Mystery: why coronavirus mortality is lower in Asia and Africa



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The coronavirus behaved very differently than expected in many ways. However, one of the most mysterious has been the distribution of deaths by region. Contrary to what the experts imagined, the virus has killed more people relative to the population in wealthy countries like the United States and some members of the European Union (EU) than in places with a relative lack of resources, like Asian and African nations.

Coronavirus deaths per million people in the 25 most populous countries, ranked by average income
Coronavirus deaths per million inhabitants in the 25 most populous countries, ranked by average incomeThe New York Times

Health emergencies don’t usually work that way. They tend to inflict their worst damage in the poorest places, which is in fact what is happening in the United States, where the death toll is higher in many minority and low-income communities.

However, overall, Covid-19 behaved differently. In a recent magazine article The New Yorker, Siddhartha Mukherjee, physician and Pulitzer Prize winner, described it as “An epidemiological novel”.

But beyond Mukherjee’s article, the phenomenon has received surprisingly little attention from the United States. For what The New York Times he devoted his daily bulletin to this mystery and to its most plausible explanations.

A health worker operates a misting machine as a precaution against bird flu in the Sola region near Ahmedabad on March 5, 2021.
A health worker operates a misting machine as a precaution against bird flu in the Sola region near Ahmedabad on March 5, 2021.Sam Panthaky – AFP

Preferably notexperts say. Part of this trend is probably due to the fact that less developed medical systems do not report all deaths. But many epidemiologists believe much of the phenomenon is real.

In India, for example, large cities keep statistics on overall mortality from whatever cause, and this has increased less than in many richer countries. Data suggests Delhi and Mumbai have “a much lower Covid-19 death rate than in the United States,” he said. The New York Times Dr Prabhat Jha, who heads the Center for Global Health Research at St. Michael’s Hospital in Toronto.

In the New Yorker article, Mukherjee recounted a temporary hospital that local Mumbai officials set up last year in Dharavi, a sprawling slum. They closed it after Dharavi suffered far fewer deaths than expected.

Covid-19 is generally more severe with the elderly: more than 80% of deaths in the United States have occurred in people aged 65 and over.

In Africa and much of Asia, the population is younger. Birth rates are higher, and other health problems more often kill people before they reach old age. In sub-Saharan Africa, only 3% of the population is aged 65 or over. In Pakistan, only 4 percent are. In the United States, the proportion is 16% and 20% in the European Union.

In sub-Saharan Africa, only 3% of the population is 65 years or older
In sub-Saharan Africa, only 3% of the population is 65 or olderAFP

A related factor may be the fact that nursing homes, where Covid-19 has often spread from resident to resident, are more common in Western countries.. Outside the West, older people often live in multigenerational households.

However, age doesn’t seem to tell the whole story. Statistical models that include age still find surprisingly low counts in many poor countries.

Daily life tends to be better ventilated in warmer, lower-income countries. People spend more time outdoors and windows are usually open. The coronavirus spreads less easily in these environments than in poorly ventilated indoor spaces.

Here’s a valuable lesson for Americans and other wealthy countries where people spend most of their time in offices or other closed places: Schools, stores, and workplaces can reduce the spread of Covid by improving their ventilation.

Women workers plant flowers along Hoan Kiem Lake in Hanoi on March 1, 2021
Women workers plant flowers along Hoan Kiem Lake in Hanoi on March 1, 2021Nhac Nguyen – AFP

Many researchers suspect this is an important part of the answer. If previous coronaviruses spread more widely in certain countries, these people’s immune systems might be better equipped to fight Covid.. “There is a lot of circumstantial evidence,” he said Reuters Salim Abdool Karim, a South African epidemiologist, “but there is no compelling evidence”.

Likewise, a team of Indian researchers argued that deaths “are lower in countries with larger populations and exposed to a diverse range of microbes”, as Soutik Biswas wrote of BBC. The large proportion of asymptomatic infections in India is consistent with this assumption, he said. The Financial Times Dr Gagandeep Kang, virologist from the southern city of Vellore.

If the hypothesis is correct, it might help explain why deaths are lower in Africa and Asia than in much of Latin America.

Rwanda swiftly and aggressively applied the social distancing, wearing masks, contact tracing and mass testing. It was the same for several Asian countries. Ghana, Vietnam and other countries have restricted entry at their borders. And a consortium of African countries has collaborated to distribute medical masks and rapid tests for Covid-19.

“Africa is doing a lot of things right, the rest of the world is not doing it,” said Gayle Smith, a former Obama administration official.

Again, however, This does not appear to be the main explanation for the relatively low number of Covid-19-related deaths.. Several countries in Asia and Africa, including India, have had much more dispersed policy responses, as have the United States and Europe.

The full answer to this mystery surely involves multiple explanations. Either way, this is one of the few ways that Covid-19 has not been as devastating as many feared. Hundreds of thousands of people in Africa and Asia have died from this terrible disease again. But many more are alive today for reasons that are not entirely clear.

The New York Times

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