Testing must be available free of cost for the virus for all those showing symptoms of Covid-19 or those that have been in direct contact with such patients
As I read what many western countries are going through in their ‘war’ against the Coronavirus, I cannot but wonder what is worse, the disease or its treatment?
Already in the United States the response to the pandemic has resulted in severe economic dislocation. If things continue as they are, the US is headed at least for a major recession. If things keep up there could be lockdowns that will be essentially like curfews,
Personally, I am all for reasonable attempts to fight Covid-19. The problem, however, is to decide what is reasonable. Where there is a choice between life and death, it is often difficult to be reasonable.
We live in a society where choices that essentially determine who lives and who dies are made without much public discussion. A small example. Just look at the ‘waiting list’ at any specialised public heart centre. ‘Non-affording’ patients who need urgent heart surgery are often told to wait for more than a year before they can be operated upon. That wait for many of them is a death sentence of sorts.
My purpose today is not to belabour the problem of waiting lists for critically sick patients who are too poor to pay for their treatment. The point is that in a poor country like Pakistan we generally don’t get quite as frantic about a few ‘preventable’ deaths as those that live in the so-called developed countries of the world.
I could present a list of serious health issues in Pakistan that need urgent attention and they do and most likely will cause many more ‘preventable’ deaths than what Covid-19 can cause at its worst. But I will ignore those for the mean time.
Frankly, the sort of steps being taken, by the US for instance, to control this epidemic remind me of what we said about surgeons that performed major radical operations on very sick patients that were often of dubious benefit. What was said was that the operation was a success but the patient died. Or perhaps what the US army supposedly said during the Vietnam war that ‘they had to destroy the village’ to save it from the communists.
Here I am going to let the US and Europe alone and think about Pakistan. Around half of our population lives at or below the poverty level and among them, there are many daily wage workers. Besides them there are the waiters in restaurants, transportation workers and even white-collar workers employed by small businesses that really cannot afford to be laid off.
The prime minister of Pakistan was entirely correct when he said a few days ago that if we had a western style lockdown in Pakistan, people would start dying from hunger. But that does not mean that Pakistan will not do anything at all to try and limit the Covid-19 epidemic.
The first thing I strongly suggest is that everybody ‘out and about’ should wear a mask. And the government should make sure that masks are available at no cost to all those that need them. And no, I am not talking of the special masks used by health workers taking care of Covid-19 patients.
Here it is important to point out that ordinary ‘surgical’ type masks do not prevent infection but do decrease the chance of getting infected. More importantly infected but not symptomatic (actually sick) people will have a significantly lesser chance of spreading the infection if they are wearing an ordinary mask properly.
Also, testing must be available free of cost for the virus for all those showing symptoms of Covid-19 or those that have been in direct contact with such patients. And of course treatment for infected patients should also be free in public hospitals.
And older, retired people should stay at home except for emergencies and necessary trips outside their homes.
Things that are already being done like school and college closures are a good idea. As long as it is for only a ‘relatively’ short while. But then from an historical perspective, closing educational institutions has been done a lot.
My medical school class was the last one to graduate in five years. After 1970, it took more than a decade before an MBBS student graduated in five years again. For instance the MBBS class that should have graduated in 1978 finally graduated in 1980.
Besides closing down educational institutions, commercial malls and many restaurants have been closed down in Karachi. Indeed places where many people get together can allow the infection from this virus to spread. But in my opinion closing down all big shops and malls is avoidable.
All those young men and women with a basic education that are unemployed or are losing their regular jobs should be hired by the government as ‘infection monitors’. They can be placed at entries to malls and big stores equipped with temperature ‘guns’ and face masks. If a person has a fever, that person should not be allowed to enter but should be advised to go to a hospital for a checkup. And those without masks should be given one to wear.
All those young men and women with a basic education that are unemployed or are losing their regular jobs should be hired by the government as ‘infection monitors’. They can be placed at entries to malls and big stores equipped with temperature ‘guns’ and face masks.
Such mass employment for a particular purpose has been done during the census taking a few years ago. And every census taker was accompanied by an armed member of the military. If these infection monitors are accompanied by an armed member of the security forces then their recommendations will be more effective.
But the public as well as the ‘shop keepers’ will have to be cooperative and make sure that everybody in a shop is wearing a mask. I believe that after a week or so of such a regimen, most people will start following such instructions.
Restaurants are, however, a problem since eating with a mask on is rather difficult. I know that from a forty year personal experience since I have had to wear a mask during much of my professional activities. So I suppose big restaurants and wedding halls that can cater to dozens of people at the same time might have to be closed down.
However, small roadside eateries that can barely seat a couple of people at a time and that also in open air should be allowed to function. Of course, the facility to wash hands must be available and appropriate distancing done. Under these circumstances patrons can take their masks off while they eat.
One area that needs attention is congregational prayers in mosques. We in Pakistan should probably follow the lead of Saudi Arabia as far as praying in public is concerned.
Our public health experts working with the business community can figure out how many other types of businesses can continue to function safely. As far as working from home is concerned, only a small slice of people in Pakistan have that capability available to them.
Finally, I am sure that my readers know what a Pyrrhic victory is. For those that do not, it is named after a king, Pyrrhus, from a long time ago who kept winning battles but had his army decimated with each victory so that his victories were essentially worthless.