Managing a pandemic disaster

Disaster is defined as a sudden, calamitous event that seriously disrupts the functioning of a community or society and causes human, material and economic or environmental losses that exceeds the community’s or society’s ability to cope using its own resources. Besides other natural disasters, epidemics and pandemics have been and continue to be a potent threat for human civilization.

In case of a pandemic, outside help becomes very difficult as everyone is busy assessing their own needs and resources. Another important factor is the growing deficit between needs and ever depleting sources so desperately needed to control the menace.

On March 11, 2020, the World Health Organization officially declared the coronavirus a pandemic. As of now, the coronavirus has spread over 170 countries, affecting more than a million people. Experts have drawn comparisons – some of them reassuring, some of them frightening – to past major disease outbreaks and pandemics, from SARS and MERS to the 1918-19 Spanish influenza that was one of the major disasters of the past 200 years of human history. Pending a realistic assessment, the situation in Pakistan can be described as the first stage of an impending disaster, moving fast towards stage two – given our lack of resources and unrealistic attitudes at all levels.

While this pandemic has exposed the healthcare systems of countries, it has raised questions about political systems and government controls as well. China has figured out well with its strict compliance backed by strong governmental control. Risk assessment is a simple product of Hazard x Vulnerability. While the hazard of the coronavirus is all around us with its uncertainties, the vulnerability of various groups of population is also pronounced due to our socio-economic conditions.

There is a hot debate in the mainstream as well as on social media about lockdowns or enforcement of social order to prevent the spread of the coronavirus. In this regard we need to understand various terms so often used in the media interchangeably. Isolation and quarantine are public health practices used to stop or limit the spread of disease.

Isolation is exercised to separate sick persons who have a communicable disease from those who are healthy. Isolation stops the movement of ill persons to prevent the spread of certain diseases. For example, hospitals routinely use isolation for patients with infectious disease like tuberculosis.

Quarantine is used to separate and restrict the movement of healthy persons who may have been exposed to a communicable disease to see if they become ill. These people may have been exposed to a disease and do not know it, or they may have the disease but do not show symptoms. Quarantine can also help limit the spread of a communicable disease.

As per the recommendation of the World Health Organization (WHO), ‘social distancing’ is a major tool to prevent the rapid spread of any pandemic. It may be difficult in a country with a population size and social norms and public behavior like Pakistan.

So, what is social distancing? Aside from being good news for introverts, social distancing is a public health measure that helps communities retard the transmission and spread of diseases like the coronavirus. Research has shown that in urban areas and regions where a disease is spreading, taking measures like working from home, shutting down schools, and canceling large events can significantly reduce the rate of new infections.

In the past few weeks, the advisory approach by the federal and provincial governments has not been taken so seriously given the threat of the pandemic. That is why we have had to resort to a sort of quarantine without declaring a complete and total lockdown. Now even the Pakistan Army has had to be called in aid of Civil Power under Article 245 of the constitution.

We need to study the disaster management cycle and especially its first two phases to have a clear idea about where we stand today and what needs to be done on an immediate basis and in the long run to save lives.

Unfortunately, in the case of Pakistan, preparations for a medical disaster are very meagre given the poor state of our healthcare system. So we are experiencing overlapping of two phases – Preparation and Response. Given the overall state of economy, governments at all levels are doing fairly well to face the challenge. The measures being taken by the government will certainly help in slowing down the rate of spread.

When the coronavirus hit Wuhan, China, it traveled fast. By February hospitals/ medical centers were filled to capacity, and the waiting list to get an ambulance stretched into the hundreds.

Medical practitioners hadn’t yet gotten a command on what they were dealing with, so social distancing measures weren’t taken until it was too late. As a result, the epidemic curve, a graphic representation of the rapid spike in infections, was steep. All measures being adopted by the government would help to flatten the curve if we project the trajectory on a graph.

To keep hospitals and medical facilities from becoming saturated with sick patients, the ultimate goal for public health authorities is to flatten the curve. Social distancing measures can make a serious impact when they’re implemented early, so that, over time, all patients get the resources they need.

This would provide the much-needed space to the limited healthcare system to cope up with the challenge. We need to understand that the government alone can’t measure up to the enormous threat and it has to be a whole-of-the nation approach for a successful response. We have to rise above our political differences to show national resolve and unity in these challenging times.

The writer is a former director general of civil defence and holds a Masters degree in DisasterManagement.