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In the United States, authorities are bracing for a post-Thanksgiving coronavirus surge within the surge. They fear that the millions of people who traveled for the holiday enabled the further spread of the virus at a time when hospitalizations and deaths are already spiking through the country. In at least nine states, more than 1 out of every 1,000 residents has died of virus-related causes. Public health experts warn that the trajectory of the current surge is pushing hospital systems to breaking points in many areas of the country, courting, in one analyst’s words, “humanitarian disaster.”

But for all the grimness of conditions in much of the United States, humanitarian organizations are more alarmed about developments elsewhere. In parts of the world where social safety nets are more meager — and the informal economy far more vast — people already accustomed to lives of precarity have slid into crisis. Those even more vulnerable, especially refugees, face even bleaker prospects.

A new joint report put out Monday by the U.N.’s refugee agency and the Norwegian Refugee Council found that millions of people may not receive the aid they need because of insufficient funding. Of some 54 million internally displaced people targeted for assistance by humanitarian nonprofits, international organizations and U.N. agencies, the report predicts that almost 40 million could miss out. In 2020, humanitarian “protection” efforts by these organizations received less than 25 percent of their required resources, compared to an estimated 38 percent between 2013 and 2019. That shortfall may have devastating, incalculable effects.

“The human toll of the pandemic on the world’s vulnerable should not only be measured by the number of lives it has taken, but by the eclipsing number it has shattered,” said Jan Egeland, secretary general of the Norwegian Refugee Council, in a statement. “COVID-19 has hardest hit millions of people with absolutely no access to protection services. Children recruited by armies cannot reclaim lost childhoods. Women raped and beaten wear their scars for life.”

The social toll of the pandemic is still difficult to measure on a global scale, but international organizations are worried about the disproportionate harm it’s causing to women. Thirteen million more underage marriages could occur over the next decade as a consequence of pandemic-induced immiseration, according to recent U.N. estimates. My colleague Miriam Berger reported in April on rights groups’ warnings about a surge in domestic violence as the pandemic spread across the world; in September, she charted how coronavirus restrictions were making access to contraception and health services more difficult for women, with the U.N. suggesting the pandemic would produce millions of unwanted pregnancies.

U.N. secretary general António Guterres has warned that a generation of progress against gender inequality risked being reversed in the shadow of the coronavirus, with girls dropping out of school and rates of domestic violence rising. “Today, millions of teenage girls around the world are out of school, and there are alarming reports of an increase in teenage pregnancies in some countries,” he said at the end of August. “We know from the Ebola outbreak in West Africa that when teenage girls leave school, they may never return.”

U.N. surveys offer a few country-by-country glimpses of the downstream pain already inflicted in part by the pandemic on some of the world’s most vulnerable populations. In Yemen, more than two thirds of women are now married before the age of 18, a rise from roughly 50 percent a few years ago. Incidents of gender-based violence involving Venezuelan refugees and migrants in Colombia increased by 40 percent over the first three quarters of the year, when compared to the same period last year, and calls to domestic violence hotlines rose by 153 percent.

In the Central African Republic, a quarter of whose population is displaced, the U.N. found that “one gender-based violence incident is recorded every hour.” A survey conducted by the International Rescue Committee in three conflict-hit regions in Africa found that, since the start of the pandemic, “73 percent of women interviewed reported an increase in intimate partner violence, 51 percent cited sexual violence and 32 percent observed a growth in the levels of early and forced marriage.”

In the Bangladeshi city of Cox’s Bazar, home to a huge population of Rohingya refugees, 42 percent of refugees polled said that women and girls had become more unsafe “inside the house” since the onset of the pandemic. Containment measures and restrictions have made it harder for victims to escape or seek help.

“With COVID’s socio-economic impact driving millions of refugees and displaced people further into poverty and destitution, we are extremely worried about the increase in violence against women and girls,” warned U.N. High Commissioner for Refugees Filippo Grandi last week. “Jobs have been lost, tensions are rising, intimate partner violence is escalating, livelihood opportunities are scarce and movement restrictions are making it difficult for survivors to report abuse and seek help.”

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