The world is starting to see fluctuations in cases and deaths related to COVID-19. In some regions, the perception is that the coronavirus is now less of a threat – and this is resulting in a sense of complacency. As countries and states begin their phased reopening, there is an emerging – albeit cautious – optimism about a return to “normal life.” The once hardest-hit Italy is now seeing its famed markets remerge; China, after a massive testing effort, is clamping down to prevent a resurgence of cases as it makes gains in its recovery.
However, not all nations and regions are seeing a similar downward trend. Latin America, especially Brazil, Peru, and Chile, has now overtaken Europe and the United States as the epicenter of the pandemic. The World Health Organization is reporting an alarming rise in cases in certain African countries. In other regions, the world waits to see the results of reopening economies – an experiment taking place on a global scale. Health authorities warn that reopening too soon could be catastrophic and that policymakers must take preventive measures to avert a second wave of infections and preserve the fragile progress already achieved. Tensions remain around balancing economic priorities with public health imperatives.
It is clear that the pandemic is far from over. And with the global spread to regions with weaker health systems, gaps in intensive care services, and shortages of critical supplies like ventilators, there is concern that these new epicenters will not be able to cope. When there are such strains on health systems, how can countries protect their citizens?
This week’s Rabin Martin COVID-19 Briefing focuses on the regional shift in prevalence as the pandemic makes its way from continent to continent. What will it take to contain the virus globally and ensure the new epicenters are equipped to provide care for those in need? What lessons can cities that have been at the center of the pandemic impart to support a more effective response? Answers are still unclear, but it is certain that global cooperation will be critical. Please find our earlier COVID-19 Briefings here.
On Tuesday, May 26, Dr. Carissa Etienne declared that Latin America had become the center of the pandemic. With 861,914 reported cases and 48,281 COVID-19 related deaths as of Wednesday, May 27, at 4:00 am ET, the region had surpassed Europe and the United States in new daily infections.
Brazil is the primary source of the rapid growth in cases in the region. With government leadership failing to acknowledge the severity of COVID-19 and instead calling for the rapid reopening of the economy, Brazil has been hard hit. The country has the second highest number of confirmed cases of COVID-19 (behind the U.S.) at 411,821 and has experienced one of the highest daily death rates of any country in the world. Dr. Etienne noted that deaths are growing exponentially and the Institute for Health Metrics and Evaluation suggests that the country’s total death toll could increase five-fold to 125,000 by early August.
Local government has been at odds with federal directives. “We don’t want to have corpses in the streets,” said São Paulo Governor João Doria. “There is only one alternative in the world to fight the coronavirus now: it is social distancing.” On Tuesday, May 26, the U.S. imposed a travel ban on the country. The restrictions prohibit the entry of most non-U.S. citizens who have been in Brazil at least two weeks prior to their arrival in the U.S.
Additionally, WHO is concerned about accelerating outbreaks in Peru, Chile, El Salvador, Guatemala, and Nicaragua – countries where incidence and mortality rates are expected to rise.
Africa is seeing a growing epidemic. Just three months after reporting a mere 600 cases in March, on Friday, May 22, WHO announced that, “The COVID-19 pandemic today reached a milestone in Africa, with more than 100,000 confirmed cases. The virus has now spread to every country in the continent.” As of Wednesday, May 27, at 3:00 am ET, there were 124,733 cases and 3,700 deaths reported in the region.
Dr. Mike Ryan, Executive Director, Health Emergencies Programme, WHO, stated that nine African countries are seeing 50 percent increases in cases. South Africa continues to report the most cases, with 24,264 cases as of May 27. South African President Cyril Ramaphosa said, “We should expect that these numbers will rise even further and even faster.” Death rates remain generally lower, however, compared to other regions. Africa has a younger population than other continents, and WHO has suggested that these demographics contribute to the lower mortality and hospitalization rates.
Of concern, more than 3,400 healthcare workers have been infected. WHO predicts that if containment measures fail, medical capacity would be overwhelmed across much of Africa. Speaking to North African countries, Dr. Ahmed Al Mandhari, Regional Director for the Eastern Mediterranean, WHO, noted: “Testing as many people as possible and protecting health workers who come into contact with suspected and confirmed cases are crucial aspects of this response.” WHO is working to prioritize the delivery of testing kits and personal protective equipment to low- and middle-income countries with the most at-risk populations.
In a recent op-ed, Dr. John Nkengasong, Director, Africa CDC, and Winnie Byanyima, Executive Director, UNAIDS, call for increased attention to the pandemic’s effects in Africa and warn of the dangers of minimizing the urgency for immediate action: “The risks which the COVID-19 crisis bring are even greater in Africa than elsewhere – and those risks will be compounded if Africa is marginalized in the global response.”
The number of new cases and deaths continues its slow decline in New York, the state hardest hit by COVID-19. On Tuesday, May 26, New York City Mayor Bill de Blasio said that the city could begin reopening by mid-June in the first step of a phased approach. While there has been gradual progress in turning the tide on the pandemic in New York and other urban areas, rural areas that were spared initially are now reporting surges in cases. A new analysis by the Washington Post finds that “The virus has made a fundamental shift in who it touches and where it reaches in America.”
Rural America is beginning to feel the impact of COVID-19, signaling “a new phase of the pandemic.” “We’re still waiting for our peak,” said Kim Engel, Director, the Nebraska Panhandle Public Health District, in an interview with TIME. “We are not out of the woods, and we’re afraid we are really just starting on that upward curve.” With a growing movement toward reopening much of the country, the consequences could be severe for rural areas. Many of these communities are home to older, economically vulnerable populations who are more likely to have health problems like diabetes and obesity which contribute to a higher risk for severe illness from COVID-19. Likewise, fewer hospitals and a shortage of trained medical staff could exacerbate the situation further.
U.S. deaths in regions with early outbreaks versus the rest of the country (Washington Post)
To support the country’s reopening, the Trump administration unveiled a new COVID-19 Strategic Testing Plan to Congress on Sunday, May 24. The Plan outlines the federal government’s intent to purchase 100 million testing swabs to be distributed to states before the end of the year. States will, in turn, be responsible for planning and carrying out all testing. Epidemiologists continue to caution that current levels of testing – and the target of 300,000 people a day set forth in the Plan – are still far below what is needed to contain the virus’ spread.
From the Experts
“For God’s sake, this is a pandemic — we need some data [on remdesivir].”
Judith Feinberg, Vice Chair of Research, West Virginia University School of Medicine
Saturday, May 23
“I was initially optimistic that, when people felt the need for a COVID-19 vaccine, the anti-vaccination movement would undergo a period of retreat. It’s actually had the effect of reinvigorating the anti-vaccine movement.”
Peter Hotez, Dean, National School of Tropical Medicine at Baylor College of Medicine
Sunday, May 24
“With the country starting to open up this holiday weekend, I again remind everyone that the coronavirus is not yet contained. It is up to every individual to protect themselves and their community. Social distancing, hand washing, and wearing masks protect us all.”
Stephen Hahn, Commissioner, FDA
Sunday, May 24
“We cannot make assumptions that just because the disease is on the way down now it is going to keep going down and we [will] get a number of months to get ready for a second wave. We may get a second peak in this wave.”
Mike Ryan, Executive Director, WHO Health Emergencies Programme
Monday, May 25
“Until all of us are safe, none of us are safe.”
Kenneth C. Frazier, Chairman & CEO, Merck & Co., Inc.
Tuesday, May 26
“Now is not the time for countries to ease restrictions…very tough weeks [are ahead].”
Dr. Carissa Etienne, Director for the Americas, World Health Organization,
and Head, Pan American Health Organization
Tuesday, May 26
Rabin Martin Perspectives
“Discussions about the COVID-19 pandemic’s effects tend to focus either on public health or the economy, as if they were two separate matters. But they are linked, and not just by data about the disease’s disproportionate impact on poor and minority populations.”
Sandro Galea, Dean, Boston University School of Public Health, in The Washington Post
Last week, the Rockefeller Foundation-Boston University Commission on Health Determinants, Data, and Decision-making launched with a virtual World Health Assembly side event. Dr. Jeffrey L. Sturchio moderated a panel discussion with Dr. Sandro Galea, Dr. Naveen Rao, Rockefeller Foundation; Ambassador Eric Goosby, University of California, San Francisco; Dr. Rebecca Martin, U.S. CDC; Dr. Muhammad Ali Pate, World Bank; Dr. Sabina F. Rashid, BRAC University; and Professor Sheila Tlou, Global HIV Prevention Coalition, examining how data can inform our understanding of social determinants of health and influence decision-making during COVID-19 and beyond. Watch the full webinar here.
On Tuesday, May 26, Dr. Jeffrey L. Sturchio participated in a panel discussion hosted by the Modernizing Foreign Assistance Network on “Responding to COVID-19 Globally: Policy recommendations for effective foreign assistance.” The conversation centered around the need for international cooperation and accountability and the role of Congress in the U.S. global response. “To actually get ahead of these issues, we need to think long-term,” Jeff said. “We need to invest now for crises that might never happen.” A recording of the event may be found here.
On Wednesday, May 27, Devex published an article about a new report, Trust or Consequences, that imagines the future of health innovation. Against the backdrop of global crises like COVID-19, Rabin Martin CEO Dr. Jeffrey L. Sturchio offered insights on the importance of developing public trust in vaccines, medicines, and other medical products. “Global problems need global solutions, and that requires…collaboration across borders and sectors,” Jeff said. Read more here.
Reports from International Governments and Bodies
- WHO COVID-19 Information and Guidance
- WHO Situation Reports, May 25, May 26, May 27
- CDC Coronavirus Resource Page
- COVID-19 Health Systems Response Monitor
- NCD Alliance COVID resources relevant to NCDs
Funding and Policy Trackers
- International Monetary Fund Policy Tracker
- Kaiser Family Foundation Coronavirus Policy Tracker
- U.S. Chamber of Commerce Foundation Corporate Aid Tracker
- Devex Interactive Funding Tracker
Resource Pages and Market Research Literature
- JAMA Resource Center
- The Lancet COVID-19 Resource Centre
- 2019 Novel Coronavirus Research Compendium (NCRC)
- National Academy of Medicine COVID-19 News and Resources
- WIPO COVID-19 IP Policy Tracker
- The COVID Tracking Project
- PharmaIntelligence: Coronavirus – What will the Impact Be?
- Health Affairs Resource Center
- STAT Preparedness Tool
- International Association of National Public Health Institutes COVID-19 Resources
- Primary Health Care Performance Initiative Forum
- U.S. Global Leadership Coalition COVID-19 Issue Briefs
- Prevent Epidemics Weekly Science Review
What We’re Reading
- How the World’s Premier Public-Health Agency Was Handcuffed – The Economist
- A Virus-Hunter Falls Prey to a Virus He Underestimated – Donald McNeil, The New York Times
- The End of Global Health Advocacy as We Know It – Loyce Pace and Katie Husselby, Devex
- We Don’t Even Have a COVID-19 Vaccine, and Yet the Conspiracies Are Here – Sarah Zhang, The Atlantic
- While U.S. Struggles to Roll Out Coronavirus Contact Tracing, Germany Has Been Doing it From the Start – Loveday Morris and Louisa Beck, The Washington Post
- Offline: Health in the Unhappy Time of COVID-19 – Richard Horton, The Lancet
- The Coronavirus Pandemic Will Turn Into a Poverty Pandemic Unless We Act Now – Sandro Galea, The Washington Post
For more information or should you have any questions, please contact us.
About Rabin Martin
Rabin Martin is a global health strategy firm working at the intersection of private sector capabilities and unmet public health needs. Rooted in our mission to improve health for underserved populations, we design strategies, programs and partnerships that both deliver public health impact and drive business results. We leverage our deep knowledge and networks across a wide range of geographies and health areas to develop tailored solutions for every client engagement. We have helped many clients create bold global health initiatives and innovative multi-sector partnerships. Our specific areas of expertise include infectious disease and vaccines, non-communicable diseases, rare diseases, maternal and child health, and universal health coverage. Our clients and partners include multinational health care companies, multilateral institutions, government agencies, large foundations and leading NGOs. Rabin Martin is part of the Omnicom Public Relations Group.
About Omnicom Public Relations Group
Omnicom Public Relations Group is a global collective of three of the top global public relations agencies worldwide and eight specialist agencies in public affairs, marketing to women, fashion, global health strategy and corporate social responsibility. It encompasses more than 6,000 public relations professionals in more than 330 offices worldwide who provide their expertise to companies, government agencies, NGOs and nonprofits across a wide range of industries. Omnicom Public Relations Group delivers for clients through a relentless focus on talent, continuous pursuit of innovation and a culture steeped in collaboration. Omnicom Public Relations Group is part of the DAS Group of Companies, a division of Omnicom Group Inc. that includes more than 200 companies in a wide range of marketing disciplines including advertising, public relations, healthcare, customer relationship management, events, promotional marketing, branding and research.