The public-health and economic consequences of the COVID-19 pandemic have varied across countries. This is true even among emerging-market and developing economies (EMDEs), which, compared to advanced economies, have higher poverty rates, poorer health care, and a lower share of jobs that can be performed remotely.

And yet, surprisingly, COVID-19 infection and death rates have so far been lower in most EMDEs than in the United States and Europe, as Pinelopi Goldberg and Tristan Reed have noted (and as Raghuram Rajan has also pointed out). But this may partly reflect massive undercounting, and in any case the situation is evolving rapidly.

Latin America’s EMDEs have been the worst hit, with those of Southeast Asia the least affected. Vietnam and Thailand, for example, have reported remarkably few cases so far.

Obvious possible reasons why the coronavirus has hit Latin America so hard include the region’s inequality, large and densely populated cities, sizeable informal sectors, inadequate public-health systems, and high levels of internal migration. A less obvious factor is that Latin America has less recent experience of pandemics than East Asia or Africa, where SARS and Ebola have made people more aware of the dangers of deadly viruses and the consequent need for social distancing.

The picture in Sub-Saharan Africa is unclear. Although the numbers of COVID-19 cases and deaths to date are relatively low, owing perhaps in part to the region’s young population, the situation in South Africa is worsening quickly. Apparently COVID-19 hotspots emerge in major metropolises with busy international airports – think of Milan, London, New York, and now Johannesburg – and then spread to neighboring regions with a lag.

There are also significant differences within regions. In Latin America, Brazil and Mexico are suffering especially badly: Brazil has reported more COVID-19 cases and deaths than any country except the US. Uruguay seems to be coping the best – but not by following US President Donald Trump’s logic of conducting fewer tests in order to report fewer cases. The country has a lower rate of positive results, which is a more meaningful statistic.

Brazil and Mexico are in deep trouble largely because of poor leadership. Their presidents are following the pandemic-response strategy pioneered by Trump: deny the seriousness of the situation, and then undermine public-health experts’ recommendations, such as mask wearing.

Then there is the case of Peru. It is hard to say what the country’s government has done wrong in its pandemic response, yet COVID-19 deaths per capita are higher than in both Brazil and the US. Equally puzzling is why Chile has reported more cases per capita than almost any other country.

The pandemic’s economic effects have been worse in EMDEs than in richer countries. Besides the direct effects of illness and lockdowns, COVID-19 has reduced EMDEs’ export revenue (especially in the case of oil exporters), tourism receipts, and remittances from expatriates. In March, risk-averse global investors fled emerging markets en masse. Capital flows later returned to some countries, encouraged by the US Federal Reserve’s stimulus measures. The current easy conditions in global financial markets mean that the much-invoked “perfect storm” analogy does not quite apply. But the current risk tolerance in financial markets may not hold up.

The US and other advanced economies responded domestically to the pandemic-induced recession with massive government-financed rescue packages. EMDEs, by contrast, lack the fiscal space to introduce big spending programs even for public health and to support hard-hit households, let alone for broad macroeconomic stimulus.

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