During any big news event, Facebook becomes even more of a pit of toxic disinformation than it is on a relatively normal day. That said, there is one particular meme that I saw pop up a few times recently and I cant stop thinking about it.
(Some context about my feed: I am from rural West Tennessee, so I saw this posted by a couple of folks back home. Please do not come at meor anyone, reallywith talk of ignorant rednecks or country hicks, I will promptly tell you that is some reductive nonsense and its not the point Im making here.)
While both posters in my circles have since deleted the meme, which Facebook has now flagged as partly false information, its still really important to explain to our readers just why this specific post is completely bogus: For the eternal record contained within the limitless 1s and 0s of the Internet, there is no vaccine for humans who contract the novel coronavirus. This is the reality; it is not an elaborate ploy made up by the media for clicks.
The confusion here rests in the fact that there are several types of the virus. There is even a coronavirus that infects cows. And that is the one that is treated with a vaccine, ScourGard 4K, for healthy, pregnant cows and heifers as an aid in preventing diarrhea in their calves caused by bovine rotavirus, bovine coronavirus, and enterotoxigenic strains of Escherichia coil, according to manufacturer Zoetisus. Bovine coronavirus has been around for years. It is not the same as the novel coronavirus causing the current pandemic, it is merely in the same family. AsReuters reports:
According to the CDC, coronaviruses were first identified in the mid-1960s. Coronavirus is a term for a group of diseases. Seven different kinds of human coronaviruses exist, including 229E, NL63, OC43 and HKU1. Most human coronaviruses cause mild to moderate upper-respiratory tract illnesses, similar to the common cold. In different species, coronaviruses can produce a wide spectrum of disease syndromes. The CDC mentions that: Sometimes coronaviruses that infect animals can evolve and make people sick and become a new human coronavirus. Three recent examples of this are 2019-nCoV, SARS-CoV, and MERS-CoV.
It makes a lot of sense that in this moment, people are desperately seeking a solution to make them feel safer. But this vaccine aint it. And if weve learned anything so far this week, its that experimenting with medication without the oversight of a physician, even if youre following the word of our president, is downright dangerous.
For the United States, the question is no longer whether or not it will take months for city- and state-wide shutdowns to end and our lives to go back to normal, but rather how many months it will take. Until were able to flatten the curve and ensure that our hospitals wont be overwhelmed by an influx of sick patients who have been infected by the novel coronavirus, social distancing, shelter-in-place orders, and bans on large gatherings will be the norm. The only hope we have for expediting that process is the discovery of a drug that can treat COVID-19.
As it stands, there are no drugs or vaccines that have been approved to treat the disease caused by the SARS-CoV-2 virus, no matter what the president claims. That said, treatments and medications are being tested and developed as I type this, and Matthew Harper of Stat News has offered up his forecast for when they might be ready.
Before we get to the forecasts, I should reiterate a few important points that Harper made in his piece. First, data from a comprehensive Biotechnology Innovation Organization paper puts the likelihood of approval for an infectious disease treatment starting clinical trials at just 19.1%. Furthermore, the timelines he mentions below could change and others could fail altogether. But at least its something concrete within this sea of uncertainty.
The first treatments that Harper discusses are existing antiviral medicines, which are available right now, but still need to be tested for efficacy before they can be more widely approved. Hydroxychloroquine and chloroquine is one of the treatments that many have pinned their hopes on. Some doctors are also starting to combine hydroxychloroquine with an antibiotic called azithromycin. Unfortunately, evidence of efficacy for these treatments is still too limited, and larger clinical trials will take time to complete. Doctors will continue to use these existing medicines to treat sick patients, but it could be a month or more before we know if they really work.
Remdesivir is another existing drug that is being tested, as its maker Gilead is working with many researchers and governments on clinical trials. The first large study in China is scheduled to finish by April 3rd, at which point we will have some data to work with. Doctors are also experimenting with plasma transfers from those who have recovered to those who are still sick in order to boost their immune system with antibodies. Although this treatment is currently being used, a more refined product could take 9-18 months to produce.
As for new treatments, Regeneron Pharmaceuticals managed to develop artificial antibodies that proved effective against Ebola, and now wants to do the same for the novel coronavirus. Trials could start as soon as this summer, and the treatment could be available as early as this fall for extremely sick patients.
Finally, when it comes to a vaccine, the realistic best-case scenario is that something is ready before the end of next year. Several groups are working on vaccines, which increase the chances that a usable product is available by fall of 2021, but, as Rajeev Venkayya of Japanese pharmaceutical company Takeda said last week: Just because we start a vaccine program doesnt mean that we will definitely get a vaccine on the other end. The silver lining is that there might be a vaccine available for certain groups, such as healthcare workers, this fall.
I highly recommend reading Harpers entire piece on Stat News, as well as this thorough breakdown of all the drugs and vaccines currently in development to fight COVID-19 that the site published last week.
Image Source: FILIPPO VENEZIA/EPA-EFE/Shutterstock
Jacob started covering video games and technology in college as a hobby, but it quickly became clear to him that this was what he wanted to do for a living. He currently resides in New York writing for BGR. His previously published work can be found on TechHive, VentureBeat and Game Rant.
Scientists around the world have started dozens of clinical trials, on more than 100 drugs, in the hunt to find a product that could attack the new coronavirus. More data will be coming soon.
The big picture: Expectations need to be tempered. A vaccine is likely a long way off, and failures are inevitable. But some experimental treatments, while they still require more research, are showing promise.
Where it stands: There are more than 100 coronavirus drugs and vaccines in development worldwide, according to Umer Raffat, an analyst at Evercore ISI who has been tracking progress.
A handful of potential treatments are worth paying particular attention to.
The race is on to develop a vaccine to protect against COVID-19. Germany, the United States, the European Union and others have collectively committed more than a billion dollars.
On March 11, Canada announced it would provide $275 million toward the research and development of some of the worlds most promising candidate vaccines, diagnostics and therapeutics, among other public health and clinical research.
Public funds are the backbone of the underlying science thats needed to develop the medical tools that we need and use. But today there is little indication and no requirement that the billions of public dollars being spent will result in a vaccine or treatment for COVID-19 that is affordable.
Instead, governments appear poised to let the private market sort out the details of who gets access and at what price. Their logic is that public funding should be used to support early stage discovery, but that the research should ultimately transferred to private companies in order to be fully developed and priced based on what the market can bear. This logic, whether for COVID-19 or for any other disease, is flawed.
For its $275 million investment, Canada has yet to announce what safeguards it will enact to ensure that the vaccines, diagnostics and therapeutics it develops are affordable and accessible to the people and health systems that need them. Given the massive public contributions being made, governments must ensure that the return on these investments comes in the form of lifesaving health services that are free for patients and affordable for health systems not in the form of high profits for private companies. This is not only the ethical thing to do, its also what makes sense as a matter of global public health policy.
Canada has recent experience in developing a vaccine that the world needed. The rVSV-ZEBOV vaccine for Ebola was developped by researchers working at the National Microbiology Laboratory in Winnipeg in the early 2000s. Yet the vaccine was only approved for use by the European Medicines Agency and the U.S. Food and Drug Administration in the fall of 2019, nearly 20 years after it was first developed and many years after the completion of the clinical trial showing it was effective.
Why the delay? For a long time, there was simply no financial interest from the private sector in moving it forward Ebola outbreaks occur in countries that cant afford the prices that make vaccine development lucrative for pharmaceutical companies.
As the Canadian government shopped around for a private sector partner to develop and commercialize the vaccine, there was little interest. One company with no previous experience bringing a vaccine to market acquired the rights in 2010 for $205,000 and has since sub-licensed the vaccine to Merck for US$50 million after having apparently done little to advance the development of the vaccine despite being contractually obligated to do so.
As a colleague put it recently in testimony to Parliaments Standing Committee on Health, there is no law of physics that says that the private pharmaceutical industry has to do research and development of lifesaving drugs and vaccines. In fact, the private sector has shown itself to be remarkably out-of-step with many global public health priorities, walking away from research and development of things we all need like new antibiotics. They have, however, become adept at demanding high prices under the threat of delaying the launch of new medicines if these pricing demands arent met.
It is essential that we learn the lessons from the Ebola vaccine and many other discoveries that have been supported by public funds and get it right, not only with COVID-19 but with our whole approach to publicly funded health innovation. Governments around the world play an integral role in supporting the science that leads to discovering lifesaving technologies.
In Canada alone, researchers in publicly funded labs have discovered an Ebola vaccine, insulin, the cardiac pacemaker, a vaccine for haemophilus influenzae and many others.
While Canada and other governments have supported this important work by directing funding towards universities and research institutes, these funding models generally fail to capture the process from discovery through to use, and instead rely on universities or the researchers themselves to figure out how to get their game-changing discoveries to patients.
Historically, theyve done this by commercializing their discoveries via the private sector, giving one company exclusive rights to do the subsequent development of the technologies and then to control the sale and price of them when they become a product with no safeguards or assurances to ensure that patients would have affordable access once the drug or vaccine hits the market.
This no-strings-attached approach to science is foolhardy in an era of patients dying because health systems cant afford drugs that now routinely cost hundreds of thousands of dollars for some conditions, and where companies are already gearing up to massively profit off of COVID-19 vaccines and therapeutics.
As these new medical tools are developed, licensed and become commercially available, there is a real risk that, given the way the biomedical innovation system works today, they may be rendered inaccessible to those who need them. This should be unacceptable to Canadians, considering the significant public investment thats been made.
Canada can get this right. We have world-class scientists who by all accounts have promising candidate vaccines and therapeutics for COVID-19 in the works. We should support their work with public funds through Canadas research granting councils and other mechanisms.
But we should not blindly accept that the only way these productive, world-class scientists can get their vaccines and therapeutics to patients is by selling them to pharmaceutical companies without negotiating access for patients and health systems upfront. We need safeguards that ensure that if the public paid for it, Canadians and everyone else around the world who needs it will be able to access it quickly and affordably, at a fair price. Public funds should deliver medicines and vaccines that are affordable for the public.
Read more: Coronavirus weekly: expert analysis from The Conversation global network
Canada may not even have to depend on commercial partners to bring medical innovation from the lab bench to the patients bedside. The experience of the Ebola vaccines development shows that public sector researchers did much of the heavy lifting in the development and even manufacturing of early batches of the vaccine. We have experts in clinical trials in our hospitals, universities and vaccine research groups who are more than capable of doing the necessary clinical trials to develop and deliver new health technologies quickly and affordably.
We can do health research and development differently, in a way that prioritizes access and affordability for patients and ends the profiteering off sick people in times of crisis. Lets get to work.
Health workers are our most valuable resource for combating the coronavirus pandemic.They are also among the most vulnerable.During the SARS coronavirus epidemic in 2003, 20 percent of those infected globally (1,701) were health care workers. We tend to focus on age as a risk factor for COVID-19, but the biggest risk may be being a health worker, of any age.
The consequence extends well beyond the individuals infected. Every health worker who sickens or dies from COVID-19 reduces the capacity of the health system that cares for us all. Yet there are important steps that public health authorities could be taking right now to better protect health workers, and only a lack of imagination is stopping them being used.
As an intensive-care pediatrician and public health specialist, I have worked in many of the worlds worstoutbreaks, several of them in war zones. Aswithmany of my colleagues around the world, this is not my first pandemic.Yet, for the first time, I am filled with dread, even despair. Why?
Even in the best of circumstances, medical staff are at risk. In any emergency room, it is a given that we often have to get close to our patients to save themto do CPR,intubate, ventilate, and resuscitate. When time is of the essence, few of us will let our patient die for the want of an N95 mask. We risk it.
[Mapping the Coronavirus Outbreak: Get daily updates on the pandemic and learn how its affecting countries around the world.]
These are not the best of circumstances.
Today,health workers are at great risk for several reasons. Medical personnel are exposed to more viral particles than the general public. That means theyre both more likely to get infected and likelier to have worse cases when they dowhich may be why so many younger Chinese doctors died. Protective equipment is in short supply as the tide of patients rises. And a combination of stress and long hours probably makes the immune systems of health workers more vulnerable than normal.This combination turns hospitals into hot spots of transmissioncoronavirus pumps.
Since the beginning of this pandemic, many front-line health workers have paid the ultimate price. The doctors in Wuhan who first raised the alarm not only were silenced by Chinese authorities, but several died of the virus. The pathogen does not discriminate among specialties. The first fatality among them was Li Wenliang, a young ophthalmologistnot a profession normally considered high-risk. His colleague Mei Zhongming, who died the following month, was also an ophthalmologist. A third was a thyroid and breast surgeon. A fourth, a neurosurgeon and hospital director. In Britain today, two ear, nose, and throat specialists are in critical condition.
We dont even have accurate numbers about the number of health workers infected or killed. China has never released accurate figuresjust as it has never released an accurate count of the total number of people who died from COVID-19. (If you died without being tested for COVID, Beijing says, you didnt die of COVID.)
A new podcast from Foreign Policy covering all aspects of the coronavirus pandemic
For six weeks, China insisted that only 13 doctors had been infected, lulling us into thinking that spread within hospitals was not a concern and could easily be prevented by standard masks and gloves. Suddenly, on Feb. 14, the announced number skyrocketed to 1,716, more than the medics infected throughout the entire SARS epidemic. By Feb. 20, the World Health Organization mission in China reported 2,055 lab-confirmed COVID-19 cases among health workers. By March 3, China estimated up to 3,200 had been infected.
By contrast, Italy consistently reported high rates of infected medicsabout 8.5 percent of total infections, or 20 percent of their health care workforce. In Spain, over 4,000 healthcare workers have been infected.
And these are well-prepared countries. In less-developed parts of the world such as much of sub-Saharan Africa, weak health care systems and inadequate infection control measuresa lack of running water, let alone disinfectant or isolation roomsmeans overburdened staff are at exceptionally high risk. The same is true in areas of conflict such as Yemen and Syria, as well as crowded refugee camps and sprawling urban slums. All of these areas are prime targets for the coronavirus.
When there are no doctors to intubate, no nurses to provide care, the death rate will skyrocket.And not just from COVID-19. None of the usual killerssuch as heart disease, cancer, and car accidentsare conveniently suspended during a pandemic.
We all know that using personal protective equipment and related protocols are essential. Yet, evenwhen health workers are in a full moon suit, virus particles can often find a way to infect them. Institutions can equally fail in their duty to protect health care workers. When two nurses in Dallas were infected with Ebola in 2014, the Centers for Disease Control and Prevention contended that it was due to a breach in protocolbut the nurses said no protocols had been established in the first place. When a Californian nurse caring for a COVID-19 patient developed symptoms and requested a test, the CDC refused, saying if she had followed protocol, she wouldnt have been infected. (The CDC subsequently changed its protocols for both cases but has never apologized to the nurses.)
In any event, today there are not enough N95 masks, gowns, suits, and goggles to go around. Given the uncertainty, risk, and fear surrounding this disease, it is hard to have the confidence needed to care for patients well. For those with families and children they spend time with after their shifts, it is even harder.
For both pragmatic and humanitarian reasons, protecting health care workers should be our highest priority in fighting the coronavirus. More beds, more hospitals, and perfect supply chains will all be redundant if there are no health care workers left or willing to take the considerable risks to fight the disease.
Yet there are things that could be done to better protect health workers. A vaccine for COVID-19 is a long way off, but certain other drugs may offer some protection.That does not mean adopting the various forms of quackery, snake oil, and supposed miracle cures that the panic of a pandemic tends to promote. Research protocols are not the same as rumors, anecdotes, and presidential tweets.
Yet one area worth exploring is the use of live vaccines to increase the recipients immune response.One such inoculation is called the Bacillus Calmette-Gurin vaccine, or BCG, which has long been used against tuberculosis.
Several studies in other contexts show that BCG primes the immune system to respond better to infections of various sorts, not just TB.Two studies in adults (one in patients aged 60 to 75) showed that BCG reduces respiratory infections by 70 to 80 percent.Two more reported a 15 to 40 percent lower risk of respiratory infections in vaccinated children. Another showed that, when given to infants in countries with severe health challenges and combined with a revived immunization scheme, BCG cut deaths from all causes by just under a third. However, some studies suggest that this protective effect lasts only until an inactivated vaccine (such as an influenza vaccine) is later given.
Given this promising research, a systematic review commissioned by the WHO and published in 2016 concluded that the BCG vaccine had beneficial off-target effects and recommended further research.Onesuch trial has just begun in the Netherlands. A larger trial of 4,000 health workers is due to start next week in Australia. Others are being considered in Greece, Britain, Germany, Denmark, and the United States.
That protection would not be perfecta BCG vaccination is not the same as a targeted vaccination for COVID-19but it is likely to significantly reduce illness and death among those who receive it. Even if BCG vaccines were given only to health workers, we might substantially reduce the risks they face and lessen the risk of our hospitals and health systems collapsing. If effective, it could also be rapidly given to other particularly vulnerable people such as the elderly. It could be especially useful in countries that have weak health care systems and would quickly be overwhelmed by a large outbreak. And the vaccine is cheap, safe, and, most important, immediately available for testing. Health care workers must be the priority, but once manufacture of the vaccine is ramped up, it could be much more widely available.
Yet the big global institutions are dawdling. Despite the WHOs recommendation, big public health institutions are not actively investigating BCG. Nor are global health foundations such as Gates funding this crucial research. While research and development into new drugs may be sexier, it is hard to understand the reluctance to explore nontraditional uses of existing drugs. The big pharmaceutical companies are also sitting on their hands, apparently because there is little profit in an established vaccine such as BCG.
Our global defenses are only as good as our front-line health workers. With so much evidence pointing to the potential for BCG to provide at least partial protection, it is indefensible, even unethical, to overlook it simply because this strategy is unorthodox and unprofitable. Trials to test its beneficial effects for COVID-19 are urgently needed.
The rapid spread of the novel coronavirus may slow down in the United States in the not-so-distant future, but that doesn't mean life will go back to normal.
In an appearance on Face the Nation Sunday, former Food and Drug Administration Commissioner Scott Gottlieb told host Margaret Brennan he expects a "slow transition" for society even if the epidemic peaks, as he expects, in late April and peters off in June. That's because it could come back in the fall, so until there's a vaccine, "life's never going to be perfectly normal."
In the meantime, he said some antiviral drugs currently in trial look like they could be effective in combating the virus, but he wasn't ready to say that there's any single development that's been overwhelmingly convincing.
New York Gov. Andrew Cuomo (D), who has been at the forefront of the pandemic, shared Gottlieb's prediction that life won't revert back to the way it was anytime soon. He rattled off a wide range of time, suggesting things may be altered for anywhere between nine and 12 months.
More stories from theweek.comTrump suggests he might soon prioritize the economy over public healthThe death penalty has been abolished in ColoradoThe worst possible president for this crisis
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The U.S. Food and Drug Administration (FDA) has updated its rules around use of experimental treatments for the ongoing COVID-19 pandemic to include use of convalescent plasma, in cases where the patients life is seriously or immediately threatened. This isnt an approval of the procedure as a certified treatment, but rather an emergency clearance that applies only on a case-by-case basis, and only in extreme cases, as a means of helping further research being done into the possible efficacy of plasma collected from patients who have already contracted, and subsequently recovered from, a case of COVID-19.
Plasma is a component of human blood specifically the liquid part which contains, among other things, antibodies that contribute to a bodys immune response. Use of plasma, through direct transfusion into a patient, like every other proposed treatment for COVID-19 (and the SARS-CoV-2 virus that causes it), has not undergone the clinical studies needed to show that its actually safe and effective in combating the disease.
Despite a lack of completed clinical trials, the FDA has granted this temporary authorization under its Investigational New Drug Applicants (eINDS) exemption, in light of the extent and nature of the current public health threat that COVID-19 represents. A number of pre-clinical and clinical trials around use of plasma from patients who have recovered are underway, however, and there are some promising signs that convalescent plasma could indeed be effective against SARS-CoV-2.
This is hardly the first time that convalescent plasma has been proposed or attempted to fight off a disease. People who have had a virus and subsequently recovered from it typically build up an immunity to it either long-term, as with chicken pox, or short-term, as with the seasonal flu. Logically, it stands to reason that it should be possible, at least in theory, to take the antibodies from one individual who has already developed them, and transfuse them into a patient whose immune system is not doing a good enough job producing its own.
Convalescent plasma transfusions have been used in previous outbreaks, including against the H1N1 flu, as well as the original SARS and MERS epidemics, with varying results.
A number of research projects are underway regarding use of plasma against COVID-19, including a study by a team of Chinese medical professionals published in pre-print format (prior to any peer review) that studied 10 severe patients who received donations from recently recovered patients. That study found that in five of the 10 cases, the level of antibodies increased rapidly immediately post-transfusion (four other patients already had a high level of antibodies, and that persisted), and that within a week, the presence of the virus was undetectable in seven patients.
That still isnt a formal clinical study, but other small-scale investigations from clinical practice have shown similar results. A group of doctors and researchers have also put together a set of protocols for use by doctors working with both donors and recipients to help align efforts across investigations and ensure that everyone working on this problem in the medical science community is working from the same playbook.
New York Governor Andrew Cuomo announced that state health agencies would be beginning a convalescent plasma trial this week, and it was cited by FDA Director Dr. Stephen Hahn as an area of early promise last week during a White House coronavirus task force briefing.
All donor patients would have to be tested to confirm that they are not at risk of transmitting the virus, and they must also qualify as a blood donor under the existing rules in place by state and federal agencies. While some early studies have shown that plasma transfusions could be effective in prophylactic use (meaning treating healthy people before they encounter the virus), this FDA specifically prohibits any prophylactic use.
As with all the treatments currently under development, this will take a lot of testing and research both to validate, and then to certify for general use though there are a lot of researchers working on those challenges, because work to date shows this is likely to be more effective as a strategy in cases that havent yet progressed to the severe symptom stage. Convalescent plasma treatment isnt new, or even all that sophisticated, but it does have the advantage of being relatively safe (in line with standard blood transfusions, once a person is confirmed to no longer be carrying any active virus), so this could be something to watch for more active updates versus some of the longer-lead treatment technologies in development.
This blog is part of a series providing regional analysis on the effects of the coronavirus.
By Jihad Azour
, Franais,
The impact of COVID-19 and the oil price plunge in the Middle East and the Caucasus and Central Asia has been substantial and could intensify. With three-quarters of the countries reporting at least one confirmed case of COVID-19 and some facing a major outbreak, the coronavirus pandemic has become the largest near-term challenge to the region. Like much of the rest of the world, people in these countries were taken utterly by surprise with this development, and I would like to express my solidarity with them as they cope with this unprecedented health crisis.
This challenge will be especially daunting for the regions fragile and conflict-torn statessuch as Iraq, Sudan, and Yemenwhere the difficulty of preparing weak health systems for the outbreak could be compounded by reduced imports due to disruptions in global trade, giving rise to shortages of medical supplies and other goods and resulting in substantial price increases.
Uncertainty about the nature and duration of the shocks has complicated the policy response.
Beyond the devastating toll on human health, the pandemic is causing significant economic turmoil in the region through simultaneous shocksa drop in domestic and external demand, a reduction in trade, disruption of production, a fall in consumer confidence, and tightening of financial conditions. The regions oil exporters face the additional shock of plummeting oil prices. Travel restrictions following the public health crisis have reduced the global demand for oil, and the absence of a new production agreement among OPEC+ members has led to a glut in oil supply. As a result, oil prices have fallen by over 50 percent since the start of the public health crisis. The intertwined shocks are expected to deal a severe blow to economic activity in the region, at least in the first half of this year, with potentially lasting consequences.
Channels of economic impact
Heres what we know.
First, measures to contain the pandemics spread are hurting key job-rich sectors: tourist cancellations in Egypt have reached 80 percent, while hospitality and retail have been affected in the United Arab Emirates and elsewhere. Given the large numbers of people employed in the service sector, there will be wide reverberations if unemployment rises and wages and remittances fall.
Production and manufacturing are also being disrupted and investment plans put on hold. These adverse shocks are compounded by a plunge in business and consumer confidence, as we have observed in economies around the world.
In addition to the economic disruptions from COVID-19, the regions oil exporters are affected by lower commodity prices. Lower export receipts will weaken external positions and reduce revenue, putting pressures on government budgets and spilling over to the rest of the economy. Oil importers, on the other hand, will likely be affected by second-round effects, including lower remittance inflows and weaker demand for goods and services from the rest of the region.
Finally, sharp spikes in global risk aversion and the flight of capital to safe assets have led to a decline in portfolio flows to the region by near $2 billion since mid-February, with sizable outflows observed in recent weeksa risk I underscored in a recent blog. Equity prices have fallen, and bond spreads have risen. Such a tightening in financial conditions could prove to be a major challenge, given the regions estimated $35 billion in maturing external sovereign debt in 2020.
Against this challenging backdrop, the region is likely to see a big drop in growth this year.
Policy priorities
The immediate policy priority for the region is to protect the population from the coronavirus. Efforts should focus on mitigation and containment measures to protect public health. Governments should spare no expense to ensure that health systems and social safety nets are adequately prepared to meet the needs of their populations, even in countries where budgets are already squeezed. Governments in the Caucasus and Central Asia, for example, are increasing health spending and considering broader measures to support to the vulnerable and shore up demand. In the Islamic Republic of Iran, where the coronavirus outbreak has been particularly severe, the government is ramping up health spending, providing additional funding to its Ministry of Health.
Beyond that overarching imperative, economic policy responses should be directed at preventing the pandemica temporary health crisisfrom developing into a protracted economic recession with lasting welfare losses to the society through increased unemployment and bankruptcies. However, the uncertainty about the nature and duration of the shocks has complicated the policy response. Where policy space is available, governments can achieve this goal using a mix of timely and targeted policies on hard-hit sectors and populations, including temporary tax relief and cash transfers.
Temporary fiscal support should consist of measures that provide well-targeted support to affected households and businesses. This support should aim to help workers and firms weather the significant, but hopefully temporary, stop in economic activity that the health measures being implemented to control the spread of the coronavirus will entail. This support will have to take account of the fiscal space that is available, and where policy space is limited be accommodated by reprioritizing revenue and spending objectives within existing fiscal envelopes. Where liquidity shortages are a major concern, central banks should stand ready to provide ample liquidity to banks, particularly those lending to small and medium-sized enterprises, while regulators could support prudent restructuring of distressed loans without compromising loan classification and provisioning rules.
When the immediate crisis from the coronavirus has begun to dissipate, consideration could be given to more conventional fiscal measures to support the economy, such as restarting infrastructure spending, although fiscal space has been significantly eroded over the last decade. Given the nature of the current slowdown, trying to stimulate the economy at this time is unlikely to be successful and would risk eliminating the limited fiscal space that is still available.
Many countries are already introducing targeted measures. For example, several countriesKazakhstan, Qatar, Saudi Arabia, and the United Arab Emirates, to name a fewhave announced large financial packages to support the private sector. These packages include targeted measures to defer taxes and government fees, defer loan payments, and increase concessional financing for small and medium-sized enterprises.
Other countries, particularly the regions oil importers, have more limited policy space. Lower revenues resulting from lower importson top of additional pandemic mitigation spendingare expected to widen fiscal deficits in these economies. And while well-targeted health spending should not be sacrificed, very high debt in many of these oil-importing countries means that they will lack the resources to respond adequately to the broader economic slowdown. As such, these countries should try to strike a balance between easing credit conditions and avoiding vulnerability to capital outflows, and, where possible, allow the exchange rate to cushion some of the shocks. Sizeable financing needs are likely to arise in some countries.
Support from the IMF
Since the outbreak of COVID-19, we have been in continuous interaction with the authorities in our region to offer advice and assistance, especially those in urgent need of financing to withstand the shocks. The Fund has several tools at its disposal to help its members surmount this crisis and limit its human and economic cost, and a dozen countries from the region have already approached the Fund for financial support. Work is ongoing to expedite approval of such requestslater this week, our Executive Board will consider a request from the Kyrgyz Republic for emergency financing, likely the first such disbursement since the outbreak of the COVID-19 pandemic. A few other requests will be considered by the Executive Board in the coming days. Now, more than ever, international cooperation is vital if we hope to prevent lasting economic scars.
The IMF and COVID-19
Today the Surgeon General of the United States, Jerome Adams, MD, said on the Today Show that this week could get bad for many Americans who will face a growing rise of COVID-19 cases in their communities.
"Everyone needs to act as if they have the virus right now. So, test or no test, we need you to understand you could be spreading it to someone else. Or you could be getting it from someone else. Stay at home," Adams said, while admonishing young Americans who are still crowding on beaches from coast to coast for not taking national calls for social distancing seriously.
Confirmed US cases rose by 9,541 today, to 42,817, according to the Johns Hopkins online tracker, with 458 associated deaths.
For the second day in a row, democratic US senators blocked a nearly $2 trillion coronavirus stimulus bill, saying the bill offered too much protection to corporations and failed to protect individuals who have lost or will lose their jobs because of the pandemic.
The Washington Post reported that several million Americans have already lost their jobs because of the virus, and the Dow Jones industrial average has lost more than 10,000 points in 6 weeks, dropping below 19,000 points today.
Included in the bill is a provision to send some American households a check for $1,200 in April, and give $350 billion to small businesses who have lost workers and consumers in recent weeks.
Over the weekend Senator Rand Paul (R-Ky), became the first senator to test positive for the virus, and Senator Amy Klobuchar (D-MN) said today her husband was hospitalized in Maryland and receiving oxygen after being diagnosed as having COVID-19.
Late last week governors in New York, New Jersey, California, Connecticut, Oregon, and Illinois all told citizens to stay home, except for essential workers. Over the weekend and through today, governors in Wisconsin, Indiana, Michigan, Ohio, West Virginia, Delaware, and Louisiana also issued similar orders.
"I know this has been difficult and has disrupted the lives of people across our state. That's why issuing a #SaferAtHome order isnt something I thought we'd have to do, and it's not something I take lightly," said Wisconsin Governor Tony Evers on Twitter. "But here's the bottom line: folks need to start taking this seriously."
"You can still get out and walk the dogsit's good exercise and its good for everyones mental healthbut please don't take any other unnecessary trips, and limit your travel to essential needs like going to the doctor, grabbing groceries, or getting medication," he said.
Governors in Maryland and Massachusetts did not issue shelter-in-place measures, but did order the closing of all non-essential businesses in each state, Politico reported. Last week Pennsylvania took a similar step.
The orders mean more than 100 million Americas, or about one third of the country, are under stay-at-home restrictions. But as governors take decisive actions, there were signs on Twitter that President Donald Trump may be considering reversing his "15 days to slow the spread" social distancing campaign, which was announced over a week ago.
"WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF. AT THE END OF THE 15 DAY PERIOD, WE WILL MAKE A DECISION AS TO WHICH WAY WE WANT TO GO!" Trump tweeted late last night.
New York Governor Andrew Cuomo late last week also shuttered non-essential businesses, but he calls his plan a "pause" for New York. That order went into effect last night.
New York has emerged as the nations biggest hot spot of the coronavirus, with 6% of the cases detected in the world, the New York Times reported. Today Cuomo ordered a new directive to state hospitals: increase capacity by at least 50%. Cuomo also announced that a 1,000-bed field hospital will be constructed at the Javits Center, and be operational by the end of next week.
Today New York reported a total of 20,875 cases, including 12,305 in New York City. According to the New York Times tracker, there have ben 125 deaths in the state.
In Washington state, the first to be hit hard with the virus, case totals stood at 1,996, with 95 deaths.
