The COVID-19 Riddle: Why Does the Virus Wallop Some Places and Spare Others?

The coronavirus has killed so many people in Iran that the country has resorted to mass burials, but in neighboring Iraq, the body count is fewer than 100.

The question of why the virus has overwhelmed some places and left others relatively untouched is a puzzle that has spawned numerous theories and speculations but no definitive answers. That knowledge could have profound implications for how countries respond to the virus, for determining who is at risk and for knowing when it’s safe to go out again.

Draconian social distancing and early lockdown measures have clearly been effective, but Myanmar and Cambodia did neither and have reported few cases. Doctors who study infectious diseases around the world say they do not have enough data yet to get a full epidemiological picture, and that gaps in information in many countries make it dangerous to draw conclusions. Testing is woeful in many places, leading to vast underestimates of the virus’s progress, and deaths are almost certainly undercounted.

Young people are more likely to contract mild or asymptomatic cases that are less transmissible to others, said Robert Bollinger, a professor of infectious diseases at the Johns Hopkins School of Medicine. And they are less likely to have certain health problems that can make COVID-19, the disease caused by the coronavirus, particularly deadly, according to the World Health Organization.

In Singapore and Saudi Arabia, for instance, most of the infections are among foreign migrant workers, many of them living in cramped dormitories. However, many of those workers are young and fit and have not required hospitalization. And Jha of Harvard warns that some young people who are not showing symptoms are also highly contagious for reasons that are not well understood.Cultural factors, like the social distancing that is built into certain societies, may give some countries more protection, epidemiologists said.

What might be called “national distancing” has also proven advantageous. Countries that are relatively isolated have reaped health benefits from their seclusion. “The best guess is that summer conditions will help but are unlikely by themselves to lead to significant slowing of growth or to a decline in cases,” said Marc Lipsitch, director of the Center for Communicable Disease Dynamics at Harvard University.

Climate, population density, demographics

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