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March 28, 2020

Desperate measures

Opinion

March 28, 2020

Like all of you I have been witnessing the news from around the world related to Covid-19 and its global impact. When I saw that 793 patients died in Italy in one day, I was shocked although not surprised. Italy has a population of around 65 million, and despite a lockdown for more than two weeks they are still unable to effectively control the damage and seeing rising deaths on a daily basis. I just wondered what the impact would be if this terrible disease gets out of control in Pakistan, with a population almost four times compared to Italy, with our limited healthcare resources.

During a pandemic, there are two options available to help control the impact. Ideally, both options need to be implemented concurrently, and even a few days delay can have catastrophic consequences. Option A is rapid, efficient and effective testing of patients and their contacts, along with early quarantine and isolation. Option B, involves following strict social distancing to prevent spread of the disease within the community.

Developed countries like the UK, US and most European countries, despite their wealth, modern technology and advanced resources, were unable to succeed by using option A alone in the beginning and are now grappling with the consequences of their delayed response. Now they have had to make tough decisions and resort to lockdowns. Today, some states in the US are locked down and the same is the case for multiple countries in Europe.

Pakistan got hit with the virus a little late and that should have given us a head start in this battle. But unfortunately due to limited testing and inefficient quarantine, we are seeing a daily and consistent rise in cases. I have received hundreds of jokes about the virus and this disease, from Pakistani people in general and even physicians. It seems very few people are taking this threat seriously -- and especially government officials. This worries me. During this critical time, everyone has to do his part, and by everyone I really mean every single one of us. We need to always ask for Allah’s help and specially during these testing times. Anas ibn Malik reported a Hadith: A man said, “O Messenger of Allah, should I tie my camel and trust in Allah, or should I leave her untied and trust in Allah?” The Prophet, peace and blessings be upon him, said, “Tie her and trust in Allah".

As mentioned earlier, the two options we have are efficient testing + effective isolation and social distancing. Both of these options must be followed simultaneously. Developed countries are reeling from the impact not because they are not following these options, they are hurting because they were too late in implementing them. Pakistan unfortunately is way behind as we are unable to follow any of the two options, so just imagine how terrible the consequences can be for us.

As an ordinary citizen, you cannot help much in following option A as that is the job of concerned authorities. But as a nation you can help reduce the impact by strictly following social distancing guidelines. Please do not go out unless absolutely necessary. Wash your hands when you enter your home before touching anything. Cancel all parties and gatherings. Avoid crowds at all cost. If someone is sick, please isolate him/her in a separate room if possible as I am sure there are not enough testing kits available.

When you decide to break the social distancing rule, you are putting not only yourself, but also your family and whole community at risk. When I say social distancing, it just doesn’t mean contact with strangers but also distancing yourselves from your siblings, parents and children as well if they don’t live with you in your house. A few weeks away from them can be life saving for your family members, especially the elderly and those with chronic illnesses. Elderly people are at a much higher risk of having severe disease and decrease chances of recovery, and this can put physicians at a terrible spot to decide whom to save and whom to let go. Please don’t make physicians like me choose between your 70-year-old mother or a 30-year-old father of two. We don’t want to be in a position like this which can haunt us for rest of our lives.

In the end I want to make a plea to the government authorities and especially to PM Imran Khan to please take this crisis seriously. No matter how many beds you increase, how many ventilators you buy, how many testing kits you import, without a mandatory lockdown this terrible disease will cost thousands of lives, if not millions. People in Europe and parts of the US are in lockdown too to control this pandemic. These decisions are not to be made next week, or next month, they must be made right now.

Without a proper lockdown I don’t see a happy ending to this crisis. I would love to be wrong on this, and I pray to Allah that my concerns and predictions are proved wrong.

The author is a Pakistani American working as a pulmonary, critical care and sleep medicine specialist.