Corona Virus Pandemic: Can Pakistan Avoid A Major Outbreak?

Corona Virus Pandemic: Can Pakistan Avoid A Major Outbreak?
The hype about Corona Virus (COVID-19) has finally caught up in Pakistan and the government took important measures including forbidding spectators from entering cricket grounds where Pakistan Super League (PSL) games are being played, closed educational institutions, banned religious or other congregations and closed borders with Iran and China. Initially the response to COVID-19 among Pakistani citizens was mixed; many declaring it a conspiracy of the West; some being very skeptical of the government not doing much; and others stating that so many citizens die of road traffic accidents and other common diseases so what really is the big deal about Corona!

Many of us practicing physicians who have been following this pandemic in the media since December, 2019 have been quite concerned, particularly since Pakistan neither has resources, nor an educated public to tackle this threat seriously and governments typically have lacked the wherewithal to implement the recommended measures.

A large segment of Pakistani population is glued to tik-tok where puerile jokes about Corona are posted without much effort to take advantage of the social media to educate the public. While some people or internet resources and the government are trying to bring awareness, much confusion remains widespread among Pakistanis.

The outbreak of COVID-19 started in Wuhan China’s Supermarket where Pangolins were being sold either as a food delicacy or for the purported medicinal value of its scales. This reptile has been reported as the most likely vehicle of COVID-19, which it acquired from bats, and ultimately infected the innocent bystanders via the air and the droplets spread by it in the market’s environment. It has been reported that the Chinese government delayed breaking the news of COVID-19 to the world for a couple of weeks and precautionary measures were delayed, which not only caused unabated viral spread within China, but the virus escaped Chinese borders to Hong-Kong, South Korea and Japan. Currently, more than 120 countries have reported COVID-19 infections and most concerning for Pakistanis, Iran with common border with Baluchistan has become the second epicenter of Corona after Wuhan.

Thus far only 53 cases of COVID-19 have been reported in Pakistan, mostly from Karachi; however, only less than 1,000 individuals have been tested raising the specter that virus might be circulating quietly in the environment and a serous outbreak is on the fringe.

The somewhat delayed measures that the government has taken are important and could curtail the viral spread. The public needs to know that not only those who have travelled to Pakistan particularly from Iran and China can be viral carriers, even those with or without symptoms of cough, fever, breathing difficulty and chest pain, or even no recent travel history could have COVID-19 infection. Avoiding handshakes, keeping a safe distance of at least 6 feet from anyone, washing hands thoroughly and frequently as well as avoiding touching face will reduce the risk of vira transmission to self and others. Avoid unnecessary travel, do not visit crowded places, eat a healthy diet and take plenty of rest as the last two measures will boast your immune system to tackle the virus. If anyone has fever, body aches and respiratory symptoms, they should get tested for Corona virus from the available nearby sites.

Unfortunately, only a few of them are present in big cities like Karachi, Islamabad and Lahore, but it is important to be tested to know your own diagnosis and avoid transmitting the virus to another person. Such individuals should cover their face with a mask and keep a safe distance from others to avoid disseminating infection. N-95 masks are the only ones that completely safeguard against the entry of small viral particles; however, wearing another ordinary mask may possibly decrease viral transmission as well. It is important to also know that many patients with COVID-19 may have gastrointestinal symptoms like diarrhea, vomiting and nausea, before exhibiting respiratory problems.

COVID-19 is a serious infection much destructive than other viruses confronted by the world in the last few decades. It transmits easily from person to person; can kill 1% of the infected and most importantly make many patients fatally ill, possibly 20-30% of those infected, requiring admissions to the hospital and ventilatory support requirement. Wuhan, China ran out of ventilators and patients were reported to die under tree shades awaiting hospital admissions.

We hope that the balmy weather in Pakistan after the cold winter might curtail viral illness, but preventive measures described need to be put in practice by citizens, hospitals and the government which will need to be on its toes to avoid a looming crisis. Procurement of protective gears for the hospital workers and COVID-19 test kits need to be seriously considered by Pakistan.

A vaccine is at least several months away and simple, doable and preventable measures can still avoid a major disaster.

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.