Spread & Containment
Global herd immunity remains out of reach because of inequitable vaccine distribution – 99% of people in poor countries are unvaccinated
The high costs of the world’s colossally unequal COVID-19 immunization rates.
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In the race between infection and injection, injection has lost.
Public health experts estimate that approximately 70% of the world’s 7.9 billion people must be fully vaccinated to end the COVID-19 pandemic. As of June 21, 2021, 10.04% of the global population had been fully vaccinated, nearly all of them in rich countries.
Only 0.9% of people in low-income countries have received at least one dose.
I am a scholar of global health who specializes in health care inequities. Using a data set on vaccine distribution compiled by the Global Health Innovation Center’s Launch and Scale Speedometer at Duke University in the United States, I analyzed what the global vaccine access gap means for the world.
A global health crisis
Supply is not the main reason some countries are able to vaccinate their populations while others experience severe disease outbreaks – distribution is.
Many rich countries pursued a strategy of overbuying COVID-19 vaccine doses in advance. My analyses demonstrate that the U.S., for example, has procured 1.2 billion COVID-19 vaccine doses, or 3.7 doses per person. Canada has ordered 381 million doses; every Canadian could be vaccinated five times over with the two doses needed.
Overall, countries representing just one-seventh of the world’s population had reserved more than half of all vaccines available by June 2021. That has made it very difficult for the remaining countries to procure doses, either directly or through COVAX, the global initiative created to enable low- to middle-income countries equitable access to COVID-19 vaccines.
Benin, for example, has obtained about 203,000 doses of China’s Sinovac vaccine – enough to fully vaccinate 1% of its population. Honduras, relying mainly on AstraZeneca, has procured approximately 1.4 million doses. That will fully vaccinate 7% of its population. In these “vaccine deserts,” even front-line health workers aren’t yet inocculated.
Haiti has received about 461,500 COVID-19 vaccine doses by donations and is grappling with a serious outbreak.
Even COVAX’s goal – for lower-income countries to “receive enough doses to vaccinate up to 20% of their population” – would not get COVID-19 transmission under control in those places.
The cost of not cooperating
Last year, researchers at Northeastern University modeled two vaccine rollout strategies. Their numerical simulations found that 61% of deaths worldwide would have been averted if countries cooperated to implement an equitable global vaccine distribution plan, compared with only 33% if high-income countries got the vaccines first.
Put briefly, when countries cooperate, COVID-19 deaths drop by approximately in half.
Vaccine access is inequitable within countries, too – especially in countries where severe inequality already exists.
In Latin America, for example, a disproportionate number of the tiny minority of people who’ve been vaccinated are elites: political leaders, business tycoons and those with the means to travel abroad to get vaccinated. This entrenches wider health and social inequities.
The result, for now, is two separate and unequal societies in which only the wealthy are protected from a devastating disease that continues to ravage those who are not able to access the vaccine.
A repeat of AIDS missteps?
This is a familiar story from the HIV era.
In the 1990s, the development of effective antiretroviral drugs for HIV/AIDS saved millions of lives in high-income countries. However, about 90% of the global poor who were living with HIV had no access to these lifesaving drugs.
Concerned about undercutting their markets in high-income countries, the pharmaceutical companies that produced antiretrovirals, such as Burroughs Wellcome, adopted internationally consistent prices. Azidothymidine, the first drug to fight HIV, cost about US$8,000 a year – over $19,000 in today’s dollars.
That effectively placed effective HIV/AIDS drugs out of reach for people in poor nations – including countries in sub-Saharan Africa, the epidemic’s epicenter. By the year 2000, 22 million people in sub-Saharan Africa were living with HIV, and AIDS was the region’s leading cause of death.
The crisis over inequitable access to AIDS treatment began dominating international news headlines, and the rich world’s obligation to respond became too great to ignore.
“History will surely judge us harshly if we do not respond with all the energy and resources that we can bring to bear in the fight against HIV/AIDS,” said South African President Nelson Mandela in 2004.
Pharmaceutical companies began donating antiretrovirals to countries in need and allowing local businesses to manufacture generic versions, providing bulk, low-cost access for highly affected poor countries. New global institutions like the Global Fund to Fight AIDS, Tuberculosis, and Malaria were created to finance health programs in poor countries.
Pressured by grassroots activism, the United States and other high-income countries also spent billions of dollars to research, develop and distribute affordable HIV treatments worldwide.
A dose of global cooperation
It took over a decade after the development of antiretrovirals, and millions of unnecessary deaths, for rich countries to make those lifesaving medicines universally available.
Fifteen months into the current pandemic, wealthy, highly vaccinated countries are starting to assume some responsibility for boosting global vaccination rates.
Leaders of the United States, Canada, United Kingdom, European Union and Japan recently pledged to donate a total of 1 billion COVID-19 vaccine doses to poorer countries.
It is not yet clear how their plan to “vaccinate the world” by the end of 2022 will be implemented and whether recipient countries will receive enough doses to fully vaccinate enough people to control viral spread. And the late 2022 goal will not save people in the developing world who are dying of COVID-19 in record numbers now, from Brazil to India.
The HIV/AIDS epidemic shows that ending the coronavirus pandemic will require, first, prioritizing access to COVID-19 vaccines on the global political agenda. Then wealthy nations will need to work with other countries to build their vaccine manufacturing infrastructure, scaling up production worldwide.
Finally, poorer countries need more money to fund their public health systems and purchase vaccines. Wealthy countries and groups like the G-7 can provide that funding.
These actions benefit rich countries, too. As long as the world has unvaccinated populations, COVID-19 will continue to spread and mutate. Additional variants will emerge.
As a May 2021 UNICEF statement put it: “In our interdependent world no one is safe until everyone is safe.”
[The Conversation’s most important politics headlines, in our Politics Weekly newsletter.]
Maria De Jesus does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
vaccine treatment pandemic coronavirus covid-19 spread epicenter deaths herd immunity transmission africa india brazil japan canada european china
Spread & Containment
Las Vegas Strip faces growing bed bug problem
With huge events including Formula 1, CES, and the Super Bowl looming, the Las Vegas Strip faces an issue that could be a major cause for concern.
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Las Vegas beat the covid pandemic.
It wasn't that long ago when the Las Vegas Strip went dark and people questioned whether Caesars Entertainment, MGM Resorts International, Wynn Resorts, and other Strip players would emerge from the crisis intact.
Related: Las Vegas Strip report shares surprising F1 race news
In the darkest days, the entire Las Vegas Strip was closed down and when it reopened, it was not business as usual. Caesars Entertainment (CZR) - Get Free Report and MGM reopened slowly with all sorts of government-mandated restrictions in place.
The first months of the Strip's comeback featured temperature checks, a lot of plexiglass, gaming tables with limited numbers of players, masks, and social distancing. It was an odd mix of celebration and restraint as people were happy to be in Las Vegas, but the Strip was oddly empty, some casinos remained closed, and gaming floors were sparsely filled.
When vaccines became available, the Las Vegas Strip benefitted quickly. Business and international travelers were slow to return, but leisure travelers began bringing crowds back to pre-pandemic levels.
The comeback, however, was very fragile. CES 2022 was supposed to be Las Vegas's return to normal, the first major convention since covid. In reality, surging cases of the covid omicron variant caused most major companies to pull out.
Even with vaccines and covid tests required, an event that was supposed to be close to normal, ended up with 25% of 2020's pre-covid attendance. That CES showed just how quickly public sentiment — not actual danger — can ruin an event in Las Vegas.
Now, with November's Formula 1 Race, CES in January, and the Super Bowl in February all slated for Las Vegas, a rising health crisis threatens all of those events.
The Arena Media Brands, LLC and respective content providers to this website may receive compensation for some links to products and services on this website.
Image source: Palms Casino
The Las Vegas Strip has a bed bug problem
While bed bugs may not be as dangerous as covid, Respiratory Syncytial Virus (RSV), Legionnaires’ disease, and some of the other infectious diseases that the Las Vegas Strip has faced over the past few years, they're still problematic. Bed bugs spread easily and a small infestation can become a large one quickly.
The sores caused by bed bugs are also a social media nightmare for the Las Vegas Strip. If even a few Las Vegas Strip visitors wake up covered in bed bug bites, that could become a viral nightmare for the entire city.
In late-August, reports came out the bed bugs had been at seven Las Vegas hotel, mostly on the Strip over the past two years. The impacted properties includes Caesars Planet Hollywood and Caesars Palace as well as MGM Resort International's (MGM) - Get Free Report MGM Grand, and others including Circus Circus, The Palazzo, Tropicana, and Sahara.
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"Now, that number is nine with the addition of The Venetian and Park MGM. According to the health department report, a Venetian guest reported seeing the bloodsuckers on July 29 and was moved to another room. An inspection three days later confirmed their presence," Casino.org reported.
The Park MGM bed bug incident took place on Aug. 14.
Bed bugs remain a Las Vegas Strip problem
Only Tropicana, which is soon going to be demolished, and Sahara, responded to Casino.org about their bed bug issues. Caesars and MGM have not commented publicly or responded to requests from KLAS or Casino.org.
That makes sense because the resorts do not want news to spread about potential bed bug problems when the actual incidents have so far been minimal. The problem is that unreported bed bug issues can rapidly snowball.
The Environmental Protection Agency (EPA) shares some guidelines on bed bug bites on its website that hint at the depth of the problem facing Las Vegas Strip resorts.
"Regularly wash and heat-dry your bed sheets, blankets, bedspreads and any clothing that touches the floor. This reduces the number of bed bugs. Bed bugs and their eggs can hide in laundry containers/hampers. Remember to clean them when you do the laundry," the agency shared.
Normally, that would not be an issue in Las Vegas as rooms are cleaned daily. Since the covid pandemic, however, some people have opted out of daily cleaning and some resorts have encouraged that.
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Not having daily room cleaning in just a few rooms could lead to quick spread.
"Bed bugs spread so easily and so quickly, that the University of Kentucky's entomology department notes that "it often seems that bed bugs arise from nowhere."
"Once bed bugs are introduced, they can crawl from room to room, or floor to floor via cracks and openings in walls, floors and ceilings," warned the University's researchers.
spread social distancing pandemic
International
Americans are having a tough time repaying pandemic-era loans received with inflated credit scores
Borrowers are realizing the responsibility of new debts too late.
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With the economy of the United States at a standstill during the Covid-19 pandemic, the efforts to stimulate the economy brought many opportunities to people who may have not had them otherwise.
However, the extension of these opportunities to those who took advantage of the times has had its consequences.
Related: American Express reveals record profits, 'robust' spending in Q3 earnings report
Credit Crunch
A report by the Financial Times states that borrowers in the United States that took advantage of lending opportunities during the Covid-19 pandemic are falling behind on actually paying back their debt.
At a time when stimulus checks were handed out and loan repayments were frozen to help those affected by the economic shock of Covid-19, many consumers in the States saw that lenders became more willing to provide consumer credit.
According to a report by credit reporting agency TransUnion, the median consumer credit score jumped 20% to a peak of 676 in the first quarter of 2021, allowing many to finally have “good” credit scores. However, their data also showed that those who took out loans and credit from 2021 to early 2023 are having an hard time managing these debts.
“Consumer finance companies used this opportunity to juice up their growth at a time when funding was ample and consumers’ finances had gotten an artificial boost,” Chief economist of Moody’s Analytics Mark Zandi told FT. “Certainly a lot of lower-income households that got caught up in all of this will feel financial pain.”
Moody’s data shows that new credit cards accounts that were opened in the first quarter of 2023 have a 4% delinquency rate, while the same rate in September 2022 was 4.5%. According to the analysts, these levels were the highest for the same point of the year since 2008.
Additionally, a study by credit scoring company VantageScore found that credit cards issued in March 2022 had higher delinquency rates than cards issued at the same time during the prior four years.
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Credit cards were not the only debts that American consumers took on. As per S&P Global Ratings data, riskier car loans taken on during the height of the pandemic have more repayment problems than in previous years. In 2022, subprime borrowers were becoming delinquent on new cars loans at twice the rate of pre-pandemic levels.
S&P auto loan tracker Amy Martin told FT that lenders during the pandemic were “rather aggressive” in terms of signing new loans.
Bill Moreland of research group BankRegData has warned about these rising delinquencies in the past and had recently estimated that by late 2022, there were hundreds of billions of dollars in what he calls “excess lending based upon artificially inflated credit scores”.
The Government's Role
Because so many are failing to pay their bills, many are wary that the government assistance may have been a financial double-edged sword; as they were meant to alleviate financial stress during lockdown, while it led some of them to financial difficulty.
The $2.2 trillion Cares Act federal aid package passed in the early stages of the pandemic not only put cash in the American consumer’s pocket, but also protected borrowers from foreclosure, default and in some instances, lenders were barred from reporting late payments to credit bureaus.
Yeshiva University law professor Pam Foohey specializes in consumer bankruptcy and believes that the Cares Act was good policy, however she shifts the blame away from the consumers and borrowers.
“I fault lenders and the market structure for not having a longer-term perspective. That’s not something that the Cares Act should have solved and it still exists and still needs to be addressed.”
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Inflation: raising interest rates was never the right medicine – here’s why central bankers did it anyway
We need to start cutting rates, but there’s something that has to happen first.
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Inflation remains too high in the UK. The annual rate of consumer price inflation to September was 6.7%, the same as a month earlier. This is well below the 11.1% peak reached in October 2022, but the failure of inflation to keep falling indicates it is proving far more stubborn than anticipated.
This may prompt the Bank of England’s Monetary Policy Committee (MPC) to raise the benchmark interest rate yet again when it meets in November, but in my view this would not be entirely justified.
In reality, the rate hikes that began two years ago have not been very helpful in tackling inflation, at least not directly. So what’s the problem and is there a better alternative?
Right policy, wrong inflation
Raising interest rates is the MPC’s main tool for trying to get inflation back to its target rate of 2%. The idea is that this makes it more expensive to borrow money, which should reduce consumer demand for goods and services.
The trouble is that the type of inflation recently witnessed in the UK seems less a problem of excessive demand than because costs have been rising for manufacturers and service providers. It’s known as “cost-push inflation” as opposed to “demand-pull inflation”.
Inflation rates (UK, US, eurozone)
Production costs have risen for several reasons. During the COVID-19 pandemic, central banks “created money” through quantitative easing to enable their governments to run large spending deficits to pay for furloughs and other interventions to help citizens through the crisis.
When countries started reopening, it meant people had money in their pockets to buy more goods and services. Yet with China still in lockdown, global supply chains could not keep pace with the resurgent demand so prices went up – most notably oil.
Oil price (Brent crude, US$)
Then came the Ukraine war, which further drove up prices of fundamental commodities, such as energy. This made inflation much worse than it would otherwise have been. You can see this reflected in consumer price inflation (CPI): it was just 0.6% in the year to June 2020, then rose to 2.5% in the year to June 2021, reflecting the supply constraints at the end of lockdown. By June 2022, four months after Russia’s invasion of Ukraine, CPI was 9.4%.
The policy problem
This begs the question, why has the Bank of England (BoE) been raising rates if it’s unlikely to be effective? One answer is that other central banks have been raising rates. If the BoE doesn’t mirror rate rises in the US and eurozone, investors in the UK may move their money to these other areas because they’ll get better returns on bonds. This would see the pound depreciating against the US dollar and euro, in turn increasing import prices and aggravating inflation.
Part of the problem has been that the US has arguably faced more of the sort of demand-led inflation against which interest rates are effective. For one thing, the US has been less at the mercy of rising energy prices because it is energy self-sufficient. It also didn’t lock down as uniformly as other major economies during the pandemic, so had a little more space to grow.
At the same time, the US has been more effective at bringing down inflation than the UK, which again suggests it was fighting demand-driven price rises. In other words, the UK and other countries may to some extent have been forced to follow suit with raising interest rates to protect their currencies, not to fight inflation.
What next
How harmful have the rate rises been in the UK? They have not brought about a recession yet, but growth remains very weak. Lots of people are struggling with the cost of living, as well as rent or mortgage costs. Several million people are due to be hit by much higher mortgage rates as their fixed-rate deals end between now and the end of 2024.
UK GDP growth (%)
If hiking interest rates is not really helping to curb inflation, it makes sense to start moving in the opposite direction before the economic situation gets any worse. To avoid any damage to the pound, the answer is for the leading central banks to coordinate their policies so that they cut rates in lockstep.
Unless and until this happens, there would seem to be no quick fix available. One piece of good news is that the energy price cap for typical domestic consumption was reduced from October 1 from £1,976 to £1,834 a year. That 7% reduction should lead to consumer price inflation coming down significantly towards the end of 2023.
More generally, the Bank of England may simply have to hope that world events move inflation in the desired direction. A key question is going to be whether the wars in Ukraine and Israel/Gaza result in further cost pressures.
Unfortunately there is a precedent for a Middle East conflict leading to a global economic crisis: following the joint assault on Israel by Syria and Egypt in 1973, Israel’s retaliation prompted petroleum cartel OPEC to impose an oil embargo. This led to an almost fourfold increase in the price of crude oil.
Since oil was fundamental to the costs of production, inflation in the UK rose to over 16% in 1974. There followed high unemployment, resulting in an unwelcome combination that economists referred to as stagflation.
These days, global production is in fact less reliant on oil as renewables have become a growing part of the energy mix. Nonetheless, an oil price hike would still drive inflation higher and weaken economic growth. So if the Middle East crisis does spiral, we may be stuck with stubborn, untreatable inflation for even longer.
Robert Gausden does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
recession unemployment economic growth reopening bonds monetary policy mortgage rates currencies pound us dollar euro governor lockdown pandemic covid-19 recession gdp interest rates commodities oil uk russia ukraine china-
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