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Monday December 5th, 2022

How are COVID-19 cases in South Asia suddenly on the decline?

Covid-19 lockdown community lunch – Image by Rajesh Balouria courtesy Pixabay

ECONOMYNEXT – New COVID-19 cases in India have plummeted from a peak of 90,000 a day in September to just over 10,000 in February. In Bangladesh, daily cases have dropped to a 10-month low. The number of active cases in Pakistan has decreased by some 20,000 over the last two months. Life is almost back to normal in Kathmandu, Nepal. Bhutan has been called the world’s unlikeliest pandemic success story. What’s going on in South Asia?

India’s numbers in particular have baffled some scientists. Just over six months ago there were very real concerns that the “fragile” healthcare system there would collapse under the weight of the raging pandemic. Fast forward to February 2021 and daily cases have dropped significantly. According to CNN, on February 9, Delhi reported zero virus deaths for the first time in nearly nine months. Contrast that to how dire things were in November last year when nearly 90% of all critical care beds with ventilators in New Delhi were full. The Associated Press (AP) reported that by the second week of February only 16% of these beds were occupied.

Credit: BBC

What has led to this dramatic change? Is there something unique about South Asia that might explain its sharply declining cases and relatively low mortality rates? Is it vaccination? Is it the climate? Is it something in the water?

A number of explanations have been put forward: The country’s (and by extension the region’s) younger population, a partial herd immunity in urban areas, under-reporting of cases and deaths, reduced testing, increased restrictions, and relatively better innate immunity owing to a higher incidence of other infectious diseases.

The Indian government, according to AP, has attributed the dip in that country’s cases to mandatory mask-wearing. But this does not explain how the decline appears uniform even in areas where mask-wearing is not strictly practiced. Under-reporting, meanwhile, does not explain the demonstrably reduced stress on India’s health system. The dip cannot be attributed to vaccination either, which began only in January.

The threshold for herd immunity for COVID-19, experts say, may be 70% or higher, which means a vast majority of the population need to have developed immunity to the virus either by getting infected or through vaccination. A serological survey that tested for antibodies in January found that more than half the population in Delhi had contracted the disease.

“This is a huge increase,” community medicine specialist Dr Hemant Shewade was quoted by CNN as saying. He added that big cities may see “considerably reduced” transmission due to the rise in immunity.

While there may be some herd immunity in urban centes, India’s total numbers are far below the 70% required to achieve national herd immunity. According to AP, only about 270 million, or about 20% of the population, had been infected by the virus before vaccination began.

Serum Institute of India CEO Adar Poonawalla was quoted by CNN as saying India might not achieve herd immunity for years. “Until you get that real magical 90% herd immunity or vaccine immunity, which will come after three or four years, you really should exercise precautions,” Poonawalla, whose company is the largest manufacturer of COVID-19 vaccines in India, told CNN in January.

Rural areas with lower population densities and therefore reduced transmission rates have reported fewer cases of infection, which may at least partly explain the nationwide decline. Another, perhaps more intriguing, possibility is the idea that the prevalence of infectious diseases such as cholera, typhoid and tuberculosis could have helped build a stronger initial immune response to the new virus.

Shahid Jameel, a virologist and director of Ashoka University’s Trivedi School of Biosciences told AP on February 16: “If the COVID virus can be controlled in the nose and throat, before it reaches the lungs, it doesn’t become as serious. Innate immunity works at this level, by trying to reduce the viral infection and stop it from getting to the lungs.”

What of the low mortality rates in the region? A study published in the International Journal of Infectious Diseases attributed this to cross-reactive immunity, which, Dr. Giridhar R. Babu, a Bengaluru-based epidemiologist who was part of the research team, says plays a significant role in reducing the severity of the disease.

”The presence of cross-reactive T cells presumably from prior coronavirus infections can also attenuate the severity of the disease. Another reason for the low mortality is based on the emerging evidence suggesting asymptomatic and mildly symptomatic patients have high SARS-CoV2 specific cytotoxic T-cell responses, ” Bahu told The Week in December.

Meanwhile, one expert in Sri Lanka does not believe there is anything unique about what’s happening in India or elsewhere in the region except perhaps Bhutan, a country that imposed stringent border controls and ramped up testing. Institute for Health Policy (IHP) Executive Director Dr Ravindra Rannan-Eliya told EconomyNext yesterday that, over the past two months, cases have been on the decline  in many developing and developed countries.

“This is not due to vaccination – although a lot of people think this is the case in the USA. You see exactly the same decline in Canada starting January 7, a country that has had much less vaccination than the US,” he said.

Credit: FT.com

Rannan-Eliya, far from being baffled by South Asia’s declining cases, believes the virus “basically won” in India, Pakistan, Nepal and Bangladesh – an outcome he attributes to inadequate testing, ineffective lockdowns and poor contact-tracing and isolation measures.

“If you extrapolate from an infection rate of 30% in India, what this means is that, at the minimum, 0.5 million Indians died. The actual number is probably more than 1 million. It’s a similar situation in the other three countries. When I looked at the data for Pakistan recently, there is very strong evidence that most deaths were not counted. There were also a large number of unreported deaths outside Islamabad and in the poorer provinces. There is probably also going to be a long term health cost also with tens of millions suffering long COVID,” he said.

The virus spread freely through the population resulting in partial immunity, said Rannan-Eliya. In combination with continued restrictions, he explained, this should now be sufficient to bring case numbers down. However, if remaining restrictions such as school closures are now lifted, cases may well go up again.

“Looking forward, the big concern is whether there are any new variants spreading. Genomic sequencing is very limited in these countries, so it’s possible we don’t know yet. Variants could easily reverse this scenario. The most obvious example of this is Manaus in Brazil which achieved 70-80% herd immunity last year, but has now suffered a huge second wave because of a variant that is immune resistant,” he said.

In Kerala, the southern Indian state that had previously done an exemplary job of containing the virus, as of mid-February contributed to nearly 50% of the country’s active COVID-19 cases. A new, more transmissible variant is suspected to be behind the recent surge. A new variant was in fact discovered in the state earlier this week, but according to Indian media, it may not be the culprit.

“I don’t think that these countries are exactly back to normal. They have continuing low levels of transmission, and as immunity wanes or as restrictions are relaxed or both, they may see further small waves. If they get some dangerous variants, then these future waves might not be small,” said Rannan-Eliya.

With regard to climate and innate immunity boosted by exposure to other diseases, he said: “I think temperature certainly, and possibly previous cold virus infections, may have slowed spread, but the impacts would have been small. Bear in mind that the worst infected countries in the world are largely hot countries – Brazil, India, Peru, South Africa, much of Africa, etc. So it’s not a big factor. South Asia can be largely explained using standard epidemiology and considering the serology survey data.”

Reported by Himal Kotelawala (Colombo/Feb27/2021)

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Paris Club proposes 10-year moratorium on Sri Lanka debt, 15 years of debt restructuring

ECONOMYNEXT — The Paris Club group of creditor nations has proposed a 10-year debt moratorium on Sri Lankan debt and 15 years of debt restructuring as a formula to resolve the island nation’s prevailing currency crisis, India’s The Hindustan Times reported.

While the Paris Club has yet to formally reach out to India and China, Colombo has yet to initiate a formal dialogue with the Xi Jinping regime, the newspaper reported on Saturday December 03, inferring that the chances of the International Monetary Fund (IMF) approving its 2.9 billion dollar extended fund facility for Sri Lanka in December now ranges from very low to nonexistent.

“This means that Sri Lanka will have to wait for the March IMF meeting of the IMF before any aid is extended by the Bretton Woods institution,” the newspaper reported.

“Fact is that for Sri Lanka to revive, creditors will have to take a huge hair cut with Paris Club clearly hinting that global south should also take the same cut as global north notwithstanding the inequitable distribution of wealth. In the meantime, as Colombo is still to get its act together and initiate a dialogue and debt reconciliation with China, it will need bridge funding to sustain the next three month before the IMF executive board meeting in March 2023. Clearly, things will get much worse for Sri Lanka before they get any better—both economically and politically,” the report said. (Colombo/Dec04/2022)

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Sri Lanka’s Ceylon tea prices up amid low volumes

ECONOMYNEXT – Sri Lanka tea prices picked up at the last auction in November amid low volumes, brokers said.

“Auction offerings continued to record a further decline and totalled 4.2 million Kilograms, of which Ex-Estate offerings comprised of 0.6 million Kilograms. There was good demand,” Forbes and Walker Tea brokers said.

“In the Ex-Estate catalogues, overall quality of teas showed no appreciable change. Here again, there was good demand in the backdrop of extremely low volumes.”

High Growns

BOP Best Westerns were firm to 50 rupees per kg dearer. Below best and plainer types were Rs.50/- per kg easier on last.

Nuwara Eliya’s were firm.

BOPF Best Westerns were firm to selectively dearer. Below best and plainer teas declined by 50 rupees per kg.

Uva/Uda Pussellawas’ were generally firm and price variances were often reflective of quality with the exception of Select Best Uva BOPF’s which were firm and up to 50 rupees per kilogram dearer.

CTC teas, in general, were mostly firm.

“Most regular buyers were active, with perhaps a slightly more forceful trend from the local trade,” brokers said.

Corresponding OP1’s met with improved demand. Well-made OP/OPA’s in general were fully firm, whilst the Below Best varieties and poorer sorts met with improved demand. PEK/PEK1’s, in general, were fully firm to selectively dearer.

In the Tippy catalogues, well-made FBOP/FF1’s sold around last levels, whilst the cleaner Below Best and cleaner teas at the bottom appreciated. Balance too were dearer to a lesser extent.

In the Premium catalogues, very Tippy teas continued to attract good demand. Best were firm to selectively dearer, whilst the Below Best and cleaner teas at the bottom appreciated

Low Growns

Low Growns comprised 1.8 million Kilograms. Market met with improved demand, in general.

In the Leafy & Semi Leafy catalogues, select Best BOP1/OP1’s were fully firm, whilst the Below Best/bolder BOP1’s were barely steady.

Low-grown teas, farmed mainly by smallholders and exported to the Middle East and Central Asia, are the most sought-after and expensive Ceylon Teas.

Low-grown CTC prices have gained this week to 982.80 per kilogram this week from 934.76 per kilogram last week.

Few Select best BOP1s maintained, whilst best and below best were irregularly lower. Poorer types maintained.

BOPF’s in general, firm market.

FBOPF/FBOPF1’s select best and best increased in value, whilst the below best and bottom held firm.

Selected best BOP1’s maintained, whilst best and below best were irregularly lower.Poorer types maintained.

OP1’s selects best together with best and below best were firm to dearer. Poorer sorts were fully firm.

Medium Growns

BOPF’s, select best gained by 50 rupees per kilogram. Others maintained.

BOP1’s select best dearer by 100 rupees per kg whilst all others moved up by 50 rupees per kg.

OP1: select best gained by 100 rupees per kg whilst all others dearer by 100 rupees per kg.

OP/OPA’s in general, dearer by 50 rupees per kg whilst the poorer sorts were firm.

PEK’s Select best gained by 50 rupees per kg whilst all others maintained. PEK1: In general, dearer by 50 rupees per kg. (Colombo/Dec 04/2022)

 

 

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Sri Lanka Ports Authority East Terminal contractor paid: Minister

ECONOMYNEXT – Sri Lanka’s Ports Authority had paid a deposit for a gantry crane and made the required payment for the contractor to complete building the East Container Terminal, Minister Nimal Siripala De Silva said.

The East Container Terminal, a part of which is already built is being completed as a fully SLPA owned terminal at a cost of 480 million dollars Ports and Shipping Minister de Silva said.

“ECT we are funding with money available in the ports authority,” he said.

“Up to now we have paid an advance for the gantry crane. And for the construction we have paid all the money agreed with the contractor. So that is going on well.”

Sri Lanka is undergoing the worst currency crisis in the history of the island’s soft-pegged (flexible exchange rate) central bank which has created difficulties in funding the project.

“Every penny we collect as dollars we are keeping them separately and utilizing that for the Eastern Terminal work,” Minister de Silva said.

“We are confident that the ECT will be completed within the envisaged time. It is a difficult task in view of the dollar problem.

Banks were also not releasing the dollar deposits of the SLPA earlier but are now doing so, he said.

“Our deposits in banks they have utilized for urgent other national purposes,” he said.

“So they are releasing that money slowly. I am happy that they are releasing that money little by little. So with that we will be able to manage that.”

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