Exploring geographical differences and disparities of COVID-19 cases and understand the gaps in responses in South Asian countries: A three-month analysis of cases and responses

Abstract

Background and Aim: Response in a beginning of an infection is important to prevent and control any infectious disease. It has never been studied how the countries in South Asia responded in the beginning of COVID-19 infections. The aim of this study was to explore the gap in responses by geographical variations and inequalities of COVID-19 cases in South Asian Countries.Methods: Covid-19 cases, geographic and demographic data for South-Asian countries were abstracted from the news medias, Johns Hopkins University dashboard, and countries government websites. The coverage period was until May 7, 2020. Descriptive analyses of COVID-19 cases were stratified by gender and age group. Clustering and spatial analysis was performed to show the COVID-19 case distribution.Results: Over 100000 confirmed cases were found in South-Asian countries until May 7, 2020, and 95% of them are in India, Pakistan, and Bangladesh. Alarmingly, a sharp increase in new cases was observed in Bangladesh and India in early May. In this region, India reported 56% of total cases, with the highest case fatality rate of 3.4%. Approximately 70% of infected cases in this region were found in men. Approximately 42% of confirmed cases were found between the ages of 20-40, and about 20% of infected cases were found over 50 years or older. All big, economically important cities in this region were mainly infected. Bangladesh and Afghanistan reported a slow rate of recovery with 16% and 13%, respectively while India reported 29%. Afghanistan used only four tests to detect a case while India used 25 tests to detect a case showing poor numbers and insufficient test facilities in Afghanistan. Conclusion: The biggest and most economically-important cities in every South-Asian country were infected with COVID-19, where returning the migrant workers to work was a significant challenge after lifting the restrictions. Data from India, Pakistan, and Bangladesh suggest that these countries did not show the peak in the first six months. In South Asia, men were at higher risk for both infection and death, regardless of age. There were many underreported cases in these regions. Scale up services to improve the testing facilities and start a surveillance system to identify the cases rapidly especially from the marginalized population and women could reduce the burden of any infections.