Hyderabad: Two different Indian studies, which have explored the factors behind low rates of Covid-19 mortality in India, have proposed that Indians and South Asians, due to their long-term exposure to various kinds of pathogens, have stronger immunity which has helped in fighting SARs-CoV-2 better.
Unhygienic conditions, lack of sanitation, low health efficiency and higher incidence of diarrhoea, lack of clean water in India and other Asian countries might have ended-up helping saving lives from Covid-19, the two studies, one by Indian Council of Medical Research (ICMR) and another by two researchers from Dr Rajender Prasad Government Medical College and Hospital, Himachal Pradesh, which are available in preprint versions and are yet to be peer reviewed, have indicated.
The ICMR study titled ‘Mortality due to Covid-19 in different nations is associated with the demographic character of nations and the prevalence of autoimmunity’ studied all publicly available data from 106 countries on parameters like demography, prevalence of communicable and non-communicable diseases, BCG vaccination status, sanitation parameters etc.
“Lack of sanitation and poor hygiene practices are known to be responsible for higher communicable disease burden in the low GDP countries. It is therefore reasonable to expect that parameters describing safe sanitation and safe drinking water to be correlated negatively with the Covid deaths. Surprisingly, we find a contrary observation, where different sanitation parameters are correlated positively with the Covid outcome. It is therefore perplexing to note positive correlation of sanitation parameters, as described in methods, with the Covid-19 case fatality rate,” the ICMR researchers, which also include its DG Dr Shekhar C Munde, in their study said.
In other words, the ICMR study has indicated that people in poor and low income countries appear to have a higher or better immunity response to Covid when compared to their counterparts in high income countries.
The second study, which was taken-up by researchers – Praveen Kumar and Bal Chander from Dr Rajender Prasad Government Medical College and Hospital, said “In our mind, the only way to explain lower mortality in regions with relative lack of sanitation and resultant higher incidence of diarrhoea coupled with low health efficiency, is the possible role of immunity. We hypothesise that Covid-19 fatalities will continue to be lower in countries with higher population exposure to microbial diversity particularly gram negative bacteria.”
Both the researchers in their study postulated that ‘populations in developing and underdeveloped countries are likely to have more resistance to Covid owing to high microbial load exposure and resultant immunity”.
“These deductions should not be interpreted as advocacy against sanitation drives. Diarrhoea and other diseases due to lack of sanitation result in much more morbidity and mortality over a period of time when compared to global Covid,” the researchers clarified.
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