The developing world is bracing for the worst of the coronavirus impact

Crowded cities and fewer hospital beds pose a challenge for the global south

Today's expression: By and large
Explore more: Lesson #248
April 6, 2020:

If you thought the coronavirus was bad in the rich world, it could be many, many times worse in the developing world. Flattening the curve will be a much greater challenge in areas without running water for hand washing, and where the choice between quarantine and work may also mean the choice between starving and putting food on the family table. Plus, learn the English expression “by and large.”

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The developing world is bracing for the worst of the coronavirus impact

Hi there, thanks for joining us for Plain English lesson number 248. I’m Jeff; JR is the producer; and I hope you are hanging in there during these tough times. You can find this complete lesson—including the video and flashcards—at PlainEnglish.com/248.

Coming up today: The developing world has largely been spared the worst of the coronavirus so far. But it could be very bad when it finally arrives. That, plus the expression. The one we’re going to talk about today is “by and large.” The video is about the phrase “by now.” And we have a quote of the week. Let’s get started.


The virus and the developing world

If you thought coronavirus was bad in the rich world, it could be many, many times worse in the developing world .

By now, we’re all familiar with how hard the rich world has been hit by the virus: doctors having to re-use masks , hospital beds in the hallways , non-essential surgeries canceled, sick patients treated on the floor or in wheelchairs , hotels commandeered as makeshift hospitals . Countries with advanced healthcare systems have been overwhelmed by the number of coronavirus patients and the lack of equipment , such as masks and ventilators .

The developing world has largely been spared the worst of the coronavirus. As of the time I’m recording this, India has just crossed 1,000 infections and has experienced only 27 deaths among its 1.3 billion people. The entire continent of Africa—20 percent of the world’s land area —had only had a few thousand cases.

Far from a success story , this is a humanitarian disaster in the making . Some developing countries, such as India, have responded sooner than their cousins in Europe. But the lack of cases in the poor world is not because of a superior strategy . The virus has simply not reached those places yet. When it does, it will be bad.

The strategy in the rich world has been to “ flatten the curve ” by imposing quarantines and social distancing and to encourage hand-washing. This is a luxury many people in the developing world don’t have. Hand-washing is much easier when your house has running water ; when you have to carry water to your house in a barrel , it’s much harder.

Social distancing is harder, too. People can afford not to go to work in countries with generous social safety nets : they may have financial worries, but starvation is not one of them. For many people, one day’s earnings buys the next day’s meal. Faced with the choice of quarantine or work, many people will choose work. And far fewer people will be able to do that at home.

For those who do stay at home, though, “home” is something much different than it is in the peaceful countryside of Spain or Italy. The typical home in Italy contains 2.3 people. In Nigeria, it contains about five; in Pakistan, it’s almost seven.

What happens when people in the developing world have to go to the hospital? The US is suffering from a shortage of intensive-care unit beds . We have 35 beds per 100,000 people. India has 2.3 beds per hundred-thousand people. Italy has four doctors per one thousand people; Bangladesh has one doctor per four thousand people. In rural areas of the developing world, access to health care is even more limited.

There are some reasons for optimism . The rich world by and large squandered its head start : it did not use the advance warning from China to adequately prepare . Many countries in the developing world are not making the same mistake . In India, Prime Minister Narendra Modi announced a three-week ban on leaving home , a stricter quarantine than other countries have imposed. The Indian government also passed a stimulus package faster than the US or Europe did.

In Africa, a handshake is even more central to the culture than it is in North America or Europe. The president of Gambia set an example by greeting others on stage with both his hands behind his back . In Lagos, the densely-populated capital of Nigeria, schools were closed after just a few cases were confirmed. Some African countries have learned valuable lessons about the transmission from disease from the Ebola epidemic that devastated so many places. Many clinics in Nigeria, for example, have specialized and separate wings for victims of an epidemic.

Other reasons for optimism: younger people can deal with the virus much better than older people can, and the developing world is much younger than the rich world. The median age in Africa is 19.7. It’s also possible that the virus will move more slowly in warmer climates , though that’s not known for sure . Despite the images many of us have of tightly-packed cities , a much larger proportion of people in the developing world lives in rural areas. This is a sort of inbuilt social distancing that could slow the spread of disease around India and Africa.


I mentioned last week that we were going to begin holding live video calls on Zoom and I’m happy to say that they have been a huge success so far! Our first call featured listeners from Italy and Spain; then a bigger one with listeners from Germany and Poland; and they’re going really, really well. We’ve had a lot of listeners share what’s going on in their towns, how they and their family members are coping with the quarantines, and when they think things will be back to normal. I’m really proud of everyone who joined our first two calls.

I’m very happy to say we will continue doing these. We’re going to do two styles of calls. One style is going to be a smaller group where we can spend the hour talking. The other style is going to be more a classroom-style where I’ll present a topic for about 30 minutes and then take questions at the end.

The first topic is going to be: how to talk about the coronavirus and quarantines. This is going to give you all the special English vocabulary we use to talk about what’s going on. Words like social distancing, the difference between a pandemic and an epidemic, super-spreader, index case, incidence, all kinds of words. That’s going to be the first topic.

We’ll also have smaller-group discussions where we can talk about what’s on our minds. Here’s how you can get involved. We set up a special page on PlainEnglish.com just for these live calls and classes. Go to PlainEnglish.com/live for the latest schedule and to register. Registration is free. JR and I would love to see you by video call, so check out the schedule at PlainEnglish.com/live.

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Expression: By and large