The coronavirus has killed so many people in Iran that the country has resorted to mass burials, but in neighboring Iraq, the body count is fewer than 100.The Dominican Republic has reported nearly 7,600 cases of the virus. Just across the border, Haiti has recorded about 85.In Indonesia, thousands are
The coronavirus has killed so many people in Iran that the country has resorted to mass burials, but in neighboring Iraq, the body count is fewer than 100.
The question of why the virus has overwhelmed some places and left others relatively untouched is a puzzle that has spawned numerous theories and speculations but no definitive answers. That knowledge could have profound implications for how countries respond to the virus, for determining who is at risk and for knowing when it’s safe to go out again.
Draconian social distancing and early lockdown measures have clearly been effective, but Myanmar and Cambodia did neither and have reported few cases. Doctors who study infectious diseases around the world say they do not have enough data yet to get a full epidemiological picture, and that gaps in information in many countries make it dangerous to draw conclusions. Testing is woeful in many places, leading to vast underestimates of the virus’s progress, and deaths are almost certainly undercounted.
Young people are more likely to contract mild or asymptomatic cases that are less transmissible to others, said Robert Bollinger, a professor of infectious diseases at the Johns Hopkins School of Medicine. And they are less likely to have certain health problems that can make COVID-19, the disease caused by the coronavirus, particularly deadly, according to the World Health Organization.
In Singapore and Saudi Arabia, for instance, most of the infections are among foreign migrant workers, many of them living in cramped dormitories. However, many of those workers are young and fit and have not required hospitalization. And Jha of Harvard warns that some young people who are not showing symptoms are also highly contagious for reasons that are not well understood.Cultural factors, like the social distancing that is built into certain societies, may give some countries more protection, epidemiologists said.
What might be called “national distancing” has also proven advantageous. Countries that are relatively isolated have reaped health benefits from their seclusion. “The best guess is that summer conditions will help but are unlikely by themselves to lead to significant slowing of growth or to a decline in cases,” said Marc Lipsitch, director of the Center for Communicable Disease Dynamics at Harvard University.
“People were saying, ‘It’s hot here; nothing will happen to me,’” said Dr. Doménica Cevallos, a medical investigator in Ecuador. “Some were even going out on purpose to sunbathe, thinking it would protect them from infection.”Countries that locked down early, like Vietnam and Greece, have been able to avoid out-of-control contagions, evidence of the power of strict social distancing and quarantines to contain the virus.
All this happened in a region where health ministries had come to rely on money, personnel and supplies from foreign donors, many of which had to turn their attention to outbreaks in their own countries, said Catherine Kyobutungi, executive director of the African Population and Health Research Center.
Uganda, which also suffered during the Ebola contagion, quickly quarantined travelers from Dubai after the first case of the coronavirus arrived from there. Authorities also tracked down about 800 others who had traveled from Dubai in previous weeks. A notable exception was Iran, which did not close some of its largest shrines until March 18, a full month after it registered its first case in the pilgrimage city of Qum. The epidemic spread quickly from there, killing thousands in the country and spreading the virus across borders as pilgrims returned home.
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