COVID-19 Pandemic in South Asia: Challenges and Mitigation
DISCOVERIES REPORTS (ISSN 2393249X), 2021, volume 4

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CITATION: Rabbi MF, Hami I, Islam MK, Akter T, Hossain MS, Rahaman MM. COVID-19 Pandemic in South Asia: Challenges and Mitigation. Discoveries Reports, 2021; 4: e18. DOI: 10.15190/drep.2021.3  Submitted: Jan. 19, 2021; Revised: Feb. 25, 2021; Accepted: Feb. 25, 2021; Published: March 31, 2021;

COVID-19 Pandemic in South Asia: Challenges and Mitigation 

Md. Fazley Rabbi (1), Ithmam Hami (1), Md. Kobirul Islam (1), Tanin Akter (2), Md. Shahadat Hossain (1,*), Md. Mizanur Rahaman (3,*)

(1) Department of Biotechnology and Genetic Engineering, Noakhali Science and Technology University, Noakhali, Bangladesh
(2) Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
(3) Department of Microbiology, University of Dhaka, Dhaka, Bangladesh

* Corresponding author: Md. Mizanur Rahaman, Associate Professor, Department of Microbiology, University of Dhaka, Dhaka-1000, Bangladesh; Phone: +8801796585290; Email: razu002@du.ac.bd and Md. Shahadat Hossain, Assistant Professor, Department of Biotechnology and Genetic Engineering, Noakhali Science and Technology University, Noakhali-3814, Bangladesh; Phone: +8801757691222; Email: shahadat5.bge@nstu.edu.bd

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already reached almost every corner of the earth. We are currently left with very limited options to battle the pandemic with containment and to provide supporting care. This review article summarizes the current situation and the future prospect of the pandemic in one of the most populated regions on the globe, South Asia. Although COVID-19 cases have been steadily increasing in many countries, the overall response in this region is polarizing but highly criticized. India is now hosting the world’s second most infected cases while Maldives and Bhutan have almost kept it under control. Most of these countries have very underwhelming healthcare facilities, and the number of RT-PCR based coronavirus tests is very insignificant so far with respect to the extent of the population. There are various challenges ahead with agriculture and export-based economy, hygiene problem and imminent dengue outbreaks in some region. With the recent clearance of Pfizer-BioNTech and Moderna vaccines, challenges remain for the South Asian countries to ensure vaccines for all their citizens and develop proper storage and transportation facilities. The countries have to opt for some extremely proactive measures to not only save its people but secure the economic longevity for the post-pandemic period.

References

1.  Zhu N et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020; 382(8): 727-733.
2. Wang C et al. A novel coronavirus outbreak of global health concern. Lancet. 2020; 395(10223): 470-473.
3. Wu F et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020; 579(7798): 265-269.
4. Lu H et al. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol. 2020; 92(4): 401-402.
5. Reported Cases and Deaths by Country Territory; Accessed On: June 10th, 2020; Available from: https://www.worldometers.info/coronavirus/.
6. Bhutta Z A et al. Covid-19 risks and response in South Asia. Bmj. 2020; 368: m1190.
7. Impact of the Coronavirus Pandemic on the Global Economy- Statistics and Facts; Accessed On: June 10th, 2020; Available from: https://www.statista.com/topics/6139/covid-19-impact-on-the-global-economy/.
8. The Economic Impact of COVID-19 in South Asia: 3 visuals; Accessed On: June 10th, 2020; Available from: https://blogs.worldbank.org/endpovertyinsouthasia/economic-impact-covid-19-south-asia-3-visuals.
9. South Asia's Stimulus for Addressing COVID-19; Accessed On: June 10th, 2020; Available from: https://thefinancialexpress.com.bd/views/views/south-asias-stimulus-for-addressing-covid-19-1587309608
10. Bhutan Reports First COVID-19 Death; Accessed On: June 10th, 2020; Available from: https://www.reuters.com/article/us-health-coronavirus-bhutan/bhutan-reports-first-covid-19-death-idUSKBN29D13B.
11. Saha O et al. SARS-CoV-2 and COVID-19: A Threat to Global Health. Discoveries Reports. 2020; 3: e13. DOI: 10.15190/drep.2020.7
12. COVID-19 Pandemic in South Asia; Accessed On: June 10th, 2020; Available from: https://en.wikipedia.org/w/index.php?title=COVID-19_pandemic_in_South_Asia&fbclid=IwAR2AbBImQ5-qQP2bL3lgLIEaH-F7-4_7E212P1QCc8wYk-tHtAbgiLBtilE.
13. Hossain MS et al. Drug Repurposing for Prevention and Treatment of COVID-19: A Clinical Landscape. Discoveries. 2020; 8(4): e121.
14. South Asia shows new spirit of collaboration to fight COVID-19 (Coronavirus) pandemic; Accessed On: March 31, 2020; Available from: https://blogs.worldbank.org/endpovertyinsouthasia/south-asia-shows-new-spirit-collaboration-fight-covid-19-coronavirus-pandemic.
15. Coronavirus in South Asia April 30, 2020: India, Pakistan and Bangladesh Begin Easing Restrictions; Accessed On: June 11th, 2020; Available from: https://www.cfr.org/blog/coronavirus-south-asia-april-30-2020-india-pakistan-and-bangladesh-begin-easing-restrictions?fbclid=IwAR1PqVwyItyGVnJ884uvwCNshZV-B_AvLcvLG Mp28cDPbhwINNW1iQzW_jM
16. Chaurasiya P et al. Epidemic and challenges of coronavirus disease-2019 (COVID-19): India response. Available at SSRN 3569665. 2020.
17. The Lancet. India under COVID-19 lockdown. Lancet. 2020; 395(10233): 1315.
18. India's Response to COVID-19 Pandemic; Accessed On: June 11th, 2020; Available from: https://www.thejakartapost.com/academia/2020/04/19/indias-response-to-the-covid-19-pandemic.html.
19. Mazzola LT et al. Diagnostics for Nipah virus: a zoonotic pathogen endemic to Southeast Asia.BMJ Global Health. 2019; 4(Suppl 2): e001118.
20. Arunkumar G et al. Outbreak investigation of Nipah virus disease in Kerala, India, 2018.Journal of Infectious Diseases. 2019; 219(12): 1867-1878.
21. Sadanadan R et al. Towards global health security: response to the May 2018 Nipah virus outbreak linked to Pteropus bats in Kerala, India.BMJ Global Health. 2018; 3(6).
22. Khanna A. Impact of Migration of Labour Force due to Global COVID-19 Pandemic with Reference to India.Journal of Health Management. 2020; 22(2): 181-191.
23. Mukhra R et al. Covid-19 Sets off Mass Migration in India.Archives of Medical Research. 2020; 51(7): 736-8.
24. Information for Testing Laboratories; Accessed On: June 12th, 2020; Available from: https://www.icmr.gov.in/pdf/covid/labs/COVID_Testing_Labs_24122020.pdf
25. Covid Vaccine: India Expects to 'Begin Vaccination In January'; Accessed On: January 7th, 2020; Available from:https://www.bbc.com/news/world-asia-india-55314709.
26. Saqlain M et al. Is Pakistan prepared to tackle the coronavirus epidemic? Drugs and Therapy Perspectives. 2020: 1-2.
27. Waris A et al. COVID-19 outbreak: current scenario of Pakistan.New Microbes and New Infections. 2020: 100681.
28. Chandir S et al. Impact of COVID-19 lockdown on routine immunisation in Karachi, Pakistan.The Lancet Global Health. 2020; 8(9): e1118-e1120.
29. Anser MK et al. Social and administrative issues related to the COVID-19 pandemic in Pakistan: better late than never.Environmental Science and Pollution Research. 2020; 27(27): 34567-34573.
30. Asghar N et al. COVID-19 pandemic and Pakistan economy: A preliminary survey.Review of Economics and Developmet Studies. 2020; 6(2): 447-459.
31. Pakistan to Conduct Phase III Clinical Trial of COVID-19 Vaccine; Accessed On: June 12th, 2020;https://health.economictimes.indiatimes.com/news/industry/pakistan-to-conduct-phase-iii-clinical-trial-of-covid-19-vaccine/77631143.
32. Coronavirus: Pakistan Pins It's Hopes on a Chinese Vaccine; Accessed On: June 12th, 2020; Available from: https://www.dw.com/en/coronavirus-pakistan-pins-its-hopes-on-a-chinese-vaccine/a-55882237.
33. Anwar S et al. COVID-19 and Bangladesh: Challenges and how to address them. Frontiers in Public Health. 2020; 8.
34. Islam MT et al. Tackling the Pandemic COVID-19: The Bangladesh Perspective. Preprints. 2020.
35. Haque M et al. Availability and price changes of potential medicines and equipment for the prevention and treatment of COVID-19 among pharmacy and drug stores in Bangladesh; findings and implications.Bangladesh Journal of Medical Science. 2020: 36-S 50.
36. Mina FB et al. COVID-19: transmission, diagnosis, policy intervention, and potential broader perspective on the rapidly evolving situation in Bangladesh.J Adv Biotechnol Therm. 2020; 3: 18-29.
37. Augustine R et al. Rapid antibody-based COVID-19 mass surveillance: relevance, challenges, and prospects in a pandemic and Post-Pandemic world.Journal of Clinical Medicine. 2020; 9(10): 3372.
38. Mousavi SH et al. The first COVID-19 case in Afghanistan acquired from Iran. 2020; The Lancet. Infectious Diseases. 20(6): 657.
39. Shah J et al. COVID-19: the current situation in Afghanistan.The Lancet Global Health. 2020; 8(6): e771-e772.
40. Lucero-Prisno III DE et al. Addressing COVID-19 in Afghanistan: What are the efforts and challenges? Journal of Global Health. 2020; 10(2).
41. Ibrahim Shire M et al. More attacks or more services? Insurgent groups’ behaviour during the COVID-19 pandemic in Afghanistan, Syria, and Somalia.Behavioral Sciences of Terrorism and Political Aggression. 2020: 1-24.
42. First COVID-19 Shipment to Arrive In 7 Months: Afghanistan; Accessed On: June 12th, 2020; Available from: https://www.khaama.com/first-covid-19-shipment-to-arrive-in-7-months-afghanistan-8798799/.
43. Police Curfew for Puttlam; Accessed On: June 12th, 2020; Available from: https://www.newsfirst.lk/2020/03/18/police-curfew-for-puttlam/.
44. Police Curfew in Puttalam until Further Notice Video; Accessed On: June 12th, 2020; Available from: https://www.hirunews.lk/236743/police-curfew-in-puttalam-until-further-notice-video
45. Liyanapathirana A et al. COVID-19 outbreak in Sri Lanka: an epidemiological response. Nutrition. 2020; 1: 2.
46. Erandi H et al. Effectiveness of the strategies implemented in Sri Lanka for controlling the COVID-19 outbreak.Journal of Applied Mathematics. 2020.
47. Ranaweera P et al. Preventing the re-establishment of malaria in Sri Lanka amidst the COVID-19 pandemic.Malaria Journal. 2020; 19(1): 1-4.
48. Hettiarachchi D et al. Ethical Responses to the COVID-19 Pandemic—Lessons from Sri Lanka.Asian Bioethics Review. 2020: 1-9.
49. Coronavirus disease (‎COVID-19)‎;Accessed On: June 13th, 2020; Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.
50. Jayatilleke AU et al. COVID-19 case forecasting model for Sri Lanka based on Stringency Index.medRxiv. 2020.
51. Wijesekara N et al. COVID-19 Case Prediction and Outbreak Control of Navy Cluster in Sri Lanka: Effectiveness of SIR Model. 2020.
52. Bhaduri SDJ Comparing COVID-19 Pandemic Responses of Three South Asian Countries-Bhutan, Sri Lanka, and Bangladesh.The Indian Practitioner. 2020; 73(11): 7-14.
53. Sri Lanka in Talks with COVAX to Purchase COVID-19 Vaccines; Accessed On: June 13th, 2020;www.xinhuanet.com/english/2020-11/26/c_139545074.htm
54. The economic impact of the COVID-19 outbreak on developing Asia;Accessed On: June 13th, 2020;: https://www.adb.org/publications/economic-impact-covid19-developing-asia .
55. COVID-19 will severely damage Maldives tourism sector; Accessed On: June 13th, 2020; Available from: https://www.emerald.com/insight/content/doi/10.1108/OXAN-DB251769/full/html
56. Health System Response to COVID 19; Accessed On: June 13th, 2020; Available fromAvailable from: https://www.who.int/docs/default-source/maldives/hs-response-to-covid19-in-maldives-wco-june-2020.pdf?sfvrsn=eb72612a_2
57. Maldives: COVID-19 Coronavirus Emergency Response Health Systems Predparedness Project; Accessed On: June 13th, 2020; Available from: https://www.worldbank.org/en/news/loans-credits/2020/04/07/maldives-covid19-coronavirus-emergency-response-health-systems-preparedness-project
58. Maldives Builds World's First Coronavirus Quarantine Resort; Accessed On: June 13th, 2020;: https://www.scmp.com/video/asia/3074862/maldives-builds-worlds-first-coronavirus-quarantine-resort
59. Hussain M et al. Management of the first severe case of COVID-19 in the small islands of Maldives.Respiratory Medicine Case Report. 2020; 30: 101118.
60. COVAX Accepts Maldives' Proposal for Free COVID-19 Vaccines; Accessed On: June 13th, 2020; Available from: https://raajje.mv/91919
61. Shrestha R et al. Nepal’s First Case of COVID-19 and public health response.Journal of Travel Medicine. 2020; 27(3): taaa024.
62. Piryani RM et al. Nepal’s response to contain COVID-19 infection.J Nepal Health Res Counc. 2020; 18(1): 128-134.
63. Marahatta SB et al. COVID-19 Pandemic: What can Nepal do to Curb the Potential Public Health Disaster? Journal of Karnali Academy of Health Sciences. 2020; 3(1).
64. Budhathoki P et al. COVID-19 Status in Nepal and the Way Forward.Europasian Journal of Medical Sciences. 2020; 2(2).
65. Sah R et al. Impact of COVID-19 on tourism in Nepal. J Travel Med. 2020; 27(6).
66. Asim M et al. COVID-19 Pandemic: Public Health Implications in Nepal. Nepal J Epidemiol. 2020; 10(1): 817-820.
67. COVID-19 Pandemic in Nepal; Accessed On: June 13th, 2020; Available from: https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Nepal#Travel_restrictions_and_border_closures
68. Govt. Preparing for Anti-COVOD 19 Vaccine for 72 Percent; Accessed On: June 13th, 2020; https://thehimalayantimes.com/nepal/govt-preparing-for-anti-covid-19-vaccine-for-72-per-cent/
69. Tsheten T et al. COVID-19 Response and Lessons Learned on Dengue Control in Bhutan. J Med Entomol. 2020.
70. Tshokey T et al. Limited Secondary Transmission of the Novel Coronavirus (SARS-CoV-2) by Asymptomatic and Mild COVID-19 Patients in Bhutan. Am J Trop Med Hyg. 2020.
71. https://www.instagram.com/tv/B-D3w59BjPB/
72. Bhutan Government Closes All International Borders with India; Accessed On: June 14th, 2020; https://nenow.in/neighbour/bhutan/bhutan-government-closes-all-international-borders-with-india.html
73. COVID-19 Pandemic in Bhutan; Accessed On: June 14th, 2020; Available from: https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bhutan.
74. Children at Increased Online Risk during COVID-19 Pandemic; Accessed On: June 15th, 2020; Available from: https://www.unicef.org/bhutan/press-releases/children-increased-online-risk-during-covid-19-pandemic
75. SIM to Cover Students without Access to Telivision or Internet; Accessed On: June 15th, 2020; Available from: https://kuenselonline.com/sim-to-cover-students-without-access-to-television-or-internet/
76. Bhutan's Decisive Response To COVID-19; Accessed On: June 15th, 2020; Available from: https://www.eastasiaforum.org/2020/11/06/bhutans-decisive-response-to-covid-19/
77. National Situational Update on COVID-19; Accessed On: June 16th, 2020; Available from: http://www.moh.gov.bt/category/covid-19.
78. Bhutan Gov't Imposes Nationwide Lockdown Amid Rising COVID-19 Cases; Accessed On: December 31st, 2020; Available from: http://www.xinhuanet.com/english/2020-12/23/c_139612942.htm
79. India's Doctor-Patient RatioStill Behind WHO Prescribed 1:1000; Accessed On: June 17th, 2020; Available from: https://www.business-standard.com/article/pti-stories/doctor-patient-ratio-in-india-less-than-who-prescribed-norm-of-1-1000-govt-119111901421_1.html.
80. Pakistan Facing Acute Shortage of Doctros; Accessed On: June 17th, 2020; Available from: https://tribune.com.pk/story/1975950/1-pakistan-facing-acute-shortage-doctors/.
81. Bangladesh: Physicians per 1000 People; Accessed On: June 17th, 2020; Available from: https://tradingeconomics.com/bangladesh/physicians-per-1-000-people-wb-data.html.
82. Patient-Doctors-Nurses Ratio: Bangladesh Far behind It's Neighbours; Accessed On: June 17th, 2020; Available from: https://www.dhakatribune.com/health/2019/07/21/patient-doctors-nurses-ratio-bangladesh-lags-far-behind-its-neighbours?_.
83. COVID-19 Rips through Fragile Afghan Health System; Accessed On: June 17th, 2020; Available from: https://www.aa.com.tr/en/asia-pacific/covid-19-rips-through-fragile-afghan-health-system-/1812821.
84. COVID-19 in India: Statewise Estimates of Current Hospital Beds, ICU Beds and Ventilators; Accessed On: June 17th, 2020; Available from: https://cddep.org/publications/covid-19-in-india-state-wise-estimates-of-current-hospital-beds-icu-beds-and-ventilators/.
85. Pakistan's COVID-19 Crisis State Unreadiness; Accessed On: June 18th, 2020; Available from: https://tribune.com.pk/story/2185241/1-pakistans-covid-19-crisis-state-unreadiness/.
86. Number of ICU Beds Insufficient to Combat COVID-19 Pandemic; Accessed On: June 18th, 2020; Available from: https://www.dhakatribune.com/bangladesh/2020/03/21/number-of-icu-beds-insufficient-to-combat-covid-19-pandemic.
87. Afghanistan to Set Up 10000 New Hospital Beds for COVID-19 Patients; Accessed On: June 18th, 2020;https://www.laprensalatina.com/afghanistan-to-set-up-100000-new-hospital-beds-for-covid-19-patients/.
88. Sri Lankan Doctors Speak Out over Coronavirus Dangers Facing Health Workers; Accessed On: June 19th, 2020; Available from: https://www.wsws.org/en/articles/2020/03/28/slvi-m28.html
89. The Maldive Govt. Turns Abandoned Island into Coronavirus Quarantine Facility; Accessed On: June 19th, 2020; Available from: https://www.businessinsider.com/maldives-turns-abandoned-island-into-coronavirus-quarantine-facility-2020-3
90. COVID-19 Hospital in Monggar Ready to Handle Any Outbreak in the Eastern Region; Accessed On: June 19th, 2020; Available from: https://www.bbs.bt/news/?p=130813.
91. Pillai HS et al. Heart failure in South Asia. Curr Cardiol Rev. 2013; 9(2): 102-11.
92. Gujral UP et al. Type 2 diabetes in South Asians: similarities and differences with white Caucasian and other populations. Ann N Y Acad Sci. 2013; 1281(1): 51-63.
93. Neupane D et al. Prevalence of hypertension in member countries of South Asian Association for Regional Cooperation (SAARC): systematic review and meta-analysis. Medicine (Baltimore). 2014; 93(13): e74.
94. Hill MA et al. Commentary: COVID-19 in patients with diabetes. Metabolism. 2020; 107: 154217.
95. Bansal M Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020; 14(3): 247-250.
96. Shaw JE et al. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010; 87(1): 4-14.
97. Tandon N et al. The increasing burden of diabetes and variations among the states of India: the Global Burden of Disease Study 1990–2016. 2018; 6(12): e1352-e1362.
98. Towhid ST et al. COVID-19 and the Cardiovascular System: How the First Post-Modern Pandemic ‘Weakened’our Hearts. Discoveries Reports. 2020: 3: e15. DOI: 10.15190/drep.2020.9
99. South Asian Canadians Concerned about Underlying Health Risks that are COVID-19 Comorbities; Accessed On: June 20th, 2020; Available from: https://thepointer.com/article/2020-04-16/south-asian-canadians-concerned-about-underlying-health-risks-that-make-covid-19-more-dangerous.
100. Resource Review: South Asian Food and Nutrition Security Initiative- SAFANSI; Accessed On: June 21st, 2020; Available from: https://www.spring-nutrition.org/publications/resource-review/updates/south-asia-food-and-nutrition-security-initiative-safansi.
101. 2020 Global Food Policy Report: Emerging Challenges of Building Inclusive Food Systems in South Asia; Accessed On: June 21st, 2020; Available from: https://www.ifpri.org/blog/2020-global-food-policy-report-emerging-challenges-building-inclusive-food-systems-south-asia.
102. Ensuring Food Security and Nutrition in South Asia during COVID-19; Accessed On: June 21st, 2020; Available from: https://blogs.worldbank.org/endpovertyinsouthasia/ensuring-food-security-and-nutrition-south-asia-during-covid-19.
103. Education: From Dispution to Recovery; Accessed On: June 22nd, 2020; Available from: https://en.unesco.org/covid19/educationresponse.
104. ASEAN's Poor Mobile Internet Connectivity; Accessed On: June 23rd, 2020; Available from: https://theaseanpost.com/article/aseans-poor-mobile-internet-connectivity.
105. Lau H et al. The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China. 2020; 27(3): taaa037.
106. Europe Faces Longer Lockdown with Over half of million GlobalDeath; Accessed On: June 25th, 2020; Available from: https://www.bloomberg.com/news/articles/2020-04-02/spain-s-deadly-day-signals-no-letup-in-europe-s-virus-lockdown.
107. Spain Imposes Italy Syle Lockdown in Bid to Contain Coronavirus; Accessed On: June 25th, 2020;https://www.aljazeera.com/news/2020/03/spain-imposes-italy-style-lockdown-bid-coronavirus-200314233749980.html.
108. Zhang L et al. Can self-imposed prevention measures mitigate the COVID-19 epidemic? PLoS Medicine. 2020; 17(7): e1003240.
109. Sharma GD et al. A qualitative enquiry into strategic and operational responses to Covid‐19 challenges in South Asia.Journal of Public Affairs. 2020; 20(4): e2195.
110. Webster RK et al. How to improve adherence with quarantine: Rapid review of the evidence.Public Health. 2020; 182: 163-9.
111. Wilder-Smith A et al. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak.Journal of Travel Medicine. 2020; 27(2).
112. Cao W et al. The psychological impact of the COVID-19 epidemic on college students in China.Psychiatry Research. 2020: 112934.
113. Xiao H et al. Social capital and sleep quality in individuals who self-isolated for 14 days during the coronavirus disease 2019 (COVID-19) outbreak in January 2020 in China.Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. 2020; 26: e923921-1.
114. COVID-19 (Coronavirus) Response; Accessed On: June 26, 2020; Available from: https:// www.worldbank.org/en/region/sar/coronavirus.