Coronavirus in South Asia: Which countries have rising numbers?
A restaurant in Karachi has been closed for violating coronavirus regulations
India has the second highest number of coronavirus cases in the world with over seven million cases and could soon overtake the US with the most infections.
But while India is showing signs of the pandemic slowing, could some of its neighbors see a second surge in some cases?
In some countries, the daily cases are increasing
India's population of 1.3 billion dwarfs is that of its neighbors, so it is not surprising that the total infection numbers are much higher.
It continues to have the highest daily case numbers in the world, although the rate of growth in cases appears to have slowed.
Is the pandemic slowing in India?
In some other countries in South Asia, however, there seems to be a renewed increase in infections.
Pakistan is seeing an increase in daily cases in its Punjab province, but overall cases are still below the 1,000 per day mark.
Authorities, including Prime Minister Imran Khan, have advised people to continue wearing masks and maintain social distance as they fear a second peak in winter.
Chart comparing infections in South Asia
After being closed for over five months, the country even reopened its schools in September.
In Nepal, reported infection rates are rising again after an earlier high in June. On October 7, it saw its highest one-day surge with over 4,000 cases - more than half of that in Kathmandu.
In Bangladesh, daily cases peaked in mid-June before declining in the last week of July and early August. Daily cases range between 1,000 and 1,500.
Sri Lanka has placed severe restrictions on the movement across the island
Afghanistan has also reported new cases, which have dropped to very low levels, despite questions about the reliability of its official numbers.
Sri Lanka is seeing spikes in some cases after a cluster was found at a clothing factory this month. There have been some spikes since April, but overall the numbers have been relatively low.
A curfew has been introduced in some areas and educational institutions have been closed until further notice.
How Much is Tested in South Asia?
Tests are key to finding out how the virus is spreading.
The Indian government pledged to significantly speed up the tests and conduct a million tests in a single day on August 21.
While this may seem like a large number, it doesn't compare to the population, says virologist Dr. Shahid Jameel.
Bar chart comparing different test countries - updated for October
"The total number of cases per million in India and the rest of South Asia is low, but so is the number of tests per million," he says.
India has carried out nearly 80 million tests to date. Pakistan has implemented nearly four million.
Bangladesh was testing more than 18,000 tests a day in June when there was an increase in some cases. Since then, the daily tests ranged from ten to fifteen thousand.
Testing numbers in Bangladesh fell after the government introduced a high testing fee in July. There was also a scandal over the sale of fake negative test certificates.
Afghanistan tested 112,278 samples as of October 5, and the Ministry of Health says the rate of positive cases in the country is 6%.
However, the Red Crescent warned earlier this year that the actual number of cases could be much higher than officially announced.
Pakistan has been stepping up its testing since September and its positivity rate remains around 2%.
However, the level of testing in these countries is generally much lower than in other countries.
The World Health Organization (WHO) has set a benchmark for adequate testing between 10 and 30 per confirmed case in a country or region.
Comparative table of the number of tests per positive case - updated October 7th
The South Asian countries have stepped up their testing and Nepal, India and Pakistan now only fall within what is considered appropriate by the WHO.
Russia and Japan, whose populations resemble Bangladesh, test far more frequently and find a positive case for all 39 and 38 tests, respectively. However, Bangladesh identifies one positive case for every eight tests performed - well below the WHO benchmark.
What about the death rate in South Asia?
The total death toll in India is currently the third highest in the world, although the proportion of people who die from illness remains low compared to the global average.
Deaths recorded elsewhere in South Asia are lower than in many other parts of the world in both absolute and per capita terms.
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This seems to be an encouraging sign, but questions remain about the reliability of data in a region with relatively low public health spending.
"Many deaths go unreported in the vital registration system and the causes of death are misclassified," says Professor Kamran Siddiqi, a public health expert at the University of York.
How many Covid-19 deaths are missing in India?
But Dr. Shahid Jameel says that even when deaths are not adequately reported, the difference with other parts of the world is "pretty big".
"The most plausible explanation is that the population in South Asia consists of much younger people than in Europe and the USA," says Prof. Siddiqi.
Additional research by Saroj Pathirana in Colombo, Waliur Rahman Miraj in Dhaka and Rama Parajuli in Kathmandu
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GLOBAL SPREAD: Tracking the coronavirus pandemic
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TRACKER: Coronavirus cases in Africa
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