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April 1, 2020

Strategy to tackle Covid-19


April 1, 2020

While the federal health ministry continues to fiddle with data on the severity of Covid-19, people are exposed to high risk of mass annihilation.

With the limited capacity of testing and screening and as Covid-19 infections become widespread across communities, we stand to face the worst crisis of our history. If we fail to respond with full strength by testing and screening at the communal level, we will not be able to stop the exponential growth of this pandemic. What is being reported on infections and deaths in the country is the tip of the iceberg only.

At a time when the economy is in shambles, the health sector is underdeveloped, public governance is weak and political leadership is divided, you cannot win wars against an invisible enemy. When we look at the exponential growth of infections and deaths in the developed world, despite being better placed as compared to us, we have strong reasons to be skeptical of the official reporting of corona cases in Pakistan.

Like Italy and the United States, we responded late and that is the only commonality between them and us. But in all other spheres like at airports and at national borders we committed bigger blunders than Italy and the United States, by allowing an influx of international travelers without proper screening Right now, we do not know exactly how many corona positive patients entered the country and we do not know their contacts’ traceability to determine the actual number of infected population.

On average, each infected person can transmit the disease to three persons a day – which means that those who have entered the country and have not been tested might have transmitted the disease to thousands of people by now. There is also a significant number of those who are infected but are asymptomatic and hence they are also transmitting disease at an exponential rate on a daily basis.

Unfortunately, Covid-19 is much faster than the pace of decision-making of our politicians. There are a number of factors contributing to the disaster in Italy which could have been avoided in Pakistan had the government come out strongly with proactive and well-informed strategies. Till now laxity, hesitation and indecision have created confusion more than offering a solution to the problem. Pakistan is in a bad shape to handle the healthcare challenges as well as economic shocks of the pandemic as compared to Italy. Our health system is underdeveloped, underfunded and disintegrated which cannot cater for even a few thousand additional patients.

Rather than learning some lessons from the Italian case, our prime minister continued to obsess with his idea of not going for a national lockdown. To him a sudden decision of lockdown could lead the ailing economy of Pakistan into an even bigger disaster, in particular for the poor of this country. What the prime minister was saying made good sense but what he did not say or what he said rather late was about the strategy to ensure the economic protection of the poorest of the poor.

The empirical evidence of the last 18 months suggests that the idea of the economic protection of the poor has not been a priority for the current government. The tirade of empathy and compassion towards the poor which the prime minister expressed during his unilateral sermons in his media briefs was not substantiated by reality given that poverty increased by 10 percent during the last one year.

One can wonder only why the prime minister and his team took a whole month to come up with a corona relief strategy. With scant resources, lack of skills and poor infrastructure, the provinces have at least shown seriousness but the federal government did not seem to be bothered enough to provide leadership in tackling the emergency. The prime minister’s actions suggested that he was waiting for some miracle to turn the tables for Pakistan without burdening his ‘strategic team’ to address the crisis.

While there is no scientific reason to show laxity in the face of a global pandemic taking human lives, the government seems to be comfortable with a two percent death rate. If we leave it to miracles rather than formulating a comprehensive national action plan in a country of more than 200 million people, a two percent death rate is huge.

More importantly, this is not only a numbers game but also about the ethical value of saving our people from this contagious and deadly disease. A two percent death rate is applicable only for the most developed countries with a universal healthcare system, adequate economic resources and proactive leadership while ours is devoid of all these.

The government must utilize the strong administrative apparatus of district government for tracing, identifying, screening and quarantining the infected population, In addition to district health facilities, the government must transform all public buildings into screening and isolation facilities to cater to local patients. In addition to medical and paramedical staff at the district level, the provincial governments must seek the services of local NGOs to conduct intensive training of screening and basic medical aid at local level.

All railway carriages must be transformed into screening and quarantine facilities so that there is enough space to accommodate patients where army medical corps and locally trained paramedics can be deployed immediately.

Through a presidential order, the federal government must engage the Foreign Office to ensure procurement of all necessary protective gear including at least 60,000 ventilators; 300,00 PPE and testing kits; and millions of masks. Healthcare teams of army medical corps and locally trained paramedics can be deployed to serve at district facilities as additional support to district health teams. The screening and testing must be enhanced multiple times and it must be decentralized to the district level with proper mechanism of supervision and monitoring.

The government must immediately bring down the interest rate to the minimum up – five percent – while reduction in fuel prices should be made for those vehicles of less than 1500 CC. The revenue generated through these actions must be spent to enhance the relief package for the poor. The government must also negotiate deferred payments, if not concessions, with international lenders.

The federal government must develop a rigorous reporting and information transmission regime in coordination with the provinces to help devise an appropriate and timely response to the severity/intensity of pandemic.

The writer is a socialdevelopment and policyadviser, and a freelancecolumnist based in Islamabad.

Email: [email protected]

Twitter: @AmirHussain76