Coronavirus is more deadly in Brazil than in India.And no one knows why

In terms of the magnitude of the infection, the two countries are similarly in agreement, with approximately 14 million cases and hospitals from Mumbai to São Paulo under increasing pressure as hospitalizations increase. But what confuses scientists is the difference in the number of deaths. In Brazil, which is home to about 214 million people, more than 365,000 have died from Covid-19. This is more than double the death toll of India, which has a much larger population of 1.4 billion.

Although deaths in India are beginning to increase and can worsen, macro-level inequality remains, symbolizing the different ways pandemics are occurring throughout the region. Experts say this needs to be better understood and deciphered in order to contain this global outbreak and avoid future public health crises.

Mortality rates for Covid in South Asia, including India, are consistently lower than the world average, just as mortality rates in Latin America are consistently high, and virologists say Covid is more deadly from Brazil to Argentina. Many theories need to be presented as to why the territory has been reduced.

“We’re not comparing apples to apples, we’re comparing apples to oranges,” said Brammer Mukelzy, director of biostatistics at the University of Michigan School of Public Health. A mystery that requires the action of Sherlock Holmes or Miss Marple. “

Brazil was hit by multiple waves, killing an astonishing number of young people, and last week reported a record surge in 4,000 Covid-19-related deaths in one day. Meanwhile, the daily surge in casualties in India has exceeded 1,000 in the last few days, well below that of last week. According to data compiled by Bloomberg, deaths in Asian countries as a percentage of confirmed cases are 1.2 compared to 2.6 in Brazil.

Age fluctuation

The mortality gap may be related to multiple factors, including differences in average age (26 in India and 33.5 in Brazil).

Experts have long criticized India’s broader mortality statistics, especially in the hinterlands of the region. According to Mukherjee, no one in five deaths was reported before the pandemic. But that doesn’t explain why Brazil’s mortality rate is higher than that of older Western nations that have been hit hard by the pandemic.

Alberto Chebabo, Vice President of the Brazilian Society of Infectious Diseases, said: “Brazil’s mortality rate is even more shocking because its population is much younger than in other countries such as European countries.

The rise in infection and mortality is caused by the accelerated pace of inoculation drives in each country over the past month after the initial downturn. India manages more than 117 million vaccinations, compared to nearly 33 million in Brazil, the latter injecting a higher proportion of the population.

Cross immunity

Other theories behind the differences between Brazil and India revolve around the different environmental and illness experiences of the two countries.

Extensive exposure to various diseases in India may have helped its citizens build a natural resilience to coronaviruses such as Covid-19, some scientists say. ..

Shekhar Mande, head of the Indian Scientific and Industrial Research Council, is one of the people who investigated this trend and co-authored public research on it. His study found a correlation that citizens of poorly sanitized countries tended to cope with Covid-19 well.

“Our hypothesis, and strictly speaking, our population is continuously exposed to many types of pathogens, including viruses, so our immune system is overloaded with new changes coming in. It doesn’t respond, “Mande said in an interview.

Many experts acknowledge that genetics and cross-immunity may be working, as other South Asian countries, including Bangladesh and Pakistan, also show far lower mortality rates than Brazil.

According to Mukherjee of the University of Michigan, 87% of Brazilians live in urban areas, while two-thirds of Indians live in larger spaces and ventilated countryside.

Mutant strain

Second, Brazil has the fact that one of the most deadly coronavirus mutations, the P.1 variant, was identified in December. In addition to the first mutations found in South Africa and the United Kingdom, studies suggest that these strains are more contagious.

“The P.1 variant has spread to many cities and states in Brazil at the same time, leading to the collapse of the healthcare system and leading to very high mortality rates,” said Chebabo of the Brazilian Society of Infectious Diseases. In a “perfect storm,” he added that the lack of political leadership in implementing effective measures such as lockdown exacerbated the Covid crisis.

The rapid and sustainable spread of variants in Brazil has also helped hospitals and frontline workers recover and plan ahead of time with the calm during the last few months of India’s 2020 wave. Unlike, it did not give the medical system room for breathing.

Apollo Hospitals Enterprises Ltd. Suneeta Reddy, Managing Director of, said in an interview: “We have learned clinical protocols for treating Covid. We can use our assets and beds in a much more rigorous way.”

India may now face the prospect of a surge due to more severe mutant strains than the first outbreak, given that Asian countries have sequenced less than 1% of Covid-positive samples. I do not know.

India is studying a new viral variant, but it was not immediately clear whether it was causing the current wave of Covid-19 infection, said Aparna Mukherjee, a scientist at the Indian Medical Research Council. I told Bloomberg TV.

Self-satisfaction, second wave

Mismanagement and Covid’s malaise are also due to the prevalence and soaring mortality rates in both countries. Brazil’s President Jair Bolsonaro has long opposed the blockade, clashing with local governments by ridiculing pandemic mitigation measures and wearing masks.

In India, people have become less vigilant due to a month-long reduction in daily infections from the first peak in September and the lifting of restrictions on rallying by authorities. Many became indifferent to the dangers of Covid after seeing mildly symptomatic friends and family recover and politicians ignoring safety protocols.

Madhukar Pai, Canadian Research Commissioner for Epidemiology and Global Health at McGill University in Montreal, said:

It is premature to say whether India can continue to avoid Brazil’s more deadly fate. Although some parts of the country have targeted blockades, elections take place in five states, with thousands of voters holding campaign rallies and bringing crowds to the banks of the Ganges. A monthly Hindu pilgrimage takes place.

These may negate the potential benefits of an enhanced vaccination drive. Daily deaths in South Asian countries have more than doubled to more than 1,000 in the past week, with crematoriums in many regions running uninterrupted and piled up. ..

“Both countries need to work harder to significantly increase vaccination rates and implement other public health measures. Importantly, countries need to work harder to contain the epidemic.”