels of protection than might be deemed necessary for the country as a whole. Some Māori activists have justified community road blocks by noting that Māori death rates have substantially exceeded Pakeha death rates in previous epidemics; for example in the Black November Influenza of 1918. In those historical events, the reason for these higher death rates is that Māori and Pacific peoples had lower acquired immunity to these kinds of illness. The argument today is that, mainly for socio-economic reasons, these groups have lower actuarial life expectancies; meaning that a typical 65-year-old Māori faces a similar risk of death as a typical 75-year old Pakeha.

We might note that not only in the Black November Flu of 1918 did Māori die disproportionately, it also hit some Pakeha regions disproportionately, most notably Southland. Without aeroplanes, and with substantial quarantining, the 1918 virus spread very quickly throughout the country. Covid19 seems quite different.

Incidence and Spread of Covid-19 so far

On March 22 I identified Covid19 as a Jetsetter Disease, noting that tax shelters, financial centres, gambling centres, ski resorts, cruise ships and high-end tourist destinations were substantially overrepresented in early cases outside of 'mainland' China. (Many of these places are very small, so have fallen under the media radar.) While not as prominent as then, that pattern of Covid19 incidence continues to persist five weeks later. San Marino remains easily the worst affected country in the world, in both cases and deaths.

Sweden's Covid19 epidemic came early and unexpectedly from the ski fields of The Alps (Switzerland, France, Italy, Austria, Bavaria); see The Grim Truth about the Swedish Model from Project Syndicate (and note Coronavirus: Sweden's Unique Approach to fighting the pandemic, from AP.)

According to another AP article, Covid19 coronavirus, What went wrong in Italy?, "epidemiologists now say the virus had been circulating widely in Lombardy since early January". Maybe it arrived in Milan via the World Economic Forum in Davos (21 to 24 January)? Maybe that's where Greta Thunberg caught it?

After the Covid19 epidemics in Italy, Scandinavia and Spain, it spread through Switzerland, Germany and France, and then to Belgium and the Netherlands. (London and New York – big financial centres – also got it, and it spread from those centres through the United Kingdom and the United States.)

In Italy, it was widely predicted that Covid19 would spread en masse to Italy's poorer south. It didn't really happen. Covid19 spread from northern Italy to the rich north of the European Union; not nearly so much to the poorer south of Italy. The trains heading south from Milan transported much less viral load than the planes flying north.

When looking at the spread of Covid19 to northwest Europe, I noted that a comprehensive regional analysis of the European Union shows that – subsequent to the outbreaks in Italy and Spain – a corridor to the west of Germany, stretching from Switzerland to the Netherlands (and on to Brussels), has become Europe's covid-central. Covid19 does not respect international borders within the European Union. Drawing a boundary around this worst-affected zone, gives an imaginary country that I have called Europia; a 'country' which is tantamount to the Federal Capital of the European Union. It suggests that European Union bureaucrats themselves have been one of the most important vectors in the spread of Covid19 in Europe.

The environments that seem to foster Covid19 are the ones that the top ten percent of 'first-world' people inhabit, at work and après-work. The cruise ship environment is already well documented. In the ski resorts, it will have been in the après-ski facilities in which the new coronavirus spread; people socialising in relatively crowded spaces with modern air-conditioning. Many of these people will have been managers, public servants and the like; people who work in medium-sized air-conditioned offices, and whose work tasks involve meetings and conferences in modern indoor facilities. And they will be people who have dined in restaurants; dining as part of work functions, and dining in restaurants après-work because they live time-poor lifestyles.

These virus-transmission spaces are substantially less prevalent in the poorer regions of 'first-world' and 'third-world' countries alike. These spaces are generally much less prevalent within 'third-world' developing countries.

As of 27 April 2020, Europe and North America together have had 78.1 percent of known cases of Covid19, and 87.8 percent of world deaths. The global figures are 393 known cases of Covid19 per million of the world's population, and 27 deaths per million.

Africa, Asia, Latin America

On March 27 I wrote Covid-19 Virus: Australia, Canada, New Zealand, the World.

In this commentary, I finished with "I have some confidence that Asia and Africa will end up with much lower rates of infection than Europe. I am much less confident about Latin America".

In an earlier commentary, I said that we should watch Turkey. Turkey was very late to announce its first case, and has had possibly the post rapid exponential rise in cases since then. Nevertheless, Turkey has subsequently tested more intensively than United Kingdom, France and Sweden; and Turkey's cases and deaths are stabilising at much lower incidences than in Northern Europe. So my sense is that the other large developing countries will have experiences comparable with Turkey; or even less severe.

If we look at Africa, by far the most affected countries (by cases) are the French territories of Mayotte, Reunion and Djibouti. While those with the most aggregate deaths so far are the Mediterranean countries of Algeria and Egypt, and also South Africa. Of these, only Algeria – with its French proximity and connections – has a death rate higher than New Zealand. I believe that, if Africa was to become as affected as Europe, the damage would be well underway by now.

South Africa still has just a quarter of New Zealand's incidence of Covid19. Maybe it will catch up with New Zealand, but will probably not exceed New Zealand's incidence by very much.

Asia includes Turkey, Iran, Korea and China. It also includes the Arabian Peninsula which has had substantial new caseloads. Also Singapore and Japan have had renewed outbreaks. Turkey has had the most cases in Asia, followed by Iran and then China. Qatar has the highest known incidence in Asia (and tenth highest in the world), though has reported fewer deaths than New Zealand.

The places in Asia that have the most potential to add most to the world's Covid19 deaths are in the Arabian Peninsula, and now better fit the 'first-world' rather than 'third-world' moniker.

While many Latin American countries are in North America, the North American Covid19 statistics are still overwhelmingly dominated by the United States and a yet-to-stabilise Canada.

By caseload, the worst affected in Latin America are, in sequence: Panama, Ecuador, Peru and Chile. These all have known caseloads above the world average. The rest, including Brazil, have below average caseloads. On deaths, it's the same story, though Chile and Peru are below average. Mexico is well-down, below Chile though higher than Algeria, Africa's worst.

Panama and Ecuador are easily the worst-affected countries in Latin America. Panama we easily recognise as a jetsetter tax haven, with lots of modern air-conditioned office spaces.

Ecuador has a huge outbreak in its coastal city of Guayaquil; its high altitude capital (Quito) is much less affected. The Guayaquil outbreak is probably random – much like a wedding cluster in New Zealand – and is in a hot and humid part of the world. While I have not been to Ecuador, I have been to Cusco and La Paz. These high-altitude tropical cities – which are also tourist cities – have congenial all-round climates, and require little heating or air-conditioning. Unlike Guayaquil. In Peru, Latin America's third-most affected country, most cases are in Lima; there are also high instances in the steamy parts of that country; the north and the Amazon northeast. These places in Peru are the places where there are built environments that are the most modified relative to their outdoor environments.

It's a similar story in Brazil. Worst affected are Brazil's economic capital (São Paulo), and its Amazon capital (Manaus). Manaus is now a very modern city (surrounded by equatorial rainforest); like Panama City. If Covid19 was going to decimate Rio de Janeiro's favelas, we should be seeing more of that by now. (Likewise Mumbai's slums, in India; I just don't see that happening.)

Conclusion

From all the evidence I have seen so far, Covid19 is very much a 'first-world' disaster, spread by relatively entitled people, and most prevalent in 'first-world' built environments.

This may be the most important lesson we can draw, when thinking about how the world's socio-economy could and should develop in the future. The pandemic and unsustainability crises appear to be related, and should be addressed together. The prevalent and entitled life-styles (work styles and leisure styles) and life-assumptions of the first-world's ten-percenters (the most privileged ten percent) need to change.

© Scoop Media

Keith Rankin

Political Economist, Scoop Columnist

Keith Rankin taught economics at Unitec in Mt Albert since 1999. An economic historian by training, his research has included an analysis of labour supply in the Great Depression of the 1930s, and has included estimates of New Zealand's GNP going back to the 1850s.

Keith believes that many of the economic issues that beguile us cannot be understood by relying on the orthodox interpretations of our social science disciplines. Keith favours a critical approach that emphasises new perspectives rather than simply opposing those practices and policies that we don't like.

Keith retired in 2020 and lives with his family in Glen Eden, Auckland.

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