Outside Europe, nations floundering in virus’ first wave

As Europe begins its cautious reopening after weathering the pandemic’s first wave in lockdown, many developing and middle-income countries continue to be battered by skyrocketing numbers of Covid-19 cases.

With infections still growing daily in India, Bangladesh, Indonesia and Nigeria among others, health experts warn that before the world can start buttressing for Covid-19 ‘s much-feared "second wave", it must help nations battling the virus now.

The World Health Organisation warned this week that the pandemic was "not even close to being over" even as European nations reopen their borders and millions head back to work.

While the United States has had by far the highest caseload, there are growing fears over the fate of hugely populous nations whose Covid-19 curve is pointing inexorably upwards. India for example now has more than 566,000 confirmed cases and is registering nearly 20,000 new infections every day.

Mexico has more than 220,000 confirmed cases, Pakistan nearly 210,000, and Bangladesh more than 150,000, with little sign of new infections slowing.

Trudie Lang, director of The Global Health Network at the University of Oxford’s Nuffield Department of Medicine, described the trend as "really quite worrying".

"Even though the numbers might not be completely accurate because we’ve not tested so many, the curve is still the same shape," Lang told AFP. When Covid-19 emerged in China late last year, the government in Beijing rapidly imposed stringent lockdown measures in a bid to contain the outbreak.

When in February European nations such as Italy and Spain uncovered clusters of the virus, they too adopted unprecedented limits on individual movement that eventually flattened the curve of new infections.

Anant Bhan, a researcher in bioethics and public health policy, said heavily populated and decentralised countries such as India are struggling to keep lockdown measures effectively.

"That makes it a bit more challenging for the healthcare system," he told AFP. "We might not have one peak, we might have multiple peaks because the spread of infection is variable across the country."

For Azra Ghani, professor of Infectious Disease Epidemiology at Imperial College London, the delayed rise in Covid-19 cases shows in part how successful countries have been until now in limiting the virus’ spread.

"If you go back a few months there was a large seeding into Europe and that caused widespread epidemics there," she told AFP. "All these countries saw what was happening in Europe and reacted. The lockdowns appeared at a relatively early stage of epidemics.

"As they’ve been coming out of lockdowns we’re seeing infections building up in the same way it had initially in Europe, starting to spread in South America, India, Pakistan, Bangladesh," Ghani explained. For example Indonesia, the fourth most populous country on Earth, is registering around 1,000 new cases daily even as it eases lockdown measures.

Hermawan Saputra, a public health expert at the Indonesian Public Health Association, told AFP the country was "still far from the peak of the pandemic". Experts previously predicted the outbreak to peak in July.

"But since Jakarta has relaxed (lockdown) we think the peak will be reached in August or September," said Saputra. "This is honestly terrifying. Easing was premature and people misunderstood it as meaning they had complete freedom -- that’s wrong."

In Afghanistan, which has more than 30,000 confirmed cases, restrictions on movement are still in place. But the public doesn’t appear to be getting the message, according to senior health official Ataullah Saeedzai. "The lockdown is still in place, but people are not taking it seriously," he told AFP. "People are not observing the lockdown, people are not observing social distancing."