Avoiding a national catastrophe

The writer heads the Sustainable Development Policy Institute.

Social distancing is a set of non-medical measures that can prevent the spread of a contagious disease. It works by ensuring that the physical distance between people is maintained and the number of times people come into close contact with each other is brought to the minimum.

During the ongoing Covid-19 crisis, social distancing has been accompanied by a strict prohibition, or a lockdown, on all social and economic activities in many countries. In some others, a lockdown has not been enforced but people are still being advised to stay indoors and avoid mingling with each other.

In Europe, which has become the second largest coronavirus hotspot after the United States and where most countries, except Sweden, have opted for a long and strict lockdown, social distancing has been a crucial part of the efforts to contain the virus. Some European governments went to the extent of barring their citizens from leaving their homes even for a walk. Sweden, on the other hand, resisted the temptation of a shutdown and relied on voluntary social distancing by its inhabitants.

But that was Sweden, where citizens took social distancing as their collective responsibility – and that too without any strict lockdown. In Pakistan, like many other parts of the world, the government tried to enforce social distancing initially through a strict lockdown, then a relaxed lockdown and now, under the orders of the Supreme Court, voluntary compliance.

First thing first, how will the country fare in its fight against Covid-19 with or without a comprehensive and effective social distancing policy?

A Sustainable Development Policy Institute study – that uses China’s ‘infection fatality rate’ as a benchmark – has projected that the number of Covid-19 deaths in Pakistan would have been as high as 856,528 in the absence of any social distancing measures. The same study estimates that even a moderate lockdown, as was being practised in Pakistan, might have saved 428,264 lives. The worrying aspects of these numbers is that more than 400,000 lives could still be lost if social distancing is ignored completely.

Many argue that Pakistan’s current measures are in consonance with the easing of corona-related restrictions in other parts of the world, particularly Europe and the United States.

The relaxations are ostensibly being made in the wake of a warning by the World health Organization (WHO) that the novel coronavirus may never go away. While medical experts and epidemiologists across the world are still worried that this may not be a suitable policy choice, governments are increasingly wary of having to impose an indefinite lockdown which could destroy individual livelihoods and national economies forever.

This approach, medical experts argue, can only be rationalised on the basis of Covid-19’s stage in a particular country. While China has next to no new cases, places like India are seeing a phenomenal growth in the number of people infected with coronavirus. Similarly, in many European countries the number of people recovering from the disease is rising and the number of deaths from it is decreasing but infections are still surging far ahead of recoveries in countries like Brazil and Russia. So, easing a lockdown might be very risky in India and Russia but not-so-deadly in Italy and Germany where the disease has already peaked.

Where does Pakistan stand in all this? The number of new infections in the country is rising at a more rapid pace than a month ago. Luckily, its coronavirus deaths are still fewer compared to those in Europe and the US but the total number of tests it has conducted so far remains far below the level achieved by many other countries.

The objective of a lockdown is to buy time to prepare for a pandemic, such as developing medical facilities to test, isolate and treat those infected by the virus, conduct large-scale testing in communities most susceptible to the virus and enforce medical caution and social distancing rules in public places such as mosques, markets and shopping malls. One can argue that Pakistan did make efforts to improve its ill-equipped public health systems during the lockdown. However, an increase in the number of ventilators, masks and PPEs may not rectify the ill-managed governance structures which remain as weak and fragmented as they ever have been. What it has done successfully so far is that it has provided billions of rupees in cash grants to the poor and the unemployed and came up with several SOPs for businesses affected by the spread of the virus.

Admittedly, some of Pakistan’s failings are not caused by an absence of will but by a shortage of means. It has a population half as large as that of the EU but its GDP is only 1.6 percent of the EU’s GDP. Understandably, it can neither allocate as many financial resources for upgrading its healthcare system as Europe could nor can it afford to impose a lockdown as long and intense as countries like Germany could.

What is making this complex situation further complicated is the existence of inequalities – both deep and wide – across Pakistan’s socio-economic spectrum. Seen this way, Pakistan is not a monolith. It is, indeed, many countries in one. So, while a large number of Pakistanis coming from urban middle and upper classes have the wherewithal to survive a prolonged lockdown, those at the lowest rungs of the societal hierarchies cannot live even for a day without working. In the same vein, doctors, architects, lawyers, accountants, journalists and bankers possess technological tools to work from home but street vendors, industrial workers and farm labourers don’t have that luxury. Leave alone a lockdown, even self-isolation will mean increased poverty and hunger for this second group of people.

Some people, including the chief justice of Pakistan, have also offered a medical reason for easing the lockdown in the country. They argue that people suffering from diseases other than Covid-19 must get the required treatment, pregnant women must be facilitated and victims of accidents and conflicts must be provided emergency healthcare. A lockdown on domestic travel and restrictions on doctors and hospitals on taking care of non-corona patients make all that impossible.

Studies conducted on the outbreak of the Ebola epidemic in West Africa corroborate their views. These studies suggest that malaria, HIV and tuberculosis killed as many people in the affected countries as did Ebola. Pakistanis suffering from diseases that require regular monitoring and hospitalisation, therefore, cannot be left to fend for themselves.

Having said all that, easing a lockdown with little to no caution runs the risk of turning the existing Covid-19 situation into a national catastrophe. Every sector of the economy and society must, therefore, realise its individual and collective responsibility to ensure that all the required measures for social distancing are properly followed. Keeping shops shuttered and closing down business and industry is certainly not feasible for Pakistan, given its financial and economic limitations, but these activities – as well as religious gatherings and public festivals – cannot be allowed to become a cause for the spread of the virus to unmanageable limits. Lives and livelihoods are certainly inextricably intertwined but livelihoods that hurt lives are neither economically desirable nor morally acceptable.

Worryingly, the signals people are getting from various tiers of the government and many public representatives are at best confusing and at worst conflicting. While some parts of the state still believe in imposing a strict lockdown, at least for a limited period of time, others have displayed their scepticism publicly over the very seriousness of coronavirus in Pakistan. Still others have been seen violating social distancing measures on multiple occasions.

The message that most people in the country are extracting from all this is riddled with conspiracy theories, confounded by rumour-mongering and overlaid with destructive fatalism which is not limited to a particular socioeconomic group. A vast majority of Pakistanis believe that matters of life and death are beyond their control so they need not worry about them at all. Given these circumstances, the government certainly has a difficult job at its hand. It has to save the national economy from collapsing but at the same time it needs to ensure that Covid-19 does not become a disaster of uncontrollable proportions. The only way the government can successfully achieve these two objectives together is to create a political and public consensus – both within parliament and on the streets – that a carefully developed and comprehensively enforced social distancing regime is our only bet to save lives and protect livelihoods simultaneously.

Sweden could survive without a strict lockdown as its citizens voluntarily implemented social distancing. If we would like to avoid a strict lockdown then people will have to follow social distancing measures. Flouting social distance is akin to opening the floodgates of a disease which will neither spare lives,nor livelihoods.

Twitter: @abidsuleri