Early in December last year, marriage halls in different areas of Karachi were brimming with people. When Aga Khan University Hospital (AKUH) and Health Department authorities reported the first suspected case of Omicron in Karachi on December 9, the news failed to make an impact as Karachi’s positivity rate was less than one percent at the time. Covid wards at hospitals were lying empty and people had started treating the pandemic like a seasonal flu with mild symptoms.
Around three weeks after the detection of the first case of the Omicron variant, Federal Minister for Planning and Development Asad Umar warned in early January that Pakistan was entering the fifth wave of the pandemic. Dr Faisal Sultan, the special assistant to prime minister (SAPM) on health, also warned that within a week or two hospitalisations would start increasing in Karachi with the Omicron variant spreading like wildfire in Karachi, in addition to the threat posed by the Delta variant in other cities, especially Lahore and Islamabad.
The warnings fell on deaf ears.
As feared by Dr Sultan and the AKUH infectious diseases’ expert Dr Faisal Mehmood, hospitalisation started rising gradually in Karachi with the Omicron variant almost completely replacing the Delta variant. As the positivity rate crossed 20 percent this week, Chief Minister Syed Murad Ali Shah stated that almost 95 percent of the new Covid cases were due to the Omicron variant.
As the number of hospitalisations increased, the mortality rate also started rising in Karachi. Nine deaths were reported earlier this week, indicating that the situation is heading from bad to worse.
Earlier in the week, provincial authorities had said that infection rates of Covid-19 and Omicron variant’s share were increasing, recording these at 11.1 percent and 95 percent, respectively. “Since August 11, 2021, the highest number of cases, 1,347 was detected on Tuesday. Karachi had a 20 percent detection rate on Wednesday. This will lead to increased burden on our health facilities,” said Syed Murad Ali Shah while commenting on the spread of Covid-19 in the city.
The CM said that by Wednesday, around 11,738 Covid-positive cases had been reported in the province, of which 11,452 were in isolation at homes, 122 at isolation centres and 164 were under treatment at various hospitals, adding that the condition of 158 patients was critical, including 18 who were on ventilators.
Karachi is the most affected city in the country recording 1,223 cases out of the 1,347 cases in Sindh. “Karachi’s District East is the most affected, where 440 cases were detected on Wednesday, followed by District South where 363 cases were detected,” said Syed Murad Ali Shah. He said that another 210 cases were reported from District Central, 90 from District Korangi, 73 from District West and 24 from Malir.
Shah worries that despite an alarming increase in the number of cases, some people are not taking the surge seriously. He lament that people continue to ignoring precautions, shaking hands, not wearing masks and not avoiding super-spreader events like wedding ceremonies.
“Such carelessness will ultimately lead to an increased burden on our hospitals. We don’t want to impose any restrictions but if the situation gets worse, what other option will the government be left with except to adopt stringent measures?,” the chief minister asked.
Dr Faisal Sultan believes that there will be a definite increase in hospitalisations following the spread of Omicron variant in Karachi. “There will be some increase in hospitalisation; how much, that depends on the degree of spread and infection,” he says. “International evidence suggests that it spreads fast. How much serious sickness it causes will become clearer in a week or two,” he adds. “What I say is this: we should not take it lightly.”
Urging people to take necessary precautions, Dr Sultan asks people to wear masks, avoid crowds and get vaccinated at the earliest.
Are the authorities worried about the low vaccination rates in major cities, including Karachi and Lahore? “We want it to be higher, for sure. I am happy that the vaccination rates have picked up but we still have some distance to go. I will not say that I am worried but we do need to enhance the numbers further.”
Heads of public as well as private hospitals in Karachi fear that if hospitalisations due to Covid cases continues to increase, they may soon run out of space for Covid patients.
“The number of patients at our hospital has started increasing gradually,” says Dr Abul Wahid Rajput, medical superintendent at the Infectious Diseases Hospital, located at NIPA Karachi. “Daily four to five Covid patients are being hospitalised at this facility. We still have many beds vacant in our HDUs and ICUs,” he says “but this trend is alarming.”
Dr Azra Pechuho, the Sindh health minister, has directed the authorities to launch a 14-day door-to-door vaccination drive in Karachi, Larkana and Sukkur divisions. The drive is intended to target women as most non-working women have been found to be unvaccinated in the province.
In an emergency online meeting with commissioners, deputy commissioners, DHOs from Karachi, Sukkur and Larkana divisions along with Health Secretary Zulfikar Shah and Parliamentary Secretary for Health Qasim Soomro, she expressed annoyance over the low vaccination rates in the province. The low vaccination coverage in urban as well as rural areas of Sindh, she said, was unacceptable, particularly in Karachi where she said a significant number of people had not even received their first dose yet.
The provincial health authorities are considering launching a vaccination drive in two phases with the first covering Karachi, Sukkur and Larkana divisions, and the second covering Karachi again (because of large population), Hyderabad and Shaheed Benazirabad.
According to Dr Pechuho, a 14-day drive is being planned on the pattern of measles and rubella (MR) vaccination drive, for which vaccinators will be hired and lady health workers trained to extend the vaccine reach to women at home by offering the service at their doorstep.
“Some multinational organisations are suspending their activities in Pakistan and Sindh, because of an uptick in Covid infections and the low vaccination rate among people”, she warned.
According to her, 90 percent of the patients in Covid wards were unvaccinated, which she said meant that vaccination targets were not being met.
Health authorities in the province will now be focusing on hotspots, and aim to increase vaccination efforts in these areas. Law enforcement agencies have been asked to follow the SOPs, such as wearing of masks, while also ensuring that the SOPs are followed by the public.
As for precautionary measures, Dr Pechuho has issued several directives to curtail the spread of the infection, including not allowing indoor activities if and where the SOPs are violated. Public transport will be monitored as authorities believe that these mediums cause high transmission.
Unvaccinated staff working in business sectors can be barred from working, and upon denial, businesses may be closed/ sealed till vaccination of the staff is ensured. Home Department is also being asked to issue a mandatory mask advisory.
Besides these measures, an increase in Covid testing as well as random testing from markets and other public spaces can be considered to get a more accurate picture of the spread of the virus.
The number of school children getting vaccinated is very low. To address this problem, school vaccinations can be focused on. Vaccination focus in mosques and madrassahs can also prove fruitful.
The writer is an investigative reporter, currently covering health, science, environment and water issues for The News International