Is the worst over?

August 9, 2020

While Covid-19 cases have dropped in the monsoon season, a ‘second wave’ may strike in winter and wreak havoc if we’re not cautious

People wearing masks in a market in Karachi — source Reuters

Japan, among some other nations of the world, made this mistake. If we think that coronavirus has vanished from Pakistan and we are now protected against it, we too could be in big trouble. Covid-19 is very likely to strike again in Pakistan in three months, if not earlier; the second wave could take us by surprise.

“There has been a sharp decline in coronavirus infections in Pakistan but according to World Health Organization (WHO) classification, the virus is still circulating in clusters and not in the community as in the case of Iran, Iraq and some other countries of Eastern Mediterranean and most of Africa. Some of Pakistan’s leading cities including Karachi, Lahore and Islamabad are badly affected; but it has not yet spread in the rural population as in the case of other countries”, Dr Rana Muhammad Safdar, eminent epidemiologist and infectious disease specialist tells The News on Sunday.

Pakistan reported 15 deaths on August 5, due to Covid-19 and 675 new cases. The latest data shows that both deaths and number of cases have started rising after a sharp decline in the last week of July – when many people concluded that the pandemic was over, at least for Pakistanis.

Highlighting the gradual rise in the number of Covid-19 cases in Pakistan, Dr Safdar says statistics for the last 24 hours reveal that overall national positivity has increased by 1.6 percent with a major increase seen in KP (9 percent), Gilgit Baltistan (5 percent) and Sindh (3 percent).

“The top three cities with increase in positivity in last 24 hours were Swat, where Covid-19 cases increased by 24 percent; Hyderabad, where cases increased by 11 percent; and Peshawar, where new cases increased by 14 percent”, says Dr Rana adding, however, that this could be due to reckless behavior around Eid-ul-Azha.

“What worries me the most is the likelihood of a second wave in Pakistan. Not a vast majority of Pakistanis has yet been exposed to Covid-19. No doubt we have seen a large number of cases in the major cities including Karachi, Lahore and Islamabad. But, the virus has not yet been to a vast majority of people who are living in our rural areas, small cities and towns across Pakistan. It can take us by surprise in November, which is the high-transmission season for respiratory viruses”, he continues.

When asked what the reasons for sharp decline in Covid-19 cases were in Pakistan, especially at a time when the virus was causing unprecedented devastation in the neighbouring India, he says one of the reasons was the administration of a variety of vaccines including Oral Polio Vaccine (OPV) to children every month for many years, producing “non-specific immunity” not only among Pakistanis but also among many in Afghanistan, where number of cases has dropped as well.

“Other reasons could be the hot and humid weather and a change in behaviours as many people have started considering it a public health issue and are taking precautionary measures including use of masks, social distancing and frequent hand washing”, he says.

However, he fears that Pakistan would have “another peak” in December this year, with a large number of cases as witnessed in the month of June when around 153 people died in a single day.

He further contextualises the ‘very high probability’ of a second wave of Covid-19 in Pakistan in November.

“By November this year, educational institutions would be open, most of the restrictions would be gone and the environment would be as if Covid-19 has vanished from the country. In these circumstances, it would strike again, [possibly] causing more destruction than it caused in June this year”, he warns, adding that people could still avoid much of the destruction by modifying their behaviours, following SOPs and taking precautionary measures.

Another eminent public health expert, Prof Tahir Shamsi, also believes that the ‘second wave’ is likely to strike in November, citing the fact that coroanvirus has not yet affected most of the rural population. In the high viral transmission season, he says, Covid-19 could wreak havoc in the country.

“In seroprevalence studies conducted by us in Karachi, some selected groups indicate that around 40 percent of the male, adult population has been exposed to Covid-19. But this is not indicative of entire city’s population. There’s an urgent need to conduct a population-based seroprevalence study of the entire country to ascertain the actual number of people exposed to the viral infection,” says Prof Shamsi, who is conducting trials of convalescent plasma for the treatment of Covid-19 in Pakistan.

According to Prof Shamsi, if 40 percent of Karachi’s population is already exposed to coronavirus and they have developed immunity against it, it means that by first week of September this year, 65 to 75 percent of city’s population would have coronavirus antibodies in their blood, which is the level required for ‘herd immunity’.

“But this is definitely not the case throughout Pakistan where the virus has not spread like it is circulating in the larger cities of the country. Although we don’t know much about virus, we definitely know that these types of viruses spread very rapidly in winter season and there is very high probability that we would have a second-wave of Covid-19 in November this year”, he adds.

According to him, although no antiviral drug has proved effective in the treatment of Covid-19 and while development of a vaccine against coronavirus is still a dream, US-FDA was likely to approve convalescent plasma therapy as the “first-line treatment” in the coming weeks, which would be a major game-changer in the fight against Covid-19.

The writer is an investigative reporter, currently covering health, science, environment and water issues for The News International

Coronavirus: Is the worst over?