This is not the end

As far as Pakistan is concerned, no major changes — political, social or economic — are likely

The world is not coming to an end. And contrary to what all the Chicken Littles have to say, the sky is not falling either. To put it in perspective, out of a world population approaching eight billion people, some two million are known to be infected by the new coronavirus. And about two hundred thousand people have died so far.

There is no such thing as a preventable death, since we will all die eventually. However, what is important is that there are premature deaths that can be prevented. Most of medicine and public health is aimed at prolonging life and improving the quality of life.

Covid-19 will probably kill far fewer people in Pakistan than entirely preventable causes like auto accidents, malaria, gastroenteritis, and treatable causes like heart disease, high blood pressure, diabetes and so many others. Still, Covid-19 is a big deal.

If so few people have been infected and have died from this virus then why is everybody so worried about this particular infection? The reasons are that it spreads easily and rapidly, it has no effective treatment, it has a relatively high mortality rate (at least ten times as high as usual influenza) and it makes many of those infected sick enough to require hospitalisation and thus overwhelm the medical care systems.

Different countries affected by this pandemic have responded in different ways. Prevention is accepted as the best ‘cure’. That said, there is no general consensus on how to prevent the spread of this virus. Complete lockdowns are one way of preventing the spread. Suspension of most economic activity in many countries has resulted in millions losing their jobs. This cannot go on for much longer without serious long-term consequences.

The one question that everybody is asking is when will this pandemic end? The short answer is that we really don’t know. What we do know is that all pandemics eventually end and so will this.

There are three ways this pandemic can end. First is that the virus mutates and becomes less contagious and less dangerous — we hope. The second possibility is the development of ‘herd immunity’. This means that enough people will develop immunity to this virus either by getting infected and surviving or by being vaccinated against it when a working vaccine becomes available. Presence of a large number of such people will then prevent the spread of the virus.

The third possibility is the most undesirable one. In this almost everybody in the world that is susceptible to this virus will get infected, millions will die and those that are able to fight off the infection will survive.

As far as the hope that hot weather will bring an end to this pandemic, temperatures in Pakistan are creeping up to forty degrees centigrade and the virus does not seem to be slowing down. Let us see what happens when it gets to be around fifty degrees in the shade.

Unfortunately, so far no existing medicine has been found to be effective in prevention or effective treatment of Covid-19. And this includes the anti-malaria medicine touted by President Trump.

It does seem that the ‘curve’ is starting to trend downwards in many places, including New York State as well as New York City. This means that the number of new patients is decreasing and, most importantly, the pressure on healthcare facilities and hospitals is also getting less intense. Some states in the US and some countries in Europe are optimistic about re-opening business activity.

The big question is the speed with which the world economies will recover. If things start getting better in the next few months then chances are that we will see a world in 2021 more or less like it was in 2019.

During the height of the pandemic some interesting things become evident. First is that in most countries affected by this pandemic, the governments are using this disease as a reason to institute policies that they support from a political perspective, policies that really have no direct impact on the pandemic itself.

Best example is the United States which has been particularly hard hit. The US president is using this pandemic to strengthen anti-immigrant policies and ‘under the radar’ is ordering cutbacks in many ‘environment friendly’ regulations. And next door to us in the worlds ‘largest democracy’ the present government is using the pandemic to expand on its anti-Muslim policies and rhetoric.

What is also becoming obvious is the divide between the political conservatives and the political liberals. In general, liberals support the policies of lockdown and social isolation to prevent the spread of this virus. Most conservatives want to end or at least cut back on the social and business restraints.

It is almost as if one side worries most about the health of the economy and the need to earn a livelihood and on the other side is the need to save as many lives as possible. In the mix are the religious conservatives that want freedom to practice their religion as they wish. And this need for religious freedom completely ignores the possible transmission of the virus during religious ceremonies and congregations.

This difference in approach to the pandemic is pretty obvious in the way the government in Sindh wants to fight against this disease and the attitude of the federal government and the government in the Punjab. On one side is a centre-left Pakistan Peoples Party (PPP) and on the other side we have the centre-right Pakistan Tehreek-i-Insaf (PTI).

Essentially, what we have is the mosque and the bazaar against the liberal ‘intelligentsia’ wedded to scientific ideas wanting to follow expert advice on the right way to fight this disease and to prevent any unnecessary loss of life. This scenario is being played out with some modification in the US also.

As futurists and forecasters try to figure out what will happen to the world after the pandemic, the big question is the speed with which the world economies will recover. If things start getting better in the next few months then chances are that we will see a world in 2021 more or less like it was in 2019.

The future of the US is, however, quite difficult to predict. In six months the US will be going through a general election. If the US economy has not rebounded sufficiently and the high unemployment persists then it is possible that the Democrats will win the presidency and possibly both Houses of Congress.

If the Democrats do win then we could see some fundamental changes in the political landscape with something like a new ‘New Deal’ being enacted. But then maybe it will be Trump and the Republicans back in power and the US continues to develop in Trump’s image.

As far as Pakistan is concerned, I do not expect any major change politically, socially or economically. All the dire predictions about Pakistan in my opinion are not applicable. As Bob Dylan sang more than fifty years ago, though in a slightly different context: “When you ain’t got nothing, you got nothing to lose.”

There is one thing I can predict with much assurance. The Mayo Hospital in Lahore will end up with a lot more respirators than it will ever need. And most of the insides of these respirators will end up in the used machinery market in Bilal Gunj.

The writer has served as Professor and Chairman at the Department of Cardiac Surgery, King Edward Medical University

This is not the end