COVID’s global death toll tops 5 million in less than 2 years

That global death toll from COVID-19 peaked at 5 million on Monday, less than two years into a crisis that has not only devastated poor countries but also humiliated the wealthy with first-class health systems.

Together, the United States, the European Union, the United Kingdom and Brazil – all upper middle- or higher-income countries – account for one-eighth of the world’s population, but almost half of all reported deaths. The United States alone has registered over 740,000 lost lives, more than any other nation.

“This is a crucial moment in our lives,” said Dr. Albert Ko, an infectious disease specialist at the Yale School of Public Health. “What are we going to do to protect ourselves so we don’t get to another 5 million?”

The death toll, as calculated by Johns Hopkins University, is roughly equal to the populations of Los Angeles and San Francisco combined. This is in line with the number of people killed in fighting between nations since 1950, according to estimates from the Oslo Peace Research Institute. Globally, COVID-19 is now the third most common cause of death after heart disease and stroke.

The staggering number is almost certainly a minority due to limited tests and people dying at home without medical care, especially in poor parts of the world, such as India.

Hot spots have changed over the 22 months since the outbreak began, making various places on the world map red. Now, the virus hits Russia, Ukraine and other parts of Eastern Europe, especially where rumors, misinformation and distrust of the government have hampered vaccination efforts. In Ukraine, only 17% of the adult population is fully vaccinated; in Armenia only 7%.

“What is unique about this pandemic is that it hit hardest in the high-resource-rich countries,” said Dr. Wafaa El-Sadr, Director of ICAP, a global health center at Columbia University. “That’s the irony of COVID-19.”

Wealthy nations with longer life expectancy have larger proportions of older people, cancer survivors, and nursing home residents, all of whom are particularly vulnerable to COVID-19, El-Sadr noted. Poor countries tend to have larger proportions of children, teenagers and young adults who are less likely to become seriously ill with coronavirus.

India, despite its fearsome delta rise, which peaked in early May, now has a much lower reported daily death rate than richer Russia, US or UK, although there is uncertainty about its numbers.

The apparent disruption between wealth and health is a paradox that disease experts will consider for years to come. But the pattern seen on the large scale when comparing nations is different when you look at them more closely. Within each affluent country, when deaths and infections are mapped, poorer neighborhoods are hardest hit.

In the United States, for example, COVID-19 has taken a heavy toll on black and Hispanic people, who are more likely than white people to live in poverty and have less access to health care.

“When we get our microscopes out, we see that within countries, the most vulnerable have suffered the most,” Ko said.

Wealth has also played a role in the global vaccination effort, with rich countries being accused of blocking supplies. The United States and others are already handing out booster shots at a time when millions throughout Africa have not received a single dose, even though the rich countries also send hundreds of millions of shots to the rest of the world.

Africa remains the world least vaccinated region, with only 5% of the population of 1.3 billion people fully covered.

In Kampala, Uganda, Cissy Kagaba lost her 62-year-old mother on Christmas Day and her 76-year-old father days later.

“Christmas will never be the same for me,” said Kagaba, an anti-corruption activist in the East African country who has been through several lockdowns against the virus and where there is still a curfew.

The pandemic has united the globe in grief and pushed survivors to the breaking point.

“Who else is there now? The responsibility lies with me. COVID has changed my life,” said 32-year-old Reena Kesarwani, mother of two boys, who was left to run her late husband’s modest construction market in a village in India.

Her husband, Anand Babu Kesarwani, died at the age of 38 during India’s devastating coronavirus wave earlier this year. It overwhelmed one of the most chronically underfunded public health systems in the world, killing tens of thousands as hospitals ran out of oxygen and medicine.

In Bergamo, Italy, once the site of the West’s first deadly wave, 51-year-old Fabrizio Fidanza was stripped of a final farewell as his 86-year-old father lay dying in hospital. He is still trying to come to terms with the loss more than a year later.

“In the last month, I have never seen him,” Fidanza said during a visit to her father’s grave. “It was the worst moment. But coming here every week helps me.”

Today, 92% of Bergamo’s eligible population has received at least one shot, the highest vaccination rate in Italy. The Chief Medical Officer at Pope John XXIII Hospital, Dr. Stefano Fagiuoli, said he believes it is a clear result of the city’s collective trauma, as the howls of ambulances were constant.

In Lake City, Florida, LaTasha Graham, 38, still gets mail almost daily to her 17-year-old daughter, Jo’Keria, who died of COVID-19 in August, days before she started her final year of high school. The teenager, who was buried in his cap and dress, wanted to become a trauma surgeon.

“I know she would have made it. I know she would have been where she wanted to go,” her mother said.

In Rio de Janeiro, Erika Machado scanned the list of names engraved on a long, undulating sculpture of oxidized steel that stands in the Penitencia cemetery as a tribute to some of Brazil’s COVID-19 victims. Then she found him: Wagner Machado, her father.

“My father was the love of my life, my best friend,” said Machado, 40, a salesman who traveled from Sao Paulo to see his father’s name. “He was everything to me.”

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