Covid is much more deadly in Brazil than India and no one knows why

Faced with a sudden rise in coronavirus infections, India is once again home to the world’s second-largest outbreak, beating Brazil after the latter advanced in March. But behind the bleak statistical mockeryeying is an epidemiological enigma about why the Latin American country has been much more devastated by the pathogen.

In terms of the scale of infections, the two nations are similarly similar, with cases hovering around 14 million and Bombay hospitals in São Paulo is under increasing pressure as tickets continue to rise. But it is the divergence in fatalities that has baffled scientists. Brazil, home of almost 214 million, has seen more than 361,800 people die due to Covid-19, more than double the number of deaths in India, which has a much larger population of 1.4 billion.

While the deaths in India have begun rising and threatening to worsen, macro-level disparity persists and is emblematic of different ways in which the pandemic unfolds across regions. Experts say this needs to be better understood and decoded, to contain this global outbreak and prevent future public health crises.

The rates of covidae deaths in South Asia, including India, are consistently lower than world averages, just as those in Latin America are consistently higher, forcing virologists to offer a range of theories as to why Covid has cut a more deadly strip from Brazil to Argentina.

“Here we don’t compare apples to apples, we compare apples to oranges,” he said Bhramar Mukherjee, president of biostatistics at the University of Michigan School of Public Health. For now, both countries present an “intriguing puzzle: an epidemiological mystery that needs a Sherlock Holmes or Miss Marple in action.”

Brazil has been hit by several waves that killed an alarming number young and reported a record one-day jump of 4,000 Covid-19-related deaths last week. Meanwhile, India’s daily casualty rise has been around 1,000 and well below last week. The number of deaths in the Asian country is the percentage of confirmed cases 1.2 vs. 2.6 in Brazil, the data compiled by Bloomberg are shown.

Age variation

Several factors could be at stake in the mortality gap, including the differences in mean age: 26 years in India and 33.5 in Brazil.

Experts have long criticized India’s broader mortality statistics, especially in its rural countries. Prior to the pandemic, approximately one in five fatalities was not reported, according to Mukherjee. But that doesn’t explain why Brazil’s mortality rate is higher than the aging of Western nations that have also been hard hit by the pandemic.

“Brazil’s mortality rate is even more shocking because the population is much younger than other countries, such as Europeans,” said Alberto Chebabo, vice president of the Brazilian Society of Infectious Diseases.

The increase in infection and mortality rates occurs as the rate of inoculation in each country has accelerated in the last month after an initially slow start. India has managed to manage more than 114 million doses of vaccine, compared to those in Brazil 32 million, although the latter has injected a higher proportion of its population.

Cross immunity

Other theories behind the divergence between Brazil and India focus on the different environments and disease experience of the two countries.

Some scientists claim that widespread exposure to a number of diseases in India may have helped its citizens build natural resistance to coronaviruses such as Covid-19.

Shekhar Mande, the head of India The Council for Scientific and Industrial Research is among those who have examined this trend and have been co-authors of a publication study on this. His research found correlations in which citizens of countries with poor hygiene tended to cope better with Covid-19.

“Our hypothesis, and this is strictly a hypothesis, is that because our populations are continuously exposed to many types of pathogens, including viruses, our immune system does not react hyperreactively to any new variation,” Mande said in an interview. .

Many experts acknowledge that genetics or cross-immunity could be at stake, as other South Asian countries, including Bangladesh and Pakistan, have also recorded far fewer deaths than Brazil.

87% of Brazilians live there urban areas, but two-thirds of Indians live in rural areas with more space and ventilation could be another reason, according to Mukherjee of the University of Michigan.

Mutant strains

Then there is the fact that in December one of the most life-threatening coronavirus mutations, variant P.1, was identified in Brazil. Along with variants first seen in South Africa and the UK, studies suggest that these strains are more contagious.

“The P.1 variant has spread simultaneously to many cities and states in Brazil, which has led to a collapse of the health system, which has led to a very high mortality rate,” said Chebabo, of the Brazilian Society of Infectious Diseases. Brazil is in a “perfect storm“, He added, with his lack of political leadership in implementing effective measures such as closures, which exacerbates the Covid crisis.

The rapid and sustained spread of the variant in Brazil also gave its healthcare system no breathing space, unlike a calm between waves in the last months of 2020 in India, which helped hospitals and front-line workers. to recover and plan ahead.

“We are much better prepared to handle this wave than before, in many ways,” said Suneeta Reddy, CEO of Apollo Hospitals Enterprises Ltd. said in an interview. “We have learned the clinical protocols to treat Covid. We can use our assets and beds in a much more rigorous way ”.

With poor data on mutants, virus overload in India remains a mystery

Now India could face the prospect of an increase in mutant strain that is worse than its first outbreak, although it is difficult to know given that the Asian nation had sequenced the genome by less than 1% of his positive samples to Covid.

Complacency, second wave

Poor management and coveted fatigue have also been blamed for rampant spread and high mortality rates in both countries. Brazilian President Jair Bolsonaro has had opposing closures for a long time, clash with local governments over pandemic mitigation measures and ridicule the masked suit.

For India, a decline in daily infections during the month since the first peak in September, along with officials lifting restrictions on public meetings, encouraged people to lower their guard. Many were also left indifferent to Covid’s dangers after seeing friends and family recover with mild symptoms and politicians ignoring safety protocols.

“Brazil is a complete disaster in terms of political leadership, and India has been pleased after the initial decline in cases,” he said. Madhukar Pai, Canadian Research Chair in Epidemiology and Global Health at McGill University in Montreal.

It is too early to say whether India can continue to avoid Brazil’s most lethal destination. While some parts of the country have prevailed targeted blockades, elections are being held in five states (seeing thousands of voters pack campaign rallies) along with a for a whole month Hindu pilgrimage carrying crowds along the river Ganges.

These threaten to undo the benefits that can be derived from increasing the vaccine. Daily deaths in the South Asian country have already doubled to more than 1,000 a day last week, with crematoria in many areas that operate non-stop and bodies accumulate.

“Both countries need to significantly increase their vaccination coverage and work harder to implement other public health measures,” Pai said. “The important thing is that each country has to work much harder to contain the epidemic.”