KARACHI: The government has missed two critical opportunities that could have placed the country at a better position today in its fight against coronavirus as official indecisiveness led to a delayed and ineffective lockdown with constant increase in cases and the government failed to utilise the period of two-month lockdown for building a policy framework on how to return to normalcy.

This analysis is part of a report recently prepared by a team of public health specialists associated with the APPNA Institute of Public Health at Jinnah Sindh Medical University.

The report titled “Easing Lockdown in Pakistan: Inevitable but Potentially Catastrophic” looks into the country’s response to Covid-19 and its implications in coming weeks and compares it with what has happened in other countries, particularly those which have successfully dealt with the situation.

According to the report, Pakistan — currently into its 11th week of Covid-19 epidemic — saw 50 per cent increase in the number of cases every week in April. It’s likely to reach 100,000 cases with some 2,000 deaths by May-end, if cases continue to rise at the same pace.

“Going by the assumption that 20 per cent patients in confirmed cases would need hospital admission, it is estimated that some 6,000 patients may require hospital admission each week by end of May.

Delayed, ineffective lockdown and absence of policy on return to normalcy blamed for situation

“Of them, 200-250 patients would require critical care. And if things go worse and the disease burden doubled every week, we may end up with 200,000 cases, 4000 deaths and 20,000 patients requiring admission every week. Of them, 700 are going to require critical care,” the report says.

Countries reporting success

The report cites examples of countries such as China, South Korea, Vietnam and New Zealand, which swiftly imposed travel restrictions, introduced strict lockdown and ensured implementation of social distancing practices. Gradually, these countries saw gradual decline in the number of coronavirus cases, which helped them successfully “reverse the trend to extremely low levels”.

Spain and Italy, the report says, reacted late and enforced lockdown after eight weeks of the first reported case. After high spikes in these countries which badly strained their health systems, their trend reversed after three weeks of lockdown. These countries are now moving towards easing their lockdown to restore normalcy.

Countries such as the US and the UK, where governments were reluctant to impose lockdown, have shown a sustained increase in the number of Covid-19 cases with high mortality.

“The result is that after more than three months of the first case in their countries, they are reporting a sustained high number of cases with thousands of weekly deaths as they are now in the fourth month of their battle with Covid-19,” the report says.

South Asian countries including Pakistan, India and Bangladesh, it points out, were also reluctant on lockdown and more concerned about their struggling economies and poverty. Surprisingly, however, the increase in the number of Covid-19 cases has not been as sharp as the US and the UK which have adopted the same approach.

The report suggests that less number of cases may be explained by lower volumes of testing performed in these countries but “constantly low number of deaths indicate that effects of the virus are less explosive in these countries”.

Lessons learnt

The report concludes that countries which have been decisive on lockdown and ensured implementation of social distancing protocols have been able to manage the outbreak effectively.

The two-month lockdown period in Pakistan, it says, should have been used as time to develop policy framework on how normalcy would be restored in the country.

“The world order has changed and countries have developed social distancing protocols on how they are going to travel and commute, how they are going to resume work, how they are going to run their businesses, how they are going to start educating their children and youth again, and more importantly how they are going to bind people to stick to new rules of this world order.

“In the new world order, wearing a mask should be like wearing a seat belt and communicating at a distance should be like stopping at a signal, the people who do not comply to it shall be punished because it is a matter of endangering your own life and lives of others.”

The Pakistan government, the report says, should have led the way and set new directions and rules of continuing the normal life.

“We are left with no choice but to return to normalcy but do we have to return as nothing has happened or nothing will happen?

“The moderate numbers at the moment have encouraged the government to ease the lockdown in phases with reopening of small businesses, factories and industries.

“However, leaving the people to determine the rules of restoring normalcy could prove fatal if growth in cases and deaths continues at current average growth rate or may even increase further. Somebody needs to wake up the state. It cannot just remain in a state of denial,” the report says.

The report has been authored by Prof Lubna Ansari Baig, Dr Shiraz Shaikh, Dr Greesh Maheshwari, Dr Rabab Naqvi, Mehjabeen Musharraf, Dr Ibrahim Hashmi and Dr Shahmeen Nazar.

Published in Dawn, May 16th, 2020