The downward trajectory of coronavirus has cut down the ratio of active cases (to total recorded infections) by more than half in the Punjab during the last month – a development that has prompted some experts to suggest that the pandemic may just be “past its peak”.

Official statistics show that the ratio of coronavirus-positive cases from normal testing declined from 23 percent at the start of previous month to 10 percent by the end of first week of this month, pointing to a downward trend in the spread of the dreaded virus in the province.

As per the Punjab’s official data over the last one month, released by the Primary and Secondary Healthcare Department on a daily basis, as many as 1,610 cases were confirmed positive out of 6,932 tests with a ratio of 23.22 percent on June 1. This percentage dropped to 9.92 percent with 706 cases out of 7,116 tests on July 6, a decline in the ratio of Covid-19 cases by more than half (57.28 percent to be precise) in the space of one month.

A similar declining trend is reflected in the weekly data over a period of last three months with the drop in ratio of coronavirus-positive cases from 24 percent in the second week of April to 12 percent by the end of first week of July.

As many as 925 cases were confirmed positive out of 3,922 tests with a ratio of 23.58 percent between April 6 and April 12, which dropped to 11.87 percent three months later with 6,572 cases out of 55,333 tests between June 29 and July 5, thereby establishing the drop in the ratio of Covid-19 cases by almost half (49.67 percent) in the space of three months.

The pandemic has seen highs and lows between the comparative monthly and tri-monthly periods with the curve rising, flattening, dropping and then surging again, until eventually maintaining a consistent downward trend since the peak in early June and falling drastically over the last three weeks – from June 20 till July 6.

The death rate due to coronavirus in the Punjab also declined in the latter half of June. Following the high of 86 deaths in a day in the Punjab on June 25, the number of Covid-19 mortalities has consistently decreased resulting in an average of less than 20 fatalities a day till July 6.

The Imperial College, London, in its scientific study on South Asia released on July 5, revealed that the Covid-19 pandemic in Pakistan is “on course to fade out”. The number of people testing positive in Pakistan has declined to 1 in 6.36 (15.7 percent) in the first week of July from the peak of 1 in 4.47 (22.3 percent) on June 4. The weekly Covid-19 deaths in Pakistan have also declined to 577 this week from 869 last week. “Since the effective coronavirus reproduction rate (Rt) of less than 1 indicates each infected person is infecting fewer than one person, Pakistan’s Rt at just 0.74 is among the lowest in the world,” the report says.

Dr Shahid Malik, the general secretary of the Pakistan Medical Association’s (PMA) Lahore chapter, agrees that the pandemic may have passed its peak, but warns that it may return in a more lethal form if citizens behave carelessly. “The declining trend of Covid-19 incidences consistently for 10 to 15 days points to the disease losing its virulence,” he says, calling this inference a mere clinical assessment because trends aren’t based on any scientific evidence the world over. “We need to be vigilant as some countries, including China, have witnessed a second spike of coronavirus,” he adds.

“Although a vast majority of asymptomatic patients have developed immunity against the existing strain of coronavirus, they remain vulnerable to a second spike of the virus which has a tendency to mutate,” says Dr Shahid Malik, general secretary of PMA’s Lahore chapter.

While calling social interventions like smart lockdown and implementation of standard operating procedures (SOPs) as insufficient and of little effect, Dr Malik says that a vast majority of people got affected but remained asymptomatic and recovered naturally, which was a major reason in the decrease in the number of testing. “Although a vast majority of asymptomatic patients has developed immunity against the existing strain of coronavirus, they remain vulnerable to a second spike of the virus which has a tendency to mutate,” he says adding that a resurgence of coronavirus in a mutated form might be particularly dangerous to patients those who have already been affected with one strain of the virus, and could turn into a fatal hemorrhagic fever.

There are rumours of less testing in a bid to report a decrease in the number of new cases and mortality due to Covid-19. The number of tests done in the Punjab has in fact come down drastically, particularly in the latter half of June.

When coronavirus was supposedly at its peak in early June, the Punjab government conducted up to 12,412 tests in a day (on June 17) for symptomatic patients and those suspected in contact-tracing. The number has declined consistently to as low as 7,116 on July 6. The largest number tests done in a week was 69,697 (from June 15 to June 21). This figure fell to 55,333 for the week from June 29 to July 5.

The Corona Expert Advisory Group (CEAG) has confirmed that, although the Punjab has a capacity of 12,000 tests per day, the actual number has decreased. “The main reason for the decreasing number of tests is a change in our strategy i.e. we stopped testing asymptomatic patients and inbound air travelers. The condition of two negative PCR tests for a discharge from hospital has also been relaxed leading to a reduction in the burden on hospitals,” says Rafia Haider, a CEAG member. However, she says, the Punjab is adding testing by the day and a further capacity for 1,000 tests would be added to deal with any situation.

Prof Dr Mahmood Shaukat, the CEAG chairman, says that the strategies to contain coronavirus were being modified continuously to suit the demographic realities. “The experts review decisions on a daily basis and make changes accordingly. Our first priority is to use the available resources efficiently and effectively,” he says adding that the social and medical interventions such as lockdown, smart lockdown, treatment plans, testing strategies, SOPs etc had all helped arrest the spread of the disease.

Health Minister Yasmin Rashid says that the ratio of Covid-19-positive cases from normal testing has fallen from 23 percent to 13 percent since early June. As such, she says the number of patients in intensive care and high dependency units (ICU/HDU) is decreasing. “Smart testing in Lahore, the epicentre of Covid-19 cases in the Punjab, has also indicated a decrease in positive cases to 0.74 percent in the first week of July from 5 to 6 percent from testing in early May,” she says.

She quotes the Imperial College of London report, which says that the latest numbers vindicate the government’s “smart lockdown” strategy of requiring face masks and selective lockdown of hotspots. “A smart lockdown with the implementation of SOPs such as wearing masks, washing hands and social distancing will help minimise, control and eventually, get rid of Covid-19,” she adds.

The writer is a reporter for The News in Lahore