In terms of the extent of infections, the two countries agree the same, with cases hanging close to 14 million and hospitals from Mumbai to Sao Paulo under increasing pressure as admissions continue to increase.
But it is the difference in deaths that has surprised scientists. In Brazil, where nearly 214 million people live, more than 361,800 people died from Covid-19, more than double the number of deaths in India, with a much larger population of 1.4 billion.
While deaths in India are starting to climb and threaten to get worse, inequality remains at the macro level and is indicative of the different ways in which the pandemic is spreading across regions. Experts believe it needs to be better understood and decoded, to curb this global outbreak and avoid future public health crises.
Covid’s mortality rate in South Asia, including India, is consistently lower than the world average, just as it is consistently higher in Latin America, forcing virologists to present a number of theories as to why Covid is a more deadly strip of Brazil. to Argentina.
“We are not comparing apples to apples here, but we are comparing apples to oranges,” said Bhramar Mukherjee, chair of biostatistics at the University of Michigan’s School of Public Health. For now, both countries offer an “intriguing puzzle – an epidemiological mystery that requires a Sherlock Holmes or Miss Marple in action.”
Brazil has been hit by several waves that have killed an alarming number of young people and last week reported a record jump on one day of 4,000 Covid-19 deaths. Meanwhile, India’s daily increase in casualties was around 1,000 and lower than last week. The deaths in the Asian country as a percentage of the confirmed cases are 1.2 versus 2.6 in Brazil, according to data compiled by Bloomberg.
Age variation
Several factors can play into the deadly gap, including the differences in average age – 26 years in India to Brazil’s 33.5.
Experts have long criticized India’s broader death statistics, especially in the rural interior. According to Mukherjee, one in five deaths was not reported at all before the pandemic. But that does not explain why Brazil’s death toll is higher than the aging Western countries that were also hit hard by the pandemic.
“Brazil’s mortality rate is even more shocking because the population is much younger than other countries, such as European countries,” said Alberto Chebabo, vice president of the Brazilian Society for Infectious Diseases.
The increasing number of infections and deaths comes as the rate of vaccination in each country accelerates over the past month after an initial sluggish start. India has managed to administer more than 114 million vaccine doses, compared to the 32 million Brazil – although the latter injected a larger portion of the population.
Cross-immunity
Other theories behind the diversity between Brazil and India are around the different countries’ different environments and experience of diseases.
Some scientists believe that the wide exposure to a variety of diseases in India has helped the citizens to build up natural resilience against coronaviruses like Covid-19.
Shekhar Mande, head of the Indian Council for Scientific and Industrial Research, is among those who have researched this trend and was co-author of a published study on it. His research found correlations where citizens of low-hygiene countries tended to handle Covid-19 better.
“Our hypothesis, and this is strictly a hypothesis, is that because our population is constantly exposed to many types of pathogens, including viruses, our immune system does not respond to any new variation that comes in,” Mande said in an interview. .
Many experts acknowledge that genetics or cross-immunity may play a role, as other South Asian countries, including Bangladesh and Pakistan, have also seen far fewer deaths than Brazil.
That 87% of Brazilians live in 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 strain
Then there is the fact that in December, one of the most deadly coronavirus mutations, the P.1 variant, was identified. Together with variants first seen in South Africa and the United Kingdom, studies suggest that these strains are more contagious.
“The P.1 variant spread simultaneously through many Brazil’s cities and states, leading to a collapse of the health care system, leading to a very high mortality rate,” said Chebabo of the Brazilian Society of Infectious Diseases. Brazil is in a ‘perfect storm’, he added, with the lack of political leadership in implementing effective measures such as accession, which exacerbates the Covid crisis.
Mourners watch workers carrying protective equipment bury the coffin of a Covid-19 victim at Vila Formosa Cemetery in Sao Paulo, Brazil, on Wednesday, March 24, 2021. Brazil has more than 3,000 Covid-19s for the first time deaths in a 24-hour Tuesday, while the pandemic spread unnoticed across Latin America’s largest economy and the country took 300,000 lives.
The rapid and sustained spread of the variant in Brazil also gave its healthcare system no respite, unlike a silence between waves during the last months of 2020 in India, which helped hospitals and frontline workers to recover and plan ahead .
“We are much better prepared to handle this wave than we used to be in many, many ways,” Suneeta Reddy, managing director of Apollo Hospitals Enterprises Ltd., said in an interview. ‘We learned the clinical protocols to treat Covid. We can use our assets and beds in a much stricter way. ”
India may now be facing a mutant tension-driven upsurge that is worse than its first outbreak, though it is hard to see as the Asian country has done genome sequencing for less than 1% of its Covid-positive samples.
Complacency, second wave
Covid’s mismanagement and fatigue are also blamed for the rampant distribution and rising death rates in both countries. Brazilian President Jair Bolsonaro has a long-standing interim exclusion and clashes with local governments over the mitigation of pandemics and the mockery of the mask.
For India, a month-long decline in daily infections from the first peak in September – along with officials lifting restrictions at public gatherings – has encouraged people to drop their guards. Many also became indifferent to the dangers of Covid after seeing friends and family recover with mild symptoms, and politicians disregard the safety protocols.
“Brazil is a total disaster in terms of political leadership, and India has become complacent after the initial decline in business,” said Madhukar Pai, the Canada Research Chair in Epidemiology and Global Health at McGill University in Montreal.
It is too early to say whether India can avoid the more deadly fate of Brazil. While some parts of the country have set up effective closures, elections are being held in five states – thousands of voters are packing campaign rallies – along with a month-long Hindu pilgrimage that brings crowds to the banks of the Ganges River.
It threatens to undo the benefits that can come from the increased vaccination system. Daily deaths in the country in South Asia have more than doubled in the past week to more than 1,000 per day, while crematoria in many areas are running non-stop and accumulating corpses.
“Both countries need to significantly increase their vaccination coverage and work harder to introduce other public health measures,” Pai said. “What is important is that each country must work much harder to curb the epidemic.”