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 China on 5 January. 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
DiseaseCoronavirus disease 2019
(COVID-19)
Virus strainSevere acute respiratory syndrome coronavirus 2
(SARS-CoV-2)[1]
LocationSouth Asia
First outbreakWuhan, Hubei, China[2]
Index caseKathmandu, Nepal
Arrival date5 January 2020
Confirmed cases1,477,255
(15 July 2020)
Active cases513,395
(15 July 2020)
Recovered929,930
(15 July 2020)
Deaths
33,930
(15 July 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 populous and least developed world regions, and is considered highly vulnerable to any large scale outbreak of an infectious disease.[12]

Pandemic by country
COVID-19 pandemic in Southern Asia
Territories Confirmed cases Active cases Cases with an outcome Population (2018)
Recoveries Deaths
South Asia 1,053,425 442,654 585,210 25,561 1,895,813,944
 Afghanistan 32,022 15,174 1,303 807 37,171,921
 Bangladesh 153,277 84,909 9,375 1,926 161,376,708
 Bhutan 77 27 6 0 754,388
 India 1,038,716 342,473 653,751 26,273 1,352,642,280
 Maldives 2,400 1,309 197 10 515,696
   Nepal 14,519 9,168 219 31 28,095,714
 Pakistan 221,896 103,722 22,305 4,551 212,228,286
 Sri Lanka 2,078 123 1,955 11 21,228,763

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.[13] On 7 March, three new cases were confirmed in Herat.[14] On 10 March, the first case outside of Herat province, was reported in Samangan province, bringing the total to five.[15] By 22 March, the day Afghanistan confirmed its first official death, the total number of cases had risen to 40.[16][17][18] As of 29 March, a total of 120 cases had been confirmed, resulting in four deaths and three recoveries.[19][20][21]

Afghanistan temporarily closed its border with Iran on 23 February when first suspected cases emerged in Herat province bordering Iran.[22] In March, it restricted most international flights.[23] By the end of March, strict restrictions on the movement of people and public gatherings were in place in several provinces;[24][25][26][27][28] lockdowns had also been implemented, including in Kabul and Kandahar.[29]

Bangladesh
Main article: COVID-19 pandemic in Bangladesh

The COVID-19 pandemic was confirmed to have spread to Bangladesh on 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.[30] 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.[31]

On 22 March, Bangladesh declared a 10-day shut down effective from March 26 to 4 April .[32]

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.[33] Bhutan immediately restricted entry of foreign tourists for two weeks.[33] On 20 March, the 59-year old partner of the American tourist tested positive for COVID-19.[34] Although the driver and guide tested negative, both were held in extended quarantine even though their quarantine period had ended.[35]

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.[36] On 24 March, the government closed all its borders with India.[37] 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.[38] 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.[39]

India
Main article: COVID-19 pandemic in India
This section is an excerpt from COVID-19 pandemic in India[edit]

The COVID-19 pandemic in India is part of the worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first case of COVID-19 in India, which originated from China, was reported on 30 January 2020. India currently has the largest number of confirmed cases in Asia,[40] and has the third highest number of confirmed cases in the world after the United States and Brazil[41] with the number of total confirmed cases breaching the 100,000 mark on 19 May, 200,000 on 3 June, [42][43] and 1,000,000 confirmed cases on 17 July 2020.

India's case fatality rate is among the lowest in the world at 2.41% as of 23 July and is steadily declining.[44] Six cities account for around half of all reported cases in the country – Mumbai, Delhi, Ahmedabad, Chennai, Pune and Kolkata.[45] As of 24 May 2020, Lakshadweep is the only region which has not reported a case. India's recovery rate stands at 63.18% as on 23 July 2020.[46] On 10 June, India's recoveries exceeded active cases for the first time.[47]

On 22 March, India observed a 14-hour voluntary public curfew at the instance of the prime minister Narendra Modi. It was followed by mandatory lockdowns in COVID-19 hotspots and all major cities. Further, on 24 March, the Prime Minister ordered a nationwide lockdown for 21 days, affecting the entire 1.3 billion-person population of India. On 14 April, India extended the nationwide lockdown till 3 May which was followed by two-week extensions starting 3 and 17 May with substantial relaxations. From 1 June, the government started "unlocking" the country (barring "containment zones") in three unlock phases.[48][49][50][51]

In March, after the lockdown was imposed, the United Nations (UN) and the World Health Organization (WHO) praised India's response to the pandemic as 'comprehensive and robust,' terming the lockdown restrictions as 'aggressive but vital' for containing the spread and building necessary healthcare infrastructure. At the same time, the 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, investment in vaccine and drug R&D and gave India a score of 100 for the strict response. Also in March, 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.[52][53][54] Other commentators have raised concerns about the economic fallout arising as a result of the pandemic and preventive restrictions.[55][56] The lockdown was justified by the government and other agencies for being preemptive to prevent India from entering a higher stage which could make handling very difficult and cause even more losses thereafter.[57][58]

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.[59] 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.[60] As of 11 March, the islands resorts of Kuredu, Vilamendhoo, Batalaa and Kuramathi island have also been placed under temporary quarantine.[61]

The Maldives declared a public health emergency over COVID-19 on 12 March.[62] 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.[63]

Nepal
Main article: COVID-19 pandemic in Nepal
Map of the outbreak in Nepal
(as of 14 May)

A Nepali student who had returned to Kathmandu from Wuhan became the first case of the country and South Asia on 24 January 2020.[64][65][66] The second was confirmed on 23 March. The first case of local transmission was confirmed on 4 April in Kailali District. As of 14 May, Nepal has confirmed 249 cases, having conducted 62,000 Rapid diagnostic tests and 22,000 PCR tests; 35 patients have been confirmed recovered.[67]

Land borders with India as well as China have been sealed off, and all international flights suspended.[68] All academic examinations were cancelled,[69][70] and schools and colleges were closed.[71] A countrywide lockdown came into effect on 24 March and is scheduled to end on 18 May.[72]

Nepal cancelled its international promotional activities related to Visit Nepal Year 2020. Its economy is expected to be severely affected by the pandemic due its impact on foreign employment, tourism, manufacturing, construction and trade.[73]

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

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).[74] On 18 March, cases had been registered in all four provinces, the two autonomous territories, and Islamabad Capital Territory,[75] and by 17 June, each district in Pakistan had recorded at least one confirmed case of COVID-19.

Pakistan currently has the 5th-highest number of confirmed cases in Asia, after India, Russia, Iran, and Saudi Arabia, the 2nd-highest number of confirmed cases in South Asia after India, and the 15th highest number of confirmed cases in the world. On 13 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. 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. As of 16 August 2020, the recovery rate in Pakistan stands at 93.0%.[76]

Despite the relatively high number of confirmed COVID-19 cases, the Case Fatality Rate of COVID-19 in Pakistan stands at about 2.14%. This fatality rate is similar to the fatality rate across Asia, which stands at about 2.05%,[77] but is significantly lower than the global average at approximately 3.6% (as of 16 August 2020). While Pakistan has the world's 15th highest case count, it only has the world's 19th highest death count.


As of 16 August 2020 there have been about 289,000 confirmed cases, 269,000 recoveries, and 6,200 deaths in the country. Sindh has recorded the most cases at about 126,000, and has also recorded the most deaths due to COVID-19, about 2,300 to date.[76] The country was put under a nation-wide lockdown from April 1 and extended twice until 9 May[78][79]. Upon its end, the lockdown was eased in phases.[80]

The distribution of COVID-19 in Pakistan is heavily concentrated in a few key areas. The city of Karachi (as of 16 August 2020) has recorded about 90,000 confirmed cases, making up more than 30% of all cases of COVID-19 in Pakistan. Meanwhile, Lahore, another large city, has recorded (as of 16 August 2020) 48,000 cases of COVID-19, making up about 17% 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 167,000 cases, which make up nearly 60% of the country's total confirmed cases.

Sri Lanka
Main article: COVID-19 pandemic in Sri Lanka

As of 6 July 2020, 2,076 confirmed cases have been reported in the country with 10 deaths. A ban on foreign arrivals has been instituted at least until 1 of August .[81]

As of 7 July 2020 Sri Lankan authorities have tested 114,765 people and had ordered self quarantine for such people.

As the spread of covid19 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 compare with other South Asian countries, Sri Lanka has the best position. It has had the corona outbreak for the longest duration but has managed to limit the case count the most. Sri Lanka also managed to keep death rate close to 0.5%.[82]

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.[83]

Statistics
Date Case Death
Afghanistan Bangladesh Bhutan India Maldives Nepal Pakistan Sri Lanka Afghanistan Bangladesh Bhutan India Maldives Nepal Pakistan Sri Lanka
07-MAY-2020 171 706 0 3,364 31 2 1,430 26 2 13 0 104 1 0 41 0
08-MAY-2020 215 709 0 3,344 96 1 1,791 12 3 7 0 96 0 0 14 0
09-MAY-2020 255 636 0 3,113 46 7 2,301 12 6 8 0 116 0 0 37 0
10-MAY-2020 369 887 0 4,353 45 1 1,598 9 5 14 0 111 0 0 23 0
11-MAY-2020 285 1,034 2 3,607 62 24 607 7 2 11 0 82 0 0 8 0
12-MAY-2020 276 969 2 3,524 7 83 1,733 26 5 11 0 121 0 0 57 0
13-MAY-2020 263 1,162 0 3,763 51 26 2,624 4 5 19 0 136 1 0 37 0
14-MAY-2020 413 1,041 9 3,942 27 6 490 32 4 14 0 98 0 0 9 0
15-MAY-2020 414 1,202 1 3,787 49 18 1,430 10 17 15 0 104 0 0 33 0
16-MAY-2020 349 930 0 4,864 47 14 1,581 22 15 16 0 118 0 1 31 0
17-MAY-2020 262 1,273 0 5,050 16 14 1,352 24 1 14 0 154 0 1 39 0
18-MAY-2020 408 1,602 0 4,630 12 80 1,974 11 4 21 0 131 0 0 30 0
19-MAY-2020 581 1,251 0 6,147 37 27 1,841 31 5 21 0 146 0 0 36 0
20-MAY-2020 492 1,617 0 5,553 43 25 1,932 5 9 16 0 132 0 0 46 0
21-MAY-2020 531 1,773 0 6,198 30 30 2,193 20 6 22 0 150 0 1 32 0
22-MAY-2020 540 1,694 0 6,568 58 59 2,603 20 12 24 0 142 0 0 50 0
23-MAY-2020 782 1,873 3 6,629 39 68 1,743 21 11 20 0 142 0 0 34 0
24-MAY-2020 584 1,532 0 7,113 58 19 2,164 52 2 28 0 156 0 0 32 0
25-MAY-2020 591 1,975 3 6,414 24 79 1,748 41 1 21 0 148 0 1 34 1
26-MAY-2020 658 1,166 0 5,843 43 90 1,356 137 1 21 0 172 1 0 30 0
27-MAY-2020 625 1,541 1 7,293 19 114 1,446 150 7 22 0 190 0 0 28 0
28-MAY-2020 580 2,029 3 7,300 56 156 2,076 61 8 15 0 177 0 1 35 0
29-MAY-2020 623 2,523 0 8,105 78 170 2,801 28 11 23 0 269 0 1 57 0
30-MAY-2020 866 1,764 2 8,336 81 189 2,429 55 3 28 0 205 0 0 78 0
31-MAY-2020 680 2,545 10 8,782 101 171 3,039 20 8 40 0 223 0 2 88 0
01-JUN-2020 545 2,381 0 7,761 56 239 2,964 10 8 22 0 200 1 0 60 1
02-JUN-2020 759 2,911 4 8,821 12 288 3,938 40 5 37 0 221 1 0 78 0
03-JUN-2020 758 2,695 0 9,633 9 201 4,065 52 24 37 0 259 0 1 67 0
04-JUN-2020 787 2,423 0 9,889 22 334 4,801 62 6 35 0 275 0 1 82 0
05-JUN-2020 915 2,828 1 9,471 11 278 3,985 4 9 30 0 286 0 1 68 0
06-JUN-2020 582 2,635 0 10,438 18 323 4,734 13 18 35 0 297 1 2 97 0
07-JUN-2020 791 2.743 0 10,864 2 213 4,960 21 30 42 0 261 0 0 67 0
08-JUN-2020 575 2,735 11 8,442 13 314 4,728 22 12 42 0 266 0 1 65 0
09-JUN-2020 542 3,171 0 10,218 26 324 4,646 2 15 45 0 277 0 1 105 0
10-JUN-2020 683 3,190 0 12,375 20 278 5,385 10 21 37 0 388 0 0 83 0
11-JUN-2020 748 3,187 3 11,128 14 250 5,834 8 21 37 0 394 0 0 101 0
12-JUN-2020 656 3,471 0 11,320 27 448 6,397 3 20 46 0 389 0 1 107 0
13-JUN-2020 556 2,856 0 12,023 10 273 6,472 4 5 44 0 309 0 2 88 0

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.

See also

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