Over the course of the COVID-19 pandemic that has gripped the planet over the past several months, the global inequality of access to clean water has quickly emerged as one of the key factors dividing how developed and developing countries have been able to cope with the SARS-CoV-2 virus. While health officials in North America, Europe, and East Asia insist the public adopt a rigorous approach to handwashing as the best way to curb transmission, many parts of South Asia, Africa, and South America have been left wondering how they are supposed to protect themselves from COVID-19 when they don’t even have access to water fit to drink or bathe with.

According to UNICEF/WHO findings published last year, 2.2 billion people don’t have access to clean drinking water, while 3 billion don’t have what they need to wash their hands properly. 4.2 billion people – well over half the global population –don’thave adequate sanitation.The predictable results of this inequality are now coming into focus. While the European countries which initially bore the brunt of the pandemic – Italy, Spain, and France – have now successfully flattened their curves, India has just overtaken the United Kingdom with a caseload of over 340,000 that represents the world’s fourth-highest total.

Mumbai demonstrates morbid consequences of inequality

Access to clean water and sanitation are longstanding socioeconomic issues in India, where 91% of the population has what the United Nations considers “basic” access to drinking water, but where fewer than 60% can say the same for sanitation or hygiene services. Then again, “basic” access is a low bar. According to the WHO, people do not even need to have water available at home to meet the criteria, so long as it does not take them more than a 30-minute round trip to collect water from an “improved source” like a protected well or a pipe.

That definition makes it easier to understand why COVID-19 poses such a grave problem for Mumbai, where hospitals are already overflowing.Despite being India’s wealthiest city, with a gross domestic product of over$350 billion (larger than the entire economy of neighboring Pakistan) and no less than 28 billionaires, 42% of the city’s residentslive in slums where clean water for drinking, handwashing, or bathing are a luxury. As a result, residents are forced to rely on a black market for water just to meet their basic needs for survival. Many of these people nonetheless work in close proximity with Mumbai’s wealthy elite, meaningeven the city’s most well-heeled denizens are not immune from its public health crisis.

Not just an issue for the developing world

It would be a mistake for Europeans to think this type of inequality of access is a problem limited to the developing world. The countries of Europe, together with Canada and the United States, are collectively some of the world’s top performers when it comes to providing clean water. The UN finds fully 95% of people living in these countries enjoy access to safely managed drinking water, compared to just 60% of people in Central and South Asia and 27% in sub-Saharan Africa. That does not mean, however, that all water in Europe is safe to drink.

Indeed, according to the WHO, unsafe water kills 14 people in Europe every day, or over 5,000 every year. 21 million Europeans – a number equivalent to the total populations of Greece and Portugal combined – don’t have access to even “basic” drinking water. That deprivation can have dire consequences, given that people deprived of clean water from protected sources are instead forced to use untreated surface water, such as rivers and streams. When that water has been contaminated by human waste, including from those still forced to practice open defecation because they do not have access to toilets, the people drinking it are exposed to serious waterborne illnesses like cholera, typhoid fever – and potentially COVID-19.

Trusting the water from your tap

All the same, for the vast majority of Europeans, Americans, and Canadians, access to clean water (or lack thereof) is an afterthought. Modern water treatment methods remove the bacteria and viruses that pose an immediate threat to human health, although ensuring that tap water is truly ‘safe’ to drink requires the use of chemical additives like chlorine. Even after treatment, tap water still contains potentially harmful substances such as nitrates, arsenic, and in North America, atrazine, a substance banned in Europe but widely used across the American Midwest.

If an individual family or community is dealing with faulty pipes, those pollutants can also include neurotoxins like lead – as the city of Flint, Michigan in the United States learned the hard way. Popular filters, like the ubiquitous Brita brand, may be able to remove substances like chlorine and mercury, but they also provide an ideal home for bacteria to grow and can ultimately make water less safe to drink if not changed regularly.

Buying bottled water instead

All of these issues with water access and safety help explain why so many consumers in both the developed and developing worlds opt for bottled water instead. Of course, not all bottled waters are created equal. Many popular brands, such as Coca-Cola’s Dasani and PepsiCo’s Aquafina, are actually purified tap waterwhich the companies ‘enhance’ with their own additional filtration and mineral additives.

By contrast, European stalwarts such as Evian, Perrier, San Pellegrino, and Volvic are what they say they are: natural mineral water bottled from protected underground sources. While each source (and as a result, each brand) has its own unique composition of minerals, all are safe to drink at the source without the need for treatment or mineral additives. Compared to other options, the only real drawback to these types of bottled water is their contribution to plastic pollution, especially in rapidly growing markets like China and India.

To combat the trend, major bottled water companies like Danone are investing in sustainable packaging solutions and alternative materials, like aluminium, which are more easily recyclable. Given how many millions of consumers in countries with unsafe or unpalatable water rely on bottled alternatives, reducing the industry’s environmental footprint is now unquestionably a matter of urgency – especially since governments in those countries may need decades’ more time to ensure their populations have full and unfettered access to safe tap water in their own homes.