Will India escape the fury of Covid-19?

Updated: April 3, 2020 3:08:06 PM

India, due to overcrowding, poverty, ignorance, illiteracy, low standards of personal hygiene, poor health infrastructure and poor public sanitation, is considered as the hotbed for any type of infectious disease.

Even with previous viral epidemics, like bird flu, ebola, MERS, etc, India had not faced the brunt as faced by other countries.
By Pankaj Chaturvedi 

The recent coronavirus (Covid-19) pandemic has brought the world to a standstill. Irrespective of the geographical location or the economic might of a country, all have been impacted without discrimination. In just a few months, worldwide over 900,000 people have been infected and over 48,000 people have lost their lives to this virus.

India, due to overcrowding, poverty, ignorance, illiteracy, low standards of personal hygiene, poor health infrastructure and poor public sanitation, is considered as the hotbed for any type of infectious disease. However, as of today, the intensity of the impact witnessed by other countries has not been the same in India. It had just over 2,000 positive cases, with about 58 deaths as of April 1. It is alleged that India has not been testing enough like the western world. In that case, the severity of the infection would be judged by the fatalities, which without a doubt have been surprisingly low.

Even with previous viral epidemics, like bird flu, ebola, MERS, etc, India had not faced the brunt as faced by other countries. This brings us to a very pertinent question—Are people living in India truly resistant to viral epidemics? We will try to address this in three headings as per the epidemiological triad—Agent (virus), host (people living in India) and environment (of Indian Subcontinent).

Agent: Researchers have found mi-RNA which could target the viral genome. One is specific to the Indian strain, making it different from that in the US or Europe. Chinese researchers have identified two strains of Covid-19: L- and S-type, with the latter being more prevalent and aggressive. Information about the dominant strain in India is currently unknown.

Host: Smokers/vapers are predisposed not only to coronavirus infection but also subsequent mortality. The smoking rate in China, Italy and the US is 21%, 14% and 15%, respectively, whereas in India it is 9%. Smoking is associated with other co-morbidities like hypertension, coronary artery disease, pulmonary disease, etc, which have been found to be associated with higher deaths in these patients.

Indian namaste is a healthy alternative.BCG vaccine against tuberculosis is a part of the national immunisation schedule and a majority of Indians have received it already. It has been found that it may have immune-modulatory effects and may provide protection from other pathogens too. Researchers in Australia and the Netherlands are currently studying this.

The apparent lack of cases (at least initially) in the malaria-endemic regions brought out a thought process that probably people staying in these regions may be resistant to coronavirus. Few hypotheses included—heightened immunity in such individuals, genetic/molecular changes which predispose to malaria may increase resistance to Covid-19. Such theories have not been proven yet. Exposure to a multitude of infectious diseases since childhood results in the development of innate immunity which may help ward of diseases like Covid-19.

Environment: Coronaviruses are enveloped by a fatty coat studded with protein spikes giving the appearance of a crown or “corona” in Latin. Due to this heat-sensitive fatty envelop, the virus cannot survive outside the body in hot weather for a long time. Therefore its transmission is reduced in hot weather. In fact, affected countries have been attempting to delay the peak of the disease to summer!

The virus is susceptible to UV rays, and these will be easily available due to clear skies and bright sun. High relative humidity has been found to affect virus survival. Further, dry ambient air reduces protective mucous production in the respiratory passages. Though the possibilities discussed above may indicate that Indians may escape Covid-19’s fury, the actual impact will be clear in the next few weeks. At this point, let’s not get swayed by these theories and do our best to stop the spread.

This is mainly a hypothesis-generating scientific review. The only proven and effective way to stop the corona epidemic is to follow the orders and advises being periodically released by the government such as lockdown, social distancing, hand washing, isolation etc. Let there be no complacency in that.

(The author is Deputy director, Center for Cancer Epidemiology, Tata Memorial Center)

 

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