Controversy has blown up over a story published in Asia Times and translated into Burmese that appears to heavily exaggerate the dangers posed by COVID-19 in Myanmar at a time when the health services have difficulty in operating. Here the author attempts to explain the misunderstandings prompted by the story and calm the fears.
Mary Callahan
In this article, “Everyone is Dying,” I cited a source most readers would rate as a public health expert and wrote this sentence: “One very reputable public health specialist expects that the population will be decimated by at least 10-15 million by the time Covid is done with Myanmar.” I framed that sentence carefully.
Neither this source nor I am crazy enough to think 10-15 million people will die of Covid in Myanmar. But the legacy of Covid, intertwined as it will be with the February 1 coup d’etat as well as decades of state failure to properly care for the Myanmar people, will yield to the decimation of 20-25 percent of the population over the next five to ten years (which is how long I think it will take for the devastation to subside).
Khit Thit translated the sentence pretty well, but not entirely correctly. By “decimation,” my source and I mean deaths, but also the incapacitation, the unnecessary health crises, the many lost opportunities for growth or progress and the wastage of a population that deserves so much better
On total deaths and infections, we will never know how many contracted or died of this disease. Anecdotally, the elderly and people with co-morbidities appear to have been hit hard, as expected. But what had been perfectly healthy young people are also now struggling to breathe, while taking care of their parents and grandparents, with no access to proper healthcare or medicine.
As for the potential of half the population to be infected over the next few weeks, we also will never know what the infection rates are in Myanmar, ever. There is abysmally and irresponsibly little testing going on. This week the government reported 35,454 cases positive this week, with a 35.5 percent positivity rate and a 2.85 percent mortality rate. Myanmar tested about 21,000 people yesterday, but it should be testing ten times that rate.
Some of the factors we considered included our assumption that as things stand, the population will not be vaccinated against Covid anytime soon, if indeed, ever. As one US professor of medicine and infectious diseases told the Guardian, “Unvaccinated people are basically the cannon fodder of the virus. The virus needs people to infect in order to replicate and the more people it has that are vulnerable or susceptible to infection, the more likely it will mutate.” An unvaccinated Myanmar will be one giant Petri dish for new mutations.
And in the meantime, where will those with tuberculosis, heart disease, high blood pressure, liver disease, pneumonia and other lung diseases, and each year’s seasonal flu obtain care, if
there is no public health system? If Covid Delta or any other mutation is still lurking in long queues at clinics, how will those with other ailments not succumb? And even if Covid clears out, far more of the population who are ill be incapacitated by diseases that might have been treatable or preventable, had the politics of Covid not wiped out the public health system. We understand those who are unnecessarily “incapacitated” to fall into the calculation of the decimation wrought by Covid.
What about Myanmar’s children who are going unvaccinated for measles, diphtheria, rotavirus, whooping cough, Hepatitis B and Haemophilus influenza type B? UNICEF reported early this month that already 1 million have missed this cycle of immunizations. Another five million kids have stopped getting Vitamin A supplements to strengthen immunity against infections and prevent blindness. Forty thousand no longer receive their treatments for malnutrition. At least 600,000 newborn babies are not receiving essential care. Again, more who are unnecessarily at risk.
The social and economic implications of Covid are as yet unstudied but will be myriad and monumental. Just one example: In Myanmar’s typically multigenerational households, grandparents typically leave the formal and informal workforce in their fifties or early sixties to provide childcare for newly arriving grandchildren. Myanmar has no other safe system for childcare. This allows parents in their prime to bring home the income. It is not unreasonable to expect that many grandparents will not survive Covid or the lingering weakening of their lungs. I would not expect Nay Pyi Taw, in a time of political madness and economic crisis, to suddenly offer the work force safe childcare. Which probably means mothers’ incomes will drop, as they will likely be assigned responsibility for day-to-day childcare. Decreases in household incomes will not be offset by household expenditures lowered from no longer feeding and caring for grandparents. Before Covid, Myanmar’s poverty rate had doubled. After Covid, it will continue to rise, and the diseases that come with poverty, like childhood diarrhea from lack of access to clean water, will only spread.
Finally, Myanmar is facing its first crisis in two decades in which its most common safety valve is not available: migration. Drought and near-famine conditions in the Dry Zone in the early 2000s, led rural families to send their able bodied teenagers and 20-somethings off to cities or Thailand for work. After the 2008 Cyclone Nargis, those who survived in Ayeyarwaddy moved into the fishing jobs in Mon State and Tanintharyi, from which locals migrated across the border to Tak province for higher paying construction and factory jobs. Again there is no quality data on how much urban, rural, and hinterland households depended on the remittances, but it is likely to be quite significant. Now Thailand is policing the border, even using cavalry in remote areas. China has deployed troops and is expanding an electrified fence to keep Myanmar migrants out. Those migrants who are abroad are getting Covid in places, like Thailand, which will not offer them medical treatment. Myanmar’s working class, spread from Hlaingtharyar to Sakhon Sathon and Dubai, can no longer prop up family incomes. Income that might once have gone to buy bottled water or medicine will simply no longer be available.
Nothing would make me happier than to be wrong. But in the first 24 hours after publishing “Everyone is Dying, I have received more than 160 texts and DMs from people inside MM
asking me to pray for their dying children and parents, or listing those already lost. Many are stories of caregivers, who died of exhaustion. One whole family died in two days, the cousin wrote me. Another told me of having been shot at while in line to buy oxygen, only to return home to find his father had passed.
Yes, technically, "everyone" is not dying. But it is hard to not to feel like they are.
