FIRST PERSON - Alex Magno (The Philippine Star) - May 6, 2021 - 12:00am

Like the flu pandemic a century ago, the second wave of this one is more severe.

Over the past two weeks, India’s daily infection tally surpassed all records. The surge in infections is replicated in Nepal, Iran and Turkey. Infections have happened at the Everest base camp. Pakistan, with its congested cities and weak health care system, appears vulnerable.

What is happening in India is catastrophic. With daily infections rates running between 300,000 and 400,000, the country’s health system is overwhelmed. Hospital demand for oxygen tanks outstrips the country’s ability to produce them. That could only mean we will see a ghastly spike in the death toll the next few days.

The real number of infections and deaths is likely understated. They could be double or even triple the official tally. The surge simply outstripped the country’s testing capacity.

Dozens of countries, in a dramatic show of solidarity, have rushed in aid to help mitigate the catastrophe. With every other country dealing with infections as well, the flow of aid can only scale up so much. One Indian doctor described the trickle of international aid a “drop in the ocean.”

Indeed. But every other country is running short of medical personnel. India has called up seniors in her medical schools to reinforce the frontlines. Even that might not be enough.

The only country with any capacity to send in an army of medical personnel equipped with military field hospitals is China. The world’s most populous nation has managed to maintain a low infection rate even without a commensurate vaccination program. Beijing has been busy donating vaccines to poor countries that desperately need them.

It is unlikely, however, that China will mobilize at any meaningful scale to help India. Their bilateral relationship has been antagonistic lately. The hyperventilating nationalism of the Modi government does not dispose it to welcome aid from Beijing.

Ironically, India is the world’s vaccine manufacturing powerhouse. Now she must divert supplies of the scarcest commodity to meet the catastrophic spread of infections. That will have adverse repercussions in the supply poor countries were expecting from India.

Epidemiologists tell us the worst is not yet over for India. High infections are expected to continue for the next two weeks at least. We will continue to be distressed by photos of people dying in hospital driveways and funeral pyres burning round the clock.

Meanwhile, the sheer scale of infections happening in India will surely result in the evolution of even newer variants of the deadly virus. The fear, of course, is that the new variants could manage to skirt around the existing vaccines. Should that happen, we face the specter of a third wave of infections circling the globe, afflicting even countries that have managed to vaccinate most of their citizens.

To everyone’s relief, there is no evidence yet of new vaccine-skirting strains. But that still remains a scientific possibility that needs to be closely observed.


It is not only the health systems of countries that were overwhelmed by this pandemic. The international organizations intended to orchestrate global responses to emerging challenges were overwhelmed as well.

There is an emerging consensus that the international organizations have managed only a feeble response to the pandemic. But these international organizations are not primed to deal with pandemics. The UN, for instance, can at best field peacekeeping forces in small conflicts – and even then only when there is consensus among all the Security Council members.

The World Health Organization (WHO) performs a largely advisory role to member-countries of the UN. It does track epidemiological outbreaks and informs countries of best practices to contain them. But it has no hospital capacity.

To its credit, the WHO quickly shared genomic information about SARS-Covid-19 when that became available. This enabled laboratories everywhere to develop testing kits and eventually vaccines. The agency regularly issues bulletins to enhance knowledge transfers but the most reliable global case count is the one supplied by the Johns Hopkins University.

The agency’s ability to coordinate an international response was seriously undermined last year when the Trump administration accused it of subservience to China and then cut US funding to it. Fortunately, philanthropic groups such as the Bill and Melinda Gates Foundation stepped in with supplemental funding to keep the agency going in the depths of a pandemic.

The WHO and the World Bank linked up to establish the Covax Facility to ensure poorer countries gain access to vaccines. For many countries, the only vaccines they have are those delivered through Covax. The WHO is the only international agency to dare denounce vaccine nationalism as a serious moral (and medical) failure.

The international finance institutions likewise stepped up by rapidly opening loan facilities for developing countries badly battered by the pandemic. In the case of the Philippines, a ready fund for procuring the vaccines we need was put together with loans from the World Bank, the Asian Development Bank and the Asian Infrastructure Investment Bank. Because of this, we are now ready to procure whatever vaccine becomes available in the market.

Feeble as they might seem to be, the international organizations managed to quickly put together programs to assist the poorer countries. Much of the load for defeating this pandemic lies with the individual governments and their capacity to mobilize local resources.

The current surge lengthened our horizon and timelines for defeating this public health challenge. Each government must build its fiscal stamina and dig deep into their human resources to battle the pandemic.

This battle will likely consume us for years.

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