The Mystery of Asia and Africa’s Low COVID Death Tolls

  One of the strangest things most of us have forgotten to take note of in the frantic scramble that has been the last year with COVID19 are the remarkably low death rates in many Asian and African countries. David Leonhardt pointed out in his Good morning article for The New York Times that this is not how pandemics usually work. We expect pandemics to take their greatest toll on the developing world due to poor sanitation, lack of access to medical care, and inaccessibility of resources needed to combat a pandemic. With COVID19, however, death per million residents in the U.S. and the U.K. due to the virus is over 1,500 while in places like Ethiopia, Pakistan, Tanzania, Thailand, and Bangladesh it is no more than 100. What might explain this unexpected phenomenon?

        There are some hypotheses, but no single hypothesis or combination of hypotheses has yet to account for the extreme discrepancy in death rates between the world's wealthiest and poorer countries. One of the hypotheses being explored is that countries in Asia and Africa have fewer old people -- most people die before reaching old age. Take the Philippines for example. The percentage of people in the Philippines who are over 65 years of age is only 5.5% compared to 16.9% in the U.S. Another interesting hypothesis is that these regions of the world may have endemic coronaviruses that the Western world doesn’t have. The theory is that exposure to other coronaviruses may confer greater immunity to people in Asia and Africa against SARS-CoV-2. Given the large number of viruses that probably circulate among humans undetected, this theory could hold its own under investigation. Indeed, many different coronaviruses are thought to be causes of the common cold syndrome. 

        Finally, it’s thought that policy matters and response to the initial warning bells of COVID’s arrival have played an important role in the spread of disease. Preparation for the pandemic in the U.S. was poor, and response was disjointed and disorganized. In contrast, several African and Asian countries took heed of the WHO’s recommendations and instituted mask mandates and closed their borders early on. Clear messaging from governments about the dangers of the virus could have made a difference in the behavioral response of the people living within their borders. When we have no vaccine and no drugs, behavioral changes are paramount in combating a pandemic. 

        While all of these factors probably played some role in the surprisingly low death tolls seen in Asia and Africa, they are not enough to account for the vast difference. Studies to determine other factors at play will provide heavily searched for answers to this pandemic mystery. 

- Renata

References

The Morning - The New York Times, March 8th

Share of population older than 65 in the Philippines from 2015 - Statista, accessed 3/12/2021

Share of old age population (65 years and older) in the total U.S. population from 1950, accessed 3/12/2021