Osmel Martinez Azcue felt unwell. Having recently returned home to Florida from China and experiencing flu-like symptoms, he went to his local hospital to get tested for coronavirus. While the test was negative, Azcue has since been billed for $3,000 - he’ll be responsible for $1,400, according to his insurer.

The coronavirus outbreak is a stark reminder of the divide that exists in countries without universal healthcare, like the US, between those who can afford healthcare and those who cannot and may be forced into extreme poverty as a result.

In the US, concerns have also been raised about access to any future coronavirus vaccine after the Secretary of Health and Human Services, Alex Azar, said he could not guarantee it would be affordable to all when available.

Who is most affected by the US healthcare crisis?

On 12 March, Africa registered its first coronavirus death. The number of cases in the continent has “mushroomed in the last week” according to the BBC and concerns are growing for populations in Africa - and the world’s - poorest countries where health systems are weaker.

“Our biggest fear involves cases arising in poor, densely populated neighbourhoods,” Dr Michel Yao, Emergency Operations Programme Manager at the WHO's Regional Office in Africa, told The Africa Report.

“In this type of situation, if health facilities don’t have the appropriate capacity to treat patients, then the death toll could be significant. And what makes this even more crucial is that the coronavirus could decrease our resources for treating other diseases such as malaria and for ensuring maternity and child healthcare.”

Access to healthcare and the capacity of health systems will be a heightened concern at this time for those already living in poverty or experiencing income inequality, especially as the pandemic brings additional economic risks for low-income or less secure workers.

While companies such as Twitter, Facebook and Google have instructed many staff to work remotely or from home, for millions of workers around the world this is not an option.

“In this way, the spread of the coronavirus exposes a widening chasm in the US economy between college-educated workers, whose jobs can be done from anywhere on a computer, and less-educated workers who increasingly find themselves in jobs that require human contact,” writes Alana Semuels.

Gig economy workers, such as Deliveroo riders or Uber drivers, and the self-employed are not entitled to statutory sick pay. They may, however, be the ones delivering essentials to increasingly self-isolating populations, putting their own health at risk for low reward.

“If I catch something I’m screwed,” 23-year-old Shane Stephen, a Deliveroo courier told the Guardian. “Gig economy workers can’t afford to be ill. My bank balance is literally £4 something right now.”