The pandemic’s death toll is now being felt most gravely in developing nations. This virus is not done yet


People queue to refill oxygen cylinders in New Delhi, India, 23 April.
Without oxygen it’s impossible to treat a severely ill Covid patient, but there’s a global shortage.’ People queue to refill oxygen cylinders in New Delhi, India, 23 April. Photograph: AP

Is there one pandemic, or two? That was a question being asked a year ago, when wealthy countries accounting for only 15% of the global population had 80% of the Covid deaths. Could it be that the rich world was more vulnerable, somehow, because its populations were older, or more individualistic, or had forgotten to be scared of infectious disease?

Even then, some were warning that the worst was yet to come, once the disease took hold in poorer countries. World Bank analysts Philip Schellekens and Diego Sourrouille, for example, predicted a “massive shift” in disease burden to the developing world. Just in terms of demography, they said, you’d expect those countries to account for around 70% of deaths. As things stand they account for a little over half of it, which is probably an underestimate due to variations in data quality – and the pandemic is far from over.

Last week saw more than 5.8 million new cases of Covid globally, the highest number yet. More than 3 million people have now died from Covid, according to the World Health Organization (WHO), which also reports that infections and hospitalisations in those aged 25 to 59 are increasing at an alarming rate. “It took nine months to reach 1 million deaths, four months to reach 2 million, and three months to reach 3 million,” WHO director general, Tedros Adhanom Ghebreyesus, said last week.


The sharpest upticks in recent weeks have been seen in south-east Asia – driven in large part by India – and the eastern Mediterranean and western Pacific regions, but the situation is also very bad in Latin America. People who migrated to Brazil in search of work are now reported to be fleeing the humanitarian catastrophe that is unfolding there.