Communication, Society and Media ISSN 2576-5388 (Print) ISSN 2576-5396 (Online) Vol. 3, No. 2, 2020 www.scholink.org/ojs/index.php/csm 126 Original Paper The Challenges Confronting Countries in the Tropics Affected by Covid-19 Amb. Dr. John O. Kakonge 1* 1 President, The Association of Former International Civ il Servants in Kenya (AFICS -Kenya) * Amb. Dr. John O. Kakonge, President, The Association of Former International Civil Servants in Kenya (AFICS-Kenya) Received: April 22, 2020 Accepted: April 28, 2020 Online Published: May 1, 2020 doi:10.22158/csm.v 3n2p126 URL: http://dx.doi.org/10.22158/csm.v3n2p126 Abstract Compared with other regions of the world, countries in the Tropics appear to have less Covid -19 cases and lower death rates. Warmer temperatures and higher humidity have been proposed as an explanation. An alternative interpretation is that the figures result from a lack of aggressive testing. Regardless of the cause, this paper suggests that the way in which governments respond to the pandemic has a significant impact on containing the pandemic. Additionally, pressing challenges for countries in the Tropics are a lack of water and sanitation, insufficient personal protective equipment, and inadequate training of clinical staff. Suggestions for moving forward are proposed. Keywords Covid-19, Tropical nations, government responses, challenges to containment 1. Introduction The new coronavirus disease, which took the world like a bush fire , o rig inated in China in late 2019. It was transmitted to the rest of the world by air, sea, and road. This paper looks at the challenges of infection within the countries of the Tropics and suggests ways to address some of these challenges. The countries in question fall between the Tropic of Capricorn, 23 0 south of the Equator, and the Tropic of Cancer, 23 0 north of the Equator. Th is area includes countries in Latin America and the Caribbean, Africa, and Asia. Tropical countries have generally had a slower rate of Covid -19 spread than other countries. A possible explanation for this is the high humidity and temperatures of the tropics. However, this exp lanation has been questioned by several scholars. For example, Dapcevich (2020) argues that there is litt le relationship between weather and coronavirus , although he does add that the influenza and cold viruses www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 2, 2020 127 Published by SCHOLINK INC. tend to peak in the colder months and slow down during summer. Other studies also confirm that coronavirus infections tend to be associated with winter because of how they spread (Aubrey, 2020). This is the case with influenza which thrives during the colder months, helping the virus to spread more easily from person to person. Drawing on empirical data, Dapcevich (2020) argues that warmer and more humid environments , such as those of Argentina, Brazil, and Australia, appear to support virus spread, as these countries have all had a considerable number of confirmed cases. Moreover, quoting experts’ views, he stipulates that rather than climate, what actually will determine the decline in the rate of transmission of coronavirus will depend on government responses, the quality of medical care, population density and other factors. However, Dapcevich (2020), quoting Professor Marc Lipsitch, emphasizes that “even seasonal infectious can happen ‘out of reason’ when they are new” due to “their temporary but important advantage: few or no individuals are immune to them”. Regardless, this virus is novel and the influence of climatic conditions on the spread of this disease is yet to be scientifically established. 2. Current Figures According to data from the Worldometer, dated 12 April 2020, most tropical countries have not only low numbers of positive cases, but also low death rates. As of that date, the only tropical country with more than 10,000 positive cases was Brazil with over 20,000 cases, which is low relative to its population of approximately 210 million. Similarly, although India had over 8,000 positive cases, that number represents a small percentage relative to its population of more than one billion people. Table 1 documents the number of cases and death rates of selected tropical nations. In the Caribbean, the Domin ican Republic had more than 2,700 positive cases and over 130 deaths. This is worry ing relative to the total population of about 11 million. Jamaica and Barbados appeared to have few positive cases and their death rates were low. It should be remembered, however, that low numbers of positive cases might be ascribed to a lack o f aggressive testing. Of the eight tropical African countries sampled, Côte d’Ivoire, Democratic Republic of Congo, Ghana, Kenya, Malawi, Nigeria, Rwanda and Senegal, each had less than 1,000 positive cases, although their numbers seemed to be growing. As of April 12 2020, Côte d’Ivoire and Ghana had more cases than the other African countries . In Asia, the number of cases in Indonesia, the Philippines, Malaysia and Thailand were g rowing, with Indonesia having the most positive cases at 3,800, with deaths totalling over 300. In general, all the figures from the tropical countries may not be realistic owing to a lack of testing facilit ies. After the end of April, the situation may become clearer. www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 2, 2020 128 Published by SCHOLINK INC. Table 1. Covid-19 in Selected Tropical Countries as of 12 th April 2020 Country Positive cases No. of deaths Testing capacity Barbados 68 4 Y Bolivia 300 24 Y Brazil 20,964 1,141 Y Colombia 2,709 100 Y Costa Rica 577 3 Y Côte d’Ivoire 553 4 Y Cuba 669 18 Y Democratic Republic of the Congo 234 20 Y Dominican Republic 2,759 135 Y Ecuador 7,466 333 - Ghana 408 8 Y Indonesia 3,842 327 Y India 8,504 289 Y Jamaica 72 4 Y Kenya 191 7 Y Malawi 12 2 Y Malaysia 4,830 73 Y Mexico 4,219 273 Y Nigeria 318 10 Y Peru 6,848 181 Y Philippines 4,648 220 Y Rwanda 120 0 Y Senegal 278 2 - Thailand 2,551 38 Y Trinidad & Tobago 113 8 Y Venezuela 175 9 Y 3. Government Res ponses As of April 12 2020, tropical countries’ government responses to the pandemic were uneven, confusing and wanting, unlike China, where the Government declared a total lockdown for over two months and achieved fairly positive results overall with only 3,300 people dying in hospital. The common guidelines endorsed by WHO include social distancing, limit ing gatherings to a small number, staying www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 2, 2020 129 Published by SCHOLINK INC. at home and self-quarantine. However, each country has interpreted the guidelines differently. For example, in Bolivia the Government prohibited large-scale gatherings of more than 1,000 people. In Brazil, the Government decided to fo llow a policy of business-as-usual. Given that the number of positive cases is increasing, this seems not to have been successful. Of the other Latin American countries sampled, as demonstrated in Table 2, only Colombia and Peru imposed national lockdown and Mexico declared a nationwide emergency. Others have declared a partial close down. In the Caribbean, Barbados imposed lockdown, Jamaica declared a national disaster and Trinidad and Tobago introduced partial restrictions. In Africa, Rwanda imposed a total lockdown, Senegal a curfew, and Nigeria a lockdown for Lagos, Abuja and Ogun states. In the case of Kenya, the Government introduced an all-n ight curfew and restricted movement into and out of Nairobi and Mombasa and their surrounding counties. In Ghana, a major lockdown was declared for greater Accra, Tema and Kumasi. In Asia, Thailand and Indonesia both declared a state of emergency, while India has been on a nationwide lockdown. In the Philippines, the Government declared a state of calamity and a partial lockdown. Table 2. Governments’ Responses to Covid-19 Outbreaks Response Measures Countries No. of cases No. of deaths Total lockdown Barbados, Colombia, India, Malaysia, Peru, Rwanda, Venezuela 23,254 656 Partial lockdown Bolivia, Costa Rica, Côte d’Ivoire, Cuba, Democratic Republic of the Congo, Dominican Republic, Ghana, Indonesia, Kenya, Malawi, Mexico, Nigeria, Philippines, Senegal, Thailand, Trinidad and Tobago 21,672 1,099 No significant measures Brazil, Ecuador, Jamaica 28,502 1,478 www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 2, 2020 130 Published by SCHOLINK INC. Figure 1. Proportional Representation of the Number of Countries according to Government Response to the Covid-19 Outbreak While Figure 1 proportionally represents the different government responses, Figure 2 depicts the total number of positive Covid-19 cases according to government response. Figure 2. Proportional Representation of the Number of Cases according to Government Response to the Covid-19 Outbreak Analysis of the data in Table 2 and Figures 1 and 2, reveals varied results. For example, under total lockdown there were 23,254 positive cases and 656 deaths in a population of 1,825 million (including 1,380 million in India), while under partial lockdown there were 21,672 positive cases with 1,099 deaths in a population of 1,065 million. The countries that took no significant measures had 28,502 cases and 1,478 deaths in a population of 233 million (including 213 million in Brazil) . One observation is that the countries under total lockdown had fewer deaths than the countries that took no significant measures. However, as a proportion of the total populations sampled, countries that imposed no significant measures had considerably less infections than those that imposed either form of lockdown. These figures represent an initial observation, as confounding factors such as who gets 7 16 3 Total lockdown Partial lockdown No significant measures 23,254 21,672 28,502 Total lockdown Partial lockdown No significant measures www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 2, 2020 131 Published by SCHOLINK INC. tested, for example only people exh ib iting symptoms of the disease or larger swathes of the population, will factor into the significance of these findings. 4. Challenges in Containing the Virus Given the viciousness of coronavirus, governments have had to make difficu lt but essential decisions that have had a huge socioeconomic impact. The challenges in implementing the measures are particularly difficult in those countries with huge slums and high unemplo yment. Two challenges that are common to many tropical countries are a lack of adequate water and sanitation, and a lack of Personal Protective Equipment (PPE) fo r, and training of, medical personnel. 4.1 Lack of Water and Sanitation One of the main messages in the global campaign for combating the coronavirus is the importance of washing hands with soap and running water. During World Water Day on 20 March 2020, Water Aid UK noted that low- and middle-income countries face a dual challenge: they do not have any way to wash hands, and knowledge on how and why to wash hands properly is not widespread (RSTMH, 2020). According to RSTMH (2020), nearly 75 per cent of households in sub-Saharan Africa lack basic hygiene facilit ies to wash their hands with soap and water in their homes. Globally, only 19 per cent of people wash their hands with soap after using the toilet despite hands being the principal cause of transmission of disease-causing germs (RSTMH, 2020). According to The Guardian, most low- and middle-income countries are at greatest risk in the coronavirus crisis (Harvey, 2020). The article suggests that low investment in water and sanitation has occurred because the services are perceived as social and environmental rather than economical. Rural areas across the Tropics , as well as the slums of major cit ies , continue to be very vulnerable to the spread of Covid-19. Governments, such as those in Latin America, are currently setting up emergency provision 是 of water supply to the poor and vulnerable groups, including water tanker distributions in Colombia, Costa Rica, Domin ican Republic, Mexico, and El Salvador (Serrano & Torres, 2020). Moreover, priority is being given to hospitals and institutions serving the most vulnerable communities , as for example, in Jamaica. In many countries in Latin America, disconnection of services due to lack of payment has been suspended (Sorreno &Torres, 2020). In Sao Paulo, Brazil, water tariffs for low-income people have been put on hold and debts of individuals and companies have been deferred for 90 days. In comparison, the urban poor in both tropical Asian and African countries are more vulnerable to this pandemic because of the inequalit ies that characterize the provision of water services, and the often lack of means to wash their hands (Amankwaa, 2020). However, some governments are providing water tanks and jerrycans for the urban poor and in open markets of major cit ies. 4.2 Insufficient Personal Protective Equipment and Lack of Training of Clinical Staff Since the onset of the new coronavirus outbreak, most countries, both developed and developing, have www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 2, 2020 132 Published by SCHOLINK INC. found themselves with insufficient or without Personal Protective Equipment (PPE). This has been the case in Italy, Spain, the United Kingdom, the United States, and of course, most of the developing world. Across the Tropics, most of the countries are ill equipped with PPE, have inadequate numbers of doctors and nurses and inadequate hospital facilities. Those nurses and doctors that are available, have had to undergo rapid training regarding how to handle coronavirus infected patients. Most of the countries have no ventilators to treat patients and lack PPE clothes, boots and masks , even for medical personnel. In Kenya, the informal sector is flourishing as local tailo rs make masks of all types for local distribution. In the light of the cancellation of flights and thus export opportunities, the few text ile companies in the country have been encouraged to make PPE. It is hoped that locally produced PPE will meet the required standards to support the work of the committed and determined health care staff. There is no doubt that other countries are also equipping themselves against this virus. 5. The Way Forward The countries in the Tropics should not be complacent about the low figures of positive cases and deaths. They should continue forward with the following: 5.1 Learn from Best Practice The available examples are China, Singapore, South Korea, and Taiwan. For example, South Korea has emphasised tracing contacts, testing and isolating (Noor & Sundaram, 2020). In the case of Taiwan, Tu (2020) states that containment has been due to effective Government-led public-private collaboration; integration of the media in efforts to regularly broadcast basic preventive informat ion, such as washing hands, wearing masks, and social distancing; the provision of clear and decisive guidelines , and ensuring the strong support of cit izens . In the case of Singapore, Heijmans (2020) concludes that its current success is based on its top-notch health care system and draconian tracing and containment measures. Based on the above, countries in the Tropics should embrace the best practices and avoid examples from Brazil and Sweden where the governments are continuing with business as usual. 5.2 Ensure Transparent and Aggressive Testing It is arguable whether the figures from the countries of the Tropics are really low in the absence of aggressive testing. From the examples of Singapore, South Korea, and Taiwan, tropical country governments should strengthen their early warn ing systems, increase the transparency of informat ion, and carry out accurate diagnosis. For instance, South Korea has 185 testing stations operating in different parts of the country as of March 2020. Interestingly, at most of these stations, one can drive in, get tested and obtain the results instantly (UNDP Seoul Policy Centre, 2020). What is needed in most of the countries in the Tropics is investment in high-quality health care systems, like those of Singapore and Cuba, so that their leaders do not have to use their meagre foreign exchange to travel abroad for medical attention. Ironically, even developed countries like Italy, Spain, the United Kingdom, and the www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 2, 2020 133 Published by SCHOLINK INC. United States are all infested with the new coronavirus: this has put leaders of developing countries on notice. 5.3 Enforce Social Distancing and Self-quarantining To win the war on the new coronavirus, social d istancing and self-quarantine are two crit ical factors. However, this is going to be a challenge fo r all countries in the Tropics. Many of the countries with densely populated urban centres , like Dar es Salaam, Delhi, Dhaka, Jakarta, Lagos, Manila, Mumbai, Nairobi, Rio de Janeiro, Sao Pao lo, and others, have huge slums, where many people or families are squeezed into small rooms. Additionally, congested public transport and teaming markets mean that social distancing will continue to be a big challenge. Hence, these will be hotspots of increasing positive cases of coronavirus. 5.4 Collaborate Internationally COVID-9 is a new and virulent disease and as such, there is urgent need for collaboration among countries, especially in the medical fields. Fortunately, the existing South-South Cooperation framework can facilitate this. For example, Cuba has been helping many countries in Latin America, the Caribbean, and in Africa, with their doctors and clin ical staff. More recently they sent their doctors to assist in Italy. India has very good facilities and many people from Africa go there for medical treatment. There should be collaboration among medical scientists in these countries, working together through South-South Cooperation, to come up with drugs against the new coronavirus or any other viruses. For example, a public university in Kenya recently reported that its faculties of engineering and medicine have manufactured a prototype ventilator that, once approved, could be used to treat COVID-19 patients. There should be collaboration in producing PPE within this reg ion for local consumption and for any eventuality. 6. Conclusion The new coronavirus pandemic exposed the poor state of preparedness of the world at large to deal with such an event. Even countries who had experienced previous pandemics were not prepared. As Macky Sall, the President of Senegal, noted, “the level of unpreparedness due to the sudden onset of the pandemic, its rapid evolution and the enormous needs to be addressed, is a clear indication that national measures remain inadequate” (Sall, 2020). Therefore, for countries located in the Tropics, the message is clear, they must priorit ize public health. Neighbouring countries need to cooperate and enforce similar measures, such as lockdown, along their borders. This global pandemic has shown us that in the face of cross-cutting threats, big or s mall, rich or poor, we are all vulnerable. Given that this virus covers the entire world, there is a call for strong collaboration and partnership between the developing world and developed countries in research, innovation and international solidarity. www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 2, 2020 134 Published by SCHOLINK INC. References Amankwaa, G. (2020). COVID-19 and “Chasing for Water”: Water access in poor urban spaces. International Water Association. Retrieved April 12, 2020, from https://iwa-network.org/covid-19-and-chasing-for-water-water-access-in-poor-urban-spaces/ Aubrey, A. (2020). Can Coronavirus be Crushed by Warmer Weather? 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