NEW YORK • Developing countries face an explosion in coronavirus infections as they exit lockdowns amid worsening outbreaks because the economic cost of remaining shuttered is too great.
From Pakistan to the Philippines, Brazil to South Africa, governments have been choosing to end orders confining people to their homes.
Researchers at the University of Michigan predict India's infections could almost double to more than 750,000 by mid-July, while Brazil just hit 1 million cases - the second-highest tally globally - with more increases forecast for this month.
Soaring unemployment and even starvation are forcing many countries to end sometimes months-long lockdowns that largely failed to stymie the virus like they did in Europe and China. These escalating outbreaks risk fuelling the wider pandemic just as richer countries start to open up their economies and nations including China and the United States see resurgences.
Policymakers in poorer countries are now left with few potent tools to combat a virus that has the potential to overwhelm their healthcare systems.
"There's a de-facto realisation that we're going to have to live with this virus at infection levels that up to this point had been seen as dangerous and unacceptable, and couple it with a different strategy," said Dr Stephen Morrison, director of the Global Health Policy Centre at the Centre for Strategic and International Studies in Washington. "The lockdown and social distancing practices don't work or have limited utility in so many developing countries."
The 10 countries from Latin America and South Asia with the most number of cases made up 29 per cent of cases globally as of Sunday. Two months ago, they comprised only 5 per cent of the global tally.
Shutting down businesses and telling people to stay at home helped prevent half a billion infections in China, South Korea, Italy, Iran, France and the US, according to a recent study in the journal Nature. But such steps are not as effective in poorer countries because housing is typically much denser, a challenge to social distancing.
India imposed its lockdown almost three months ago. It has ramped up manufacturing of face masks, ventilators and testing kits, and sports stadiums and railway cars have been set up as isolation centres. But mega cities like New Delhi and Mumbai are already showing signs of being overwhelmed.
Countries like India and the Philippines are relying on other tactics such as locking down only communities where the virus is spreading vociferously.
While Brazil did not have a nationwide lockdown, various states imposed restrictions on people's movements and some have now begun to ease quarantine orders. But there are a confluence of factors working against countries like Brazil, beyond a president who has been criticised for dismissing the seriousness of the pandemic.
FACING NEW REALITY
There's a de-facto realisation that we're going to have to live with this virus ... and couple it with a different strategy.
DR STEPHEN MORRISON, director of the Global Health Policy Centre at the Centre for Strategic and International Studies in Washington, on having to live with the virus for some time yet.
In the slums of Sao Paulo and elsewhere, extended families share one-room shanties. Lack of reliable clean water and sanitation systems also allowed the virus to take root. Estimates from PUC University show Brazil's infections will likely surpass 1.4 million by late June, with more than 60,000 deaths.
"Longer-term lockdowns in developing countries are just not an option - we don't have social safety nets," said Mr Kobi Annan, an analyst at risk consultancy Songhai Advisory.