Waking up in the morning and feeling low is quite common these days. Many have lost their jobs, daily routine has become mundane, uncertainty seems to have no end, fear of catching the virus is prevalent and news commentators make us nauseated.
One of my Asian physician friends in the USA told me that he felt suffocated with a sense of impending doom after spending 10 minutes in a supermarket and got out of there quickly. Another physician phoned in anxiously that her nurse with whom she works daily has been coughing for two days and her corona test returned positive. Now she is obsessing whether she herself is in the incubation period of the Covid-19 illness and how she will protect her family from getting infected.
Political games have been played around this pandemic throughout the world. People are trying to undo each other, proving they are better at taking care of the entire world during this war-like situation. The US President Trump is under fire for his poor handing and frankly megalomania which he has demonstrated while proclaiming that he has known-it-all right from the beginning of this crisis and took correct steps which has avoided the potentially cataclysmic repercussions of the pandemic in USA. Pakistanis have done no better and many intellectuals are quick to make opinions without interpreting the data and have kept giving illogical assessment of the situation in Pakistan to fulfil their own agenda. In March, such geniuses were predicting that by the end of March, Pakistan will be inundated with the viral spread and the entire health care system of the country will collapse and a new government will potentially have to take over to replace the current administrators of the country. Now they are predicting that the country will be in dire straits by the end of April when about 2,000 patients of corona virus infection would die and the health care facilities will be unable to handle the situation with the meager resources available.
While the number of deaths from covid-19 is rising throughout the world, new cases are declining. This was to be expected. For example in New York, social distancing and lockdown took place only about 2-3 weeks earlier, in mid-to-late March. These steps were taken long after it was realized that person-to-person corona virus transmission was occurring in the big apple for several weeks, without any known risk factors of travel to an endemic area or exposure to a known case of covid-19. Thus low level transmission converted to exponential rise of infection particularly in New York City, where JFK airport greets more passengers than perhaps anywhere else in the world. Nonetheless, as demonstrated by the Chinese already, an effective and sustained lock-down can reduce the viral transmission and ultimately flatten the linear rise of corona infection and ultimately eliminate it as reported last week from Wuhan where the corona infection was first reported. Thus in New York after an effective lockdown, where 12,000 new cases were being reported daily before the lockdown, now three weeks later, on an average the trend is downward with less than 8,000 cases reported on a daily basis, showing that the so-called social distancing after all is working.
Pakistan has documented about 5,000 cases of corona infections in the last six-week period. This is indeed a lower number in a country with 230 million population; however, the health department has been criticized for conducting only 40,000 corona tests thus far. Many have been casting aspersions on Pakistani authorities, who they allege have been misleading the public about the true number of infections, which according to them is many times higher. The recent report of mishandling of coronavirus patients in a quarantine area in Multan is alarming. Many individuals suspected of corona infection after undergoing corona testing, were allowed to return to their residences in distant areas. Later, several of these people were found to be positive for the infection, scrambling health authorities to contact them and contain the further spread of the contagion. The stories of mishandling of returning Pakistani pilgrims from Iran on the Taftan border and failure to stop the large congregation of evangelists, hundreds of thousands of them, many among them foreigners, in mid-March, show how difficult a country like Pakistan is to govern, where lack of education and poverty has no end. These pilgrims and evangelists as well as the returning passengers from Europe have become the hot spots of corona’s viral spread throughout Pakistan. Thankfully, international air travel was effectively banned in Pakistan on March 21.
On the other hand, one has to give credit to the governments, both the federal and provincial, where there is due. Not allowing Chinese students back to Pakistan in mid-February, until they completed a mandatory quarantine in China, despite public and media pressure, was a wise step and no reports of Chinese import of coronavirus has been documented. Pakistan was effectively closed long before wide-spread community transmission was reported and remains in a lock down in the third week, despite tremendous economic pressures. A very effective public campaign on all possible media outlets has helped and one does not see handshakes or traditional embraces as well. By and large the six-foot distancing among individuals is being practiced and citizens have become obsessed with the use of hand sanitizers which many are carrying with them in their pockets.
Because of good management, Pakistan is in a low-level transmission of corona infection. Thankfully the number of dead are low in Pakistan and despite the unproven theories of many about this anomaly, it is very possible that unfortunately mortality will rise, but the overall situation at least at this point of time remains optimistic in Pakistan. It is very likely, if Pakistani nation continues with her efforts a bit longer, Pakistan may never see the exponential rise in infection. It has been reported that the government has achieved the capability to test 25,000 patients for corona virus daily, which is ten-fold higher than what is being done today. The government already knows the major hot spots are around the fabled Grand-Trunk road, which is the exit and entrance throughout Pakistan. Many areas of quarantine have been created, capacity building is taking place in the government and private hospitals, essential supplies particularly Personal Protective Equipment (PPE) are being procured and the federal and provincial governments despite their differences are talking to each other.
While Pakistan might have averted a medical disaster, an economic meltdown has also been predicted. The only way to prevent it will be to make a policy of slowly opening the country as the rest of the world is doing where coronavirus has killed hundred times more people than in Pakistan. The corona crisis will decline, but not vanish completely for many months, perhaps until an effective vaccine becomes available, which might still be another year away. As many are saying, we need to embrace the reality of living along with the coronavirus. In Pakistan, where we are confronting poverty and ignorance, a smart lock-down will still need to be imposed for many months. It will entail defining and then opening up of the essential services, watching the hotspots of coronavirus with a hawk’s eye, implement more and more testing to define endemic areas and imposing harder lockdowns there, and keeping up the pace with the ever evolving situation.
The situation will become better earlier than later. If we can survive thus far, we can make it through the crisis and ultimately defeat the corona virus. It is time to keep up the positive attitude and be proud of what has been accomplished thus far in our country.
One of my Asian physician friends in the USA told me that he felt suffocated with a sense of impending doom after spending 10 minutes in a supermarket and got out of there quickly. Another physician phoned in anxiously that her nurse with whom she works daily has been coughing for two days and her corona test returned positive. Now she is obsessing whether she herself is in the incubation period of the Covid-19 illness and how she will protect her family from getting infected.
Political games have been played around this pandemic throughout the world. People are trying to undo each other, proving they are better at taking care of the entire world during this war-like situation. The US President Trump is under fire for his poor handing and frankly megalomania which he has demonstrated while proclaiming that he has known-it-all right from the beginning of this crisis and took correct steps which has avoided the potentially cataclysmic repercussions of the pandemic in USA. Pakistanis have done no better and many intellectuals are quick to make opinions without interpreting the data and have kept giving illogical assessment of the situation in Pakistan to fulfil their own agenda. In March, such geniuses were predicting that by the end of March, Pakistan will be inundated with the viral spread and the entire health care system of the country will collapse and a new government will potentially have to take over to replace the current administrators of the country. Now they are predicting that the country will be in dire straits by the end of April when about 2,000 patients of corona virus infection would die and the health care facilities will be unable to handle the situation with the meager resources available.
While the number of deaths from covid-19 is rising throughout the world, new cases are declining. This was to be expected. For example in New York, social distancing and lockdown took place only about 2-3 weeks earlier, in mid-to-late March. These steps were taken long after it was realized that person-to-person corona virus transmission was occurring in the big apple for several weeks, without any known risk factors of travel to an endemic area or exposure to a known case of covid-19. Thus low level transmission converted to exponential rise of infection particularly in New York City, where JFK airport greets more passengers than perhaps anywhere else in the world. Nonetheless, as demonstrated by the Chinese already, an effective and sustained lock-down can reduce the viral transmission and ultimately flatten the linear rise of corona infection and ultimately eliminate it as reported last week from Wuhan where the corona infection was first reported. Thus in New York after an effective lockdown, where 12,000 new cases were being reported daily before the lockdown, now three weeks later, on an average the trend is downward with less than 8,000 cases reported on a daily basis, showing that the so-called social distancing after all is working.
Pakistan has documented about 5,000 cases of corona infections in the last six-week period. This is indeed a lower number in a country with 230 million population; however, the health department has been criticized for conducting only 40,000 corona tests thus far. Many have been casting aspersions on Pakistani authorities, who they allege have been misleading the public about the true number of infections, which according to them is many times higher. The recent report of mishandling of coronavirus patients in a quarantine area in Multan is alarming. Many individuals suspected of corona infection after undergoing corona testing, were allowed to return to their residences in distant areas. Later, several of these people were found to be positive for the infection, scrambling health authorities to contact them and contain the further spread of the contagion. The stories of mishandling of returning Pakistani pilgrims from Iran on the Taftan border and failure to stop the large congregation of evangelists, hundreds of thousands of them, many among them foreigners, in mid-March, show how difficult a country like Pakistan is to govern, where lack of education and poverty has no end. These pilgrims and evangelists as well as the returning passengers from Europe have become the hot spots of corona’s viral spread throughout Pakistan. Thankfully, international air travel was effectively banned in Pakistan on March 21.
On the other hand, one has to give credit to the governments, both the federal and provincial, where there is due. Not allowing Chinese students back to Pakistan in mid-February, until they completed a mandatory quarantine in China, despite public and media pressure, was a wise step and no reports of Chinese import of coronavirus has been documented. Pakistan was effectively closed long before wide-spread community transmission was reported and remains in a lock down in the third week, despite tremendous economic pressures. A very effective public campaign on all possible media outlets has helped and one does not see handshakes or traditional embraces as well. By and large the six-foot distancing among individuals is being practiced and citizens have become obsessed with the use of hand sanitizers which many are carrying with them in their pockets.
Because of good management, Pakistan is in a low-level transmission of corona infection. Thankfully the number of dead are low in Pakistan and despite the unproven theories of many about this anomaly, it is very possible that unfortunately mortality will rise, but the overall situation at least at this point of time remains optimistic in Pakistan. It is very likely, if Pakistani nation continues with her efforts a bit longer, Pakistan may never see the exponential rise in infection. It has been reported that the government has achieved the capability to test 25,000 patients for corona virus daily, which is ten-fold higher than what is being done today. The government already knows the major hot spots are around the fabled Grand-Trunk road, which is the exit and entrance throughout Pakistan. Many areas of quarantine have been created, capacity building is taking place in the government and private hospitals, essential supplies particularly Personal Protective Equipment (PPE) are being procured and the federal and provincial governments despite their differences are talking to each other.
While Pakistan might have averted a medical disaster, an economic meltdown has also been predicted. The only way to prevent it will be to make a policy of slowly opening the country as the rest of the world is doing where coronavirus has killed hundred times more people than in Pakistan. The corona crisis will decline, but not vanish completely for many months, perhaps until an effective vaccine becomes available, which might still be another year away. As many are saying, we need to embrace the reality of living along with the coronavirus. In Pakistan, where we are confronting poverty and ignorance, a smart lock-down will still need to be imposed for many months. It will entail defining and then opening up of the essential services, watching the hotspots of coronavirus with a hawk’s eye, implement more and more testing to define endemic areas and imposing harder lockdowns there, and keeping up the pace with the ever evolving situation.
The situation will become better earlier than later. If we can survive thus far, we can make it through the crisis and ultimately defeat the corona virus. It is time to keep up the positive attitude and be proud of what has been accomplished thus far in our country.