The numbers related to Covid-19 infections and deaths in Bangladesh, India and Pakistan disguise both widespread undercounting and a rate of growth that was frightening even before the recent lifting of restrictions, the Economist reported.
At the current pace, it said, the numbers are doubling every two weeks, suggesting that by the end of July, when some models predict the outbreak will peak, the official number infected may reach 5m and the death toll could approach 150,000.
If one goes by official counts, the region's toll looks relatively modest -- some 350,000 confirmed cases and fewer than 9,000 deaths so far.
Low levels of testing mean that the real numbers could be far worse. One foreign health official in Pakistan reckons the death toll is between two and three times the government's count, wrote the London-based weekly newspaper.
John Clemens of ICDDR,B (formerly the International Centre for Diarrhoeal Disease Research, Bangladesh), estimates that Dhaka, Bangladesh's capital, may already have as many as 750,000 cases, even though the official national tally is less than 60,000.
Over the past week the three countries have largely lifted nationwide lockdowns intended to curb the spread of covid-19. The freeing of 1.7bn people—more than a fifth of humanity—from varied restrictions will bring relief to the region's battered economies. Alas, it promises no relief from the pandemic itself. In luckier countries, stay-at-home rules reduced the number of new infections. In South Asia they managed only to moderate the disease's acceleration, but not to halt it. The lifting of the lockdowns, in turn, is likely to hasten its spread again.
Doctors in Pakistan say the government's claim that there are adequate hospital beds is nonsense. "The situation is very, very unsatisfactory," says Qaisar Sajjad of the Pakistan Medical Association.
In normal times, the region's rich can largely insulate themselves from the implications of decades of puny public spending on health. "If they so much as sneeze they flee to Thailand, Singapore or India," says a doctor at a private hospital in Dhaka. Now, she says, it is "almost impossible" to gain admission to Bangladesh's elite hospitals, whether for covid-19 or other illnesses.
Finding places in morgues, cemeteries and crematoria is also becoming a challenge. At the municipal graveyard of Narayanganj, an area with lots of garment factories on the outskirts of Dhaka, a typical month sees fewer than 250 burials. Last month it jumped to 575, only 70 of which were officially recorded as victims of covid-19.
Inevitably, the failure of all three countries to control the pandemic has led to soul-searching and blame-casting. Imran Khan, Pakistan's prime minister, has loudly pointed out that he was never a fan of the lockdown, which he had warned would hit the poor unduly hard, and could only slow the disease. His detractors respond that a big reason for failure was precisely the half-hearted and inept way Pakistan's lockdown was enforced. In Bangladesh, inconsistent rulemaking, a collapse in average income in slum areas of an estimated 75% and the mass return to villages of hundreds of thousands of garment-workers undermined any gains from the lockdown.
Perhaps the most egregious errors were made by India's government. Despite imposing the most stringent and heavily policed restrictions in the region, the government failed to foresee that its measures might prompt a mass exodus from cities of tens of millions of migrant workers made suddenly destitute. The authorities first tried to block the movement, bottling migrants in urban slums with the highest infection rates, and then allowed perhaps 20m workers to leave, spreading the disease across the country.
Whatever the cause, the damage is now done. Farid Uddin, a gravedigger in the Bangladeshi port city of Chattogram (formerly Chittagong), comes close to tears as he explains that he and his team have scarcely slept in four days. "There are so many deaths," he gulps. "We are overwhelmed. Please pray for us so Allah forgives us and takes back this disease."