The Challenges Confronting Countries in the Tropics Affected by Covid-19

Compared with other regions of the world, countries in the Tropics appear to have less Covid -19 cases and lower death rates. Warmer temperatures and higher humidity have been proposed as an explanation. An alternative interpretation is that the figures result from a lack of aggressive testing. Regardless of the cause, this paper suggests that the way in which governments respond to the pandemic has a significant impact on containing the pandemic. Additionally, pressing challenges for countries in the Tropics are a lack of water and sanitation, insufficient personal protective equipment, and inadequate training of clinical staff. Suggestions for moving forward are proposed.


Introduction
The new coronavirus disease, which took the world like a bush fire , o rig inated in China in late 2019. It was transmitted to the rest of the world by air, sea, and road. This paper looks at the challenges of infection within the countries of the Tropics and suggests ways to address some of these challenges.
The countries in question fall between the Tropic of Capricorn, 23 0 south of the Equator, and the Tropic of Cancer, 23 0 north of the Equator. Th is area includes countries in Latin A merica and the Caribbean, Africa, and Asia.
Tropical countries have generally had a slower rate of Covid -19 spread than other countries. A possible explanation for this is the high humidity and temperatures of the tropics. Ho wever, this exp lanation has been questioned by several scholars. For examp le, Dapcevich (2020) argues that there is litt le relationship between weather and coronavirus , although he does add that the influenza and cold viruses www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 2, 2020 127 Published by SCHOLINK INC. tend to peak in the colder months and slow down during su mmer. Other studies also confirm that coronavirus infections tend to be associated with winter because of how they spread (Aubrey, 2020).
This is the case with influenza wh ich thrives during the colder months, helping the virus to spread more easily fro m person to person.
Drawing on empirical data, Dapcevich (2020) argues that warmer and mo re hu mid environments, such as those of Argentina, Brazil, and Australia, appear to support virus spread, as these countries have all had a considerable number of confirmed cases. Moreover, quoting experts' views, he stipulates that rather than climate, what actually will determine the decline in the rate of transmission of coronavirus will depend on government responses, the quality of med ical care, population density and other factors.
However, Dapcevich (2020), quoting Professor Marc Lipsitch, emphasizes that "even seasonal infectious can happen 'out of reason' when they are new" due to "their temporary but important advantage: few or no individuals are immune to them". Regardless, this virus is novel and the influence of climatic conditions on the spread of this disease is yet to be scientifically established.

Current Figures
According to data fro m the Worldometer, dated 12 April 2020, most tropical countries have not only low nu mbers of positive cases, but also low death rates. As of that date, the only tropical country with more than 10,000 positive cases was Brazil with over 20,000 cases, which is low relative to its population of approximately 210 million. Similarly, although India had over 8,000 positive cases, that number represents a small percentage relative to its population of more than one billion people. Table 1 documents the number of cases and death rates of selected tropical nations.
In the Caribbean, the Domin ican Republic had more than 2,700 positive cases and over 130 deaths. This is worry ing relative to the total population of about 11 million. Jamaica and Barbados appeared to have few positive cases and their death rates were low. It should be remembered, however, that low numbers of positive cases might be ascribed to a lack o f aggressive testing.

Government Res ponses
As of April 12 2020, tropical countries' govern ment responses to the pandemic were uneven, confusing and wanting, unlike China, where the Govern ment declared a total lockdown for over two months and achieved fairly positive results overall with only 3,300 people dying in hospital. The co mmon guidelines endorsed by WHO include social distancing, limit ing gatherings to a small nu mber, staying at home and self-quarantine. However, each country has interpreted the guidelines differently. For example, in Bolivia the Govern ment prohibited large-scale gatherings of more than 1,000 people. In Brazil, the Govern ment decided to fo llo w a policy of business-as-usual. Given that the nu mber of positive cases is increasing, this seems not to have been successful. Of the other Latin A merican countries sampled, as demonstrated in Table 2, only Colo mbia and Peru imposed national lockdown and Mexico declared a nationwide emergency. Others have declared a partial close down.
In the Caribbean, Barbados imposed lockdown, Jamaica declared a national disaster and Trinidad and Tobago introduced partial restrictions. In Africa, Rwanda imposed a total lockdown, Senegal a curfew, and Nigeria a lockdown for Lagos, Abuja and Ogun states. In the case of Kenya, the Govern ment introduced an all-n ight curfew and restricted movement into and out of Nairobi and Mo mbasa and their surrounding counties. In Ghana, a major lockdown was declared for greater Accra, Tema and Ku masi.
In Asia, Thailand and Indonesia both declared a state of emergency, while India has been on a nationwide lockdown. In the Philippines, the Govern ment declared a state of calamity and a partial lockdown.

Response to the Covi d-19 Outbreak
Analysis of the data in Table 2 and Figures 1 and 2 tested, for example only people exh ib iting symptoms of the disease or larger swathes of the population, will factor into the significance of these findings.

Challenges in Containing the Virus
Given the viciousness of coronavirus, governments have had to make difficu lt but essential decisions that have had a huge socioeconomic impact. The challenges in imp lementing the measures are particularly difficult in those countries with huge slums and high unemplo yment. Two challenges that are co mmon to many tropical countries are a lack of adequate water and sanitation, and a lack of Personal Protective Equip ment (PPE) fo r, and training of, medical personnel.

Lack of Water and Sanitation
One of the main messages in the global campaign for co mbating the coronavirus is the importance of washing hands with soap and running water. During World Water Day on 20 March 2020, Water Aid UK noted that low-and middle-income countries face a dual challenge: they do not have any way to wash hands, and knowledge on how and why to wash hands properly is not widespread (RSTMH, 2020). According to RSTMH (2020), nearly 75 per cent of households in sub-Saharan Africa lack basic hygiene facilit ies to wash their hands with soap and water in their homes. Globally, only 19 per cent of people wash their hands with soap after using the toilet despite hands being the principal cause of transmission of disease-causing germs (RSTM H, 2020).
According to The Guardian, most low-and middle-inco me countries are at greatest risk in the coronavirus crisis (Harvey, 2020). The article suggests that low investment in water and sanitation has occurred because the services are perceived as social and environmental rather than economical. Rural areas across the Tropics, as well as the slums of majo r cit ies, continue to be very vulnerable to the spread of Covid-19. Govern ments, such as those in Latin America, are currently setting up emergency provision 是 of water supply to the poor and vulnerable groups, including water tanker distributions in Colo mb ia, Costa Rica, Do min ican Republic, Mexico, and El Salvador (Serrano & To rres, 2020).
Moreover, priority is being given to hospitals and institutions serving the most vulnerable commun ities, as for examp le, in Jamaica. In many countries in Latin A merica, disconnection of services due to lack of payment has been suspended (Sorreno &Torres, 2020). In Sao Paulo, Brazil, water tariffs for low-inco me people have been put on hold and debts of individuals and companies have been deferred for 90 days. In co mparison, the urban poor in both tropical Asian and African countries are mo re vulnerable to this pandemic because of the inequalit ies that characterize the provision of water services, and the often lack of means to wash their hands (Amankwaa, 2020). However, some govern ments are providing water tanks and jerrycans for the urban poor and in open markets of major cit ies.

Insufficient Personal Protective Equipment and Lack of Training of Clinical Staff
Since the onset of the new coronavirus outbreak, most countries, both developed and developing, have personnel. In Kenya, the informal sector is flourishing as local tailo rs make masks of all types for local distribution. In the light of the cancellation of flights and thus export opportunities, the few text ile companies in the country have been encouraged to make PPE. It is hoped that locally produced PPE will meet the required standards to support the work of the co mmitted and determined health care staff.
There is no doubt that other countries are also equipping themselves against this virus.

The Way Forward
The countries in the Tropics should not be complacent about the low figures of positive cases and deaths. They should continue forward with the follo wing:

Learn from Best Practice
The available examp les are Ch ina, Singapore, South Korea, and Taiwan. For examp le, South Korea has emphasised tracing contacts, testing and isolating (Noor & Sundaram, 2020). In the case of Taiwan, Tu (2020) states that containment has been due to effective Govern ment-led public-private collaboration; integration of the media in efforts to regularly broadcast basic preventive informat ion, such as washing hands, wearing masks, and social distancing; the provision of clear and decisive guidelines , and ensuring the strong support of cit izens . In the case of Singapore, Heijmans (2020) concludes that its current success is based on its top-notch health care system and draconian tracing and containment measures. Based on the above, countries in the Tropics should embrace the best practices and avoid examples fro m Brazil and Sweden where the governments are continuing with business as usual. United States are all infested with the new coronavirus: this has put leaders of developing countries on notice.

Enforce Social Distancing and Self-quarantining
To win the war on the new coronavirus, social d istancing and self-quarantine are two crit ical factors.
However, this is going to be a challenge fo r all countries in the Tropics. Many of the countries with densely populated urban centres , like Dar es Salaam, Delhi, Dhaka, Jakarta, Lagos, Manila, Mu mbai, Nairobi, Rio de Janeiro, Sao Pao lo, and others, have huge slums, where many people or families are squeezed into small roo ms. Additionally, congested public transport and teaming markets mean that social distancing will continue to be a big challenge. Hence, these will be hotspots of increasing positive cases of coronavirus. and medicine have manufactured a prototype ventilator that, once approved, could be used to treat COVID-19 patients. There should be collaboration in producing PPE within this reg ion for local consumption and for any eventuality.

Conclusion
The new coronavirus pandemic exposed the poor state of preparedness of the world at large to deal with such an event. Even countries who had experienced previous pandemics were not prepared. As Macky Sall, the President of Senegal, noted, "the level of unpreparedness due to the sudden onset of the pandemic, its rapid evolution and the enormous needs to be addressed, is a clear indication that national measures remain inadequate" (Sall, 2020). Therefore, for countries located in the Tropics, the message is clear, they must priorit ize public health. Neighbouring countries need to cooperate and enforce similar measures, such as lockdown, along their borders. This global pandemic has shown us that in the face of cross-cutting threats, big or s mall, rich or poor, we are all vulnerable. Given that this virus covers the entire world, there is a call for strong collaboration and partnership between the developing world and developed countries in research, innovation and international solidarity.