Asian nations beat India in Covid control

Paran Balakrishnan | Updated on August 18, 2020

Battling on: India’s Covid containment efforts haven’t really paid off

This is a bit perplexing as we were quick to act, while most of our neighbours reacted tardily and, yet, are better-off

Whatever went wrong? India played it by the book, stopped flights from China and Europe and moved swiftly to impose a draconian lockdown on March 25. And, yet, here we are, almost five months later with 2.65 million Covid-19 cases, third behind only the US and Brazil.

To be sure, that’s a smaller percentage of our giga-normous population, but it’s a huge number by any yardstick. What’s more, in the last week we’ve added more cases than both the US and Brazil.

It would be easy to fling blame at the Government. But other countries reacted more tardily and still got away more lightly. Take a look at our neighbours, for instance — but keep in mind the fact their numbers may be kept down because they did much less testing for Covid-19 than we did.

Still, there’s a stark contrast between India and the rest of South and South-East Asia. Just look at Pakistan, which did province-wise lockdowns and then resorted to what it called ‘smart lockdowns’, shutting down only hotspot localities. The World Health Organization (WHO) sternly warned Pakistan about “the hasty lifting of restrictions”. On June 24, Pakistan had 188,926 cases compared to India’s 440,215 cases — which was high considering their population is less than one-sixth of ours. Today, they’ve fallen from a daily tally of over 6,000 cases to 679.

As for Afghanistan, many experts predicted it would be a Covid-19 disaster area because of non-existent healthcare facilities and the fact that many Afghans work in quarries in next-door Iran. When Iran became one of the worst-hit countries after China, most Afghan workers were herded onto crowded buses and pushed back across the border. So far, it claims to have only 37,676 cases and 1,377 deaths.

Inevitably, experts say the Afghan figures must be hugely under-reported, but the catastrophe forecast doesn’t appear to have occurred.

It’s the same pattern in Bangladesh and Sri Lanka and even Myanmar with which we share a 1,643-km border. Bangladesh got its first Covid-19 cases in April and they peaked in June at slightly over 4,000 a day. The numbers have fallen steadily since then and were at 2,024 on August 14. The catch with Bangladesh’s figures is the country has the lowest test/positive cases ratio in the region so they may be woefully under-counting numbers.

As for Myanmar, it hass recorded only 375 cases and six deaths. Of these, 69 returned from India and the country and it says it had its first locally transmitted case a few days ago.

Myanmar may be helped by the fact it’s one of the world’s Hermit Kingdoms, at the tail-end of globalisation and still gets few foreign tourists.

Similar trend

It’s much the same story across Asia. Take Thailand, one of the world’s great tourism destinations. Back in 2010, the Thais had about 15.94 million tourists annually. That zoomed to 29 million by 2019. Where were the new tourist hordes coming from? No prizes awarded for getting that answer right. In 2019, 11 million Chinese tourists headed to Thailand’s beaches and green and pleasant land.

So, it wasn’t a surprise when Thailand was the first country to have a confirmed case of Covid-19 cases after China. By March 22, the Thais were shooting ahead of their neighbours with 188 cases. But, then, the infection vanished as suddenly as it arrived and after April 25 the Thais have reported less than 20 cases daily.

The New York Times reports that other Mekong Delta countries, Vietnam, Laos and Cambodia, have also had low case numbers, as has Yunnan, the Chinese province next door to these countries.

One explanation offered by Thai doctors is there’s no resistance to wearing masks and the country doesn’t have a Western-style touchy-feely culture and they do what’s called the Wai, very much like the namaste.

The obvious point here is doing the namaste hasn’t helped India keep down Covid-19 cases. Is there a genetic reason? Thai doctors are looking into this but they aren’t anywhere near an answer.

Across Asia, Covid-19 fatality figures have been lower than in Europe and the US and the only plausible reason doctors offer is Asians are attacked by all kinds of infectious diseases like dengue and this could have left us all with better Covid-19 immune responses.

There could be one reason for India’s zooming numbers. That’s the migrant crisis which had people travelling hundreds of miles, some in crowded lorries and other conditions where social distancing wasn’t possible. But in Bangladesh, too, large numbers returned to their villages when they lost jobs in urban areas.

What could the future hold for India? One prediction is we’re heading towards becoming the global Covid-19 hotspot — though the US with 5.41 million cases and 171,000 deaths is still far out in front. But we’ve just crossed the 50,000 cases a day mark and that should be raising alarm bells everywhere.

Is there good news amidst this gloom? A survey conducted between July 20 and August 5 in five sub-wards or prabhags in Pune indicates an average of 51.5 per cent sero prevalence in these areas. The sero prevalence was higher in areas with hutments and tenements than in places with larger apartments or houses.

A similar study in Mumbai’s Dharavi district found 57 per cent of people there had antibodies against the infection.

This could indicate achieving “herd immunity” — when the virus peters out because there are no longer enough susceptible hosts — is closer than we think. (The rider to that is it’s still not known whether antibody prevalence confers immunity against subsequent infection, doctors say.)

Dark matter

Alternatively, there’s the theory of what virologists call ‘dark matter’. This simply means that many people in any given country have built-in immunity to Covid-19 or other illnesses and aren’t likely to ever contract them.

Going by this theory, it could be that herd immunity can be reached after 20-25 per cent of the population has been exposed to the illness. Look at it this way and herd immunity becomes a much less daunting target.

Fortunately for us, we now live in the Big Data era. That has enabled us to work towards a vaccine at a speed that would have been impossible even a decade ago. Indian doctors are swapping data and information with their counterparts in places like Lombardy, Italy, and New York that were struck savagely by the pandemic.

The doctors say, with the knowledge gained, they’re saving more lives than a few months ago which can only be good news for those who will still inevitably be stricken by the virus.

Published on August 18, 2020

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