What is our strategy?

What is Prime Minister Imran Khan’s strategy to fight the coronavirus other than relying on the miracle that our genes might somehow be less susceptible or that the virus will die out as mercury rises?

At a time when we need leadership that projects a clear message and the confidence that the state is in charge and knows what it is doing, PM IK is dabbling in and spreading confusion and presenting false dichotomies to a hapless public. At a time of national crisis one wishes to rally behind its government. But what is the plan one should rally behind?

No leader wants people to die on his watch. So intentions are not in question. But our leaders must understand that their judgment, ability and performance in the time of Corona will be judged. So far PM IK has been found wanting. The message emanating from his government has been that Covid-19 isn’t as serious as it is being made out to be. Even if it is, let’s hope it doesn’t afflict us as it has afflicted others. And if it does afflict us, there isn’t much we can do anyways as we have to choose between dying of starvation or of Covid-19; and the latter is preferable.

Confusion in a time of crisis is as contagious as a contagion such as Covid-19. Does our government view containment and suppression as alternatives? Or, worst, does it see riding out the storm doing nothing as a viable option? When the government refused to bring our students back from China, it seemed to be opting for mitigation. Then it allowed folks back from Iran (the disastrous handling of the quarantine camp is a separate issue altogether), creating confusion that mitigation by isolating Pakistan wasn’t our strategy.

It opted early on to shut down all educational institutions. This hinted that it was sold on mitigation through lockdown. But then business-as-usual continued in all other realms creating confusion about the purpose of closure of schools. The government said people should avoid large gatherings. But then it didn’t impose restrictions on large gatherings including marriages, funerals, prayers etc. Contrary to its advice. it continued to host large gatherings itself, such as the oath-taking ceremony of the new Lahore High Court chief justice to name one.

Amidst contradictory signals, folks waited for PM IK to speak to his country. He finally did and fermented further confusion. At the risk of simplification, he seemed to be saying that 97 percent Pakistanis would survive even if afflicted by the contagion and so why take drastic steps. Was he insinuating that the lives of three percent Pakistanis could be acceptable loss? He said only developed countries could opt for lockdowns. Was he saying that lockdown helped states buy time to bolster health systems and as we can’t improve ours in any event, why bother?

PM IK conjured up a false dichotomy of choosing between death by Corona in case of business-as-usual (that would help the poor) or death by poverty in case of a lockdown (that would help the rich). By presenting these false choices, he further confused public discourse at a time when we needed certitude. The challenge thrown up by the coronavirus isn’t unique to Pakistan or to one economic class. This isn’t a time to amplify class divisions but to bring the entire citizenry together to get behind a unified strategy to defeat this monstrosity.

The right to prevention from disease and access to a functional health system on one hand and the right to subsistence on the other are both subsets of the right to life. The thing about fundamental rights is that they need not to be approached in an all-or-nothing manner. They often compete and must be balanced against one another. It is for public policy to strike the right balance between competing rights. So PM IK essentially said he was out of ideas on how to balance our need to mitigate the Corona threat without disrupting our right to subsistence.

Within a day of IK presenting the lockdown option as a death sentence for the poor (that he estimated as 25 percent of our population), Sindh, Punjab and Gilgit-Baltistan opted for lockdowns, followed by the DG ISPR’s presser endorsing the containment approach. So even if it were an either or choice between death by lockdown and Corona, the country seemed to have opted for the former. That Pakistan would at some point need to shut itself down for business-as-usual was not unpredictable in view of the experiences of other countries further ahead of us on the Corona curve.

Based on studies put out by epidemiologists, it’s been obvious for a week even to ordinary observers that containment and suppression aren’t either-or choices but complementary strategies. Lockdown isn’t a permanent solution to anything, but an attempt to create a limited time window to slow down the spread of the virus and get a handle on treating those infected. The idea is to limit the spread to enable the healthcare system to cope with patients who need critical care, while segregating clusters of population that are exposed from those that aren’t.

To be able to defeat the virus, the world will need to find ways to suppress it. But till that happens, affected parts of the population need to be identified, treated and separated from the unaffected parts. Identification and separation is key to acquiring control over the spread of the disease and establishing effective means to monitor those exposed, as a precondition to lifting the lockdown and slowly bringing life back to near normalcy while continuing the practice of social distancing so as not to accelerate the spread of the virus post lifting of lockdown.

According to this prevalent theory, the smaller the size of population affected at the lockdown stage the easier it would be to control the spread and to treat the patients. And the quicker a country acquired control over the virus’s spread, the sooner it could come out of lockout mode. A key factor in moving from lockdown to post-lockdown ‘near normalcy’ would be identification of all carriers of the virus. The smaller the size of the population affected, the quicker the identification. The greater the ability to test potentially exposed citizens, the quicker the identification.

No sane mind has presented lockdown as a permanent solution. It’s a time-bound strategy to: (i) identify human vectors with extensive testing; (ii) devise protocols to not commingle the healthy with the infected at the testing state and subsequently to segregate those suffering mild-symptoms (to be prescribed with self-quarantine) versus the seriously ill who need hospital care; and (iii) enhance the ability of the healthcare system to undertake testing, segregation and treatment, while equipping health workers with the required protective tools and devices.

Will temporary lockdown cause financial distress? Of course it will. The longer the lockdown, the more disruption it’ll cause. In a short and focused lockdown, those better off will have greater ability to support the poor, through paid leave, charity etc. But if it stretches over months, everyone will run out of cash. In an interdependent world, with demand and productivity cutoff due to lockdown, no one will come out of this unscathed. Bottom line: lockdown for us is like wartime consumption, unsustainable for more than a few weeks. So let’s make it count.

In the lockdown phase, cash will become non-fungible. Other than the healthcare system’s capacity building, this is where public policy will be most relevant. We’ll need to carefully calibrate state intervention to keep the wheel of economy and life moving. You can suspend utility payments for some consumers for a while, but beyond that it’ll threaten utility companies. You can force employers to pay salaries to employees, but by month two employers will be out of pocket too. You can freeze repayment of loans, but for how long before the banks go bankrupt?

Corona has posed an epochal challenge like none other faced by any of today’s decision-makers. Notwithstanding one’s partisan sensibilities, the last thing any Pakistani would wish at this time is for PM IK to fail. But this is no time to run with gut sense or voodoo logic or be complacent or defeatist. PM IK must let himself be guided by facts, science and experts and then get into campaign mode.

The writer is a lawyer based in Islamabad

Email: sattar@post.harvard.edu