ROME – With over a million cases of the COVID-19 coronavirus and close to 65,000 deaths worldwide, most in China and the West, focus is now shifting to Africa, the Middle East and Latin America, where a major crisis could risk collapse of already strained economies and healthcare systems.

Experts say that crisis could be in the works right now, we may just not be able to see it yet.

According to Dr. Peter Hotez, professor and dean of the National School of Tropical Medicine at Baylor College of Medicine, what makes the COVID-19 coronavirus unique is “high transmissibility and the fact that there’s a group of people with low-grade symptoms or who are asymptomatic that can spread the virus through the community, especially crowded urban areas, many areas of poverty.”

“Many of these places were unprepared for the surge of patients requiring ventilation or other intensive support,” he told Crux, saying that as the virus spreads, he is increasingly worried about poor and developing countries in Africa and South America, such as the Democratic Republic of the Congo, Angola, the Philippines and Papua New Guinea.

“How do you practice social distancing in the crowded slums of São Paolo or Manila?” he asked.

It’s precisely such questions international Catholic charity organizations currently are trying to tackle. Aid agencies such as Caritas International and the AVSI Foundation are trying to get in ahead of the game, launching awareness-raising campaigns, fundraising and partnerships with local projects already in place.

Speaking to Crux, Flavia Chevallard, AVSI representative for Syria, said “there’s a lot of fear” about just how bad things are. Though the country has just 19 confirmed cases and two deaths, after nine years of civil war that has left only half of the country’s hospitals fully functional, testing is inconsistent and supplies short.

“This is the uncertainty now, there are very strong measures in Syria for the number of cases we have, but there are not that many tests, so we are all aware that there are more cases,” she said.

Since March 12 Syria’s borders have been closed and schools, universities and mosques shut down. Around 10 days ago a curfew was implemented, barring citizens from going out for large parts of the day. However, with a large percentage of the population living in poverty, self-isolation in crowded houses without a paycheck is impossible.

“There are many people who live day-to-day, either day jobs or a daily salary, so by now they are not working for several days. It’s not a sustainable situation,” Chevallard said.

Hunger is growing, she said, as people crowd around bread shops that sell at a discounted price.

“There are some people, if the bread is not at that price, who cannot eat,” meaning that in the struggle to get to the front of the line, no one is paying attention to social distancing.

“This is a big problem. There will also be an economic crisis in Europe, but here it’s a question of hunger from day one. This is the difference,” she said, noting that Syria is currently “on its knees”. With the financial crisis in neighboring Lebanon, “the economic situation is like a bomb that could explode, because people are really at their limit.”

For the past three years AVSI has run an “Open Hospitals” project in partnership with the Holy See and the Hungarian government aimed at providing healthcare to poor families and individuals who cannot afford payment but require treatment, regardless of ethnicity or religion.

In addition to the on-the-ground support AVSI provides, Caritas International is also offering assistance to Syria in the same ways it is other at-risk countries: awareness campaigns, door-to-door visits to see what the biggest needs are, and handing out food and hygiene kits.

Caritas is also offering additional help to countries such as Venezuela, where it is trying to open soup kitchens so children and the elderly can find nutritious meals. They are also working with migrants and refugees throughout Latin America, the Middle East and Africa and are lobbying with the United Nations to ensure adequate funds are available for an adequate humanitarian response.

Speaking to journalists at an April 3 virtual press conference using Zoom, Aloysius John, secretary general of Caritas International, said the organization is particularly concerned about the humanitarian situations in warring countries in the Middle East, as well as South Sudan and Central Africa, “where an outbreak of the pandemic could lead to a major humanitarian disaster in countries already fragile due to war and violence.”

“We advocate for non-diversion of humanitarian assistance which will pose a massive threat on communities that are surviving on aid,” John said, adding that “We need to be more active in building creative solidarity to be with the people. I think the needs are going to be very high.”

Africa is a particular area of concern, he said, noting that various projects aimed at fighting poverty and providing a crucial water supply to areas that otherwise would not have it, need to be updated and “scaled up” in order to be prepared for a worse coronavirus outbreak.

“Water is going to be a major issue,” he said. In addition to targeting sanitary problems in some areas, Caritas is now focusing on how to provide a steady water supply should a lockdown occur.

“I think we need to be really proactive, and there is a new wave of solidarity coming and I think we need to keep it up,” John said, explaining that Caritas is in conversation with the Vatican about possible assistance and they will soon be sending out a questionnaire to local offices to determine what the greatest needs are.

“What is important to understand here is, the needs will be immense, and the solidarity has to be at the expectation of these needs,” he said, noting that one advantage Africa has is the experience medical personnel, local authorities and charity offices gained during the Ebola epidemic in 2014, which killed more than 11,300 people.

Suzanna Tkalec, humanitarian director of Caritas, told journalists the organization is “really working to integrate and look at lessons learned by Africa and the Church with the Ebola outbreak.”

“Caritas today throughout Africa, together with the Church, is extremely active in messaging and awareness raising,” she said, adding that they are also working with local organizations on the ground in South Sudan to meet ongoing humanitarian and sanitary needs.

John met with Pope Francis on April 4, likely to discuss Caritas’s various initiatives and explore areas of further funding.

In addition to their work in Africa and the Middle East, Caritas is also partnering with local organizations and projects in India and Bangladesh to raise awareness and promote proper hygiene, especially given the thousands of refugees still camped out along the Bangladesh-Myanmar border.

Efforts being made, John said, consist of “not just waiting for things to happen,” but their offices “are already doing things (and) trying to be creative” in getting in ahead of the curve in at-risk areas.

Follow Elise Ann Allen on Twitter: @eliseannallen