Like the rest of the world, Pakistan faces a grim challenge of fighting off the threat of the coronavirus pandemic. The scourge has devastated large parts of the world, including Europe, Asia, America, Africa and Australia. Infections and death rates have been rising and whole populations have been locked down to control the spread of the virus. But the situation is not yet under control.
Mercifully, Pakistan is still safe from the kind of a severe viral attack that killed thousands in China and Italy. But we cannot be complacent. With a few infected people detected about a month ago, the numbers have continuously been rising as new diagnostic tests are being made. In a situation like this, statistics become outdated by the time they reach the public.
The name of the game is prevention and control, because there is no specific medicine to cure the affliction. Beginning in February, thousands returning from Iran and other countries were not screened and as such there is no knowing how many of them were infected. All the returnees must be tracked down, tested and, if need be, isolated.
Although a bit late, yet in mid-March, Pakistan’s National Security Committee (NSC) meeting was held to discuss the looming healthcare crisis following which a National Coordination Committee for Covid-19 was established to monitor the situation and take necessary decisions on a daily basis. The National Disaster Management Authority (NDMA) was tasked with the responsibility of coordinating all operations for the implementation of the preventive and curative actions.
All educational institutions, including schools, colleges, universities and madrassas, both public and private, across the country were ordered shut until April 5, 2020. Pakistan’s border with Afghanistan and Iran were closed for two weeks for both travel and trade to prevent the spread of the pandemic. To effectively screen travellers, the arrival and departure of international flights were restricted to only three airports – Karachi, Lahore, and Islamabad – with enhanced safety measures.
At the same time, all public gatherings and large conferences have been banned with immediate effect. Wedding halls and cinemas have also been closed for two weeks. Screenings of travellers at all points of entry to the country are being done, while checkpoints have been established for those entering from neighbouring Afghanistan or Iran at Gwadar, Taftan and Chaman ground-crossing points.
The World Health Organisation (WHO) has appreciated the measures taken by the government of Pakistan to deal with the coronavirus outbreak as a health emergency and treating the patients as per standardised clinical protocols. It has also announced the provision of immediate support to the government so that preparedness and response measures were in place to handle the situation as it developed. The WHO representative in Pakistan, Dr Palitha Mahipala, said, “I am impressed by the swift and diligent way the government has handled the crisis so far and WHO is committed to supporting them every step of the way.”
Within our limited resources we have come up with a strong response to the virus outbreak, but the truth is that our existing medical infrastructure is too weak and inadequate to tackle a major health crisis. Our per capita expenditure on health is one of the lowest in the world and hospitals lack basic equipment and supplies. The doctor-patient ratio is extremely low in far-flung areas.
A booming population and poor health literacy among the public make matters worse. Even in normal times, hospitals, short of doctors and beds, cannot cope with the rush of patients. Dengue outbreaks during the past few years have fully exposed the inadequacies of our medical system, especially highlighting the lack of collaboration between health administrators and environmental, sanitation or public works departments. In other words, the healthcare system is too disjointed to make a coordinated response if the coronavirus infection curve suddenly curls upwards.
The immediate challenge is to break the chains of infection transmission and hunt down those with primary and secondary infections. Lockdown is an obvious answer to the problem but such a drastic step may not be possible in a country like ours where millions are daily wage earners and lack means to buy supplies in bulk. In such a situation, what we can do is to go for partial and targeted lockdown.
To break the chains of transmission, we will need to trace all those with a foreign travel history over the past couple of months and also those with whom they have lived and interacted with since their return. This operation should be coupled with the setting up of testing and quarantine centres in all districts. At the same time, in all cities and major urban clusters, rapid response teams should be formed to support the medical staff and distribute informative material to raise public awareness about the issue.
The coronavirus constitutes an existential threat to the nation and calls for a total war on all fronts.