COVID 19: South Asia in Global Context

Ian Inkster, SOAS, University of London.

There is a very high probability that South Asia is about to enter the more severe phase of the COVID 19 attack. This will involve an acceleration in the number of people infected by the virus, but also a greater proportion of those people will die as sufficient time passes for the more vulnerable older people and those with some immune deficiency, to suffer full effects.

But what we can indicate is that a global perspective suggests that it is by no means too late to avert some of the worst impacts, to reduce mortality rates by developing management and social policies that focus on the ground level and are not duplications of the Western, expensive model of total ‘lockdown’.

Using the global statistics for 3 May we calculate that Covid cases in the 6 major affected nations (India, Pakistan, Bangladesh, Afghanistan, Sri Lanka, and Maldives) total 72, 466, 21% of the world total within a population of around 1.7 billion, 23% of the world. Most importantly, though the mortality rate (the ratio of deaths to confirmed infected) globally is now 7%, that for these 6 nations is only 2.8%. The likelihood is that this low mortality rate is primarily a function of South Asia being generally a region of later virus invasion.

This suggests strongly that there is room to move, time to focus down on strategies to both reduce infection but – very importantly – to keep down the mortality rate, something that the West has been failing to do for some weeks, but which East Asia has managed well despite those nations having been hit earlier and harder, and coping with the virus within greater proximity to China.

However much we may doubt the exactness of any official statistics, this in fairness should be said of all nations and institutions, it does not reside only in non-democracies, nor is it only an outcome of devious political machinations, for it comes also from sheer incompetence. Because the figures for infection and death are accumulative from January to the present, they are constantly adjusted and debated and examined, and are more reliable than data covering a matter of days or involving technical complexities that reduce further their accuracy or their comparative value.

Looking at things comparatively, focusing on the mortality rate seems to be good common sense and is most likely to capture the efficiency of Covid management in any nation.

Presently the mortality rate for the Western core of the virus (USA, Spain, Italy, France, Germany and UK) averages at 8%, with the British figure highest at 15.4%, the German lowest at 4.1%. So, notice that low mortality within the West is associated with less emphasis on lockdown of population, schools and economy, more attention to identification of infected and their contact networks, basic supplies to hospitals, social distancing, and general civil acquiescence. This is hugely confirmed with the East Asian comparison, where the 6 nations there average a mortality rate of 4.3%, with China as understandably the highest at 5.6%.

Unless only Eastern folk lie, then the contrast between the two great groups of the Western core and the East Asian nations is of true importance at this juncture. Between them these 12 nations are hosts to 46% of global virus cases. This is a reasonable basis for generalization. As far as it is possible to tell, East Asia has been most successful at managing the COVID 19 virus and keeping down the mortality rate. And this result has come out of policies that were focused on the ground level and on mass civil acquiescence.

To argue from this that liberal democracy allows greater choice and freedom than does more authoritarian regimes, so has more difficulty in implementing strict isolation and targeting of specific infected groups is pure nonsense and not supported by the data. Germany is a democracy within Europe with a low mortality rate though bordered and much inter-connected with the high mortality nations of France (14.4%), Belgium (15.7%), and the Netherlands (12.4%). Second, Japan, Taiwan, Singapore, and South Korea are in different degrees, but nevertheless, clearly democracies. Third, lockdown imposes more on citizens than does social distancing, supplying hospitals and early interventions generally. It causes exacerbation of the more disguised civil rights problems such as domestic abuse, and it compounds the existing social class distinctions and inequalities. It is not especially a liberal democratic response to virus invasion. And it is very expensive.

More importantly for South Asia, the East Asian model is simpler and less expensive and depends more on community responsiveness and institutional flexibility. Bureaucracy is a friend to the virus, civility is its enemy.

In addition, certain features of South Asia – often seen as disadvantages to modernity by those living in the West or East Asia – might be converted into advantages by management regimes that rely more on flexibility, isolating and treating more elderly and vulnerable members of the population, and community response.

In the western and East Asian groups, the proportion of the population over 65-years is around 17.5-20.7%, but in South Asia it ranges from 2.4% (Afghanistan) to 12.4% (Sri Lanka). This is a major demographic advantage, increasing the probability of lower mortality rates.

Per capita carbon dioxide emissions in metric tons in the West are very high, ranging from 16.1 in the US, 9.1 in Germany, to a low of 5.0 in France; in East Asia they range from 13.6 in South Korea and 6.1 in Hong Kong. In South Asia emissions are highest in India at 1.9, followed by Pakistan at 1.0, Bangladesh at 0.6, and Afghanistan at 0.3: the highest are the smallest, Maldives at 2.0 and Sri Lanka at 1.1. Given the growing claim that air pollution is especially linked to mortality rates, this significant contrast is of real importance to South Asia’s prospects.

Thirdly, the urban populations of both the Western core group and East Asia are a very much higher proportion of the total population than is the case in South Asia. The lowest in the first group is Italy with 70%, the highest the UK with 83%. In East Asia, the urban population ranges from 56.7% for China, 81.6% for S. Korea, but 100% for both Hong Kong and Singapore. In South Asia by distinct contrast the highest urban population is 36.2% for Pakistan and 35.1% for Bangladesh. The lowest urbanism is in Sri Lanka at 18.4% and Afghanistan at 25.4%.

These three features of the South Asian landscape should in themselves reduce pressure on both contagion and the mortality rates and stimulate more bottom-up approaches to management regimes.

But finally, the lower level of connectivity should assist South Asia in keeping down original contagions and contacts, and this can be measured through the extent of commerce, borders, and the influx of tourists from other countries. This requires some evidence.

The proportion of income from all foreign trade to total output in the world is presently around 59%, for East Asia it is 58%, for the European union 87%, but for South Asia it is 42%, but especially low in the large nations of Pakistan 29% and Bangladesh 38%. This smaller trading figure spells a lower number of commercial contacts and travelers, and a lesser number of contagion points. This may be a little offset by the quite large proportion of this smaller trade being with China, the first epicentre of the pandemic – India, Pakistan, and Bangladesh each have China as their major source of imports.

Are contentious and disputed borders a good thing when it comes to inhibition of original points of contagion? Certainly, lengthy and multiple borders did not help northern Italy, whilst Belgium with a very high mortality rate has some 39 unique land borders which includes the high mortality nations France and Netherlands, and Europe is replete with a multiplicity of borders. It is by no means a sufficient factor, thus Germany. But if border areas are densely populated and proximate or open to centres of population then contagion is more likely. The four largest of the South Asian nations have a tremendous length of border, totalling some 31,000 kilometres, India sharing its borders with 11 other states. But this is a difficult feature to estimate for our purposes. The borders are often areas of friction, they are often very far from centres of population with low population densities along them, they coincide with difficult terrain. They do not equate with the close proximities of Europe in particular.

The lower level of tourism also measures a lower connectivity. The western core group has outstanding levels of tourism, with incomers per annum outnumbering the total home populations – in France tourists represent 137% of the population, Italy 105%, Spain 178%, the UK 54%; in East Asia the numbers can be startling, 390% in Hong Kong, 263% in Singapore. In South Asia only in the Maldives is tourism of major concern – 371%, but on a population base of only 400,000 people, far isolated from the mainland. In contrast, India’s ratio of annual tourist to total population is around 1.3%, that of Pakistan 0.49%.

The several advantages of South Asia combined with its relatively low level of connectivity to leading areas of infection or contagion, means that it is better placed than might otherwise be expected.

But this difference can only be optimised if the management regimes choices are wise. The Western approach has been expensive and of only dubious efficacy, generally ineffective in dampening down the mortality rate of the virus. East Asia is the superior mode. But South Asia has a unique combination of characteristics in terms of demography, environment, and geography, as well as lower connectivity with the other parts of the world. So, it can forge its own version of virus management, but in doing so should remain properly sceptical of all that which is expensive and which removes officialdom from the level of local communications and civil responsiveness. If such management could be forged at a South Asian regional level then all the better, and perhaps frontiers can be considered as possible assets rather than potential liabilities.

Ian Inkster is Professorial Research Associate, Centre of Taiwan Studies, SOAS, London; a Senior Non-Residential Fellow at the Taiwan Studies Programme and China Policy Institute at the University of Nottingham; and editor of History of Technology (London) since 2001.

(views are personal)