Coronavirus testing needs to be enhanced, mechanisms of contact tracing where anyone who has been potentially exposed to the virus would be tested and quarantined should be developed before Pakistan lifts the lockdown, writes Abdul Nadir.
Prime Minister, Imran Khan, after meeting with the shareholders of Pakistan’s Covid-19 policy on April 14th declared, “We are extending the lockdown for two weeks; however, the essential services will be opened and provinces will decide how stringent their lockdown should be.
The federal and provincial governments are in 98% agreement.” Later on the government announced a long list of businesses including cement, fertilizer, chemical, glass, e-commerce, mines, paper and packaging industry besides a number of other small businesses like hair salons and stationary shops etc. will open. Airports, train, metro and other means of public transportation, besides educational and many other institutions will remain closed in Pakistan.
After a three-week lockdown, many weary Pakistanis, particularly daily wagers, who have been struggling to earn two square meals a day want the lockdown to relax. Some were reported as saying, “We are going to die anyway, either from the Coronavirus or from hunger and we are ready to take our chances.” While the government has been giving up to 12,000 rupees to several million citizens living below the poverty line, many have either not received the help or wouldn’t want alms or charity, instead wanting to earn their own livelihood.
Daily wage workers in Hyderabad, Sindh reflecting many moods during the pandemic
Clearly Federal and Sindh government as well as other notables are polarized about the degree of lockdown that should be undertaken. Syed Murad Ali Shah, Chief Minister of Sindh, clasped his hands, during a press conference held immediately after the lockdown decision was announced, “For God’s sake, do not mix politics with Covid-19. Too many people are dying.”
He further reported higher than expected number of dead on arrival in Karachi’s government hospitals, many of whom are suspected of Coronavirus infection, although not tested to confirm it.
Indian Citizens Lineup to receive government aid. However, many other places are not as organised.
Since the lockdown has been relaxed, city intersections in Lahore and Karachi have been reported to display the usual hustle and bustle, with no regard to social distancing. The religious leaders want mosques to open right away so the nation can pray together, “Religious duties are essential and should be immediately opened.” Typically, several hundred worshipers congregate in Pakistani mosques, with their feet tightly aligned to show the solidarity of Muslim brethren.
This number is going to increase from April 23rd, when Ramzan, the holy month of fasting is expected to begin in Pakistan.
History has taught us some important lessons. When San Francisco recovered from the initial surge of Spanish flu epidemic in 1918, people came out celebrating as in a carnival. Two weeks later patients inundated city hospitals, sickened with the deadly flu once again! Singapore and South Korea after the initial success with containment of covid-19 are seeing a secondary wave of the virus yet again after the international travel was resumed and travelers are bringing Coronavirus along with them. A vibrant and contentious debate about how and when to open the country again is ongoing in US where 29,000 people have died from the corona virus infection thus far.
Outdoor Sunday Church Service in San Francisco in 1918 after the First Outbreak was contained, without six-foot distance Observed
Prime Minister Imran Khan correctly pointed out, “Decision to open the country should be based on scientific data.” To date, close to 7,000 patients have been reportedly infected with the corona virus, more than 100 of them have succumbed to it, while only 80,000 tests have been performed throughout Pakistan. The number of tests performed for corona virus infection are expected to jump from 5,000 to 25,000 daily by the end of April.
Even a lower death rate, while comforting, cannot be completely trusted as data reported are analogous to cherry picking and deaths may have been under reported. The conjecture about strong immune system of Pakistanis and great response of Covid-19 affected patients to anti-malarial drugs have to be taken with a grain of salt as well.
Covid-19 situation is unraveling very rapidly and what is true today may not even hold up tomorrow. Developed countries are talking about giving immune certificates to those who have successfully recovered from Covid-19. Immunologists, however, don’t know for sure whether the antibodies detected from the blood of recovered patients would indeed be protective, and if protective, how long will such protection last and whether such patients will indeed be at a lower risk of giving the virus to the other unsuspecting people around them or such individuals may even get re-infected with a repeated exposure to the deadly virus.
The effort to make a vaccine has been undertaken on war footings in the developed world. Considering the complexity of the Corona virus, it is extremely unlikely that an effective and innocuous vaccine will become available in less than a year. Drug companies are trying hard to make a medicine that will decrease the intensity of the covid-19 illness, but even if such medicines will work, they are still a little bit away from approval, and their availability to developing countries may take even longer.
Pakistani nation is caught between a rock and a hard place. Policy makers will be damned if they do and damned if they don’t! Someone said aptly, “If the entire world can freeze for two weeks, Corona virus will die”. This is not possible! Even in Wuhan, China where the lockdown was the strictest, it took 3 months before the eradication of the virus occurred.
With the burgeoning population, extreme poverty, dense population, widespread ignorance and unproven popular beliefs, Pakistani nation and government are both in a bind as to how to overcome this huge challenge.
Clearly Pakistan cannot be locked down as if under a curfew for much longer. Patients are becoming sick with Covid-19, but with the focus on the pandemic, patients with other conditions have been ignored. On the other hand, Pakistani authorities have to be ready before they can open the country again. Coronavirus testing needs to enhance, mechanisms of contact tracing where anyone who has been potentially exposed to the virus would be tested and quarantined. The protective equipment for health care providers need to be made available to them and finally, the government somehow needs to extricate public cooperation through the assistance of political and religious stake holders to be able to implement any strategy on the ground.
Public has to be educated about the basic preventive measures and should be informed about the importance of isolating themselves if there is any doubt they possibly have corona infection. Cell phone and social media platforms can be used to follow these patients exposed to Corona virus, but such a policy has to come from the government sooner than later.
The authorities need to be on their toes in the next few days and if the virus raises its ugly head again, they should have no qualms about imposing tougher restrictions yet again. The Pakistani nation has thus far escaped the exponential rise of the viral spread and it is hoped that situation will improve further, rather than becoming worse. We will all keep our fingers crossed!
Prime Minister, Imran Khan, after meeting with the shareholders of Pakistan’s Covid-19 policy on April 14th declared, “We are extending the lockdown for two weeks; however, the essential services will be opened and provinces will decide how stringent their lockdown should be.
The federal and provincial governments are in 98% agreement.” Later on the government announced a long list of businesses including cement, fertilizer, chemical, glass, e-commerce, mines, paper and packaging industry besides a number of other small businesses like hair salons and stationary shops etc. will open. Airports, train, metro and other means of public transportation, besides educational and many other institutions will remain closed in Pakistan.
After a three-week lockdown, many weary Pakistanis, particularly daily wagers, who have been struggling to earn two square meals a day want the lockdown to relax. Some were reported as saying, “We are going to die anyway, either from the Coronavirus or from hunger and we are ready to take our chances.” While the government has been giving up to 12,000 rupees to several million citizens living below the poverty line, many have either not received the help or wouldn’t want alms or charity, instead wanting to earn their own livelihood.
Daily wage workers in Hyderabad, Sindh reflecting many moods during the pandemic
Clearly Federal and Sindh government as well as other notables are polarized about the degree of lockdown that should be undertaken. Syed Murad Ali Shah, Chief Minister of Sindh, clasped his hands, during a press conference held immediately after the lockdown decision was announced, “For God’s sake, do not mix politics with Covid-19. Too many people are dying.”
He further reported higher than expected number of dead on arrival in Karachi’s government hospitals, many of whom are suspected of Coronavirus infection, although not tested to confirm it.
Indian Citizens Lineup to receive government aid. However, many other places are not as organised.
Since the lockdown has been relaxed, city intersections in Lahore and Karachi have been reported to display the usual hustle and bustle, with no regard to social distancing. The religious leaders want mosques to open right away so the nation can pray together, “Religious duties are essential and should be immediately opened.” Typically, several hundred worshipers congregate in Pakistani mosques, with their feet tightly aligned to show the solidarity of Muslim brethren.
This number is going to increase from April 23rd, when Ramzan, the holy month of fasting is expected to begin in Pakistan.
History has taught us some important lessons. When San Francisco recovered from the initial surge of Spanish flu epidemic in 1918, people came out celebrating as in a carnival. Two weeks later patients inundated city hospitals, sickened with the deadly flu once again! Singapore and South Korea after the initial success with containment of covid-19 are seeing a secondary wave of the virus yet again after the international travel was resumed and travelers are bringing Coronavirus along with them. A vibrant and contentious debate about how and when to open the country again is ongoing in US where 29,000 people have died from the corona virus infection thus far.
Outdoor Sunday Church Service in San Francisco in 1918 after the First Outbreak was contained, without six-foot distance Observed
Prime Minister Imran Khan correctly pointed out, “Decision to open the country should be based on scientific data.” To date, close to 7,000 patients have been reportedly infected with the corona virus, more than 100 of them have succumbed to it, while only 80,000 tests have been performed throughout Pakistan. The number of tests performed for corona virus infection are expected to jump from 5,000 to 25,000 daily by the end of April.
Even a lower death rate, while comforting, cannot be completely trusted as data reported are analogous to cherry picking and deaths may have been under reported. The conjecture about strong immune system of Pakistanis and great response of Covid-19 affected patients to anti-malarial drugs have to be taken with a grain of salt as well.
Covid-19 situation is unraveling very rapidly and what is true today may not even hold up tomorrow. Developed countries are talking about giving immune certificates to those who have successfully recovered from Covid-19. Immunologists, however, don’t know for sure whether the antibodies detected from the blood of recovered patients would indeed be protective, and if protective, how long will such protection last and whether such patients will indeed be at a lower risk of giving the virus to the other unsuspecting people around them or such individuals may even get re-infected with a repeated exposure to the deadly virus.
The effort to make a vaccine has been undertaken on war footings in the developed world. Considering the complexity of the Corona virus, it is extremely unlikely that an effective and innocuous vaccine will become available in less than a year. Drug companies are trying hard to make a medicine that will decrease the intensity of the covid-19 illness, but even if such medicines will work, they are still a little bit away from approval, and their availability to developing countries may take even longer.
Pakistani nation is caught between a rock and a hard place. Policy makers will be damned if they do and damned if they don’t! Someone said aptly, “If the entire world can freeze for two weeks, Corona virus will die”. This is not possible! Even in Wuhan, China where the lockdown was the strictest, it took 3 months before the eradication of the virus occurred.
With the burgeoning population, extreme poverty, dense population, widespread ignorance and unproven popular beliefs, Pakistani nation and government are both in a bind as to how to overcome this huge challenge.
Clearly Pakistan cannot be locked down as if under a curfew for much longer. Patients are becoming sick with Covid-19, but with the focus on the pandemic, patients with other conditions have been ignored. On the other hand, Pakistani authorities have to be ready before they can open the country again. Coronavirus testing needs to enhance, mechanisms of contact tracing where anyone who has been potentially exposed to the virus would be tested and quarantined. The protective equipment for health care providers need to be made available to them and finally, the government somehow needs to extricate public cooperation through the assistance of political and religious stake holders to be able to implement any strategy on the ground.
Public has to be educated about the basic preventive measures and should be informed about the importance of isolating themselves if there is any doubt they possibly have corona infection. Cell phone and social media platforms can be used to follow these patients exposed to Corona virus, but such a policy has to come from the government sooner than later.
The authorities need to be on their toes in the next few days and if the virus raises its ugly head again, they should have no qualms about imposing tougher restrictions yet again. The Pakistani nation has thus far escaped the exponential rise of the viral spread and it is hoped that situation will improve further, rather than becoming worse. We will all keep our fingers crossed!