Response to Covid-19

Eminent doctors in Karachi and Lahore, most of whom have a work history of dedication to serving the poor and the vulnerable, held press conferences in their respective cities warning the governments (federal and provincial) that until and unless strict lockdown is enforced the coronavirus will spread exponentially that the existing health infrastructure would be unable to cope with and the number of deaths as a percentage of the total infected may, therefore, be much higher than in other countries. Including Secretary General Pakistan Medical Association, Dr Qaiser Sajjad, Indus Hospital's head Professor Abdul Bari Khan, Professor Azeemuddin of the Pakistan Islamic Medical Association and Professor Atif Hafeez Siddiqui - doctors unlikely to be swayed into making political statements on the say so of any one including the Sindh government - the doctors released some disturbing statistics: "week-wise data suggests an exponential increase in the number of Covid-19 patients. We have seen a rapid increase in the numbers in just five days (6,772 on April 16 to 9,464 on April 21) - an increase of 2,692 patients. This is very alarming and we fear the situation is getting out of control of the doctors and the governments in the country."

The doctors unanimously contended that "with all due respect, our government has made a very wrong decision and our ulema have demonstrated extreme insensitivity [akin to] playing with human lives." This was supported by the Sindh government which stated that the agreement between the federal government and the ulema on opening mosques for daily congregational prayers and taraweeh during Ramazan is confusing and beyond logic. Reports indicate that the decision to open mosques was made in light of the ulema challenging the government's decision to reopen construction industry and not mosques. The only option for the government, reports contend, was to insist on the same standard operating procedures (SOPs), social distancing, for the mosques that it has established for the construction industry though implementation would be the key to ensuring that the virus does not spread - and needless to add, implementation is particularly weak in this country with the Prime Minister urging the police to guide those on the streets rather than arrest them and the Sindh government's stricter lockdown rules now being openly flouted by the public partly because of the need to procure necessities as well as the desire for an 'outing' after being couped up in their homes for weeks and partly because of conflicting signals from the federal government.

The projected increase in the number of patients was supported by Special Assistant to the Prime Minister on National Health Service Dr Zafar Mirza who recently stated that the number of suspected cases of the virus is increasing at an average rate of 12 percent which he added was a "matter of concern." The Prime Minister guided by his team including Dr Mirza stated during a recent press conference that Pakistan is expecting to see a spike in the cases by the middle of May, the second half of Ramazan, and one would sincerely hope that this projection is not based on an assumption of open violation of the SOPs for mosques as well as opening of other industries.

Perhaps the most poignant of all comments made by one of the doctors was that he was unsure of how many have died of hunger (the Prime Minister's overarching objective in all his press conferences since almost the first coronavirus patient was identified in the country) but deaths as a consequence of contracting the virus are almost certain; and projected cases to rise to 70,000 out of which 7,000 may need life support whereas Pakistan's health infrastructure allows for only 3,500 to be treated.

There is, therefore, an urgent need to take the unpopular decision of a lockdown/curfew to check the rise in the number of patients. The federal government is nearing the end of phase two of cash disbursements under the Ehsaas programme and perhaps it is time now to focus on ensuring that the projected spike in the number of cases does not take place rather than insisting on opening industries/mosques under SOPs that may or may not be implementable by civilian law enforcement; and the army, with experience of implementing a strict curfew, may have to be called in.