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In terms of the extent of infections, rates are similar in both countries, with cases ranging between 14 million, and several hospitals, from Mumbai to São Paulo, are under increasing pressure as hospitalizations continue to rise. . But researchers are puzzled by the differences in the COVID-19 death rates recorded in the two countries.
Brazil, home to almost 214 million people. More than 384,000 people have died from COVID-19, more than double the number in India, with a population much larger than 1.4 billion.
Although the death toll in India has started to rise very steeply and it is feared that the situation will only get worse, large disparities persist, reflecting how different regions are developing into a pandemic. According to experts, a better understanding and deciphering of ongoing processes is essential to curb the global outbreak and prevent future public health crises.
Death rates from COVID-19 in South Asia, including India, are consistently lower than global averages, while in Latin America they are consistently higher, forcing virologists to suggest various theories as to why the COVID wave is much more ruthless in the band, from Brazil to Argentina.
“We are not comparing apples to apples, we are comparing apples to pears,” said Bhramar Mukherjee, a researcher at the University of Michigan School of Medicine and School of Public Health. So far, both sides are hinting at an “intriguing conundrum, an epidemiological mystery that would require the abilities of Sherlock Holmes or Miss Marpl to unravel.”
Brazil has been hit by a series of COVIDs that have claimed the lives of many young people. Last week, the country reported a record increase in one-day casualties of 4,000 COVID-19-related deaths. In India, meanwhile, the increase in deaths per day has been less in recent days, at more than 2,000. The death rate in Asia as a percentage of confirmed cases is 1.2, compared to 2.6 in Brazil, according to data compiled by the Bloomberg news agency.
Age differences
This gap in deaths can be influenced by a variety of factors, including the difference in average age, from 26 in India to 33.5 in Brazil.
Experts have long criticized India’s death statistics, especially in its remote rural areas. According to B. Mukherjee, about one in five deaths was not recorded at all before the pandemic. But that doesn’t explain why Brazil’s death rate is higher than that of aging Western states, as well as those affected by a painful pandemic.
“In Brazil, the mortality rate is even more shocking because the population is much younger than in other countries, especially in Europe,” says Albert Chebabo, vice president of the Brazilian Society for Infectious Diseases.
Infections and deaths are on the rise at a time when both countries have accelerated the pace of vaccination in March after a particularly slow start. India has managed to inject more than 117 million. vaccine doses compared to nearly 33 million. doses administered in Brazil, although the latter vaccinated a greater proportion of its population.
Cross immunity
Other theories about the differences between Brazil and India revolve around the different environments and disease experiences of the two countries.
According to some researchers, the widespread risks of many diseases in India may have contributed to the development of citizens’ natural resistance to coronaviruses such as COVID-19.
Shekdar Mande, head of the Indian Council for Scientific and Industrial Research, is one of those who has examined this trend and has published a study on the subject together with other authors. Their study found correlations showing that people in countries with poor hygiene tend to cope better with COVID-19.
“Our hypothesis, which is purely hypothetical, is that because our populations are constantly exposed to many pathogens, including viruses, our immune systems do not react too strongly to any new emerging strain of the virus,” Sh said in an interview. What.
Many experts acknowledge that genetics or cross-immunity may be affected, as other South Asian countries, including Bangladesh and Pakistan, also have fewer COVID-19 deaths than Brazil.
Another reason may be that 87 percent. Brazilians live in urban areas and two-thirds of indigenous people live in rural areas with more space and better ventilation, says Mukherjee of the University of Michigan.
Mutant strains
It should also be taken into account that last December one of the deadliest coronavirus mutations, the P.1 strain, was detected in Brazil. Along with other strains first identified in South Africa and the United Kingdom, this strain is much more contagious, according to research.
“The P.1 strain is simultaneously spreading in many Brazilian cities and states, destroying the healthcare system, which in turn leads to very high mortality,” says Chebabo of the Brazilian Society of Infectious Diseases. Brazil is being hit by a “real storm”, he added; the lack of political leadership in introducing effective measures such as quarantine only exacerbates the COVID crisis.
The rapid and uninterrupted spread of the Brazilian strain also does not allow the country’s healthcare system to breathe a sigh of relief “in contrast to the respite between waves of the virus in the last decade of 2020. months in India, which helped hospitals and primary workers in the country to recover and plan the follow-up.
“In many ways, we are much better prepared to weather this wave than before,” said Suneeta Reddy, chief executive officer of Apollo Hospitals Enterprises Ltd. in an interview. – We were familiar with the clinical protocols for the treatment of COVID. We can use our tools and beds for much more purpose. “
India is now threatened by an outbreak caused by virus mutations, much more powerful than the country’s first outbreak, although, as it really will be, it is difficult to say given that this Asian country has made less than 1 percent of its genomic sequence. positive COVID samples.
India is investigating a new strain of the virus, but it is not yet clear whether this strain has caused the current wave of COVID-19 infections, Aparna Mukherjee, a researcher at the Indian Council for Medical Research, told Bloomberg TV.
Calm down, second wave
The uncontrolled spread of the virus and rising mortality in both countries are fueled by poor crisis management and COVID-induced fatigue. Brazilian President Jair Bolsonoro has long opposed the quarantine, is in conflict with local governments over mitigating the pandemic, and scoffs at wearing face masks.
In India, the decline in daily infection rates since the peak in September, as well as the decision by officials to lift restrictions on public gatherings, has led the population to weaken their vigilance and become less alert. Furthermore, many have dismissed the dangers of COVID, seeing friends and family recover with less severe symptoms, and politicians ignoring safety protocols.
“Brazil, in terms of political leadership, is a complete disaster, and India has calmed down unacceptably after an initial decline,” said Madhukar Pai, head of Canadian research in the Department of Epidemiology and Global Health at McGill University in Montreal.
It is too early to say whether India can avoid the higher mortality scenario that has emerged in Brazil. Although selective quarantines have been introduced in some parts of the country, elections are taking place in five states, with mass demonstrations during campaign events; and where a month-long Hindu pilgrimage will gather crowds of believers along the banks of the Ganges River.
All of this could thwart efforts to speed up vaccination. Already, the number of deaths from COVID-19 in the South Asian country alone has more than doubled in the last week alone, to more than 1,000 per day, with crematoria operating in many areas without interruption, with a full line of bodies waiting in line. .
“Both countries must significantly increase vaccination rates and apply other public health measures more effectively,” Pai said. “It is important that each country needs to do much more work and effort to stop the epidemic.”
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