Tag: Health
COVID-19 in the Middle East
The outbreak of coronavirus in Iran began on February 21. The World Health Organization (WHO) has reported at least 1300 deaths in the Middle East and North Africa. On March 20, the Middle East Institute hosted a panel discussion on “COVID-19 in the Middle East: Assessing the Risks, Exploring Policy Remedies.” The discussion featured four speakers:
Basma Alloush: Policy and Advocacy Advisor, Norwegian Refugee Council.
Jihad Azour: Director, Middle East and Central Asia department, International Monetary Fund (IMF)
Rana Hajjeh: Director of Program Management, World Health Organization (WHO) Regional Office for the Eastern Mediterranean
Hannah Kaviani: Senior Journalist, Radio Farda, RFE/RL’s Persian Language service
Paul Salem, President of the Middle East Institute, moderated
Current Context
Hajjeh pointed out that testing standards are different from state to state. For example, Iran only tests severe cases and makes mild cases stay at home. Iran’s country-wide transmission will lead to an increased number of deaths. Conflicts and wars in the region have weakened health infrastructure, which may not be able to handle the pandemic and may increase the risk of suffering. To reduce the proliferation of COVID-19, WHO is increasing the supply of personal protection equipment across the region. It also attempts to convince religious figures to stop mass gatherings and maintain social distance.
Alloush demonstrated that the COVID-19 has a severe impact on refugee communities. In Yemen and Syria, health infrastructure has been targeted by militias. Public facilities and services are insufficient. Ongoing conflicts have weakened local governance and imposed restrictions on humanitarian assistance. Living conditions don’t allow refugees to do social distancing. Quarantine leads to a decreased access to market. As the situation deteriorates, there have been more tensions between communities.
Kaviani attributed Iran’s pandemic crisis to several reasons:
- Iranians’ lack of education
- Lack of trust in the government
- Sanctions
- Mismanagement
- Lack of regional cooperation
These factors cause the shortage of medicine and medical devices, as well as Iranians’ distrust of government’s instructions and statistics.
Impacts
Azour stated that the pandemic and the oil war between Russia and Saudi Arabia are leading to economic turmoil. Domestic and external demand has dropped because customers have lost confidence on the market. Trade has slowed. The oil price has dropped by more than 60%, which puts pressure on government budgets. Azour expects that any measures to contain the pandemic will cause an increase in unemployment and a reduction in wages. Investments in production and manufacturing will also decline. The impacts will spread to the bond and the equity markets as well.
Remedies
Alloush emphasized that refugees are more vulnerable in this pandemic due to the lack of service access. She listed four main concerns of nongovernmental organizations (NGOs):
- Maintaining operations aimed at meeting pre-existing humanitarian needs,
- Ensuring humanitarian exemptions in order to provide services to refugee communities,
- Providing accurate information and instructions, and
- Guaranteeing the duty of care and protection of NGO staffs.
Hajjeh added that new political agendas may create more uncertainty at this time. States’ ministries of health should take what happened in China into consideration.
Azour prioritized public health and financial improvements in his policy recommendations. The market should reduce consumer payments. Governments should offer timely, targeted support to sectors in need. They should also preserve financial stability by allowing cash transactions as well as encouraging regional and international coordination.
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At risk
President Trump, concerned about the stock market’s more than 20% falloff, is still minimizing the risk and pushing for aid to the travel industry (including his own hotels of course) as well as a payroll tax cut, which he hopes will bury the memory of his massive tax cut for the wealthy in 2017. Neither move will do much for the non-payroll poor, who either vote for or against him because he is a racist. There is no buying them off his poor opponents or his poor proponents. He knows it.
I suppose his economic moves might cheer the markets temporarily, but there is no way we don’t get a big slowdown and likely a contraction this quarter and into the next. The failure of the US government to act promptly against Covid-19, has condemned us all to self-quarantine. While the economy is digitalizing, face-to-face interaction is still indispenable to industries that handle physical stuff and important to others, like teaching international relations. Presidents Xi and Trump may want to purvey happy talk, but reality bites.
It’s biting me too. I’m scheduled to travel to San Antonio Sunday and Atlanta during the following week to visit with our grandchildren, whom I haven’t seen since Thanksgiving. I’m not really worried about protecting myself from the virus. Lots of sanitizer and surgical masks will do a decent job of that, with some residual risk. But if we happen to cross paths with an infected person and are advised to self-quarantine, we could end up stranded for a couple of weeks in one of the destinations or the other. As attractive as that might be for seeing the grandchildren, it won’t help me get my work done. Nor will housing a grandparent for an unexpectedly long period, sick or not, be easy on the kids. So we need to choose between taking the risk or canceling the trip. Ugh.
Many millions of people are now making similar decisions. The Italian government has made it for them: stay home except for work and emergencies it says. I won’t be surprised if we end up there, but the President is still thinking more about his re-election prospects than about the welfare of the American people. Fortunately, they get the final say. How anyone watching the bozotic performance of this Administration in responding to Covid-19 would want it back in office come November is beyond me. It would be fitting if the germophone fell to a virus. Trump is at risk.
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Comeuppance
President Trump yesterday called the corona virus Covid-19 a Democratic hoax and bragged about a false number of (relatively few) cases that have occurred in the US. He claimed it was 16 when the actual number was four times that. And 24 hours later it is significantly higher. The cases are no longer linked to international travel but rather are being infected within American communities. This and the US government’s failure to provide adequate numbers of test kits quickly to state and local health officials make it likely we are nowhere near the peak.
No one would want thousands or even millions of Americans to be infected, but if it happens Donald Trump is in big political trouble. His minimizing of the problem combined with an inadequate response are going to be hard to hide, even from his most fervent supporters. He and his son Donald are trying to sell the notion that Democrats want the infections to spread to weaken his hold on power. Nothing could be further from the truth, and the line isn’t going to protect a culpable president.
Covid-19 will also highlight the health care issue in the presidential campaign. President Trump has interfered with and weakened Obamacare, which had decreased the number of uninsured Americans. Despite frequent promises to do so, the Republicans have proposed no serious alternative. Instead, they have gone to court trying to eliminate Obamacare entirely, including its popular provision of insurance for pre-existing conditions. You don’t have to be a Democrat to think increasing the number of uninsured just before an epidemic hits was a bad political move.
The economic impact is even more politically potent than the health impact. The stock market Trump was fond of boasting about has lost more than 10% in a week. The sharp sell-off is due to expectations of slower growth and uncertainty about how bad it could get. The “correction” has its own implications: it reduces the availability of capital and decreases demand, at least among those who own stock or have retirement plans invested in the market. There is now a pretty good chance for a sharp slowdown, if not a negative growth quarter or more.
The Trump Administration has gotten away with a lot of lying. The President himself has told many thousands of whoppers in his three years in office. But a corona virus epidemic is going to be hard to hide or to blame on his political opponents. Vice President Pence, put in charge of the government response this week, may be tapped as the fall guy. But the truth is Trump limited the initial response to clamping down on non-Americans entering the US, which was not the problem. If the corona virus turns out to be the President’s comeuppance, it will be richly deserved.
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Stevenson’s army, February 28
– WaPo explains Trump administration disinvestment in pandemic capability in recent years.
– Putin or Erdogan? How will Trump choose on Syria?
-Huawei is looking for PR help in DC.
– Duterte says he doesn’t need US military.
– Shame! Shame! WSJ says many states have dropped parallel parking from their driver tests — because too many people were failing.
My SAIS colleague Charlie Stevenson distributes this almost daily news digest of foreign/defense/national security policy to “Stevenson’s army” via Googlegroups. I plan to republish here. If you want to get it directly, To get Stevenson’s army by email, send a blank email (no subject or text in the body) to stevensons-army+subscribe@googlegroups.com. You’ll get an email confirming your join request. Click “Join This Group” and follow the instructions to join. Once you have joined, you can adjust your email delivery preferences (if you want every email or a digest of the emails).
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Big trouble
No one should minimize the health impact of COVID-19, the corona virus originating in Wuhan, China. It is spreading rapidly and will likely make a lot of people sick. The death rate is high–over 2%. It hits older people especially hard and kills younger people much less. President Trump’s effort to portray the virus as not so bad is deplorable.
That said, the impact is likely to depend on how the world reacts as much as on the virus itself. This is obviously true for public health measures: getting sick people isolated and treated correctly will surely lower the risks both to others and to them. The virus has already tested the Chinese and Iranian public health systems. While the initial Chinese reaction in Wuhan was inexcusably slow, WHO is praising China’s vigorous response since. In Iran, the response appears to have been much less effective. In both countries, the publics are unconvinced of their respective governments’ veracity. Health epidemics are going to prove a tough test for governments unused to telling the truth.
That applies to the US as well. President Trump has wisely delegated responsibility to Vice President Pence, whose credibility is far higher than his own. But Pence did not do well as Governor of Indiana in responding to HIV. Nor will he be free to do and say what he wants. His primary responsibilities will be to prevent the American experts Trump boasts about from saying anything to contradict the President and to take the rap if the virus spreads widely in the US. He can’t be fired, but he can be denied renomination.
There is also a risk of overreacting. In retrospect, it is clear that Washington and most of the rest of the world overreacted to 9/11, not only by grounding all aircraft immediately thereafter for longer than necessary but also by launching two wars that each have killed about as many Americans as the initial attacks, plus many thousands of Iraqis and Afghans. In the aftermath of dramatic events, officials want to err on the side of caution–there is no reward for taking additional risks. The World Bank has already cancelled a big conference in DC for next week, despite the absence of COVID-19 here. I suppose the reasoning was that people would be coming from abroad, but remote participation might well have reduced if not eliminated the risk they would have posed.
President Obama handled the Ebola outbreak well: he reacted quickly and did what was needed to keep it in Africa and deal with it there. It is already too late for containment in the current outbreak. The initial Chinese delay eliminated that possibility, and in any event Trump had already dismantled the White House apparatus set up for early reaction. Now we need to try to isolate those infected and ensure that we don’t overreact in ways that cause unjustifiable harm.
The damage to the stock market is already gigantic, though not necessarily irreversible: US markets have declined more than 10%. Only time will tell if that reflects weakening economic fundamentals, caused by disruption of supply chains as well as dampening demand, or is an overreaction. Certainly it illustrates that the United States has a great deal to lose from Chinese economic failure. Maybe a good deal more to lose than from Chinese success, which is vital to American industry and agriculture.
The virus is also having a political impact. Whatever WHO thinks, Chinese are complaining bitterly about their government’s response, and Iranians won’t be far behind. There is nothing wrong with that: citizens should expect their governments to protect public health and criticize them when they fail. But neither Iran nor China permits a serious challenge to their autocratic regimes. Excessive rigidity there could spawn dissent and even cause collapse.
The United States does allow a political alternative to come to power. That is potentially the silver lining. Kakistocracy is only tolerable if it doesn’t appear to matter. If the corona virus makes it clear that we can ill afford incompetence and mendacity, the Trump Administration could be in big trouble.
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Stevenson’s army, February 24
– Administration plans request for coronavirus health measures.
– Islamic State and Al Qaeda are teaming up in the Sahel..
– Big week for congressional hearings.
– Embarrassingly low turnout in Iran elections.
My SAIS colleague Charlie Stevenson distributes this almost daily news digest of foreign/defense/national security policy to “Stevenson’s army” via Googlegroups. I plan to republish here. If you want to get it directly, To get Stevenson’s army by email, send a blank email (no subject or text in the body) to stevensons-army+subscribe@googlegroups.com. You’ll get an email confirming your join request. Click “Join This Group” and follow the instructions to join. Once you have joined, you can adjust your email delivery preferences (if you want every email or a digest of the emails).
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