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March 24, 2020

Significance of Saeed Ghani’s case

Pakistan

March 24, 2020

ISLAMABAD: When Saeed Ghani was tested positive on Monday for coronavirus, he was taken aback.

Sindh’s education minister has not been to any hospital or quarantine facility recently where he could have contracted virus nevertheless he did. “I am now thinking of the person who has infected me. I don’t think even if he knows he’s been infected,” he said talking to The News.

Saeed is surprised at this discovery also because he didn’t have any symptom of a coronavirus like cough, fever, respiratory problem and tiredness. Now he has his wife tested to ensure she hasn’t contracted virus from him; children will follow. He has also made his case known so that people he met recently could also have themselves tested. Saeed’s case bears significance for a couple of reasons: 1) he doesn’t have a recent foreign travel history which means the virus is locally transmitted; 2) he didn’t have symptoms of a coronavirus patient.

If the evidence is taken a guide, he is not the first such case. In Sindh alone, 24 percent of the total patients are locally infected. As of Monday evening, there were 83 such cases; all of them in Karachi. Sindh is proactively tracking this local transmission which, if goes unchecked, can create a major health emergency difficult to handle through dysfunctional health system.

“We are using immigration data to track those having returned Pakistan after January 15,” Saeed Ghani said. One woman who returned from Umra has infected as many as 12 people in Karachi. She went to attend a wedding not knowing she is carrier of corona.

When and where a foreign-returned is tested positive, Saeed said, we get to know whoever he has met since landed in Pakistan. They are also tested. In case of any positive result among them, he continued, we do another round of testing of those the infected individual has met. In Sindh, as many as 3316 suspects have been tested till Monday and 11 percent (352) of them are positive. This disclosure of local spread of the virus triggered provincial government’s decision of immediate lockdown in order to contain the transmission and isolate the affected population.

The situation is different in other provinces. As of Punjab, officials there claimed that there is no local spread. Other than a Wazirabad-based journalist tested positive without having any travel history, there is no other local case, according to officials with whom The News spoke on late Sunday. Punjab’s statistics are not available but the number of tested suspects is significantly lower than Sindh. Less tests means less cases. As for as Khyber Pakhtunkhwa is concerned, 448 people have been tested which form 14 percent of those tested in Sindh.

Contrast this with the number of people who enter Pakistan every day. Before the closures of border and flights, Pakistan used to receive 60 thousand people through Torkham, Taftan and airports, said an FIA official. We have shared the information of passengers (from January 1 onward) with Nadra that provides detail to Pakistan Telecommunication Authority (for mobile phone details) and the information is passed on to Ministry of Health through Directorate of Military Operations. “Health officials are approaching everybody who has returned from abroad,” said an FIA official. However, The News found passengers returned from Umra on March 10 haven’t been contacted for tests. If there is any vigilance at display in this respect that can be found in Sindh.

In addition to local transmission of the virus, another issue, which is also evident from Saeed Ghani’s case, is related to the growing number of asymptomatic patients. The News spoke to officials of Punjab, Sindh and KP. All were unanimous on this finding. Incidentally, Saeed while talking to The News a day before turning positive was highlighting this point to explain that many patients would go unchecked if symptom was the only measure to test somebody. “Asymptomatic is a new phenomenon which was first surfaced in Diamond Princess Cruise Ship quarantined aboard near Tokyo,” Dr Rana Jawad Asghar, an epidemiology expert.

Taking one quarantine facility in Dera Ghazi Khan as example, a well-placed official in Punjab said late Sunday that out of 159 tested positive, as many as 150 patients are asymptomatic. In Sindh, 90 percent of the patients are asymptomatic. A KP official put this estimate at “more than 80 percent.” This discovery has its positive and negative aspects. “Theory is that asymptomatic patients have strong immune system and therefore practice of social distancing can save them from further implications,” said an official. However, if such asymptomatic patient goes untested and socialise with people having weak immune system, they will be in trouble.