It is intriguing that the number of reported cases infected or died due to COVID-19 infection in India is comparatively much lower than the United States (US), China and other European countries.
Very easy to ask questions, but very difficult to answer them correctly , especially about COVID-19 pandemic.
A similar question was raised by me, without much answers::
Why are the mortality trends due to COVID-19 so different in Pakistan, India, and Bangladesh situated in the most populated area of the world?
https://www.researchgate.net/post/Why_are_the_mortality_trends_due_to_COVID-19_so_different_in_Pakistan_India_and_Bangladesh_situated_in_the_most_ populated_area_of_the_world
To me the variable morbidity and mortality in different countries of the World depends on certain factors, some explainable, and other unexplainable.
Three patterns have emerged or are emerging:
Pattern1: Countries with resources to do mass for COVID-19 (on symptomatic and asymptomatic cases) starting with the beginning of report of initial cases in that country) have lower rate of detection, but rapidly increasing number of patients, with initial lower case fatality rate (CFR), a good example has been South Korea, and now Russia. Problem is once a huge number of cases are diagnosed, it becomes a problem to handle all their contacts, then gradually the mortality starts increasing, as has happened with Germany and now Turkey. Most of these countries still have lower CFR compared to other countries in the area.
Pattern 2. Countries with smart testing for COVID-19 at the beginning of first few cases (testing clusters of patients and all their contacts and locking down specific areas) leads to less expenses. The examples are Australia, Canada and South Africa.
Pattern 3: Countries having very selective testing of only the people with symptoms of COVID-19 and starting lockdowns of schools, businesses late (even if they increasing the testing later on) had high number of patients, and had high mortality. Examples are Italy, Spain, United Kingdom, France, Iran, United States)
However, overtesting, undertesting, under-reporting or over-reporting of death, availability of healthcare resources, ICU beds, number of ventilators available, genetic factors, age mix of the population, possible effects of BCG, other vaccinations, herd immunity of the people of that country, probably is also contributing to the number of patient having morbidity and mortality due to COVID-19.
In the end, SARS-CoV-2, the cause of COVID-19 is surprising us all, it is very difficult to predict. We still can not say with surety why there are less cases in Africa, why Pakistan is having less mortality compared to India and Bangladesh. Why Philippines and Indonesia having high mortality. compared with Malaysia and Thailand? Similarly, why Algeria is having higher mortality than its neighbouring countries. Is it a different variant of SARS-Cov-2 (S or L type) or more lethal mutant of the virus in countries with high mortality, is just a speculation until the COVID-19 pandemic in the end.
COVID-19 pandemic is surprising the world, hitting hard the strong economies and playing havoc in countries with best or better health care systems while having a blind eye on resource poor countries with less than ideal or sketchy health care systems.
It is my viewpoint, anyone can differ with me but no one can definitely predict what would be the situation after a few months.
Dr Raju Vaishya; how interesting; I hadn't realised this was so.
I looked it up online and saw a discussion by Prof Anup Malani, Prof Arpit Gupta and Reuben Abraham but even after a detailed discussion, they remain puzzled:
https://qz.com/india/1839018/why-does-india-have-so-few-coronavirus-covid-19-cases-and-deaths/
In another link, Dr Ravi Shekhar Jha and Dr Rajesh Chawla suggested that it was owing to the relatively young population in India:
https://economictimes.indiatimes.com/news/politics-and-nation/indias-covid-19-death-rate-lower-than-many-developed-nations-like-us-uk-medical-experts/articleshow/75084199.cms?from=mdr
However, Prof Malani et al (above) did not feel that this was the reason, as even the young population have chronic illnesses that would increase the fatality of those with the virus.
I will follow this discussion and read future responses with interest.
Mary Wilson
Very easy to ask questions, but very difficult to answer them correctly , especially about COVID-19 pandemic.
A similar question was raised by me, without much answers::
Why are the mortality trends due to COVID-19 so different in Pakistan, India, and Bangladesh situated in the most populated area of the world?
https://www.researchgate.net/post/Why_are_the_mortality_trends_due_to_COVID-19_so_different_in_Pakistan_India_and_Bangladesh_situated_in_the_most_ populated_area_of_the_world
To me the variable morbidity and mortality in different countries of the World depends on certain factors, some explainable, and other unexplainable.
Three patterns have emerged or are emerging:
Pattern1: Countries with resources to do mass for COVID-19 (on symptomatic and asymptomatic cases) starting with the beginning of report of initial cases in that country) have lower rate of detection, but rapidly increasing number of patients, with initial lower case fatality rate (CFR), a good example has been South Korea, and now Russia. Problem is once a huge number of cases are diagnosed, it becomes a problem to handle all their contacts, then gradually the mortality starts increasing, as has happened with Germany and now Turkey. Most of these countries still have lower CFR compared to other countries in the area.
Pattern 2. Countries with smart testing for COVID-19 at the beginning of first few cases (testing clusters of patients and all their contacts and locking down specific areas) leads to less expenses. The examples are Australia, Canada and South Africa.
Pattern 3: Countries having very selective testing of only the people with symptoms of COVID-19 and starting lockdowns of schools, businesses late (even if they increasing the testing later on) had high number of patients, and had high mortality. Examples are Italy, Spain, United Kingdom, France, Iran, United States)
However, overtesting, undertesting, under-reporting or over-reporting of death, availability of healthcare resources, ICU beds, number of ventilators available, genetic factors, age mix of the population, possible effects of BCG, other vaccinations, herd immunity of the people of that country, probably is also contributing to the number of patient having morbidity and mortality due to COVID-19.
In the end, SARS-CoV-2, the cause of COVID-19 is surprising us all, it is very difficult to predict. We still can not say with surety why there are less cases in Africa, why Pakistan is having less mortality compared to India and Bangladesh. Why Philippines and Indonesia having high mortality. compared with Malaysia and Thailand? Similarly, why Algeria is having higher mortality than its neighbouring countries. Is it a different variant of SARS-Cov-2 (S or L type) or more lethal mutant of the virus in countries with high mortality, is just a speculation until the COVID-19 pandemic in the end.
COVID-19 pandemic is surprising the world, hitting hard the strong economies and playing havoc in countries with best or better health care systems while having a blind eye on resource poor countries with less than ideal or sketchy health care systems.
It is my viewpoint, anyone can differ with me but no one can definitely predict what would be the situation after a few months.
Unlikely to be genetic reason, since BAME minority seem disproportanely affected in the UK. Is it related to BCG vaccination ? Exposure to Malaria endemically?
Has lockdown in the country for 40 dsys contributed to retard its spread?
This is an answer under an epistemological point of view.
The number of cases in any given country is related more with the capacity of their healthcare system to meassure those cases than the real cases of virus infection itself.
If you watch graphics, of course 1st world countries have a lot more reported cases because they have more resources to count them.
2nd and 3rd world countries only does what we can with the poor resources we have. I.E. In Mexico we have registered only 8ish thousand cases confirmed, but with a correction factor of 8.5 propossed for the Health Minister subdirector. Actually, other people calculates a factor of +15.
But we can´t know it for sure because we don´t have the infrastructure.
BUT, it´s the same with rich countries, because they are counting only the cases that goes to the system; only in Corea and in Japan, the system is actively hunting all cases around all country. The yhave real numbers about the disease, everybody else have numbers about their healthcare system, not about the virus.
1) India's population is younger than average and younger people are more often asymptomatic and have fewer comlications,
2) Many deaths can occur without being included in the statistics, because they occur in remote areas, slums etc. Some deaths may be attributed to co-morbidities rather than COVID 19.
3) may deaths may occur inpatients who have not been diagnosed because there have been too few testing kits available.
and less likely
4) The strains of virus in India may be among the less virulent mutations
Good Luck!
In my opinion the our atmospheric condition environmental and genetic makeup protect us from developing advanced pneumonia.
Bcg could have role ?
Agree with Vijay K Jain . Hard environmental conditions may not always be negative to the residents.
Anyone who read the following paper may be frightened by the hygiene condition of the Ganges river:
"River Ganges Water as Reservoir of Microbes With Antibiotic and Metal Ion Resistance Genes: High Throughput Metagenomic Approach (//pubmed.ncbi.nlm.nih.gov/30579213/)"
Article River Ganges water as reservoir of microbes with antibiotic ...
Yet, people who live along the Ganges riversides are going will with the river water, and it is well known that Gangajal has helped the people to keep in good health.
More research should be done on the microbiome-human interactions.
A mutant less-lethal variant of SARS-CoV2 might be the causative agent in India.
There are many good points being made here. Mauricio del Olmo points out varying reporting systems. I had heard that in the US we are finally testing more, but the disturbing part is that the percent of those tested who are positive is going up. If that is correct, that is a problem. (I just found the following, which supports this: https://www.washingtonpost.com/outlook/2020/06/22/no-more-testing-doesnt-explain-rise-covid-19-cases-us/?outputType=amp.) I'd like to know more about that kind of statistic, perhaps by age group.
(Apparently deaths are gender related. Why??? There is a lot more to learn.)
Also, the reliability of the testing matters. For stopping the disease, overall accuracy matters. For measuring the amount of infection, a statistical bias toward either false positives or false negatives matters. The combination of types of test matters.
I do think that the US has been too sloppy in dealing with this disease, and India has quite possibly done better.
A very interesting response from James R Knaub but I could not access the Washington Post link. However, I looked it up and I think this works?:
https://www.washingtonpost.com/outlook/2020/06/22/no-more-testing-doesnt-explain-rise-covid-19-cases-us/
I found this recent article regarding the gender differences:
Article Sex Differences in Mortality from COVID-19 Pandemic: Are Men...
Read this recent publication: https://www.sciencedirect.com/science/article/pii/S1871402120302368
1) increased testing numbers, more cases detected
2) missed deaths due to improper data collection.
Interestingly, the mortality rate amongst the health care professionals is quite high. Raju Vaishya Sir, what is your opinion on this?
Dear Researcher,
Your question can not get appropriate answers until and unless the veracity of the relevant data in India is respected without any reservations!
Regards
COVID-19: Then (April 2020) and now (15 October 2020) Ref: https://www.worldometers.info/coronavirus/
Now India is 2nd to USA in number of cases, and number 3 in total deaths due to COVID-19, after USA and Brazil. The top 20 countries see a second surge in Iran, Turkey, Indonesia, Philippines, and most of the European countries.
By hindsight, given the highest world populations, China has had set an example, few countries have matched in controlling COVID-19 pandemic.
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