2020 coronavirus pandemic in South Asia

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2020 coronavirus pandemic in South Asia
South Asia (excluding internal borders) (orthographic projection).svg
South Asia
DiseaseCOVID-19
Virus strainSARS-CoV-2[1]
LocationSouth Asia
First outbreakWuhan, Hubei, China[2]
Index caseKathmandu, Nepal
Arrival date5 January 2020
Confirmed cases6119 (including foreign nationals, as of April 4th)
Deaths
135
Territories
Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka
Official website
SAARC Disaster Management Centre

Countries and territories in South Asia have been affected by the 2019–20 coronavirus pandemic.

The first country to report a confirmed case was Nepal which documented its first case on 24 January, in a man who had returned from China on 5 January. As of 29 March, at least one case of COVID-19 has been reported in every country in South Asia. Afghanistan has reported 120 cases with four deaths, Bangladesh has confirmed 48 cases with five deaths, Bhutan has reported four confirmed cases, India has confirmed 1024 cases and 27 deaths, Maldives has reported 16 cases, Nepal has confirmed five cases, Pakistan has reported at least 1526 confirmed cases with 13 deaths and Sri Lanka has confirmed 115 cases with one death. Afghanistan, Bangladesh, Pakistan and Maldives have implemented partial 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.

Governments are attempting to coordinate a response to the pandemic through the regional organisation, 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 25 March, Sri Lanka had contributed US$5 Million to the SAARC COVID-19 Emergency Fund while Bangladesh, Maldives and Nepal had given more than $1 Million each.

Background[edit]

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]

Epidemiology[edit]

Afghanistan[edit]

Map of provinces with confirmed cases of COVID-19 in Afghanistan (as of 29 March 2020)
  Confirmed cases reported
  Suspected cases reported

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[edit]

The 2019–20 coronavirus 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[edit]

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[edit]

Map of the pandemic in India (as of 28 March)
  100+ confirmed cases
  50–99 confirmed cases
  10–49 confirmed cases
  1–9 confirmed cases

The first case of the 2019–20 coronavirus pandemic in India was reported on 30 January 2020, originating from China. As of 6 April 2020, the Ministry of Health and Family Welfare have confirmed a total of 1024 cases, 96 recoveries, 1 migration and 27 deaths in the country. Experts suggest the number of infections could be a substantial underestimate, as India's testing rates are among the lowest in the world.[40] The infection rate of COVID-19 in India is reported to be 1.7, significantly lower than in the worst affected countries.[41]

The outbreak has been declared an epidemic in more than a dozen states and union territories, where provisions of the Epidemic Diseases Act, 1897 have been invoked, and educational institutions and many commercial establishments have been shut down. India has suspended all tourist visas, as a majority of the confirmed cases were linked to other countries.[42]

On 22 March 2020, India observed a 14-hour voluntary public curfew at the insistence of the prime minister Narendra Modi. The government followed it up with lockdowns in 75 districts where COVID cases had occurred as well as all major cities.[43][44] Further, on 24 March, the prime minister ordered a nationwide lockdown for 21 days, affecting the entire 1.3 billion population of India.[45] As of 1 April 2020 there have been 1,590 cases with 148 recovered and 45 died.

Maldives[edit]

The 2019–20 coronavirus 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.[46] 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.[47] As of 11 March, the islands resorts of Kuredu, Vilamendhoo, Batalaa and Kuramathi island have also been placed under temporary quarantine.[48]

The Maldives declared a public health emergency over COVID-19 on 12 March.[49] 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.[50]

Nepal[edit]

Map of the outbreak in Nepal (as of 29 March)
  Confirmed cases reported

A Nepali student who had returned from Wuhan[51] became the first case of the country and South Asia on 24 January, after a sample sent to WHO Collaborating Centre Hong Kong.[52][53] He was discharged after his condition improved[54][55] and was told to quarantine himself at home. Another case was confirmed on March 23, 2020. A 19-year-old female who returned from France via Qatar was diagnosed positive of Corona Virus in Kathmandu, Nepal.[56] As of 29 March, three additional cases had been confirmed bringing the total to five, all in people who had recently returned from abroad.[57][58]

Land borders with India as well as China have been sealed off, and all international flights suspended.[59] All academic examinations were cancelled,[60][61] and schools and colleges were closed.[62] A country-wide lockdown came into effect on 24 March, and is scheduled to end on 8 April.[63]

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.[64]

Pakistan[edit]

Spread of the Coronavirus in Pakistan by 26 March 2020
  Confirmed cases reported
  Suspected cases reported

By the end of January, the Government of Pakistan began screening of passengers at airports in Islamabad, Karachi, Lahore and Peshawar to prevent entry of coronavirus in the country.[65][66] Pakistan closed its borders with Iran on 23 February.[67]

The first case in the country was confirmed on 26 February. On 1 March, two more cases of COVID-19 were confirmed in Karachi and Islamabad, bringing the country's total to four.[68]

As of 19 march, 380 confirmed cases and 2 deaths had been reported.[69] On 20 March, the number of confirmed coronavirus cases in Pakistan jumped to 454 after Balochistan, Punjab, Sindh, Gilgit-Baltistan and Khyber-Pakhtunkhwa announced an increase in their provincial tallies.[70] As of 29 March 2020, the number of confirmed cases in the country was 1,526, with 28 recoveries and 13 deaths. Punjab region had the highest number of cases at over 500.[71] Several regions have been put under lockdown.[72]

Sri Lanka[edit]

As of 1 April 2020, 160 confirmed cases have been reported in the country with 5 death. The country is under "curfew" and a ban on foreign arrivals has been instituted at least until 30 April.[73]

As of 25 th March 2020 Sri Lankan authorities have tracked down over 21000 people who had contacted the identified patients and had ordered self quarantine for such people.

As the spread of covid19 government has banded all public events and all schools will be closed until May as a measure of preventing the spread of virus through out the country.

Health officials work hard to protect the patients from this desese.


Regional response[edit]

15 March conference call[edit]

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.[74] 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.[75] Modi also proposed creating a common research platform to coordinate research within the South Asia region,[76] while Afghan President Ashraf Ghani proposed creating a common framework for telemedicine.[75]

SAARC COVID-19 Emergency Fund[edit]

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.[77] 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.[78]

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.[79] As of 23 March 2020, the Emergency fund had accumulated sum of US$18.8 million with the pool of contributions from seven member countries except Pakistan.[80] Pakistan was sought to have gone for the consent with China over the SAARC fund.[81]

Bangladesh announced it would contribute US$1.5 million, Nepal and Afghanistan each announced that they would voluntarily contribute US$1 million.[82] 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.[83] Maldives announced it would contribute US$200, 000 while Bhutan announced it would contribute US$100, 000.[84][85]

Medical response coordination[edit]

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.[76]

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.[86]

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