The processes accompanying the pandemic, including the lockdowns, are intimately connected to demographic trends and patterns.
This World Population Day,, starting with the trinity of fertility, mortality and migration and their implications.
On mortality first. The pandemic will alter mortality trends just as the HIV/AIDS epidemic has in many countries, if not more so. But estimating COVID-19 mortality is not a simple enterprise, although it has become easier with better testing.
In the early days, when testing was rationed, it was difficult to ascertain cause of death—was it the coronavirus or something else? So data scientists focused on calculating excess mortality, that is, a month-on-month comparison of the number of deaths compared to the previous year.
But this only works in countries with robust vital registration systems, or where every death is registered. At the World Bank, we work in too many countries where that’s not the case. So, we rely on demographers to devise alternative ways, whether it is by deriving data from cremations and burials or from verbal autopsies.
A second important aspect of population science is age structure. Countries and regions with older populations have seen higher case fatality rates, and this raises huge issues for the manner in which elderly people are treated. In Europe and some parts of the United States, triage plans have focused on those who are healthy and most likely to recover, putting older patients at the bottom of the treatment hierarchy.
Third, migration is a big part of the pandemic and lockdown story. Migrants who work in precarious, informal, manual jobs, usually in urban areas, have suffered disproportionately due to business closures. Their aggregate welfare has been overlooked in almost every region of the world and especially in countries and cities that rely heavily on migrant labor. And too often countries and cities do not have a count of migrants or an understanding of their needs.
Fourth, population scientists spend a lot of time and energy analyzing marriage and cohabitation, including, but not only, because they have to do with fertility. These patterns are upended as many of us join the bittersweet Zoom weddings or cancel wedding plans. In some countries, the progress in addressing child marriage will likely be stalled, as families come under pressure to marry off young daughters to stave off the effects of the pandemic. Further, COVID-19 has curtailed women’s access to contraception and other sexual and reproductive health services and put them and their children at greater risk of violence. The UNFPA and other national and international actors have highlighted these substantial risks.
Fifth, living arrangements and residential patterns matter for many reasons. The study of population dwells on and draws inferences from who lives where, with whom, and in what conditions. This has been stood on its head as well, as recently unemployed young adults come back to live with parents, and as families work from home and in close proximity. Quarantines and social distancing can also keep older and immunosuppressed people in solitary living conditions, with adverse effects on mental and physical health. Plus, as the pandemic has until recently been largely urban, there is increasing focus on slums and other crowded spaces that can serve as hotspots of contagion, if they are not managed well.
Sixth, the study of race ethnicity and gender, and their intersections, are part and parcel of demography. During the pandemic, some groups are at greater risk of falling ill because they are unable to stay distanced from others, unable to access healthcare, or because they work in essential jobs that put them at higher risk. In the United States for instance, Black and Hispanic groups are at higher risk of being infected and of death.
Therefore, this day when we commemorate the importance of population, let us pause to think about the many ways in which COVID-19 can be better understood if we pay attention to population trends and patterns. This is only possible if we invest in data and analysis, which is itself in jeopardy as 2020 is census year for many countries and most will not be able to conduct it due to the constraints posed by the pandemic.
Several existing platforms and dashboards have refined their offerings to include better demographic data and analysis. Of these, the World Bank’s curated and harmonized databases, Our World in Data, the Johns Hopkins Coronavirus Resource Center, and many country-level dashboards and trackers are a few excellent examples. Therefore, despite the challenges, there are many ways we can invest in the understanding of population dynamics. Getting it right is important: it will help lead to better policies and programs, better support, and better outcomes for countries and groups that need them most.