Lockdown Is Over. Let's Learn How To Live With The Coronavirus

Lockdown Is Over. Let's Learn How To Live With The Coronavirus
As Pakistan struggles with the hard choices of protecting livelihoods or saving lives, the debate to relax or reinforce the lockdown has intensified. There are no clear cut answers, but there are competing views of government officials, medical professionals, the politicians and the media. There is no consensus but the government has already expressed its intent: lockdowns are not the way forward.

As expected, with the relaxation of the lockdown on April 21, the number of viral infections have continued to rise with over 28,000 infections reported in Pakistan. This number is twice of what was documented ten days earlier. Indeed these numbers are staggering, particularly when considering only about 10,000 tests are conducted daily throughout Pakistan, of which 20% were reported to be positive in a single day recently! To everyone’s surprise, despite the steep rise of infections, mortality remains low at under 2%, and the Pakistani health care system has not shown any signs of being overwhelmed as yet.

What might be the reasons for a low mortality rate among Pakistanis? In contrast, other parts of the world like New York, United Kingdom and Lombardi have reported case fatality rates of 6 %, 16% and 14 % respectively. Is it the younger population? Is it the rising temperature throughout the country? Or Pakistanis have not yet caught up with the mortality, which typically lags several weeks after the onset of new infections. Unfortunately, the last explanation seems most plausible. With 600 Pakistanis dead to date, sadly, the numbers will multiply significantly in the next few weeks. This trend has been witnessed in other epicenters of the pandemic like Wuhan, New York and Lombardi. We just cannot close our eyes to this reality.

So why the current administrators of Pakistan are actually leaning on further relaxing the lockdown in the coming days? One has to look at the Covid-19 scenario in the big picture of Pakistan – a poor country on the verge of bankruptcy. Millions of Pakistanis are daily wagers, thousands working overseas have been laid off, unable to send home remittances which keep the stoves burning in their households in Pakistan. Business activity is stalled, leaving firms no choice except to furlough employees. The government is in no position to provide the type of bailout package sanctioned by a rich democracy like US or a single party, communist country such as China. In view of these hard facts, Pakistanis will have to live with the coronavirus for many more months to come.

How many months is it going to be? Well, the virus is not just going to vanish anytime soon. Even if by a long shot, an effective and safe vaccine becomes available in September, 2020, it may not reach the people for many more months. Most experts are betting that Covid-19 will not go away before 18-24 months, by which time either 70% of the world population will become immune to it, rendering the so-called herd immunity, or a vaccine will become available. So what are the options available for Pakistanis until such time?

The essential services have to open and the government will have to outline those services precisely. On the other hand, there is no way mass transit systems in the air or railroad tracks or roads should open. Schools have to remain closed, as children while not typically prone to sickness are likely to bring infection home. The Pakistani government will have to ensure, using the security apparatus of armed forces and police, that people do not gather in crowds at markets or streets for whatever reason. Public health officials will have to be on their toes to constantly educate the public about the most effective means of prevention: simple hand washing, social distancing and using appropriate protective equipment while caring for patients in any health care facility in Pakistan.

There is good news, too. An effective medicine Remdesevir has been approved recently by the Federal Drug Authority (FDA) in that US, which likely works against the Coronavirus. On Saturday, FDA approved, an antigen based simplified test that can give the result within few minutes rather than the more expensive and cumbersome virus based PCR test which takes a few days to be reported. A scientific study tells us that almost everyone who gets exposed to the coronavirus develops an antibody to it and confers some immunity to the exposed person for some period of time.

While the scientific knowledge will support us in the coming days, it is the responsibility of the Pakistani government to ensure their citizens are least affected by this pandemic. Any failure will be on the shoulders of the government who wouldn’t be able to shift the blame.

With a clear and enforceable strategy, the government can still reduce the number of dead, while keeping the food on the table of every Pakistani citizen.

Dr. Abdul Nadir M.D. is an Assistant Professor at University of Arizona, U.S. He is the head of Gastroenterology and Hepatology at Maroof International Hospital, Islamabad.