The global coronavirus pandemic, now in its third month, is precipitating a financial crisis for water utilities in low- and middle-income countries as many of these service providers face drastic cuts in revenue and rising costs to respond to the public health emergency.

Until several months ago, demographers regarded a youthful age structure as an unequivocally detrimental demographic characteristic. Where more than half of the population is younger than age 25, countries are unable to attain high levels of economic and human capital development and face an increased risk of some forms of civil conflict. Yet, so far, during the ongoing pre-vaccine stage of the COVID-19 pandemic, the most age-structurally mature countries have been hardest hit by the disease. These countries are generally urbanized, wealthy, well-educated, and include a large proportion of seniors. And, somewhat surprisingly—despite being equipped with advanced medical technologies—these countries are experiencing the highest rates of mortality from complications related to COVID-19.

Rohingya refugees fleeing anti-Muslim persecution in Myanmar are exploited by the Arakan Army to smuggle synthetic drugs into Bangladesh. The army, which demands greater autonomy for Myanmar’s Rakhine State, uses the drug sales to purchase arms and ammunition. It moves the drugs from production centers in Myanmar’s interior to Rakhine State, where Rohingya make the arduous trek along refugee migration routes into neighboring Bangladesh. Lacking other sources of income, the Rohingya are vulnerable to recruitment by the army’s drug smugglers.

Late last year, what is thought to be a bat-associated coronavirus infected humans in Wuhan, a city of 11 million in China, possibly after a stopover in illegally traded pangolins—setting off a global pandemic. This kind of thing has happened before—with AIDS, SARS, and MERS, for example. Much remains unknown about the biology of COVID-19, which is alarmingly communicable by people with few or no symptoms. But an epidemic is only part biology. It is also driven by cultural factors, and urbanization is a crucial aspect. As sites of large gatherings and dense living conditions, cities offer the perfect settings for the spread of infection, yet their role seems to have often gone unremarked in discussions of the pandemic.

On May 6, Médecins Sans Frontières (MSF) announced it had started to treat COVID-19 patients in Tijuana, in northwestern Mexico. Tijuana, which is on the border with San Diego, has the greatest number of cases in Mexico and one of the highest death rates.

“We will be providing support to health institutions [by] relieving the hospital burden in Tijuana,” said Maria Rodríguez Rado, MSF’s COVID-19 Emergency Response Coordinator in Mexico, according to the group’s website. “Through this support, we want to relieve the enormous workload of health workers who are responding to this pandemic and help alleviate the suffering of patients.”

The move is welcome. Across Central America, megacities such as Guatemala City, Tegucigalpa in Honduras, and Managua in Nicaragua are vulnerable to the rapid spread of COVID-19.

COVID-19 isn’t the only problem going viral. Economic insecurity is driving gold prices to record highs around $1,700 per ounce, causing levels of global mercury pollution to rise too. In the United States coal-fired power plants drive mercury pollution, but globally, the leading cause is small-scale ‘artisanal’ gold mining. Roughly 30 million men, women, and children in poor countries depend on mining for subsistence incomes. Unfortunately, the cheapest and easiest way to mine gold uses mercury, a highly toxic heavy metal the United Nations is striving to eliminate.

Development specialists are sounding the alarm. The pandemic will not be stopped unless we provide safe water to the world’s most vulnerable people, according to UN experts. Soap and clean water are part of the arsenal of weapons we can deploy on the frontlines of the battle to halt the virus’ spread. Yet Covid-19 continues to pose an unprecedented threat to more than 2 billion of the world’s poorest people who lack the access to safe water, sanitation, and health services (WASH) needed to protect them during infectious disease outbreaks, according to the World Health Organization.

At an event organized by the Coalition of Atoll Nations on Climate Change in December 2019, Tabitha Awerika, 21, from Kiribati, urged world leaders to listen to the climate science and to the pleas of those living in the South Pacific. “I will not leave the lands of my ancestors,” she said. “I will not abandon my motherland. I refuse to leave the only place I call home.”