NEW DELHI —Indian scientists recently conducted a research to provide an explanation to the anomaly of despite having a big number of coronavirus infections the number of deaths in India is relatively small. India has one-sixth of the total coronavirus caseload globally, but correspondingly the death toll is less than two percent, which is one of the lowest in the world.

The study suggested poor hygiene, lack of clean drinking water, and unsanitary conditions might have kept Indians from contracting severe COVID-19 infections. This means, people living in low and lower middle-income nations may be more immune to COVID-19 and other infections because of their sustained exposure to multiple pathogens since birth, according to Moneycontrol News.

One paper that remains to be peer reviewed looked at data available in the public domain of 106 countries and compared them based on 24 parameters including population density, demography, and quality of sanitation. The researchers involved with the study found that COVID-19 deaths were higher in high-income countries.

Millions of Indians have limited access to clean water, consume unhygienic food, breathe foul air and live in densely packed surroundings.

Researchers have found this makes them susceptible to a host of non-communicable illnesses like heart and chronic respiratory diseases, cancer and diabetes. These contribute significantly to the disease burden, according to a government report. Air pollution alone kills more than a million Indians every year, according to a report in BBC.

The World Health Organization says safe water, sanitation and hygienic conditions are essential for protection of health against COVID-19.

A joint study by the WHO and the United Nations' children's agency, UNICEF, found that nearly three billion people — some 40% of the global population and living almost entirely in developing nations — lack "basic hand washing facilities".

This was enough to spark concerns that the coronavirus would tear through their populations, and lead to millions of deaths in countries such as India.

"Typically access to healthcare facilities, hygiene and sanitation is poorer in these countries and is often believed to be the contributing factor of higher incidence of communicable diseases there.

“It was not unexpected that COVID-19 would have catastrophic consequences in the low and low-middle income countries," said Dr. Shekhar Mande, director general of the Council of Scientific and Industrial Research (CSIR).

India has a sixth of the world's population and a sixth of the reported cases. However, it accounts for only 10% of the world's deaths from the virus, and its case fatality rate or CFR, which measures deaths among COVID-19 patients, is less than 2%, which is among the lowest in the world.

One paper compared publicly available data for 106 countries on two dozen parameters like density of population, demography, prevalence of diseases, and quality of sanitation. The scientists found more people had died of COVID-19 in high income countries.

"People in poorer, low income countries seem to have a higher immunological response to the disease compared to high income peers," Dr. Mande, one of the authors of the study, said.

The other paper looked at the role played by microbiome — the trillions of microbes that reside inside a human body — in COVID-19 infections. Microbiome includes bacteria, viruses, fungi and single-celled archaea.

They help in digestion, protect against disease-causing bacteria, regulate the immune system and produce vitamins.

Scientists believe it all boils down to the "hygiene hypothesis".

Its philosophy is that our environment has become so clean that it has left our immune system insufficiently trained, according to Matt Richtell, author of An Elegant Defense: The Extraordinary New Science of the Immune System.

"The broad idea is that we are starving our immune systems of training and activity by excessive focus on cleanliness," he said. — Agencies