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Covid 19: Are we immune or not?

Some Indian doctors (one of them a former president of IMA) have suggested that Indians have

By Bhamy V Shenoy

As of April 3, India had 3,082 cases, Italy had 1,19,827, and Spain had 1,17,710. Italy and Spain have 39-times more cases. This is surprising given the high population density, below par health delivery system and relatively high migration in India.

Even though the starting date for comparison is the same, the number of cases in India are extremely low. This itself should raise some interesting questions.

Though Italy has far more Chinese migrants than Spain, both had an equal number of infected cases. Italy and Spain have more Chinese tourists than India. Can this be a reason for India to have low numbers? Even after discounting for this factor, India had very few cases.

All three countries were slow to act. In the case of Italy and Spain, it was not a complete lockdown in the beginning. Both Italy and Spain implemented complete lockdown on March 9 and 14, respectively-much before India (March 24).

Italy and Spain had reached the exponential stage much earlier, and India is yet to reach that stage. An article published in Bloomberg (March 30) warned after interviewing doctors that India will face a dramatic increase "soon". In comparison to many countries, especially the US, the Indian government has been more aggressive and might have delayed the community transition stage or stage 3.

It is also possible that we may already be at Stage 3, and there is no exponential spread, as predicted. I hypothesise that Indians have high immunity, and Covid-19 has been contained.

Some Indian doctors (one of them a former president of IMA) have suggested that Indians have "natural defence against coronavirus", a dividend for India's notorious "dirtiness".

A scientific paper (not peer-reviewed) published just a few days back in the US pointed that countries like Japan and Brazil, which like India, have been using BCG vaccination may have less morbidity and mortality than countries like Italy, USA, and Belgium.

Besides, I have two statistics (number of Covid-19 afflicted and the number of deaths) to offer support to my hypothesis. I readily agree that both these statistics may not be sufficient. But, I have an out of the box idea to prove or reject the hypothesis.

India's population (1.4 bn) is far more than that of Italy (61 million) and Spain (47 million), and still, India has a considerably less rate of incidence. It is true, as argued by several international and Indian experts, that India has not done the required amount of testing and might have failed to diagnose those who have been infected. Indian statistics may not be reliable.

Now, let us take a look at the number of Covid-19-related deaths. As of April 3, the number of fatalities reported for India, Italy and Spain are 86, 14,681, and 10,935, respectively. Even assuming that India's death rate has been under-reported to the extent of 500% (highly unlikely), this clearly shows that Covid-19 did not have much impact on India. On a per-capita basis, the number of deaths per million in India, Italy and Spain is 0.05, 243, and 234, respectively-one of the lowest in the world.

One possible way to prove the hypothesis is to conduct randomised surveys in some areas where there are infected people. By the time authorities learn about those infected, they might have been in contact with several hundred. If in such localities-one such city may be Kasargod in Kerala-100 randomly selected people are tested, and it is found that more than 30-40% are positive, it will show Indians to have high immunity. If the percentage of people tested is small, then we cannot prove the hypothesis.

It may be necessary to conduct the survey in three or four different regions of the country, to gain more confidence.

Experts may be able to suggest a different threshold limit than what I have suggested. My suggestion of 30-40% is guesswork. Cost of undertaking such a survey is insignificant in comparison to a lockdown. The plight of the migrant labourers trying to go to back to villages should convince anyone to lift the lockdown as soon as possible.

If we prove that Indians do have a high level of immunity, then we will be able to lift the lockdown sooner. Even if we allow the lockdown to complete the course, we need not extend it after a randomised survey.

It should be stressed that the decision of the government to impose total lockdown was a sound one. We did not have the luxury of time to conduct the survey I have suggested. But, the government should have anticipated the impact on poor and should have been prepared to help them.

Now is the time to take up studies to find out if Indians indeed have high immunity or not, and make an informed decision on the duration of this lockdown.

The author is Former manager, Conoco. Views are personal