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In a recent article for the New Yorker, physician/author Siddhartha Mukherjee discussed a surprising finding: that COVID-related deaths in a number of low-income countries are a fraction of the totals in developed nations such as the United States, United Kingdom, Belgium, Italy and Spain (Mukherjee, 2021). How could this be? Was this a reflection of inaccurate mortality reports, or were other factors at work?

Further research confirmed that the statistics were largely accurate, that nations lacking the hospital networks and medical technology of their affluent neighbors had done a much better job of managing virus transmission. Some of the factors contributing to lower mortality were epidemiological (lower average age) or environmental (in warmer climates, more activities occur outdoors).

Still others were more difficult to explain; that infected individuals in countries such as Mumbai more readily produced antibodies for the novel virus, perhaps due to B and T cell “memory,” that enables these cells to quickly create antibodies to previously encountered pathogens (Muckherjee, 2021). In some cases, these immune cells can raise robust defenses even if they have not contacted an identical virus, but rather a pathogen displaying similar characteristics.

But what is equally important is the will of the people in low-income nations, to do what was necessary for the greater good. For example, Mukherjee contacted Bethany Hedt, a statistician at Harvard Medical School who currently works in Rwanda. According to Hedt, the Rwandan government imposed a strict curfew when the pandemic hit, and the people of Rwanda adhered to it.

As a result, that country of 13-million residents contained COVID-related mortality during 2020 to a few hundred individuals (Mukherjee, 2021). Based on OECD statistics, the World Health Organization reported that in 2018, healthcare costs in Rwanda accounted for 8% of the Gross Domestic Product (GDP) and $58 (constant US dollars) per capita, versus 17% of the GDP and $10,624 per capita in the United States (World Health Organization, 2018).

At the end of the day, we must ask the question: At what price, liberty? To what extent are Americans willing to make personal sacrifices such as social distancing, mask wearing and when available, vaccination, to contribute to the greater good? Is asking citizens to avoid large public gatherings a First Amendment violation, or does the issue go deeper than that? What is the true meaning of human rights?

These are novel times, during which we face questions for which there is no easy answer. But what we decide will not only impact us, but our children and our children’s children. Can we find a way to work together to ensure the best quality of life for future generations of Americans?

References

Mukherjee, S. (2021). Why does the pandemic seem to be hitting some countries harder than others? New Yorker, February 22, 2021. http://www.newyorker.com

World Health Organization (2018). Global Health Expenditure Database. https://apps.who.int/nha/database/ViewData/Indicators/en