Coronavirus: Did India's 'poor' hygiene standards lower COVID-19 infection rates? A CSIR study suggests so

Despite heavy lockdowns, it is believed that 'poor' sanitation standards and huge population figures pushed India in toe with the world's worst-affected countries by COVID-19. However, all might not be true. A new paper published by CSIR aims to prove the contrary, suggesting that low-income countries like India have been faring better against the 10-month-old pandemic because of the history of communicable diseases, existing infection and pathogens.

The study which was carried out by CSIR (Council of Scientific Research, India), which has not been peer-reviewed yet correlates the presence of the high burden of communicable diseases and chronic exposure to several types of bacteria and viruses to a higher and natural level of 'immunity' amongst populations in low and middle-income countries, including ours.

The paper further mentions that a low, or subdued presence of some infections, along with better-developed hygiene standards in developed countries could give rise to a problem like 'immune hypothesis', i.e., a flare-up in autoimmune troubles, which have also been infamously linked to cytokine storm, allergies and rising COVID severity rates.

If yes, this could probably be one of the reasons India and other underdeveloped countries may be faring somewhat better than progressive nations, including the USA.

For the same, authors decided to analyze and compare COVID-19 death rates amongst high GDP countries with that of countries with a higher burden of communicable risk factors.

An excerpt from the paper reads:

“Our observation of the weak negative correlation of Covid-19 LDM (log of deaths per million) with communicable diseases, and its positive correlation with the incidence of autoimmune disorders in the high GDP countries, is an indication of the interplay of host immunity and viral infection."

(Representative image used)

The authors further commented saying that with developed countries which had a higher share of COVID severity and mortality, non-communicable risk factors, such as smoking, increasing life expectancy, sedentary lifestyle and unhealthy diet were slightly more prevalent than that of countries like ours. With few exceptions, the infection rate, severity and mortality are significantly overrepresented in countries like Italy, Spain, USA, UK.

Experts also point out that previous exposure to viruses and pathogens can make a person's immune system smarter. It could be for the same reason that children have been found to have a lower risk of contracting COVID-19 since their immune systems work more proficiently to filter out germs and protect the body.

(Image used for representational purposes)

While good sanitary practices are key to preventing COVID-19 spread, exposure to pathogens from an early age can 'train' the immune system to react to the germs and viruses early on, provide sufficient response, instead of creating an overzealous one, which could result in a fatal cytokine storm.

Pre-existing medical conditions (including diabetes, cardiovascular complications, hypertension) and old age are examples of non-communicable risk factors. They are also two conditions which can determine your risk of COVID severity.

The study found that most of the world's population impacted by these risk factors resided in places with higher HDI (Human Development Index) and GDP, which could be yet another reason why some countries are experiencing staggering death rates, while some, like India, are seeing surprisingly better recovery rates and fewer deaths.

A better life expectancy, found in developed nations could also make people live longer, compromise their immunity and make them more vulnerable to COVID-19. A statement reads:

“Similarly, people above the age of 65 are also believed to be at greater risk, with the percentage of such people being significantly more in the higher HDI countries. Thus, co-morbidities with non-communicable diseases and the fraction of people living above the age of 65, being skewed towards the high-income countries, offers possible explanations to the perplexing observation of CFR dichotomy among nations,"

However, it should be noted that India is currently the world's diabetes capital and has a fair share of hypertension and cardiovascular caseload.

While it is too early to base our conclusions on the CSIR study, COVID-19 is not the first epidemic India has battled. There has been extensive exposure to several types of bacteria, viruses and other disease-causing pathogens in the past, which may have promoted certain cross-reactivity in the immune cells, to give Indians slightly better odds at defeating COVID-19. This could also be the reason many other economically under-developed nations could be faring better in the war against coronavirus.

For example, Tuberculosis, HIV and Malaria have been responsible for causing a lot of fatalities in India and Africa in the past. Brush against these diseases could be giving Indians 'intrinsic immunity' over others.

Even so, with the science behind our side giving us an immuno-edge, we must not get too complacent about the crisis at large. Social distancing, disinfection and mask hygiene must still be followed and effective hygiene encouraged at all levels to emerge victorious in our battle against COVID-19.

Deep-rooted in traditional sciences, some also believe that India's largely prevalent dietary preferences could already work as an immuno-shot to safeguard the body against COVID-19 severity. This, coupled with Ayurvedic principles, which have been found to be somewhat effective in preventing and fighting the COVID-causing virus could be protecting several million against the risk.