COVID-19 pandemic in South Asia

Countries and territories in South Asia have been affected by the COVID-19 pandemic. The first South Asian country to report a confirmed case was Nepal, which documented its first case on 23 January 2020, in a man who had returned from Wuhan on 9 January.[2] As of 2 July, at least one case of COVID-19 has been reported in every country in South Asia. Afghanistan, Bangladesh, Pakistan and Maldives have implemented lockdowns, Sri Lanka has responded with quarantine curfews while India and Nepal have declared a country-wide lockdown. Countries have also instituted various levels of restrictions on international travel, some countries have completely sealed off their land borders and grounded most international flights.

COVID-19 pandemic in South Asia
South Asia
DiseaseCOVID-19
Virus strainSARS-CoV-2
LocationSouth Asia
First outbreakWuhan, Hubei, China[1]
Index caseKathmandu, Nepal
Arrival date5 January 2020
Confirmed cases8,395,617
(19 October 2020)
Active cases1,176,416
(19 October 2020)
Recovered7,347,826
(19 October 2020)
Deaths
128,625
(19 October 2020)
Territories
Government website
SAARC Disaster Management Centre

India, Pakistan and Bangladesh were three South Asian countries that overtook China in terms of the number of coronavirus cases. In the middle of May, India was the first South Asian country to overtake China in terms of the number of coronavirus cases. On 4 June, Pakistan was the second South Asian country. And on 13 June, Bangladesh was the third South Asian country. In India, the number of recoveries exceeded the number of active cases on 10 June. In Pakistan, the number of recoveries exceeded the number of active cases on 3 July. And in Bangladesh, the number of recoveries exceeded the number of active cases on 12 July.

Governments are attempting to coordinate a response to the pandemic through the regional organization, SAARC, the South Asia Association for Regional Cooperation. India Prime Minister Narendra Modi proposed a joint emergency fund to tackle the pandemic, and pledged to seed US$10 Million. As of 11 April, Sri Lanka had contributed US$5 million to the SAARC COVID-19 Emergency Fund and Pakistan $3 million, Bangladesh $1.5 million, Afghanistan and Nepal had given $1 million each, Maldives had given $200,000 while Bhutan $100,000.

Background

The ongoing pandemic of coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[3] The outbreak was first identified in Wuhan, Hubei, China, in December 2019 and recognised as a pandemic by the World Health Organization (WHO) on 11 March 2020.[4] As of 29 March 2020, more than 708,000 cases of COVID-19 have been reported in over 190 countries and territories, resulting in approximately 33,500 deaths.[5] More than 150,000 people have since recovered.[5][6]

The virus primarily spreads between people in a way similar to influenza, via respiratory droplets from coughing or sneezing.[7][8][9] The time between exposure and symptom onset is typically five days, but may range from two to fourteen days.[9][10] Symptoms are most often fever, dry cough, and shortness of breath.[9][10] Complications may include pneumonia and acute respiratory distress syndrome. There is no vaccine or specific antiviral treatment, but research is ongoing. Efforts are aimed at managing symptoms and supportive therapy. Recommended preventive measures include handwashing, covering the mouth when coughing, maintaining distance from other people (particularly those who are unwell), and monitoring and self-isolation for fourteen days for people who suspect they are infected.[8][9][11]

South Asia is one of the most densely populated regions and having low testing rates, and is considered highly vulnerable to any large scale outbreak of an infectious disease.[12]

Statistics
Territories Date Confirmed cases Active cases Recoveries Deaths Total tests Tests per million population Ref.
 India 19 Nov 8,958,48 443,303 8,383,602 131,578 129,591,786 95,806 [13]
 Bangladesh 19 Nov 420,238 76,026 338,145 6,067 2,606,952 16,154 [14]
 Pakistan 19 Nov 368,665 33,562 327,542 7,561 5,098,291 24,022 [15]
Nepal 1 Feb 271,118 2,489 266,600 2,029 2,075,152 73,860 [16]
 Afghanistan 19 Nov 44,133 7,144 35,339 1,650 133,691 3,404 [17]
 Maldives 19 Nov 12,384 927 11,405 45 150,743 277,260 [18]
 Sri Lanka 14 Jan 50,899 6,901 43,747 251 1,430,864 65,627 [19]
 Bhutan 19 Nov 378 21 357 0 173,785 224,401 [20]

By country

Afghanistan
Main article: COVID-19 pandemic in Afghanistan
Map of the number of confirmed cases of COVID-19 in Afghanistan as of 17 April 2020.
  Confirmed cases 0
  Confirmed cases 1–9
  Confirmed cases 10–19
  Confirmed cases 20-99
  Confirmed cases ≥100

On 24 February, Afghanistan confirmed its first COVID-19 case, in a 35-year-old man from Herat province.[21] On 7 March, three new cases were confirmed in Herat.[22] On 10 March, the first case outside of Herat province, was reported in Samangan province, bringing the total to five.[23] By 22 March, the day Afghanistan confirmed its first official death, the total number of cases had risen to 40.[24][25][26] As of 29 March, a total of 120 cases had been confirmed, resulting in four deaths and three recoveries.[27][28][29]

Afghanistan temporarily closed its border with Iran on 23 February when first suspected cases emerged in Herat province bordering Iran.[30] In March, it restricted most international flights.[31] By the end of March, strict restrictions on the movement of people and public gatherings were in place in several provinces;[32][33][34][35][36] lockdowns had also been implemented, including in Kabul and Kandahar.[37]

Bangladesh
Main article: COVID-19 pandemic in Bangladesh

The COVID-19 pandemic was confirmed to have spread to Bangladesh in March 2020. The first three known cases were reported by the country's Institute of Epidemiology, Disease Control and Research (IEDCR) on 7 March 2020.[38] As of 29 March 2020, the Government of Bangladesh has confirmed testing 1095 samples among which there is a total of 48 confirmed cases, 15 recoveries, and 5 deaths in the country.[39]

On 22 March, Bangladesh declared a 10-day shut down effective from March 26 to 4 April .[40]

Bhutan
Main article: COVID-19 pandemic in Bhutan

On 6 March, Bhutan confirmed its first COVID-19 case, a 76-year-old US male who travelled to the country via India. Around 90 people who came directly in contact with him, along with his 59-year-old partner, driver, and guide were quarantined.[41] Bhutan immediately restricted entry of foreign tourists for two weeks.[41] On 20 March, the 59-year old partner of the American tourist tested positive for COVID-19.[42] Although the driver and guide tested negative, both were held in extended quarantine even though their quarantine period had ended.[43]

On 22 March, Jigme Khesar Namgyel Wangchuck, the king of Bhutan, announced in a national address that the country's land borders would be sealed off.[44] On 24 March, the government closed all its borders with India.[45] On 25 March, a student who had returned from the United Kingdom was found to be positive for COVID-19, the third case in the country.[46] On 29 March, According to the Ministry of Health, a returning student in the quarantine facility tested positive. The patient was moved to the isolation ward in Thimphu.[47]

India
Main article: COVID-19 pandemic in India
Confirmed cases of COVID-19 infections in India as of 7 September 2020

India has more than 5 million confirmed COVID-19 cases in the world which is largest in Asia and second largest in the world after United States with more than 82 thousand deaths and around 4 million patients recovered.

Country reported its first infection on 30 January 2020 while eventual moderate rise of infections took place due to students from Wuhan and tourist groups from Italy.[48][49] In March, the transmissions grew after several people with travel history to affected countries, and their contacts, tested positive. On 12 March, a 76-year-old man, with a travel history to Saudi Arabia, became the first COVID-19 fatality of India.[50] A gathering by Tablighi Jamaat emerged as a super spreader event adding more than 4,000 cases directly.[51] On 22 March, the Government of India announced complete lockdown in 82 districts in 22 states and Union Territories of country where confirmed cases were reported.[52] 80 cities including Delhi, Bengaluru, Chennai, Mumbai,[53] Chandigarh[54] and Kolkata were put under lockdown.[55] Some states sealed their borders barring inter-state movement.[56] On 24 March, PM Narendra Modi announced a complete 21-day national lockdown to contain the pandemic.[57] By 6 April, the doubling rate had slowed to six days from earlier figure of three days.[58]

Oxford COVID-19 Government Response Tracker (OxCGRT) noted the government's swift and stringent actions, emergency policy-making, emergency investment in health care, fiscal stimulus, and investment in vaccine and drug R&D and gave India a score of 100 for the strict response. Michael Ryan, chief executive director of the WHO's health emergencies programme noted that India had tremendous capacity to deal with the outbreak owing to its vast experience in eradicating smallpox and polio.[59][60][61] In June, India was ranked 56th of 200 countries in COVID-19 safety assessment report by Deep Knowledge Group.[62]

India initially suffered from a low testing rate, however has substantially increased it.[63] Country also has launched a number of research projects for treatment of disease and development of anti COVID vaccines. Demand amid pandemic has also turned India into world's second largest manufacturer of PPE after China.[64]

Maldives
Main article: COVID-19 pandemic in the Maldives

The COVID-19 pandemic was confirmed to have spread to the Maldives on 7 March 2020 from an Italian tourist who had returned to Italy after spending holidays in Kuredu Resort & Spa.[65] The Health Protection Agency of the Maldives confirmed two cases in the Maldives, both employees of the resort. Following this, the hotel was locked down with several tourists stranded on the island.[66] As of 11 March, the islands resorts of Kuredu, Vilamendhoo, Batalaa and Kuramathi island have also been placed under temporary quarantine.[67]

The Maldives declared a public health emergency over COVID-19 on 12 March.[68] On 27 March, the government announced the first confirmed case of a Maldivian citizen with COVID-19, a passenger who had returned from the United Kingdom. This brought the total number of confirmed cases in the country to 16; the other 15 were foreign citizens.[69]

Nepal
Main article: COVID-19 pandemic in Nepal

A Nepali student who had returned to Kathmandu from Wuhan became the first case of the country and South Asia on 23 January 2020.[2][70] The first case of local transmission inside the country was confirmed on 4 April, while the first COVID-19 death came on 14 May.[71] The country observed an almost four-month-long nationwide lockdown between 24 March and 21 July.[72] As of 1 February 2021, the country has a total of 271,118 confirmed cases, 266,600 recoveries, and 2,029 deaths.[16]

Sri Lanka
Confirmed cases per districts[73]
Main article: COVID-19 pandemic in Sri Lanka

As of 14 January 2021 50,899 confirmed cases have been reported in the country with 251 deaths. A ban on foreign arrivals has been instituted postponed .[74]

As of 14 January 2021, Sri Lankan authorities have tested near 1,430,864 people and had ordered self quarantine for such people.

As the spread of COVID-19 government has banned all public events and all schools will be closed until further notice by the education ministry as a measure of preventing the spread of the virus.

When compared with other South Asian countries, Sri Lanka has the best position. It has had the COVID-19 outbreak for the longest duration but has managed to limit the case count the most. Sri Lanka also managed to keep lowest death rate in Asia. Sri Lanka's fatality rate is 0.5%.[75][76]

On May Sri Lanka was ranked the 9th best country in the world for its successful response in tackling the virus but Sri Lanka is ranked the 16th most vulnerable country to COVID-19.[77]

Pakistan
Main article: COVID-19 pandemic in Pakistan
This section is an excerpt from COVID-19 pandemic in Pakistan[edit]
Map of confirmed cases per million inhabitants by administrative unit
   > 20,000 confirmed cases per million
   > 10,000 confirmed cases per million
   > 5,000 confirmed cases per million
   > 2,000 confirmed cases per million
   > 1,000 confirmed cases per million
   > 500 confirmed cases per million

The COVID-19 pandemic in Pakistan is part of the ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was confirmed to have reached Pakistan on 26 February 2020, when two cases were recorded (a student in Karachi who had just returned from Iran and another person in the Islamabad Capital Territory).[78] On 18 March, cases had been registered in all four provinces, the two autonomous territories, and Islamabad Capital Territory,[79] and by 17 June, each district in Pakistan had recorded at least one confirmed case of COVID-19.

Pakistan currently has the 8th-highest number of confirmed cases in Asia, after India, Russia, Iran, Iraq, Indonesia, Bangladesh, and Turkey; the 3rd-highest number of confirmed cases in South Asia after India and Bangladesh; and the 28th highest number of confirmed cases in the world. On 15 June, daily new confirmed case numbers reached their peak, with 6,825 new cases recorded, but since then, new daily cases and the percentage of people testing positive have trended downwards. In late June, the number of active cases in Pakistan stabilized, and beginning in July, started showing a significant decrease.[80] On 2 July, recoveries exceeded active cases for the first time as 8,929 recoveries were recorded, meaning that 51% of all confirmed cases in the country to date had recovered. While Pakistan has the world's 28th highest case count, it only has the world's 29th highest death count.

The province of Sindh has recorded the most cases at about 134,000, and has also recorded the most deaths due to COVID-19, about 2,500 to date. The country was put under a nation-wide lockdown from April 1 and extended twice until 9 May.[81][82] Upon its end, the lockdown was eased in phases.[83]

The distribution of COVID-19 in Pakistan is heavily concentrated in a few key areas. The city of Karachi (as of 5 September 2020) has recorded about 84,000 confirmed cases, making up about 28% of all cases of COVID-19 in Pakistan. Meanwhile, Lahore, the country's second-largest city, has recorded (as of 5 September 2020) 49,000 cases of COVID-19, making up about 16% of the country's cases. Islamabad Capital Territory and Peshawar District have also both recorded over 10,000 cases. Karachi, Lahore, Islamabad, and Peshawar account for about 163,000 cases, which make up nearly 55% of the country's total confirmed cases.

Regional response

15 March conference call

On 13 March, India Prime Minister Narendra Modi called for a joint regional response to the pandemic through the regional organisation, SAARC; the proposal was met with positive response.[84] A conference call was attended by heads of governments of all member states, except Pakistan which sent the special adviser to the Prime Minister, on 15 March. Modi's proposal to setup an emergency fund was agreed upon.[85] Modi also proposed creating a common research platform to coordinate research within the South Asia region,[86] while Afghan President Ashraf Ghani proposed creating a common framework for telemedicine.[85]

SAARC COVID-19 Emergency Fund
Main article: SAARC COVID-19 Emergency Fund

On 15 March 2020, coinciding with the International Consumer Rights Day the emergency fund was proposed by Indian Prime Minister Narendra Modi during a video conference of SAARC heads of government from New Delhi as a result of the global coronavirus pandemic.[87] The purpose of this fund is to tackle and mitigate the risks associated with the coronavirus pandemic in the South Asian region. Other member nations welcomed the decision of Modi for the proposal of coronavirus emergency fund.[88]

India announced US$10 million as its initial contribution to support the initiative and Modi stated that the contributions for the fund from member countries would be voluntary.[89] As of 11 April 2020, the Emergency fund had accumulated sum of US$21.8 million with the pool of contributions from seven member countries.[90]

Bangladesh announced it would contribute US$1.5 million, Nepal and Afghanistan each announced that they would voluntarily contribute US$1 million.[91] On 23 March, Sri Lanka announced it would contribute US$5 million which was the second most highest contribution from a member country besides India.[92] Maldives announced it would contribute US$200, 000 while Bhutan announced it would contribute US$100, 000.[93][94] On April 10, Pakistan also announced a contribution of $3 million.[95]

Medical response coordination

The SAARC Disaster Management Centre later launched a website for information related to the pandemic in member countries, as proposed by Modi in the conference call.[86]

A video conference was held among health professional of all countries at the Director General of Health Services (DGHS) level on 26 March, to discuss a framework for cooperation as agreed in the 15 March conference. A shared electronic platform for sharing of information, knowledge and expertise was proposed.[96]

Censorship

People in India,[97][98] Pakistan,[99] Bangladesh,[100] and Sri Lanka[98] have been arrested for allegedly spreading false information about the COVID-19 pandemic.

Impact of mobility reduction on air quality
AQI PM2.5 changes across SAARC countries indicates a reduction of particle emission due to COVID-19 containment measurement as well as a positive environmental outcome in the cities. The data has been smoothed using the locally weighted scatterplot smoothing (LOWESS) method.

In light of the Google COVID-19 community mobility reports,[101] apparently Afghanistan has a base decrease of mobility and a lower mobility in residential from the base. As far as indoor activity, rate versatility expanded in all nations at a comparable level aside from Afghanistan. Bangladesh, India, Nepal, Pakistan, and Sri Lanka had a higher decrease in outdoor, open air versatility. Notwithstanding, for Bangladesh and Pakistan, mobility in the parks didn't lessen that much (around 10-25%) contrasted with other SAARC nations aside from Afghanistan.[102] Likewise, in all classes, Sri Lanka has a reliably higher decrease in portability.

The impact of mobility decrease was likewise seen noticeable in air-quality record [102] (in view of particulate issue size 2.5 micrometers, otherwise called AQI PM2.5). Aside from the Bhutan and Maldives, all nations in SAARC have day by day records of PM2.5 (as announced in airnow.gov) which has been imagined in figure 4 from mid 2020 until May 10 for all urban areas for which the information is accessible in SAARC. Afghanistan, Bangladesh, and Sri Lanka indicated an expansion of AQI PM2.5 esteem in mid 2020 that crested in mid February, and afterward reliably declined until May. In every single other nation, a consistent diminishing has been seen in these five months. Since a huge extent of PM2.5 can be credited to traffic vehicle's gas and mechanical consuming of fills, this overall decrease of AQI information by implication shows an impact of lockdown in these nations.

See also

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