A Covid mystery

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It’s one of the biggest mysteries of Covid-19: Why has the death toll been relatively low across much of Africa and Asia?

The virus has killed a fraction of as many people on these continents – despite their relative lack of resources – as in Europe or the United States:

This is not how public health emergencies usually work. They tend to inflict their worst damage in the poorest places, which is actually what happens in the United States, where the toll has been. upper in many minority and low-income communities.

Overall, however, Covid has been different. In a recent New Yorker article, Pulitzer Prize-winning physician and author Siddhartha Mukherjee described him as “An epidemiological thriller.”

Aside from Mukherjee’s article, the model has received surprisingly little attention in the United States. This is one of those cases where the good news is ignored. I want to devote today’s newsletter to the mystery and its most plausible explanations.

Almost certainly not. Part of the trend probably stems from underreporting of deaths by less developed medical systems. But much of the trend is real, believe many epidemiologists.

In India, for example, the big cities keep statistics on overall mortality – whatever the cause – and this has increased less than it has. in many rich countries. Data suggests Delhi and Mumbai have “a much lower Covid death rate than in the United States,” Dr Prabhat Jha, who heads the Center for Global Health Research at St. Michael’s Hospital, told me. from Toronto.

In Mukherjee’s article, he describes a temporary hospital that local Mumbai authorities set up last year in Dharavi, a sprawling slum. They closed it after Dharavi suffered far fewer deaths than expected.

Covid is generally more difficult for the elderly: more than 80% of deaths in the United States have occurred in people aged 65 or older.

Across Africa and much of Asia, the population is younger. Birth rates are higher and other health problems kill people more frequently before they reach old age. In sub-Saharan Africa, only 3 percent of the population is 65 years or older. In Pakistan, only 4 percent are. In the United States, the share is 16 percent and 20 percent in the European Union.

A related factor may be the fact that retirement homes – where Covid has often spread from one resident to another – are more common in Western countries. Outside the West, the elderly often live multigenerational households.

Yet age doesn’t seem to be the full answer. Statistical models that include age still find surprisingly low counts in many poor countries.

Daily life tends to be better ventilated in warmer, lower-income countries. People spend more time outdoors and the windows are often open. Covid spreads less easily in these environments than in poorly ventilated indoor spaces.

There is a lesson here for Americans: Schools, stores, and workplaces can reduce the spread of Covid by improve their ventilation.

Many researchers suspect this is an important part of the answer. If previous coronaviruses spread more widely in some countries, the immune system of populations there may be better prepared to fight Covid. “There is a lot of circumstantial evidence”, Salim Abdool Karim, a South African epidemiologist, told Reuters, “but there is no smoking gun.”

Likewise, a team of Indian researchers argued that deaths “are lower in countries that have a higher population exposed to a diverse range of microbes,” according to the BBC. Soutik Biswas wrote. The large share of asymptomatic infections in India is consistent with this hypothesis, Dr. Gagandeep Kang, a virologist from the southern city of Vellore, told the Financial Times.

If the hypothesis is correct, it could help explain why deaths are lower in Africa and Asia than in much of Latin America.

Rwanda quickly and aggressively forced social distancing, mask wear, contact tracing and mass testing. It was the same for several Asian countries. Ghana, Vietnam and other countries have restricted entry at their borders. And a consortium of African countries have collaborated to distribute medical masks and rapid tests for Covid.

“Africa does a lot of things right, unlike the rest of the world,” said Gayle smith, a former Obama administration official.

Again, however, this does not appear to be the main explanation for the relatively low death toll from Covid. Several countries in Asia and Africa, including India, have had much more dispersed policy responses – as the United States and Europe have.

The full answer to this mystery surely involves multiple explanations. Regardless, this is one of the few ways that Covid hasn’t been as bad as many had feared. Hundreds of thousands of people in Africa and Asia have still died from this terrible disease. But many more are alive today for reasons that are both unclear and wonderful.

The media equation: They had a fun pandemic, and you can read about it in print.

From the review: Gail Collins and Bret Stephens discuss Cuomo’s problems.

Lives lived: It was the hockey dad who taught his son to “skate where the puck goes, not where it has been”. And when an aneurysm stole his memories, he rebuilt his life with his family and friends. Walter Gretzky died at 82.

Last month, Apple TV + released “Billie Eilish: The World’s A Little Blurry,” a documentary depicting the singer’s rise to the fore and the creation of her Grammy-winning debut album. It follows other recent documentaries on pop stars including Justin Bieber, Beyoncé and girl group Blackpink.

The artists or their labels have contributed to the production of all of these films, which promise an unvarnished glimpse into the lives of performers. This is not quite what they deliver.

Celebrities have long used documentaries to manage their images, even when the production team is technically independent. Music labels are often involved in documentaries, in part because “directors have little choice: films about musicians need music and licenses can be prohibitively expensive”, Danny Funt written in the Columbia Journalism Review.

Perhaps the best way to approach celebrity documentaries is to appreciate them for what they are: carefully crafted entertainment. In Eilish’s case, the documentary often feels “almost observational, like a nature film,” according to Times critic Jon Caramanica. written in a review. Yet, he says, “there is never anything other than a sense of security in these images.”

Like Simran Hans written in The Guardian, “Artists continue to use the documentary form as a shortcut for truth – but this truth is yet another construction.”

Friday’s spelling pangram was matron. Here is today’s puzzle – or you can To play online.

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