Scientific world is bewildered by the fact that how come third world countries with deplorable healthcare facilities and huge populations have witnessed lower COVID-19 mortality rates compared with many developed countries?

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A recent study conducted earlier this month gives us stats which further solidify these observations. It tells us that as of this month, the world's richest countries accounted for more than 90% of all reported deaths from COVID-19. Ninety percent! 

What it means is that most nations of South Asia and Africa along with some nations belonging to Middle Eastern part of the planet have had much lesser fatality rates compared with the West.

According to this study, in Europe, the observed case fatality ratio (CFR, or the percentage of deaths among confirmed COVID patients) has been alarmingly high, with France reporting a rate of 15.2 %, the UK 14.4 %, Italy around 14% and Spain 11.9 % and in USA , the CFR is 6%.

On the other hand, the Case Fatality Rate in South Asian countries is in stark contrast to that of Western countries. For example the highest CFR in the region is India's. It's 3.3%. While the numbers in other countries are even lower , Pakistan has CFR of 2.2%, Bangladesh 1.5% and Sri Lanka 1%.

So what exactly is the reason behind this clear-cut disparity between the mortality rates? Experts are still unable to pinpoint the exact reason behind it with certainty but there are some theories and some believe that any one of these theories could be the reason.

 Younger Populations 

South Asian countries have significantly lower life expectancy than Europe and America ,thus have much lower median age meaning overwhelming majority of countries of this region comprise of youth. Some experts believe that this might be the biggest reason why death rate is lesser in Asian countries as the majority of COVID-19 deaths in the west have been of older people especially those living in nursing homes.

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 Environmental Factors

Some gurus believe that differences in climate might have something to do with CFR. The effect of heat and humidity on the virus or other environmental factors might have changed immune responses.

 Underreporting

One possible explanation is underreporting in developing countries, as the concern is that who knows how many people die even before getting to a  healthcare facility. Thus such numbers don't end up adding in COVID death tally.

But doctors believe that health system is so sensitised right now to COVID that in the current scenario, the possibility of bulk of underreported deaths is very unlikely.

Varying Immune Responses

Some epidemiologists are of the opinion that robust levels of immunity of South Asian people caused by a lack of sanitation and persistent malaria and dengue, or even some kind of residual immune-boosting effect from BCG TB vaccine may have something to do with low Case Fatality Rate of the region.

 Early Lockdown 

Some public health experts believe that one likely reason may be that Asian nations opted to implement countrywide lockdown much earlier than Europe and America and it might have saved them from catastrophe, atleast until now.

It must be said that these all are theories at the moment and nothing can be said with certainty about the contrasting fates of developed and developing worlds. Only time will tell, as there will be multiple researches on the matter in coming years. Atleast that is certain.