Hyderabad — Sindh's second-largest city after Karachi — is fast emerging as a coronavirus hotspot, with a rise in both the city's positivity ratio and mortality rate worrying doctors.

As Hyderabad's health care workers brace for the second wave of Covid-19, three patients lost their lives from the virus in the past day at Liaquat University Hospital's (LUH) City branch.

“Three deaths are reported in our high dependency unit (HDU) and intensive care unit (ICU),” said Dr Aftab Phull, focal person for LUH Hyderabad. The deceased included two men aged 71 years and 58 years, respectively, and a 70-year-old woman.

Hyderabad reported its first Covid-19 case on March 10, a woman who had arrived from Iran after pilgrimage. The city's positivity rate declined in the July-August period but from then onwards, a rise in cases was seen in laboratory reports.

The National Command and Operation Centre had last week reported that Hyderabad had the highest positivity ratio of Covid-19 cases in Pakistan at 16.59 per cent. However, Sindh government spokesperson Murtaza Wahab at the time contradicted the figure, saying the positivity rate in the Hyderabad district stood at 8.7pc.

According to Prof Dr Ikram Ujjan, head of the Diagnostic and Research Laboratory (DRL) of the Liaquat University of Medical and Health Sciences (LUMHS), Hyderabad's positivity ratio in late October and early November had varied between 10pc and 12pc.

“And now cases are increasing,” he said, adding that the positivity rate was increasing in districts of Sindh other than Karachi and Hyderabad as well. “These districts in lower and upper Sindh were [earlier] reporting around 1pc positivity ratio but it is now climbing up to 4pc which is a sharp increase.”

According to reports of tests conducted at the DRL, 293 samples were tested in Hyderabad during the last 24 hours of which 42 returned positive — a positivity rate of 14pc.

The rate is based on tests conducted only at the government facility, and does not include tests conducted at private labs.

In June, 'smart' lockdowns were imposed in 70 areas of the city by the district administration with the Sindh government’s approval, leading to a drop in the positivity ratio from 38pc to 2pc in August, according to daily situation reports issued by the provincial government.

“The situation is worrying us. The second wave seems to be more severe. We need to go for intermittent lockdown,” said Prof Dr Imran Ali Shaikh of LUMHS. “The situation had changed when the lockdown was imposed. We can perhaps keep businesses closed on Friday and Sunday. It will help reduce the ratio of the infection’s transmission among people.”

According to him, the positivity ratio of Hyderabad was 2.4pc to 2.5pc during the first wave in March-April. “Now it is clearly 12pc to 13pc and it is dangerous,” he added.

Despite the increasing numbers, Dr Shaikh said the general public appeared unfazed.

“People don’t care what we advise them as they don’t follow standard operating procedures or observe social distancing,” he said. He strongly advised for immediately shifting Covid-19 patients to hospitals or to quarantine them in homes.

Dr Shaikh also pointed out another worrying factor, concerning unconfirmed reports of different laboratories. “We are getting reports in which patients have clear symptoms of novel coronavirus but on the basis of some private laboratories' reports, those patients are being treated for typhoid and not Covid-19,” he said, urging the government to look into the matter. “I am getting patients at my clinic with clear symptoms of coronavirus and there are several other doctors who are receiving such patient.”

As per the district health office (DHO) figures, there are 1,355 active coronavirus cases in Hyderabad. And out of these, 1,332 patients are in home isolation. Since the outbreak hit Hyderabad, a total of 6,774 positive cases were reported and of them 5,314 recovered. At least 105 deaths have been reported in the district so far. However, this mortality figure is exclusive of the patients who hailed from other districts of Sindh but were admitted to and died in LUH's City branch.

LUH’s Dr Phull said the hospital currently had 23 Covid-19 patients. Of them 11 are in HDU, nine in ICU and three are under-trial prisoners. “We have 20 beds each in HDU and ICU. Normally not all patients need ICU but positive coronavirus patients’ flow is indeed now increasing,” he remarked.

The district administration has been enforcing timing restrictions on all wedding halls and businesses except for pharmacies and medical stores. Officials have been imposing fines on eateries and owners restaurants if they are seen serving customers after 10pm.

“All businesses are to close by 10pm except for medical stores in Hyderabad," said Fuad Soomro, Hyderabad's deputy commissioner. “We will also ensure implementation of the ban on holding of weddings in marriage halls as per Sindh government’s directives.”