Low-income countries are more immune to COVID-19: A misconception

OBJECTIVE: The COVID-19 pandemic has hit countries such as Italy, Spain, France, UK, and the USA with great force, whereas the number of cases in countries such as India and most parts of Africa is comparatively lower. Such observation has made many people believe that the low-income countries may be more immune to COVID-19. Theories such as warm climate, weaker strain of the virus, and cross-protection by malaria have been popularly put forward. One such interesting theory is that since the general people of the low- income countries are mostly habituated to dwell in lesser hygienic condition and with lesser medical attention throughout their lifetime; hence, they have naturally acquired better immunity and more resilience against many infective diseases. MATERIALS AND METHODS: We sought to investigate the above claim by comparing the case fatality rate (CFR) as well as number of cases per million population versus the gross domestic product at purchasing power parity per capita of different countries. RESULTS: We found that while the number of cases showed a slight decline in the lower-income countries, the CFR was independent of the financial condition of the country. CONCLUSION: We conclude that the theory of better immunity in economically poor countries is a misconception. We suggest that people must come out of these misconceptions and resort to strict home isolation.