Coronavirus: the third pandemic wave is silently growing
The third global wave will hit developing countries such as India, Pakistan, Bangladesh, Brazil, Russia, Nigeria, Mexico, Indonesia, and will be accompanied by global economic turmoil and famine.
- Two thirds of world’s population live in the countries that didn’t peak, nor contained the virus yet.
- Pandemic waves can be observed on different graphs: from total cases to death rates.
- There was a big delay between the first and second waves, but the time gap between the second and third waves will be much smaller.
- The second global wave affected mostly developed countries, while the third wave will hit developing countries.
- According to the popular in finance Elliot waves principle, the third epidemic wave will peak at the higher level, than previous waves.
- India, Pakistan, Bangladesh, Brazil, Russia, Nigeria, Mexico, and Indonesia, are likely to lead the coronavirus dashboard during the third coronavirus wave.
- The third pandemic wave is already silently growing and will be observed on global graphs by summer 2020.
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Intro
In the previous article of the coronavirus series we’ve explained why the case fatality rate (CFR) is a very misleading estimation of a real death rate during an outbreak with exponential daily increase of new cases.
In this article we will talk about the third global wave of the coronavirus. Many people think that we’ve already peaked and the worst is behind. Unfortunately, only around one third of world’s population live in the countries that have already peaked or contained the virus. For the majority of the world’s population it’s just the beginning.
In this article we will mainly focus on 10 most populated countries, which account for 57% of the global population.
As of April 27, only 2 out of 10 most populated countries have already peaked.
Two countries.
Out of ten.
Waves on death rate graph
Many people struggle to understand why the coronavirus death rate (among closed cases) slowly fell from 42% to 6%, then climbed back to 22% and then started decreasing again.
The explanation is easy —pandemic waves. The death rate among closed cases was very high in the beginning of the first wave and then it started rising again in the beginning of the second wave.
But shouldn’t the death rate be consistent through out the whole course of an outbreak?
Not exactly. Both the real death rate (or the infection fatality rate) and an estimation of the death rate can vary a lot, depending on the wave. There are many reasons for why the death rate keeps changing.
- The median time from development of symptoms to death is shorter than from development of symptoms to full recovery. In other words, people die faster from COVID-19 than they recover. As a result, in the beginning of each wave, there are many new cases, which progress faster to “deaths” category than to “recoveries”. That spikes the death rate among closed cases. Interestingly, the case fatality rate (CFR) among all confirmed cases changes a bit differently, because it decreases when there is a huge spike of new cases.
- Most deaths of the first wave occurred in China, which has a proven record of covering up the outbreaks, so the data cannot be trusted. The second wave, on the other hand, affected mostly developed countries with much more transparent governments. In other words, there is no proof that the coronavirus death rate among closed cases in China was as low as 6%.
- Health care systems of many countries were overwhelmed during the peak of the second wave, so there were not enough resources to treat all critical patients, which increased the actual death rate (or infection fatality rate).
- Many nations faced shortage of testing kits during the peak of the second wave, so only symptomatic patients were tested, which increased the official death rate among closed cases.
- Different pandemic waves affect different countries with different health care systems, so the real death rate can be very different as well.
Note: many news outlets use the case fatality rate (CFR), which is a very misleading estimation of a real death rate during an outbreak with exponential daily increase of new cases. If you want to learn more about the coronavirus death rate, read the previous article of this series.
Apart from the death rate graph, what are the other graphs that can clearly show us different global waves of COVID-19?
OK, first two waves are seen clearly, but what are the evidences that there will be more waves? And when? To answer this question let’s leave graphs aside and talk about each wave separately.
First Wave
The first wave was seeded from Wuhan in late December 2019 and started in January 2020. China was the only affected country. All other countries didn’t have enough imported cases to seed the local transmission.
The first wave started because Wuhan’s local officials and then the China’s central government covered up the outbreak, so the virus had an opportunity to spread before any serious measures were taken.
Second Wave
The second wave was mainly seeded from China in January — February and started in March. The most affected places were the US, EU, Iran, Turkey, and South Korea, which had lots of air traffic with China and with each other.
The second wave started because of a few main reasons:
- Even though nobody from Wuhan, an epicenter of the outbreak, could travel to anywhere else in China since January 23, the CCP allowed the coronavirus to escape Wuhan to other countries via international flights, while the WHO was opposing any travel restrictions with China.
- During the first wave, the personal protective equipment (PPE) from around the world was shipped to China and the CCP banned any export of the PPE to other countries. That created a shortage of the PPE needed for medical workers around the globe during the second wave, so many of them contracted the coronavirus, which decreased the capacities of the health care systems in affected countries.
- The World Health Organization (WHO) downplayed the seriousness of the outbreak, delayed a declaration of a global emergency, criticized travel bans and called for resuming flights to China on February 4, and praised China’s efforts in battling the virus.
- Many countries (e.g., Iran and Italy) that joined China’s controversial Belt and Road Initiative didn’t implement strict measures to protect their population from the virus, because the governments of these countries either believed China’s official numbers, or they were simply too afraid to anger the CCP.
The second wave was accompanied by the global market crash and collapse in oil demand.
Note: we will talk more about the geopolitics of the coronavirus pandemic in later articles of this series.
Third Wave
The third wave was seeded mainly from the developed countries and started some time in April, but it will show up on global graphs only in May — June. The third wave will hit developing countries the most and will be accompanied by the famine, disruption of food supply chains, global economic turmoil, and hyper-inflation of local currencies.
Here is a list of countries that have high chances to lead the coronavirus dashboard during the third wave: India, Pakistan, Bangladesh, Indonesia, Nigeria, Russia, Brazil, and Mexico.
Apart from that, many developed countries will slowly start lifting up the lockdowns, which will inevitably lead to a new wave of infection there, but probably much smaller than the previous one.
There was a big delay between first and second epidemic waves, but the time gap between second and third waves will be much smaller.
According to the popular in finance Elliot waves principle, the third pandemic wave will peak at the higher level than two previous waves.
We cannot see the third wave on the global graphs yet, but we can see that it’s coming by analyzing the following data.
Developing countries
Let’s start with some good news. There are at least 3 major factors that might play in favor of developing countries:
- they usually have a hotter climate, which might slightly reduce the spread of the infection;
- they have generally younger and healthier population;
- the virus will be better researched once it hits developing countries.
Now let’s look at some maps to understand the fundamental challenges of many developing countries amid coronavirus pandemic: high population density and weak health care systems with a small amount of hospital beds and medical doctors.
As we see from the maps above, the whole Indian subcontinent, which accounts for around 25% of world’s population, is in a high risk zone.
Let’s have a closer look at its biggest country.
India
India is the strongest candidate to lead the coronavirus dashboard during the third coronavirus wave due to several reasons: it has the world’s second largest population, very high population density, huge slums, very limited health care system capacity, and poor hygiene practices among populace comparative to developed countries.
Indian government understood the seriousness of this situation very early, so they’ve implemented the world’s largest nation-wide lockdown on March 22, when there were less than 400 confirmed cases in the country of 1.4 billion people. Unfortunately, lockdown not only created huge problems for millions of migrant workers, but it also didn’t stop the spread of the coronavirus.
Despite the lockdown, the number of confirmed cases surged from 396 to 28,380 as of April 27.
To be fair, a nation-wide lockdown did help India buy more time to prepare for an upcoming health care crisis by slowing down exponential growth, at least according to official statistics. We can see that on the logarithmic scale.
However, it’s not clear whether the exponential growth was actually stopped, or is it simply not being reported due to lack of proper testing. For examples, it’s very hard to do testing in slums and certain communities where people literally throw stones at health care workers to keep them away. Assaults have been reported across all India.
There are at least three main reasons why people attack medical workers who try to contain the virus:
- Firstly, people are afraid of catching the virus from medical workers.
- Secondly, there are lots of coronavirus deniers in India, especially in certain highly-religious communities.
- Thirdly, there is fundamental distrust of Muslim communities towards current pro-Hindu government, which sparked huge nation-wide protests before the coronavirus pandemic started.
India is performing 0.5 tests per every thousand people, compared to 17 per thousand in the U.S., and 29 per thousand in Italy as of April 27. Such a low rate of testing is similar to those in Bolivia, Mexico, Uganda, Guyana, and Rwanda. That has increased fears the outbreak could be much larger than official data shows.
However, the devil is in the detail. Despite a low number of tests per capita, India performed more tests (665,819) than most other countries with the similar amount of confirmed cases (28,380). Here is an interesting comment from DarthusPius in a Reddit thread:
Test/million is a baseless statistic given that 80% of the cases are concentrated in 6 cities and over half the 700 districts in India haven’t seen a new case in 2 weeks with over 100 districts not having seen a case at all.
Basically, he refers to the fact that the level of urbanization in India is still low, so most people live in rural areas with lower population density. Since coronavirus is mostly targeting big cities, the amount of performed tests should be enough to effectively identify and isolate new cases. That could be true if the virus stayed only in those 6 big cities. Unfortunately, lockdown sparked a huge exodus of migrant workers from big cities back to their villages, which could have seeded rural areas enough to facility rapid local transmission in the upcoming months.
Additionally, since a nation-wide lockdown froze the economy and put millions at risk of starvation, many states decided to slowly lift lockdown restrictions in “green” zones where the amount of coronavirus cases is low. Unfortunately, this risky plan to revive the Indian economy can backlash with exponential growth of COVID-19 cases, starting from much higher numbers than before the lockdown.
Pakistan, Bangladesh, Nigeria, Indonesia
The situation in Pakistan and Bangladesh is pretty similar to that in India, but with one big exception. Pakistan, Bangladesh, as well as Nigeria and Indonesia, are Muslim-majority countries.
Why does it matter?
Ramadan
It’s still unclear to what extend authorities in Muslim-majority countries will enforce curfews and bans on religious gatherings during the holy month of Ramadan, which will continue till May 23. For example, Pakistan allowed congregational prayers at mosques during Ramadan.
Let’s also add the fact that there are lots coronavirus deniers in highly-religious communities, and now we can see a big challenge that authorities in Muslim-majority countries will have to tackle amid coronavirus pandemic.
Meanwhile, lets have a look at graphs that suggest that the virus spreads rapidly in these countries.
Russia
Russia is very different from other countries mentioned above. Unlike many developing countries, Russia has a much lower population density, it has a relatively strong health care system, and enough resources to perform lots of testing.
Here is the amount of coronavirus tests per thousand people performed in different countries, as of April 27:
- 21 tests in Russia
- 17 tests in the U.S.
- 1.4 tests in Brazil
- 0.7 tests in Pakistan
- 0.5 tests in Mexico
- 0.5 tests in India
- 0.3 tests in Bangladesh
- 0.3 tests in Indonesia
- 0.05 tests in Nigeria
Testing is very important for the early isolation of infected people and their close contacts. Seem like Russia is doing well, right?
Not so fast, the Russian economy is crippled by military conflicts, sanctions, recently plunged oil prices, and political instability, which fuel the crisis. There are also lots of coronavirus deniers, because many people generally don’t trust state-run media outlets, especially due to now-canceled controversial constitutional referendum, which was scheduled to take place in April. Some people even believe that the state-run media started pushing coronavirus fears to justify cancellation of the so-called “referendum”, because government analysts realized that people will not vote in favor of new amendments.
To contain the virus, the Russian government implemented lockdown, so people in big cities need to get digital permissions to go out. However, low population density, intensive testing, and lockdown didn’t significantly slow down the spread of the virus yet.
Brazil and Mexico
Both Brazilian and Mexican governments reacted very slow to the outbreak, and they still have to ramp up coronavirus testing. Experts suggest that the real amount of cases is much higher in both countries due to very low testing per capita.
Since Brazilian government took very soft approach at handling the outbreak, people had to rely on themselves. For example, local gangs in Rio de Janeiro’s favelas imposed strict curfews back in March to slow coronavirus spread.
Unfortunately, even according to official data, the virus spreads rapidly in both Brazil and Mexico. The true scale of the outbreak is unknown.
Conclusion
As of April 27, seven out of ten most affected countries by coronavirus have the population of less than 100 million people. The majority of world’s population lives in the countries, which are still in the beginning of the outbreak.
Here is a good visual representation of world’s population:
Developing countries don’t have enough resources, no experiences to contain the virus, which was largely seeded from China and from rich developed countries.
However, developing countries have large amounts of poor people, who are the most vulnerable during pandemic, economic turmoil, and food shortage.
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