Faced with a sudden surge in coronavirus infections, India once again faced the world’s second-largest outbreak, surpassing Brazil after the latter moved forward in March. But those grim statistical maneuvers pose an epidemiological conundrum as to why the Latin American country has been so much more devastated by the pathogen.
When it comes to the scale of infections, the two countries are tied: cases rise to around 14 million and hospitals from Mumbai to Sao Paulo are under increasing pressure as admissions continue to rise. But it’s the divergence in deaths that perplexes scientists. , home to nearly 214 million people, has seen more than 365,000 people die from Covid-19, more than double the number of deaths in India, which has a much larger population of 1. 4 billion.
While the death toll in India has begun to rise and threatens to worsen, the disparity at the macro point persists and is emblematic of the other tactics in which the pandemic manifests itself in other regions. Experts say this needs to be better understood and decoded. engage this global outbreak and long-term public health crises.
Covid death rates in South Asia, along with India, are consistently lower than global averages, just as those in Latin America are consistently higher, forcing virologists to come up with a number of theories about why Covid has reached a deadlier swath from Brazil to Argentina.
“Here we’re comparing apples to apples, we’re comparing apples to oranges,” said Bhramar Mukherjee, a professor of biostatistics at the University of Michigan School of Public Health. For now, the two countries offer an “intriguing conundrum: an epidemiological mystery. “that requires the intervention of a Sherlock Holmes or a Miss Marple. “
Brazil has been hit by waves that have killed an alarming number of young people and last week reported a record one-day rise of 4,000 Covid-19 deaths. Meanwhile, the number of daily deaths in India has topped 1,000 in recent days and has been much lower. than last week. The number of deaths in this Asian country as a percentage of registered cases is 1. 2 compared to 2. 6 in Brazil, according to information compiled by Bloomberg.
Age Variation
Multiple points may play a role in the mortality gap, adding differences in average age: 26 years in India to 33. 5 years in Brazil.
Experts have long criticized India’s broader death statistics, especially in the rural hinterland. Before the pandemic, about one in five deaths went unreported at all, according to Mukherjee. But that doesn’t explain why the death rate in Brazil is higher than in aging. Western countries that have also been hit hard by the pandemic.
“The death rate in Brazil is even more shocking because the population is much younger than in other countries, such as those in Europe,” said Alberto Chebabo, vice president of the Brazilian Society of Infectious Diseases.
The rise in infection and death rates comes as the speed of vaccination campaigns across countries has accelerated over the past month after an initially slow start. India has managed to administer more than 117 million doses of vaccine, compared to just about 33 million in Brazil, despite the latter injecting a higher proportion of its population.
Cross-immunity
Other theories about the divergence between Brazil and India focus on the other settings of the two countries and concentrate on the disease.
Some scientists say widespread exposure to a wide diversity of diseases in India would have possibly helped its citizens expand herbal resilience against coronaviruses like Covid-19.
Shekhar Mande, president of the Indian Council of Scientific and Industrial Research, is among those who have tested this trend and is a co-author of a published study on the subject. Their studies found correlations between citizens of countries with poor hygiene tending to cope better with COVID-19.
“Our hypothesis, and this is strictly an assumption, is that because our populations are continually exposed to many types of pathogens, in addition to viruses, our immune formula overreacts to any new variation that arises,” Mande said in an interview.
Many experts acknowledge that genetics or cross-immunity may be at play, as other South Asian countries, such as Bangladesh and Pakistan, have also recorded fewer deaths than Brazil.
The fact that 87% of Brazilians live in urban regions, while two-thirds of Indians live in rural regions with more surface area and ventilation, may be a good reason, according to Mukherjee of the University of Michigan.
Mutant strains
Then there is the fact that in Brazil one of the potentially deadly mutations of the coronavirus, the P. 1 variant, was known in December. In addition to the variants first detected in South Africa and the United Kingdom, studies recommend that those strains are more contagious.
“The P. 1 variant has spread in many cities and states in Brazil, causing a collapse of the fitness system, resulting in a very high mortality rate,” said Chebabo, of the Brazilian Society of Infectious Diseases. a “perfect storm”, he added, whose lack of political leadership when it comes to implementing effective measures such as lockdowns, aggravates the Covid crisis.
The immediate and sustained spread of the variant in Brazil hasn’t given its fitness formula any room to maneuver either, unlike the pause between waves in the final months of 2020 in India, which helped hospitals and frontline staff plan for the future.
“We are much more prepared than before to deal with this wave in many ways,” Suneeta Reddy, chief executive of Apollo Hospitals Enterprises Ltd. , said in an interview. “We learned the clinical protocols for the treatment of Covid. We can use our goods and beds much more rigorously.
India may now face the prospect of a rise in mutant strains worse than its first outbreak, which is hard to say given that the Asian country has proceeded to sequence the genome of less than 1% of its Covid-positive samples.
India is studying the new variant of the virus, but it is not immediately clear whether it triggered the current wave of Covid-19 infections, Aparna Mukherjee, a scientist at the Indian Council of Medical Research, told Bloomberg TV.
Pleasing, greeting
Poor Covid control and fatigue have also been attributed to rampant and skyrocketing death rates in both countries. Brazilian President Jair Bolsonaro has long opposed lockdowns, clashing with local governments over pandemic mitigation measures and ridiculing mask-wearing.
In India, a multi-month decline in daily infections since the first peak in September, coupled with the lifting of restrictions on public gatherings, has encouraged others to let their guard down. Many have also distanced themselves from the risks of Covid after seeing friends and family with mild symptoms and politicians ignoring protective protocols.
“Brazil is an absolute crisis in terms of political leadership, and India is complacent after the initial drop in cases,” said Madhukar Pai, research professor of epidemiology and global health Canada at McGill University in Montreal.
It is too early to say whether India can continue with Brazil’s deadliest fate. While some parts of the country have imposed targeted lockdowns, elections are being held in five states, where thousands of voters gather for month-long election rallies. A Hindu pilgrimage that gathers crowds on the banks of the Ganges.
This threatens to wipe out the benefits that could accrue from the intensification of the vaccination campaign. Daily deaths in the South Asian country have already more than doubled to more than 1,000 a day over the past week, with crematoriums in many spaces running non-stop and bodies piling up.
“Both countries want to especially strengthen their vaccination policy and redouble efforts to implement other public health measures,” Pai said. “The point is that each and every country will have to redouble its efforts to combat the epidemic. “
Download the Mint app and premium items
Log in to our to save your favorites. It will only be a matter of a moment.