The rating agency has already downgraded or cut the outlooks on nearly 60 countries this year, but only relatively few have been higher-rated richer nations.

With some though piling on 15-20 points of debt as a percentage of gross domestic product (GDP) – amounts that would normally take four or five years to accumulate – and locked into higher spending for the next 3-5 years, that could be about to change.

The associated lockdowns, restrictions and continued uncertainty have caused investments, trade, and remittance flows to plummet, eroded jobs and human capital, kept children out of school, and pressured food and medical supply chains, it said.

The monetary institutions warned that the humanitarian crisis can further exacerbate fragility, conflict, and violence as well as intensify risks, including in small island states. The economic crisis is threatening the lives and livelihoods of vulnerable populations, including women-led households, youth and the elderly, refugees and displaced people.