From Pandemic to Syndemic: Covid and the world’s divisions

By Ellen Hietsch 

“Reunión familiar sin protección = enterrar a su abuela.” A family gathering without protection equals burying your grandmother. From Madrid, this advertisement used as the pandemic had reached one of its highest levels back in 2020 reminds us of the heightened costs of Covid-19 for the elderly. In a country that values family, sacrifices were made as Zoom calls replaced the typical nochebuena gatherings, the kickoff to the winter holidays around plentiful dinner tables with family and grandparents. The lives of the elderly were valued beyond the fleeting joy that a holiday meal could bring.

Elderly people aren’t receiving the rights they deserve

In a talk at SLU-Madrid this past November, Dr. Peter Lloyd Sherlock reflected on “Global Public Health in the Second year of the Covid-19 Crisis”. He argued that such valuation of elderly lives during the pandemic has been lacking on the global scale, citing data from vaccine trials to make his case. He emphasized how the elderly, a group that has made up 95% of Covid deaths, have also been excluded from 100% of vaccine trials. According to Dr. Sherlock, this has been a cynical prioritization of speed over saving lives, and it isnt anything new to Covid. The UN, in its drive to meet its global development goals, limits itself to reducing premature mortality, the WHO claims to have no room for funding research into geriatric health. Such conditions give pause to celebrations over the arrival of Covid vaccines: how can we be sure they are effective for those on whom Covid has the most effect when research suffers deficits?

The arrival of the vaccine hasnt reduced agism. Focusing on low-middle income countries, Dr. Sherlock described how in many cases, the elderly have been directed to the end of the line to receive the Covid vaccine. Listening to Dr. Sherlock from a high-income country, this situation was unfamiliar. In Spain, young people waited patiently for the elderly to receive the first shots. After a traumatic and deadly management of care homes during the first wave of the pandemic, it was well worth it to give the most vulnerable protection first. Despite the lack of research into the vaccines effects on the elderly that Sherlock highlighted in his presentation, deaths have dropped enough to leave us breathing a little easier as the holiday season is approaching once again.

In Spain, the population was among the lucky ones to even have the vaccine at the beginning of 2021. In the global distribution of vaccines, pharmaceutical corporations set the prices and countries bid. Those that could afford what the corporations asked for were able to start vaccinating their populations sooner. Those who couldnt were forced to wait, relying on the goodwill of wealthy countries that were able to stock up on vaccines quickly. The wait has been extended as these corporations refuse to release the vaccine patents, leading to a two-tiered world along the lines of wealth in this new phase of the pandemic. Countries such as Thailand, which was a focus of Dr. Sherlocks talk for its prioritization of vaccinating younger workers over the elderly, did not receive the coveted Pfizer and Moderna vaccines before late 2021. Unable to manufacture their own vaccines without the release of patents and ineligible for the vaccine-sharing program Covax (an international program created to offset the vaccine disparity for countries without extensive access to vaccines), Thailands hands were tied.

“Syndemic”, a crisis combined

In another talk given at SLU-Madrid, “Crises of the Poliscene: Glocalisation, Climate Emergency and the Pandemic”, Dr. Jonathan Barton described the pandemic beyond the developed world as a syndemic: a confluence of crises in which preventing Covid might be less of a priority for some than simply surviving day-to-day. This is a situation that applies to Thailand in the Covid era. Already one of the most unequal countries in the world, Thailand’s situation exacerbated with the arrival of Covid as many in low-income households found themselves with jobs that were incompatible with working online. Meanwhile, social programs were neglected in the face of the pandemic, leaving intergenerational households without a means to feed their families. Add this to the risk of catching Covid at one of Thailand’s crowded markets for example, or while standing in close quarters at a factory job common among workers in the country, and danger becomes all but inevitable. Under these conditions, in which work cannot be taken home nor can families survive without a salary, the prioritization of workers in a country with limited vaccines is understandable. 

Of course, it is still a tragedy that countries are forced to make such a choice between using the vaccine to send people back to work or to protect the elderly, who are most vulnerable to the virus itself. But, in a world in which receiving the vaccine depends on the wealth of a country, can we really cast blame on low-middle income governments for the choices they make? Until wealthy countries step up to put pressure on the corporations producing the vaccine, they may hold some of the blame for the pandemics perseverance.

Ellen Hiestch is a Masters student of Political Science and International Relations at Saint Louis University – Madrid Campus. 

To quote this article, please use the following reference:  E. Hietsch (2021), “From Pandemic to Syndemic: Covid and the world’s divisions”.

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