COVID-19: Building a case for optimism

Pakistan is not alone in facing an unprecedented challenge caused by the spread of COVID-19. Containing its spread, isolating the infected and treating the seriously affected are daunting challenges confronting the country. Considering the limited resources at hand, the response from federal and provincial governments is satisfactory and has been applauded by the citizenry and international institutions.

The basic transmission mechanisms of the COVID-19 are identical everywhere, but the speed and pattern of spread varies from place to place. The most important global indicator is the comparative spread of the disease in Europe, USA and South-East Asian countries. Within two months of the emergence of the first case, the disease has caused 355 deaths per million in Spain, 322 in Italy, 62 in USA, while morality rate in South East Asian countries remained far lower, with Thailand recording 0.5 deaths per million, Indonesia 1 per million and Malaysia having 2 deaths per million of the population.

The difference in mortality and morbidity in these two regions can be attributed to mandatory BCG vaccination, median age difference, cross immunity with the malarial parasite, higher temperature and relative humidity, and daily average sunshine. The difference may be multi factorial and no direct causative links have yet been identified. However, WHO continues to view the COVID-19 outbreak from a global perspective, suggesting one fix for all solutions due to exigency.

Developing countries have been criticized for under testing their population due to resource constraints and also of data manipulation. While it is easier to manipulate data but mounds of dead bodies and heaps of people struggling to breathe is harder to conceal.

The first COVID-19 case in Pakistan emerged on February 26, 2020, surprisingly two months after the outbreak began in China when a pilgrim from Iran returned to Karachi.

Over the last 45 days the disease pattern in Pakistan is similar to other regional countries of South and South East Asia with low mortality rate of 0.4 deaths per million and about 150 critically ill patients. Currently a major number of COVID-19 patients have returned from abroad and most of the secondary infections have had a history of direct contact with these patients. Major clusters of the outbreak in the country are quarantine centers housing pilgrims returning from Iran and Tableeghi Jamaat Marakiz. Incidences of spontaneous local outbreak affecting hundreds in communities remain either low or altogether absent.

On informal inquiry, friends and colleagues working in different hospitals, health authorities and district governments across the country, have not reported any unusual spike in hospital visits for unexplained respiratory distress or pneumonia in the previous days. The virus might be present in our community before the official announcement of the first case and considering an average incubation period of 5 days, the disease has already completed 10 cycles of spread in Pakistan. Although little empirical evidence is available, still the comparative numbers clearly show that spread of the COVID-19 virus in our country is slow and comparatively inefficient, similar to the pattern in other South East Asian countries with similar environmental conditions.

The spread of the disease will hopefully slacken in the coming days with rising temperatures and humidity. Due to high stakes and uncertainty about a new condition, experts are generally cautious in issuing any statements that may invite complacency in governments, however, preliminary data obtained from China, USA and other parts of the globe suggests that spread of COVID-19 is also sensitive to temperature, sunshine and humidity.

With the information available on the mortality, morbidity and spread of the disease in Pakistan, there are reasons to be optimistic that we will endure this crisis with limited loss of life. However the economic damage might not be manageable. The World Bank is painting a dire picture of the country falling into recession for the first time in its history. Pakistan’s economy is expected to shrink up to 2.2% with a sharp decline in per capita income.

After the initial success in containing the devastation of COVID-19, focus must be shifted towards restarting the economy at the earliest, while adhering to social distancing measures. Arrangements like online schools, work from home, rotational duties in offices, ban on marriage functions, closure of shopping malls and restrictions on prayer congregations should continue till the daily number of cases show a considerable declining trend for at least two consecutive weeks.

Relief package to the construction sector is a step in the right direction and should be extended to other sectors of industry. Currently, most of the industrialized world is grappling with the devastation caused by the virus, with some reports predicting national lockdowns in some European countries and the USA to continue for a year. Reassessing the needs of the global supply market is crucial for us at this moment and our export driven economy needs to adapt to the drastically changed global demands.

The events unfolding since the announcement of the national lockdown in Pakistan clearly show that the economic challenge presented by COVID-19 is grimmer and will outlive the biological challenge. In a globalized competitive world, seizing the moment is the most important part of development and utilizing the unique global opportunities at hand may eventually assist the country in tackling the long term economic devastation caused by COVID-19.

Dr. Awais Zafar

The writer is a doctor and diplomat