Which means that India could not be more different than Brazil. Say what you want about Brazilian President Jair Bolsonaro—for instance, that he’s a homophobic, Fascist-sympathizing, anti-Semitic, anti-globalist, expertise-dismissing, xenophobe who holds vast swathes of his own country in utter disdain, while making America’s Donald Trump and Hungary’s Viktor Orban look like hippy pansies (his supporters see these as his good points)—but his extreme COVID-19 denial has evolved from being confusing and worrisome to borderline genocidal.
Bolsonaro not only continues to reject calls for nationwide measures to stem the spread of disease, he actively agitates against governors and mayors trying to enact social distancing on the regional and local levels. Even worse, Bolsonaro continues to lead mass rallies with he presses the flesh with thousands of supporters, even after many in his immediate circle have tested positive for coronavirus. Bolsonaro may well be the world’s best known “super-spreader”.
That’s the current political disaster. Here’s the coming health disaster:
Every major Brazilian city has a ring of slums, the infamous favelas, nearly all of which are more densely populated than Manhattan, but utterly lacking high-rises. These shanty towns-turned communities suffer high degrees of lawlessness paired with an autonomy resulting from the simple fact that more affluent Brazilians want to keep them out of sight and mind. All now have local economies and services unto themselves, typically independent of whatever urban governments they should at least nominally be linked to. While formal statistics are hard to come by, Brazil's 2010 census indicates that over 11 million people – roughly 6% -- of Brazil's population lives in one. That provides Brazil with deep and ongoing issues of economic inequality, educational disparity, racial divides and…health challenges.
Add in minimal coordinated testing (remember, President Bolsonaro thinks it's a hoax), an over-extended and underfunded health sector, and densely populated urban cores, and managing the impacts of COVID-19 in Brazil, like in India, is going to be a nightmare.
And these are the trillion-dollar economies.
Elsewhere in the world, we are looking for where the witch's brew of very dense population centers, minimal internal testing relative to population size, weak health infrastructures, and populations with a high percentage of pre-existing health conditions all meet. In addition to India and Brazil, Egypt, Bangladesh, Yemen, Pakistan, Iraq, South Africa, the Philippines, Algeria, Nigeria, the Persian Gulf states, and Russia all make the list. Low levels of national spending on health, frequent bouts of political and social unrest, large migrant and refugee populations, and governments more interested about quelling panic than testing, tracking and isolating coronavirus patients is a recipe for disaster. Russia, in particular, seems intent on following Brazil's lead.
Which is not to say governments aren't doing anything.
South Africa is attempting to institute a national lockdown a la India, but outside of a few elite neighborhoods in the cities, most of the country's health infrastructure is crumbling. And that's the areas with any hospitals and clinics at all. The densely populated townships have little to nothing in way of permanent healthcare facilities, in addition to suffering high rates of unemployment and lifestyle diseases. Such townships are 40% of the South African population. Another 20% live in shanty towns which are even worse. From 2009 to 2017 the country was ruled by the corrupt thugocracy of Jacob Zuma, and for most of the century before that, Apartheid. Incumbent President Cyril Ramaphosa faced an epically difficult task in unwinding a system that either deliberately denied services to or sought to rob most of its population, even before coronavirus barred its fangs.
If you’re looking at the above criteria and thinking the wealthy Arab Gulf states, with well-funded social safety nets and huge spending on health, are the odd ones out: yes and no. Most of the populations of the Gulf states live in small, dense cities along the coast—frequently in high-rises or other multi-family units. It’s a society built around inside activities—shopping malls, movie theaters (where allowed), playground and indoor amusement parks. Lots of central air conditioning, and staggeringly high rates of diabetes, obesity, heart disease, smoking and generally poor cardiovascular health. It’s a ticking time-bomb, and not just because of the proximity to the ongoing failure of the Iranian government’s handling of its COVID-19 crisis. Think of these communities as so many cruise ships, just sitting in one place.
The cruise ship comparison is not one we make lightly.
A cruise ship is a series of cabins linked by central air systems which recirculate what everyone is inhaling and exhaling. In medical terms, it is a petri dish, ergo why cruise ships generate ever-rising numbers of coronavirus infections. Something along those lines is undoubtedly brewing in the vast living quarters throughout Doha, Dubai and Abu Dhabi. (Incidentally, America’s aircraft carriers are proving to be nearly as problematic as cruise ships, but without the bar.)
Living in the advanced world it is often easy to dismiss issues in the developing world as a problem for another country, even another hemisphere. It is not. The coronavirus emerged in interior China where the developed and developing world’s rub shoulders. It crossed the line just fine. It can, and will, do so again.