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bloated, inefficient health-care system

Racist policies that have endured since the days of colonization and slavery left Indigenous and Black Americans especially vulnerable

decades-long process of shredding the nation’s social safety net

same social-media platforms that sowed partisanship and misinformation during the 2014 Ebola outbreak in Africa and the 2016 U.S. election became vectors for conspiracy theories

the COVID‑19 debacle has also touched—and implicated—nearly every other facet of American society: its shortsighted leadership, its disregard for expertise, its racial inequities, its social-media culture, and its fealty to a dangerous strain of individualism.

SARS‑CoV‑2 is neither as lethal as some other coronaviruses, such as SARS and MERS, nor as contagious as measles. Deadlier pathogens almost certainly exist. Wild animals harbor an estimated 40,000 unknown viruses, a quarter of which could potentially jump into humans. How will the U.S. fare when “we can’t even deal with a starter pandemic?,”

The U.S. cannot prepare for these inevitable crises if it returns to normal, as many of its people ache to do. Normal led to this. Normal was a world ever more prone to a pandemic but ever less ready for one. To avert another catastrophe, the U.S. needs to grapple with all the ways normal failed us

Many conservationists jump on epidemics as opportunities to ban the wildlife trade or the eating of “bush meat,” an exoticized term for “game,” but few diseases have emerged through either route. Carlson said the biggest factors behind spillovers are land-use change and climate change, both of which are hard to control. Our species has relentlessly expanded into previously wild spaces. Through intensive agriculture, habitat destruction, and rising temperatures, we have uprooted the planet’s animals, forcing them into new and narrower ranges that are on our own doorsteps. Humanity has squeezed the world’s wildlife in a crushing grip—and viruses have come bursting out.

This year, the world’s coronavirus experts—and there still aren’t many—had to postpone their triennial conference in the Netherlands because SARS‑CoV‑2 made flying too risky.

In 2003, China covered up the early spread of SARS, allowing the new disease to gain a foothold, and in 2020, history repeated itself. The Chinese government downplayed the possibility that SARS‑CoV‑2 was spreading among humans, and only confirmed as much on January 20, after millions had traveled around the country for the lunar new year. Doctors who tried to raise the alarm were censured and threatened. One, Li Wenliang, later died of COVID‑19. The World Health Organization initially parroted China’s line and did not declare a public-health emergency of international concern until January 30. By then, an estimated 10,000 people in 20 countries had been infected, and the virus was spreading fast.

Even after warnings reached the U.S., they fell on the wrong ears. Since before his election, Trump has cavalierly dismissed expertise and evidence. He filled his administration with inexperienced newcomers, while depicting career civil servants as part of a “deep state.” In 2018, he dismantled an office that had been assembled specifically to prepare for nascent pandemics. American intelligence agencies warned about the coronavirus threat in January, but Trump habitually disregards intelligence briefings. The secretary of health and human services, Alex Azar, offered similar counsel, and was twice ignored.

“By early February, we should have triggered a series of actions, precisely zero of which were taken.”

Travel bans make intuitive sense, because travel obviously enables the spread of a virus. But in practice, travel bans are woefully inefficient at restricting either travel or viruses. They prompt people to seek indirect routes via third-party countries, or to deliberately hide their symptoms. They are often porous: Trump’s included numerous exceptions, and allowed tens of thousands of people to enter from China. Ironically, they create travel: When Trump later announced a ban on flights from continental Europe, a surge of travelers packed America’s airports in a rush to beat the incoming restrictions. Travel bans may sometimes work for remote island nations, but in general they can only delay the spread of an epidemic—not stop it.

countries “rely on bans to the exclusion of the things they actually need to do—testing, tracing, building up the health system,”

genetic evidence shows that the specific viruses that triggered the first big outbreaks, in Washington State, didn’t land until mid-February. The country could have used that time to prepare. Instead, Trump, who had spent his entire presidency learning that he could say whatever he wanted without consequence, assured Americans that “the coronavirus is very much under control,” and “like a miracle, it will disappear.” With impunity, Trump lied. With impunity, the virus spread.

it found a nation through which it could spread easily, without being detected

sluggish response by a government denuded of expertise

In response to the global energy crisis of the 1970s, architects made structures more energy-efficient by sealing them off from outdoor air, reducing ventilation rates. Pollutants and pathogens built up indoors, “ushering in the era of ‘sick buildings,’ ” says Joseph Allen, who studies environmental health at Harvard’s T. H. Chan School of Public Health. Energy efficiency is a pillar of modern climate policy, but there are ways to achieve it without sacrificing well-being. “We lost our way over the years and stopped designing buildings for people,”

As of early July, one in every 1,450 Black Americans had died from COVID‑19—a rate more than twice that of white Americans. That figure is both tragic and wholly expected given the mountain of medical disadvantages that Black people face

The indoor spaces in which Americans spend 87 percent of their time became staging grounds for super-spreading events. One study showed that the odds of catching the virus from an infected person are roughly 19 times higher indoors than in open air. Shielded from the elements and among crowds clustered in prolonged proximity, the coronavirus ran rampant in the conference rooms of a Boston hotel, the cabins of the Diamond Princess cruise ship, and a church hall in Washington State where a choir practiced for just a few hours.

Between harsher punishments doled out in the War on Drugs and a tough-on-crime mindset that prizes retribution over rehabilitation, America’s incarcerated population has swelled sevenfold since the 1970s, to about 2.3 million. The U.S. imprisons five to 18 times more people per capita than other Western democracies. Many American prisons are packed beyond capacity, making social distancing impossible. Soap is often scarce. Inevitably, the coronavirus ran amok. By June, two American prisons each accounted for more cases than all of New Zealand. One, Marion Correctional Institution, in Ohio, had more than 2,000 cases among inmates despite having a capacity of 1,500.

America’s nursing homes and long-term-care facilities house less than 1 percent of its people, but as of mid-June, they accounted for 40 percent of its coronavirus deaths. More than 50,000 residents and staff have died. At least 250,000 more have been infected. These grim figures are a reflection not just of the greater harms that COVID‑19 inflicts upon elderly physiology, but also of the care the elderly receive. Before the pandemic, three in four nursing homes were understaffed, and four in five had recently been cited for failures in infection control. The Trump administration’s policies have exacerbated the problem by reducing the influx of immigrants, who make up a quarter of long-term caregivers.

the Department of Health and Human Services paused nursing-home inspections in March, passing the buck to the states. Some nursing homes avoided the virus because their owners immediately stopped visitations, or paid caregivers to live on-site. But in others, staff stopped working, scared about infecting their charges or becoming infected themselves. In some cases, residents had to be evacuated because no one showed up to care for them.

its problematic attitude toward health: “Get hospitals ready and wait for sick people to show,” as Sheila Davis, the CEO of the nonprofit Partners in Health, puts it. “Especially in the beginning, we catered our entire [COVID‑19] response to the 20 percent of people who required hospitalization, rather than preventing transmission in the community.” The latter is the job of the public-health system, which prevents sickness in populations instead of merely treating it in individuals. That system pairs uneasily with a national temperament that views health as a matter of personal responsibility rather than a collective good.

“As public health did its job, it became a target” of budget cuts,

Today, the U.S. spends just 2.5 percent of its gigantic health-care budget on public health. Underfunded health departments were already struggling to deal with opioid addiction, climbing obesity rates, contaminated water, and easily preventable diseases. Last year saw the most measles cases since 1992. In 2018, the U.S. had 115,000 cases of syphilis and 580,000 cases of gonorrhea—numbers not seen in almost three decades. It has 1.7 million cases of chlamydia, the highest number ever recorded.

In May, Maryland Governor Larry Hogan asserted that his state would soon have enough people to trace 10,000 contacts every day. Last year, as Ebola tore through the Democratic Republic of Congo—a country with a quarter of Maryland’s wealth and an active war zone—local health workers and the WHO traced twice as many people.

Compared with the average wealthy nation, America spends nearly twice as much of its national wealth on health care, about a quarter of which is wasted on inefficient care, unnecessary treatments, and administrative chicanery. The U.S. gets little bang for its exorbitant buck. It has the lowest life-expectancy rate of comparable countries, the highest rates of chronic disease, and the fewest doctors per person. This profit-driven system has scant incentive to invest in spare beds, stockpiled supplies, peacetime drills, and layered contingency plans—the essence of pandemic preparedness. America’s hospitals have been pruned and stretched by market forces to run close to full capacity, with little ability to adapt in a crisis.

Sabeti’s lab developed a diagnostic test in mid-January and sent it to colleagues in Nigeria, Sierra Leone, and Senegal. “We had working diagnostics in those countries well before we did in any U.S. states,”

American hospitals operate on a just-in-time economy. They acquire the goods they need in the moment through labyrinthine supply chains that wrap around the world in tangled lines, from countries with cheap labor to richer nations like the U.S. The lines are invisible until they snap. About half of the world’s face masks, for example, are made in China, some of them in Hubei province. When that region became the pandemic epicenter, the mask supply shriveled just as global demand spiked. The Trump administration turned to a larder of medical supplies called the Strategic National Stockpile, only to find that the 100 million respirators and masks that had been dispersed during the 2009 flu pandemic were never replaced. Just 13 million respirators were left.

The supply of nasopharyngeal swabs that are used in every diagnostic test also ran low, because one of the largest manufacturers is based in Lombardy, Italy—initially the COVID‑19 capital of Europe. About 40 percent of critical-care drugs, including antibiotics and painkillers, became scarce because they depend on manufacturing lines that begin in China and India. Once a vaccine is ready, there might not be enough vials to put it in, because of the long-running global shortage of medical-grade glass—literally, a bottle-neck bottleneck.

As usual, health care was a matter of capitalism and connections. In New York, rich hospitals bought their way out of their protective-equipment shortfall, while neighbors in poorer, more diverse parts of the city rationed their supplies.

A study showed that the U.S. could have averted 36,000 COVID‑19 deaths if leaders had enacted social-distancing measures just a week earlier. But better late than never: By collectively reducing the spread of the virus, America flattened the curve. Ventilators didn’t run out, as they had in parts of Italy. Hospitals had time to add extra beds.

the indiscriminate lockdown was necessary only because America’s leaders wasted months of prep time. Deploying this blunt policy instrument came at enormous cost. Unemployment rose to 14.7 percent, the highest level since record-keeping began, in 1948. More than 26 million people lost their jobs, a catastrophe in a country that—uniquely and absurdly—ties health care to employment

In the middle of the greatest health and economic crises in generations, millions of Americans have found themselves disconnected from medical care and impoverished. They join the millions who have always lived that way.

Elderly people, already pushed to the fringes of society, were treated as acceptable losses. Women were more likely to lose jobs than men, and also shouldered extra burdens of child care and domestic work, while facing rising rates of domestic violence. In half of the states, people with dementia and intellectual disabilities faced policies that threatened to deny them access to lifesaving ventilators. Thousands of people endured months of COVID‑19 symptoms that resembled those of chronic postviral illnesses, only to be told that their devastating symptoms were in their head. Latinos were three times as likely to be infected as white people. Asian Americans faced racist abuse. Far from being a “great equalizer,” the pandemic fell unevenly upon the U.S., taking advantage of injustices that had been brewing throughout the nation’s history.

Of the 3.1 million Americans who still cannot afford health insurance in states where Medicaid has not been expanded, more than half are people of color, and 30 percent are Black.* This is no accident. In the decades after the Civil War, the white leaders of former slave states deliberately withheld health care from Black Americans, apportioning medicine more according to the logic of Jim Crow than Hippocrates. They built hospitals away from Black communities, segregated Black patients into separate wings, and blocked Black students from medical school. In the 20th century, they helped construct America’s system of private, employer-based insurance, which has kept many Black people from receiving adequate medical treatment. They fought every attempt to improve Black people’s access to health care, from the creation of Medicare and Medicaid in the ’60s to the passage of the Affordable Care Act in 2010.

A number of former slave states also have among the lowest investments in public health, the lowest quality of medical care, the highest proportions of Black citizens, and the greatest racial divides in health outcomes

“We’re designed for discrete disasters” like mass shootings, traffic pileups, and hurricanes, says Esther Choo, an emergency physician at Oregon Health and Science University. The COVID‑19 pandemic is not a discrete disaster. It is a 50-state catastrophe that will likely continue at least until a vaccine is ready.

Native Americans were similarly vulnerable. A third of the people in the Navajo Nation can’t easily wash their hands, because they’ve been embroiled in long-running negotiations over the rights to the water on their own lands. Those with water must contend with runoff from uranium mines. Most live in cramped multigenerational homes, far from the few hospitals that service a 17-million-acre reservation. As of mid-May, the Navajo Nation had higher rates of COVID‑19 infections than any U.S. state.

Americans often misperceive historical inequities as personal failures

the largely unregulated, social-media-based communications infrastructure of the 21st century almost ensures that misinformation will proliferate fast. “In every outbreak throughout the existence of social media, from Zika to Ebola, conspiratorial communities immediately spread their content about how it’s all caused by some government or pharmaceutical company or Bill Gates,”

Rumors coursed through online platforms that are designed to keep users engaged, even if that means feeding them content that is polarizing or untrue. In a national crisis, when people need to act in concert, this is calamitous. “The social internet as a system is broken,” DiResta told me, and its faults are readily abused.

Like pandemics, infodemics quickly become uncontrollable unless caught early.

In 2016, when DiResta spoke with a CDC team about the threat of misinformation, “their response was: ‘ That’s interesting, but that’s just stuff that happens on the internet.’ ”

The WHO, the CDC, and the U.S. surgeon general urged people not to wear masks, hoping to preserve the limited stocks for health-care workers. These messages were offered without nuance or acknowledgement of uncertainty, so when they were reversed—the virus is worse than the flu; wear masks—the changes seemed like befuddling flip-flops.

Drawn to novelty, journalists gave oxygen to fringe anti-lockdown protests while most Americans quietly stayed home. They wrote up every incremental scientific claim, even those that hadn’t been verified or peer-reviewed.

By tying career advancement to the publishing of papers, academia already creates incentives for scientists to do attention-grabbing but irreproducible work. The pandemic strengthened those incentives by prompting a rush of panicked research and promising ambitious scientists global attention.

In March, a small and severely flawed French study suggested that the antimalarial drug hydroxychloroquine could treat COVID‑19. Published in a minor journal, it likely would have been ignored a decade ago. But in 2020, it wended its way to Donald Trump via a chain of credulity that included Fox News, Elon Musk, and Dr. Oz. Trump spent months touting the drug as a miracle cure despite mounting evidence to the contrary, causing shortages for people who actually needed it to treat lupus and rheumatoid arthritis. The hydroxychloroquine story was muddied even further by a study published in a top medical journal, The Lancet, that claimed the drug was not effective and was potentially harmful. The paper relied on suspect data from a small analytics company called Surgisphere, and was retracted in June.**

Science famously self-corrects. But during the pandemic, the same urgent pace that has produced valuable knowledge at record speed has also sent sloppy claims around the world before anyone could even raise a skeptical eyebrow.

No one should be shocked that a liar who has made almost 20,000 false or misleading claims during his presidency would lie about whether the U.S. had the pandemic under control; that a racist who gave birth to birtherism would do little to stop a virus that was disproportionately killing Black people; that a xenophobe who presided over the creation of new immigrant-detention centers would order meatpacking plants with a substantial immigrant workforce to remain open; that a cruel man devoid of empathy would fail to calm fearful citizens; that a narcissist who cannot stand to be upstaged would refuse to tap the deep well of experts at his disposal; that a scion of nepotism would hand control of a shadow coronavirus task force to his unqualified son-in-law; that an armchair polymath would claim to have a “natural ability” at medicine and display it by wondering out loud about the curative potential of injecting disinfectant; that an egotist incapable of admitting failure would try to distract from his greatest one by blaming China, defunding the WHO, and promoting miracle drugs; or that a president who has been shielded by his party from any shred of accountability would say, when asked about the lack of testing, “I don’t take any responsibility at all.”

Trump is a comorbidity of the COVID‑19 pandemic. He isn’t solely responsible for America’s fiasco, but he is central to it. A pandemic demands the coordinated efforts of dozens of agencies. “In the best circumstances, it’s hard to make the bureaucracy move quickly,” Ron Klain said. “It moves if the president stands on a table and says, ‘Move quickly.’ But it really doesn’t move if he’s sitting at his desk saying it’s not a big deal.”

everyday Americans did more than the White House. By voluntarily agreeing to months of social distancing, they bought the country time, at substantial cost to their financial and mental well-being. Their sacrifice came with an implicit social contract—that the government would use the valuable time to mobilize an extraordinary, energetic effort to suppress the virus, as did the likes of Germany and Singapore. But the government did not, to the bafflement of health experts. “There are instances in history where humanity has really moved mountains to defeat infectious diseases,” says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. “It’s appalling that we in the U.S. have not summoned that energy around COVID‑19.”

People suffered all the debilitating effects of a lockdown with few of the benefits. Most states felt compelled to reopen without accruing enough tests or contact tracers. In April and May, the nation was stuck on a terrible plateau, averaging 20,000 to 30,000 new cases every day. In June, the plateau again became an upward slope, soaring to record-breaking heights.

It is no coincidence that other powerful nations that elected populist leaders—Brazil, Russia, India, and the United Kingdom—also fumbled their response to COVID‑19. “When you have people elected based on undermining trust in the government, what happens when trust is what you need the most?”

the United States underperformed across the board, and its errors compounded. The dearth of tests allowed unconfirmed cases to create still more cases, which flooded the hospitals, which ran out of masks, which are necessary to limit the virus’s spread. Twitter amplified Trump’s misleading messages, which raised fear and anxiety among people, which led them to spend more time scouring for information on Twitter.

The virus was never beaten in the spring, but many people, including Trump, pretended that it was. Every state reopened to varying degrees, and many subsequently saw record numbers of cases. After Arizona’s cases started climbing sharply at the end of May, Cara Christ, the director of the state’s health-services department, said, “We are not going to be able to stop the spread. And so we can’t stop living as well.” The virus may beg to differ.

The long wait for a vaccine will likely culminate in a predictable way: Many Americans will refuse to get it, and among those who want it, the most vulnerable will be last in line.

It is almost unheard-of for a public-health measure to go from zero to majority acceptance in less than half a year. But pandemics are rare situations when “people are desperate for guidelines and rules,” says Zoë McLaren, a health-policy professor at the University of Maryland at Baltimore County. The closest analogy is pregnancy, she says, which is “a time when women’s lives are changing, and they can absorb a ton of information. A pandemic is similar: People are actually paying attention, and learning.”

As the economy nose-dived, the health-care system ailed, and the government fumbled, belief in American exceptionalism declined. “Times of big social disruption call into question things we thought were normal and standard,” Redbird told me. “If our institutions fail us here, in what ways are they failing elsewhere?” And whom are they failing the most?

It is hard to stare directly at the biggest problems of our age. Pandemics, climate change, the sixth extinction of wildlife, food and water shortages—their scope is planetary, and their stakes are overwhelming. We have no choice, though, but to grapple with them. It is now abundantly clear what happens when global disasters collide with historical negligence.

America would be wise to help reverse the ruination of the natural world, a process that continues to shunt animal diseases into human bodies. It should strive to prevent sickness instead of profiting from it. It should build a health-care system that prizes resilience over brittle efficiency, and an information system that favors light over heat. It should rebuild its international alliances, its social safety net, and its trust in empiricism. It should address the health inequities that flow from its history. Not least, it should elect leaders with sound judgment, high character, and respect for science, logic, and reason.

in Tanzania, a global pandemic is colliding with a turn toward authoritarianism, making both problems far worse

Things in Tanzania got markedly worse in April, when three members of the country’s parliament died from unknown causes within days of each other. Suspecting COVID-19, members of the main opposition party, Chadema, called for the suspension of parliament and COVID-19 testing for all parliamentary members, staff, and families. Chadema Chairman Freeman Mbowe accused the Magufuli government of a cover-up regarding the extent of coronavirus infections in Tanzania. Magufuli’s government was vague in its response, acknowledging the three deaths but leaving speculation about the cause of their deaths unanswered. Late that month, the Tanzanian government submitted its COVID-19 infection data to the World Health Organization, reporting 509 cases and 21 deaths. It has not updated the figures since. It is hard to trust these numbers; scores of observers have noted the difficulty many African countries have had effectively collecting data.

A strikingly similar situation has unfolded in Burundi, where the country’s president is thought to have died from COVID-19 after months of official denials about the disease’s seriousness. The government even encouraged citizens to attend religious services and other large gatherings in the country. In Madagascar, too, the country’s authoritarian president has been dogged by criticism, including from the WHO, about his government’s response, or lack thereof, which has featured the promotion and distribution—including to Tanzania—of an unproven “herbal cure.”

those countries in Africa that have demonstrated the most effective COVID-19 responses are also the most democratic and transparent

Senegal and Ghana, which have led the continent in the development of affordable and effective rapid testing for the new coronavirus. Senegal, specifically, has stood out for its relative success, ranking No. 2 globally in Foreign Policy’s COVID-19 Global Response Index.

Some observers have argued that the pandemic might serve to strengthen democratic resistance and expose the weakness of authoritarian rule. It seems more likely that the vulnerable countries will get sicker before they can start to recover.

Despite testing far less than its neighbors, Somalia has the highest death toll in East Africa. On April 17 and 18, 72 people were tested, out of which 55 were confirmed positive, a staggering 76 percent infection rate. Since this revelation, the Somali government has stopped sharing the numbers of people tested with the public.

Anecdotal accounts of COVID-19 symptoms and a spike in burials abound. “There is extraordinary community transmission. Infections and deaths are out of control,” explained a Mogadishu doctor on the condition of anonymity. “And why visit a hospital if they can’t treat you?” Somalia’s health infrastructure is mere scaffolding: scarce public hospitals struggling with a lack of equipment, unaccredited doctors in private facilities offering unaffordable services, and medication that is as low-grade as it is scarce.

Somalia’s best-equipped medical institution, Erdogan Hospital in Mogadishu, was shut down in April after 3 of its doctors were infected. Martini Hospital—kitted with 76 beds—is the only medical facility in the whole country designated to treat the infected

Answers to this acute health crisis lie in part with the government’s 2020 budget, which allocated $9.4 million for health spending, a mere 2 percent of the national budget. A whopping $146.8 million was reserved for security institutions—a telling indication of a cash-strapped state facing widespread security threats.

The group heralded the disease as divine punishment for the treatment of Muslims globally. Weaponizing the disease, al-Shabab ushered in Ramadan with an attempted vehicle-borne explosive attack at a military base on the first full day of the holy month.

Like the virus, al-Shabab transcends national borders and presents risks not only to Somalia but to its pandemic-weakened neighbors, particularly Kenya, which has weathered violent attacks from the group for years. Born out of a power vacuum itself, al-Shabab will capitalize on lapses in states’ security apparatus as governments redirect resources from preempting terror attacks to enforcing curfews

risks reversing critical security gains

Kenya’s northeastern towns lying on its border with Somalia have been particularly vulnerable to devastating al-Shabab attacks. In response to the illegal smuggling of people and goods from both Somalia and Ethiopia, Kenyan security authorities have recently ramped up aerial surveillance along its borders, in part, to curtail cross-border infection. Ethiopia’s health minister announced last week that 13 of its new cases were imported via illegal migration from Djibouti and Somalia

More than 80 percent of global trade passes through the Gulf of Aden

the resurgence of piracy can be expected

For more than a year now, the central government has been embroiled in a rancorous fight with two of its federal states. This being an election year, the fledgling Somali state finds itself at a critical juncture. It remains to be seen whether federal elections will be postponed, following in the footsteps of neighboring Ethiopia.

The disappearance of remittances—a lifeline for millions on the continent and estimated at $1.4 to $2 billion annually in Somalia alone—makes the situation all the more desperate. These critical cash flows have dried up as a global recession sets in and incomes of workers in the diaspora shrink.

harrowing statistics from across Europe show that Somali communities have been disproportionately affected by COVID-19. In Sweden, Somalis are dying from the virus at “an astonishing high rate” according to the BMJ despite accounting for only 0.69 percent of the population. The World Bank is calling on governments to designate remittance companies as an essential service, a crucial step to easing restrictions on these financial flows.

The populations most at risk in Somalia are those living in the densely populated camps scattered across the country. More than 2.5 million internally displaced people live in these cramped conditions, already weakened by malnutrition and compromised immune systems, and with limited access to clean water, soap, or bathrooms.

According to the World Food Programme, the number of food-insecure people in East Africa is projected to reach up to 43 million in the next few months—more than double what it is now—sparking fears of conflict over scarce resources.

The specter of drought and famine, alongside the unforgiving plague of locusts that has ravaged crops in recent months

deadly flash floods

will force more people to move, compounding the internal displacement crisis and heightening intercommunal tensions  even as it spreads the disease further

Border closures across the region have throttled migration flows, making it ever harder for people to escape conflict or starvation. This will simply force migration into the shadows, opening up avenues for human trafficking and exploitation. Irregular movement of refugees has already been observed across the Horn of Africa’s highly porous borders.

During  Friday prayers at Mogadishu’s Marwazi mosque on April 10, armed forces tried to forcibly disperse a congregation of worshippers without notice. A massive demonstration broke out, and shoulder-to-shoulder prayers continue across the country today

Riots swept the streets of Mogadishu again on April 24 in response to the fatal shooting of two innocent civilians by police as they tried to enforce a curfew. Ramadan, replete with nightly rounds of public taraweeh prayers, is likely to catalyze disease spread in the absence of clear communication with communities and Islamic leaders.

The virus demands self-sufficiency. Countries are forced to make do with their own systems, however broken.

government’s restrictions on press freedom and access to information about the novel coronavirus to the detriment of its own people

As has often been the case in the disaster-prone country, it will be up to grassroots community groups, the private sector, and members of the diaspora to mobilize en masse to contain the crisis.

Two officials at the Ministry of Health have already been arrested on corruption allegations related to COVID-19 response donations, denting public confidence.

With domestic flights suspended, it is all the more critical to invest in hospital and testing capacity across the country. This cannot be achieved without genuine collaboration between the federal government and its constituent member states.

As many countries begin partially reopening their economies, traffickers may now be in a position to become more powerful than ever. With economies in distress and many businesses facing ruin, cash-rich narcos may be able to cheaply buy their way into an even bigger share of the legitimate economy.

“There has always been a stock, it’s a very organized chain. It’s the way to control everything, especially the price. The stocks are on beaches such as Tarena [near the border with Panama], banana plantations, in the jungle. The stashes are everywhere,”

Traditionally, smugglers have used small, very fast speedboats, as well as fishing vessels and submarines, to ply their northern route. Lockdowns have made these methods harder to use, mainly for logistical reasons. So instead, smugglers are turning back to older, slower routes that are often broken up in parts.

Unlike exports to the United States, cocaine bound for Europe is typically moved in legal air and sea cargoes, especially fast-moving fresh goods such as flowers and fruit. The latter, as food, has continued to move unimpeded during the pandemic, helping feed Europe’s 9.1 billion euro-a-year cocaine habit. Colombia’s banana industry, for example, has been exempt from local lockdown measures, allowing cocaine to keep moving through the crop’s supply chain. “[Anyone] in the authorities or security that meddles with this route goes down,” said Rául, the Gulf Clan member, adding that people who are paid off to facilitate the smuggling of cocaine have an incentive to keep the drugs flowing. “Everybody eats,” he said.

Mexican cartels have used the crisis as a public relations opportunity. People associated with the cartels, including the daughter of imprisoned Sinaloa cartel chief Joaquín “El Chapo” Guzmán, have publicly distributed food and other essential items to the poor. Meanwhile, the country’s drug violence continues unabated, claiming an average of 80 lives per day.

Italy has fallen silent as a point of arrival, despite being home to mafia groups that dominate Europe’s cocaine trade. Seizures dropped by 80 percent over the months of March and April compared to the same period last year

Ramón Santolaria, the head of anti-narcotics at Spain’s national police in Catalonia, said cocaine traffickers may have mistakenly assumed that the pandemic would have reduced monitoring at ports. The cartels “have to continue exporting,” Santolaria said. “They are like a company. They can’t store everything in their countries, since it would be very risky.”

In March and April, Spain seized over 14 tons of cocaine in inbound shipments — a figure six times higher than the same period the previous year, said Manuel Montesinos, the deputy director of Customs surveillance at the Spanish Taxation Agency. “We are very struck by the frenetic pace,” Montesinos said. “Almost every day we receive alerts of detections of suspicious operations.”

“Italy did not receive much via ports or airports and that is because during lockdown we have been controlling them a lot,” said Marco Sorrentino, the head of anti-mafia department of Italy’s financial police, the Guardia di Finanza. Italian crime groups have shifted their operations to Spain, where they have large “colonies” according to Sorrentino. “Italian mafias and their partners thus sent cocaine mainly to Algeciras or Barcelona, and then from there they moved it on wheels to the rest of Europe and to Italy,” he said. “As cover-up they used trucks filled with fresh fruits or also soy flour,” which resembles cocaine.

At the street level, lockdowns have played havoc with cocaine sales — but have also failed to stop the trade. But in some cases at least, dealers’ adaptations may have actually put them in a more profitable position than before, as cocaine users are desperate and confined at home. “Even though they don’t lack product, they have raised prices a bit and are cutting it more,”

The solution? Delivering it to customers in the guise of food orders, or couriered by essential workers carrying documents that give them permission to move around freely. Dealers have also staked out positions in socially distanced queues outside supermarkets — one of the only permitted places to gather in public under Italy’s strict lockdown rules, which began easing up in early May.

The main dark web marketplaces have seen an increase in sales of roughly 30 percent since lockdown measures started coming into effect worldwide

“Private citizens who are in need and won’t have access to a bank loan will be victims of loan sharks,” he said. “But what worries us the most is that licit companies might be in need, and be approached by mafia organizations that will propose to become minority shareholders.” “And once this happens, they actually take over the whole company,”

“The correlation between influenza mortality and the vote share won by right-wing extremists is stronger in regions that had historically blamed minorities, particularly Jews, for Medieval plagues,”

authoritarian regimes, such as those in Hungary, Turkmenistan and Rwanda, have used the pandemic to crack down on opposition voices and critics

On January 24, the government opened a control room to deal with the situation, made plans to isolate people, including home quarantine, and looked at the existing provisions of equipment including N95 masks, and PPEs (Personal Protective Equipment). On January 30, India registered its first Coronavirus infection in Kerala; it was a student who’d returned home from China.As of May 4, 462 people have recovered from the infection in Kerala, and there have been just three deaths. Even the oldest patients have recovered—a couple, aged 88 and 93. “When their tests came back positive, they were moved to a medical college because they were very vulnerable,” she shares. “In fact, we had special nurses and the best ICU set aside for them. And so, we brought them back to life,”

Kerala has long been focused on public health, education and social upliftment. Over the last few years, and since Shailaja Teacher got the health portfolio, there’s been renewed attention to the state’s public healthcare institutions. “We had a three-point agenda: government hospitals should be patient-friendly, high-tech, and out-of-pocket expenditure must reduce. Primary healthcare units are very important, especially in rural areas, they now have testing labs and are able to catch early signs of different diseases. Medical college hospitals have new equipment, and good infrastructure. Our focus definitely strengthened the system,”

a daily video conference with different frontline staff of the healthcare community across 14 districts. “Each day’s video conference is dedicated to groups of people doing different kinds of work, from district medical officers, nurses, ASHA workers. It gives us the opportunity to talk to people and hear them out. Keeping in touch with those working at the grassroots level is extremely important, we try to maintain that at all costs. When the minister, or a health secretary directly wants to understand their ground reality, it makes a huge difference, especially to keep morale up.”

Morale is especially important because there’s little knowing how things will pan out. Shailaja Teacher is cautious: “It will take time to get back to normal life. It is a truth that people must accept now. This virus is not like others. Many people test positive then test negative within a few days, but others take upward of 30 days to test negative. It sometimes takes five or six tests before it comes back negative. So that means this virus remains in the body for a while, and there’s a possibility of a transfer. In Kerala, we have it under control but if we get over-confident then we may have a second wave.”

When I spoke to Shailaja Teacher, she had another 9 or 10 hours of meetings, files, discussions, and even a press conference ahead of her. Her husband, two grown-up sons and their families, check in on her just before midnight via phone calls. 

By exploiting governance gaps, terrorists and insurgents gain valuable propaganda victories

by launching public health campaigns and dispensing information and advice on how to avoid being infected, terrorist and insurgent groups can position themselves as a trusted voice on these issues.

Good governance and competent public administration are the best medicine for pandemics and insurgencies alike.

it is particularly worrying how far the coronavirus is spreading within the political elite in countries where many senior politicians are over 60, making them especially at risk. In Burkina Faso, a country that has experienced more than its fair share of instability in recent years—and which is currently struggling against an insurgency—the ministers of foreign affairs, education, the interior, and mines have all tested positive.

In Nigeria, one of the most economically and politically important countries on the continent, Abba Kyari, the chief of staff to 77-year-old President Muhammadu Buhari, has come down with the disease. Although media outlets have reported that Buhari tested negative, this has not stopped damaging rumors that the often ill president has been incapacitated from circulating in Twitter.

The world should also be paying close attention to Iran, where media censorship has obscured the extent of the crisis. So far, two vice presidents and three cabinet officials are known to have gotten the virus. It is also estimated that 10 percent of parliament and many prominent figures within the Islamic Revolutionary Guard Corps are sick—including a senior advisor to the 80-year-old supreme leader, Ayatollah Ali Khamenei, raising questions about his health.

A leadership crisis is just one of the potential sources of political instability the coronavirus could spark. Others include the risk of popular unrest and the debt crises that will soon engulf many countries around the world. Along with the fact that some of the main providers of foreign aid are now preoccupied with their own financial crises, there is a serious risk that politically and economically weak states will face a perfect storm of elite deaths, debt, mass unemployment, and social unrest

In countries where poverty is widespread, health systems are weak, and the cost of food is high, citizens are already under intense financial pressure. Despite earning the least, those who live in slum areas around capital cities often have to pay more for access to water and food than those who have valuable properties in the city centers. While the cramped conditions of slum living make it implausible to self-isolate, limited and inconsistent income make it impossible to buy in bulk—or to stay home for weeks on end without working and risk starvation. For many of the poorest people in the world, hunger is just a few days away

Already, there have been sporadic incidents of unrest in a number of countries, including prison protests in Italy. Meanwhile, heavy-handed efforts to enforce the curfew threaten to further erode public confidence in the government and the security forces. There are reports of widespread human rights abuses being committed in Kenya and South Africa, where the police have been using water cannons and rubber bullets to enforce the lockdown.

Unless the deferral of debt goes hand in hand with debt cancellation and long-term rescheduling, the end of the coronavirus crisis could be followed by a series of economic collapses across the developing world. In turn, this will undermine the ability of governments to provide affordable fuel and food, further increasing the risk of public unrest.

Civil wars, political instability, and poverty kill millions of people every year. These deaths rarely elicit the kind of comprehensive media coverage that COVID-19 has received, but they are no less important. It is possible to prevent the worst political consequences of the coronavirus but only if governments and institutions act now. Wealthy nations must increase their aid budgets rather than cut them, and international organizations must anticipate and work to avoid political crises more proactively than ever before. That is the only way to collectively survive the present in a way that does not undermine the future.

This growth in immigration, in turn, is changing the image of Japan from ethnically homogenous to moderately diverse. Among Tokyo residents in their 20s, 1 in 10 is now foreign-born. And Tokyo is no longer an outlier. Much of the migration is happening in small industrial towns around the country, such as Shimukappu in central Hokkaido and Oizumi in Gunma prefecture, where migrant populations make up more than 15 percent of the local population. In the mostly rural Mie prefecture, east of Osaka and Kyoto, foreign migration has reversed years of population loss.

Conservative Prime Minister Shinzo Abe has based his support for the changing immigration policy not on any humanitarian concerns but rather on pragmatic, demographic arguments. By 2050, the world population is expected to increase by 2 billion people, according to the United Nations, but Japan’s population is expected to shrink by at least 20 million. Meanwhile, the fertility rate in Japan has fallen to 1.4 children per woman, while 28 percent of the country is over 65 years old. This means that the country’s population has been dropping by around 400,000 people a year

With unemployment consistently below 3 percent in recent years, even after the pandemic, employers are increasingly raising alarms about labor shortages. Last year, for the first time in Japan’s history, there were more jobs available than the number of job seekers in all of Japan’s 47 prefectures. In a country long known for its restrictive borders, immigration is now seen as the most obvious solution to that demographic challenge.

Japan has developed a unique program of customized immigration, based on specific requests for workers from various countries

Japan custom-orders a labor force in the 14 sectors where they are most urgently needed, including nurses and care workers, shipbuilders, farm workers, car mechanics, and workers in the fishing and construction industries

he said he prefers the casual xenophobia of Japan to the structural racism of America

most of Japanese society supports the changing immigration policy. In a recent survey by Nikkei, almost 70 percent of Japanese said it is “good” to see more foreigners in the country. “The nationalist, anti-immigrant groups here only make up perhaps 1-2 percent of voters. It’s not like Europe. And they have not raised their voices about this so far,”

bilateral agreements Japan has drafted with countries such as Indonesia and the Philippines, which will allow them to send tens of thousands of care workers to Japan annually. Both countries see this as a win-win proposition. Japan gets much-needed labor, the Philippines gets an increase in foreign remittances, and many workers will eventually return, having learned new valuable skills

opposition has largely come from Abe’s left, over concerns about a lack of regulation on employers, which they fear could lead to exploitation. Many foreign workers are already forced to work overtime, receive less pay, and risk having their passports and travel documents confiscated by employers

some factories in the mostly rural Gifu prefecture have implemented segregated bathrooms and locker rooms for domestic and foreign workers

This dynamic was common in the immigration debate in Europe and the United States in the 1980s and ’90s, when pro-business conservatives often pushed for more immigrants and guest workers, while labor unions raised concerns for workers’ rights and downward pressure on wages.

The widespread xenophobia in Japan is hardly a myth. In 2010, the U.N.’s human rights experts called out Japan for racism, discrimination, and exploitation of migrant workers. Increased immigration has not changed the country’s notoriously strict asylum policies. In 2018, only 42 asylum-seekers were approved, out of around 10,000 applicants.

given that latest bill allows an easier pathway for skilled foreign workers to apply for permanent residency and, eventually, Japanese citizenship—it may do more than simply sustain society. “More workers will try to stay here permanently,” Oguma said. “So even if the bill is not meant to change Japan, it certainly has the potential to change Japanese society in the long term.”

Sooner or later, Japan may face nationwide debate on what it means to be Japanese in the 21st century. Few countries undergoing demographic shifts are able to avoid these challenges.

When South Korea accepted 500 Yemeni refugees in 2018, it created storms of protests, with street rallies demanding that the Yemenis be sent back, calling them “fake refugees.”

In early June, thousands of people participated in Black Lives Matter protests in Tokyo, which has contributed to a nationwide debate on harassment of migrants and foreigners—as well as race.

“Xenophobic nationalists are generally irrelevant in politics. If there is a backlash, it will most likely begin as a local uprising against Tokyo, a populist revolt against the central government, just as in the EU,” Oguma said. “But I don’t see it happening right now. The far-right here is too atomized, each faction want different things. So I don’t really worry about an organized uprising.”

With massive stimulus spending and a robust, universal health care system, Japan has weathered the pandemic fairly well. Unemployment in April was 2.5 percent. While there has been some anecdotal evidence of increased racist harassment of foreign workers, coupled with an emerging skepticism toward globalization and migration, Japan at the moment is one of the few countries where resentment against immigrants is not the defining feature of politics.

Britain completely removed coal-fired power from its grid for 67 days starting April 9 — a record set since the Industrial Revolution as the National Grid works toward a zero-carbon system by 2025.

U.S. coal companies, already in financial trouble, are more likely to default because of the pandemic, according to S&P Global Market Intelligence. Italian utility ENEL says it will be able to close coal-fired power stations that it operates across the world sooner than anticipated due to the virus.

China, the world’s biggest emitter of greenhouse gases, actually has been accelerating plans for new coal power plant capacity as it tries to revive its virus-hit economy

Poland is the only EU state refusing to pledge carbon neutrality by 2050. Governments in Warsaw have argued for years that as an ex-communist country still trying to catch up with the West, it cannot give up the cheap and plentiful domestic energy source. It also says its reliance on coal plays is important for weaning itself from Russian gas.

Poland’s coal production is becoming less efficient, and it has increasingly been importing cheaper coal from Mozambique, Colombia, Australia and even Russia. As it does so, Poland’s own coal piles up unused, and some mines have been closed.

falling demand for coal because of warmer winters; wind and other renewables becoming cheaper; rising costs of carbon emissions; and a society less willing to tolerate high levels of air pollution

“Censorship cannot be regarded as a country’s internal matter. Information control in a given country can have consequences all over the planet and we are suffering the effects of this today. The same goes for disinformation and rumours. They make people take bad decisions, they limit free will and they sap intelligence.” 

RSF has taken measures to ensure that it remains as fully operational as possible while guaranteeing the safety of its personnel and partners. The data RSF collects comes from its network of bureaux and correspondents. Tracker-19 offers an interactive world map on the press freedom situation, constant coverage of developments and analyses of key issues. 

As sources of information proliferated, long-standing sources of authority (monarchy, aristocracy, and the established Church) feared losing power and turned reactionary. At the same time, the longer-term transformations on which these social and cultural innovations were built—the growth of European overseas empires and the emergence of settler colonialism, massive silver exports from South and Central America, the trans-Atlantic slave trade—continued, and in ever more brutal forms. More than 6 million Africans were sold into slavery in the 18th century—a time that some still call the “Age of Enlightenment.”

Today, as in the 1790s, an old order is ending in convulsions. Even before the coronavirus prompted flight cancellations and entry bans, climate activists were rightly telling us to change our modes and patterns of travel. Even before nonessential businesses were shut by government orders, online shopping and same-day deliveries were rapidly remaking retail commerce, while environmental concerns and anti-consumerism were revolutionizing the fashion industry.

real revolutions are the ones that nobody sees coming

The men and women who made the French Revolution—a revolution which, in a few short and hectic years, decriminalized heresy, blasphemy, and witchcraft; replaced one of the oldest European monarchies with a republic based on universal male suffrage; introduced no-fault divorce and easy adoption; embraced the ideal of formal equality before the law; and, for a short time at least, defined employment, education, and subsistence as basic human rights—had no model to follow, no plans, no platform agreed upon in advance. As the UCLA historian Lynn A. Hunt has argued, they made it up as they went along. Yet for more than two centuries, elements of their improvised politics have been revolution’s signature features: a declared sovereignty, devised symbols, an anthem, war. At the junction Americans face today, however, we need to imitate not the outcome of the French revolution but the energy, creativity, and optimism of the French revolutionaries.

In hindsight a revolution may look like a single event, but they are never experienced that way. Instead they are extended periods in which the routines of normal life are dislocated and existing rituals lose their meaning. They are deeply unsettling, but they are also periods of great creativity.

the claim that Chernobyl caused a legitimacy crisis for the Soviet Union rests on sweeping causal claims that underestimate authoritarian resilience and oversimplify how complex societies really work

More than two decades after the end of the U.S.-Soviet Cold War, it should be clear that authoritarian regimes can endure chronic and acute crises that rival, if not exceed, the severity of Chernobyl. After all, the Soviet Union itself had done so many times, from the famines of 1921 to 1922, 1932 to 1933, and 1946 to 1947.

Many systems endure a long time even as they produce a plenitude of lies.

relying on analogical reasoning clutters rather than clarifies thinking about international relations and foreign policy.

The National Endowment for Democracy’s blog pivoted effortlessly from calling the January 2020 shootdown of a Ukrainian airliner “Iran’s ‘Chernobyl’ moment” to labeling the COVID-19 infection as “China’s biological ‘Chernobyl.’” The Atlantic Council mused (as did others) whether the coronavirus could be a “Chernobyl moment” for Russian President Vladimir Putin. An independent review panel suggested the coronavirus could be a “Chernobyl moment” for the World Health Organization—the clearest evidence the Chernobyl metaphor has become untethered from any evidence-based moorings.

Where the logic of the fable emphasizes how closed authoritarian systems promote untruths and thus engender disaster, the relatively open societies of the United States, Canada, Europe, Brazil, and now India have proved vulnerable to COVID-19, a failing that crossed ideological complexions of ruling parties and varieties of democracy alike.

the appeal of the fable is it reassures Western audiences that democratic institutions possess some natural immunity to the lies and bureaucratic dysfunction that poisoned the Pripyat marshes with radiation.

It may be true (indeed, it’s probably likely) that open systems prove more self-correcting in the long run than closed ones. Yet societies that pride themselves on being democratic are apt to overrate their own virtues—and their preparedness for disaster.

COVID-19 failures are already creating a fable in China that democracies won’t take the tough measures needed to halt disasters despite the counterexamples of Taiwan, Australia, and New Zealand.

Authoritarian systems are not fated to crumble because of one or another catastrophe, and democratic ones will not avert disaster out of their own innate virtues.

In the early hours of Monday, Ghannouchi arrived at the parliament where he said he would call a session in defiance of Saied, but the army stationed outside the building stopped the 80-year-old former political exile from entering.

Dozens of Ennahda supporters faced off against Saied supporters near the parliament building, exchanging insults as the police held them apart

He said his actions were based on Article 80 of the constitution and framed them as a popular response to the economic and political paralysis that have mired Tunisia for years.However, a special court required by the 2014 constitution to adjudicate such disputes between Tunisia's branches of state has never been established after years of wrangling over which judges to include, allowing rival interpretations of law

Two of the other main parties in parliament, Heart of Tunisia and Karama, joined Ennahda in accusing Saied of a coup. Former president Moncef Marzouki who helped oversee the transition to democracy after the revolution said it could represent the start of a slope "into an even worse situation".

also suspended the legal immunity of parliament members and that he was taking control of the general prosecutor's office

the parliamentary election delivered a fragmented chamber in which no party held more than a quarter of seats

Under the constitution, the president has direct responsibility only for foreign affairs and the military, but after a government debacle with walk-in vaccination centres last week, he told the army to take charge of the pandemic response.Tunisia's soaring infection and death rates have added to public anger at the government as the country's political parties bickered

Mechichi was attempting to negotiate a new loan with the International Monetary Fund (IMF) that was seen as crucial to averting a looming fiscal crisis as Tunisia struggles to finance its budget deficit and coming debt repayments.Disputes over the economic reforms, seen as needed to secure the loan but which could hurt ordinary Tunisians by ending subsidies or cutting public sector jobs, had already brought the government close to collapse

Paediatricians said the ill-equipped healthcare system was also a problem. "The biggest discrepancy in Indonesia is the availability of paediatric intensive care units,"

Remittances from Yemeni workers abroad had dropped by 80% – $253m (£200m) – in the first four months of 2020 as a result of job losses across the Gulf region. The closure of supply routes has led to food shortages and food price hikes in the country, which imports 90% of its food.

Democratic Republic of the Congo, Venezuela, the west African Sahel, Ethiopia, Sudan, South Sudan, Syria, and Haiti as extreme hunger hotspots.

Oxfam said countries with existing problems, such as South Sudan and Syria, were already seeing hunger worsen but there was also concern for middle-income countries such as India and Brazil. Mass unemployment was affecting all countries, but informal labourers were suffering the most, often unable to travel to work. Travel restrictions were also hitting food supplies by preventing farmers from hiring workers and small-scale producers from accessing their own fields.

humanitarian assistance around the world had been curtailed by restrictions on movement and other precautions to prevent the virus spreading

a crisis in Africa’s Sahel region, where at least 4 million people have been displaced by extreme climate conditions that were damaging crops, causing greater tension between communities sharing resources.