COVID-19 is not the “great equalizer”

Maria Abi-Habib writing for NYT,

“For the first time since 1998, the World Bank says, global poverty rates are forecast to rise. By the end of the year, half a billion people may be pushed into destitution, largely because of the pandemic, the United Nations estimates.

… Since 2000, Bangladesh brought 33 million people — 20 percent of its population — out of poverty while funding programs that provided education to girls, increased life expectancy and improved literacy.

Famines that once plagued South Asia are now vanishingly rare, and the population less susceptible to disease and starvation.

But that progress may be reversed, experts worry, and funding for anti-poverty programs may be cut as governments struggle with stagnant growth rates or economic contractions as the world heads for a recession.

… In India, millions of migrant laborers were left unemployed and homeless overnight after the government there announced a lockdown. In parts of Africa, millions may go hungry after losing their jobs and as lockdowns snarl food aid distribution networks. In Mexico and the Philippines, remittances that families relied on have dried up as primary breadwinners lose their jobs and can no longer send money home.”

Millions Had Risen Out of Poverty. Coronavirus Is Pulling Them Back.

From Peter Orszag (formerly director of the Office of Management and Budget under President Obama),

The Covid-19 pandemic will likely leave us with an economy in which larger companies play an expanded role, representing a higher share of both employment and revenue. The stock market illustrates the phenomenon: The biggest firms have seen smaller stock market declines, on average, than smaller ones have. It’s the corporate version of the Matthew effect: The strong get stronger.

… The trend may be accelerated now because, during the pandemic, bigger companies are less likely to run aground: They are perceived to have more liquidity than smaller companies do, and to be more spread out geographically. The pandemic has hit small and medium-sized businesses, which often have little cash on hand, very hard — and government policy responses so far may be insufficient to avoid a cascade of resulting bankruptcies. It’s entirely possible that many small companies won’t survive, or return after the crisis subsides. At the same time, Covid-19 has hit different regions with varying force, policy responses have also varied, and these differences are likely to continue through the summer and beyond. Because larger companies are more diversified across markets, they’re better able to survive shocks whose force varies from place to place.”

The Pandemic Will Make Big Companies More Dominant Than Ever

And a sad, underappreciated consequence of lockdowns and travel bans; the WHO points out that children will die as a result of lockdown-induced shortages of vaccines for preventable diseases,

“The World Health Organization warned Monday that children across the world will die as the coronavirus pandemic forces some countries to temporarily halt vaccinations for other deadly diseases such as polio.

At least 21 countries are reporting vaccine shortages as a result of travel restrictions meant to curb the spread of the Covid-19 pandemic, WHO Director-General Tedros Adhanom Ghebreyesus said during a press conference at the agency’s Geneva headquarters. “The tragic reality is children will die as a result.”

Just as immunization has been postponed in some countries, health-care services for other diseases, such as malaria, have been disrupted, Tedros said, noting that the number of malaria cases in sub-Saharan Africa could double.”

WHO warns that ‘children will die’ as coronavirus pandemic postpones vaccinations against other diseases

In the near-term, lockdowns are causing delays or avoidance of urgent, potentially life-saving treatment at ERs and urgent care centers. From CNBC,

“At Providence, the volume of heart attack patients fell by about 50% in March compared with the same month last year, Hochman said, adding that the notion that people have just stopped having heart attacks is “too good to be true.” He and other physicians suspect patients that have mild heart attacks or strokes — which would normally have sent them to the ER — are seeking treatment from family doctors or outpatient clinics or are forgoing it altogether as Covid-19 patients inundate hospitals across the country. The consequences could last years, he said.

“The big question is are we going to see a lot more people that have bad outcomes from heart disease, from stroke, from cancer because they’ve put off what they should have had done but were too afraid to come to the hospital,” he said.

… “If I have a mass in my groin and I need to have a biopsy, I’m not sure that’s elective,” he said. He also said preventive care is down, including colonoscopy screenings for cancer and mammograms, which could have long-term public health consequences, such as a jump in cancer rates a year or so down the road.

“We’re possibly going to see a blip in other disease entities as a consequence of doubling down on Covid-19,” he said, adding that it will take years to fully understand the consequences.

… If people delay care by waiting to go to the hospital until symptoms have developed into a serious illness, it could be too late to prevent long-term damage or even death, he said.

“If you’re having trouble speaking or you have weakness in one of your arms or legs, these aren’t things to tough out,” he said. “More people are dying at home, and some of them are dying of things that aren’t directly related to the virus.

Doctors worry the coronavirus is keeping patients away from US hospitals as ER visits drop: ‘Heart attacks don’t stop’