Two years on: Policy assessment

An assessment of Pakistan’s Covid policy responses during the last two years should help determine if it is prepared to deal with more variants

Two years on:  Policy assessment

The Omicron variant’s rapid spread can be gauged from the numbers provided by the World Health Organisation (WHO). According to the WHO, new global Covid-19 infections increased by 55 percent to over 15 million during the second week of January 2022, a record high. Week-on-week, deaths reported on account of Covid-19 have increased by 43,000. The availability of various approved vaccines, antiviral pills and acquired or induced immunity against Covid virus have resulted in an increased acceptance of the “new normal” as a way of life amidst the pandemic. Lessons learnt from the successes and failures - what worked and what did not to - contain the pain of both the disease and allied socio-economic damage. The world must be in a better position now to brave this variant (and more that might follow). It seems that the pandemic may now turn into an endemic both within and across national boundaries. The virus will no longer be life-threatening for those vaccinated but it may still prove highly deadly for others. The latter may also catalyse mutation in virus leading to more infectious and fatal variants.

Let us analyse how prepared Pakistan is to avoid this situation. A good yardstick for this purpose would be to assess Pakistan’s policy responses to Covid-19 during the last two years. Let us start with our public health policy response.

Our coordinated response is the one defining factor that explains why the Delta variant that wreaked havoc in India remained manageable in Pakistan. Full marks to the National Command and Operation Centre (NCOC) for synergising unified national efforts against Covid-19 and implementing the decisions (including SOPs) of the National Coordination Committee (NCC) on Covid-19. The NCOC coordinated the supply of Covid-19 testing kits, personal protective equipment (PPEs) and ventilators across the federating units. It also played a crucial role in acquiring, supplying and administrating the Covid vaccine. More than 100 million people in Pakistan have received at least one dose so far. Of these, nearly 75 million are fully vaccinated, citizens aged 12 plus and 30 plus are eligible for vaccine and booster dose, respectively. This is a significant achievement compared to India, one of the leading manufacturers of Covid vaccine, which has started vaccinating those 15 years of age and older last week and where only senior citizens are eligible for a booster dose. Last year, the shortage of oxygen cylinders in India was also due to the absence of a centralised policy response mechanism on Covid-19. One is optimistic that the NCOC will ease the pain of Covid-19 in 2022.

Having said that, the NCOC could only help improve the hardware of public health infrastructure. The software side, especially having a standardised therapeutic regime for Covid treatment, was lacking. Most physicians seemed to have their own therapeutic protocols depending upon their expertise. Availability of trained paramedics to operate ventilators, bi-pap, C-pap etc, also remained a problem, not only in the peripheries but also at the Pakistan Institute of Medical Sciences in Islamabad. Likewise, many Covid-19 ICUs were not ready to deal with emergencies involving multiple organ problems (especially, dialysis). Another problem observed during the last two years was the hoarding of certain antibiotic and antiviral drugs used to treat Covid patients. Amidst Omicron spread, the NCC on Covid-19 should consult with physicians’ bodies to agree on a standard treatment protocol for various stages of the disease. The operational side of public and private health facilities dealing with Covid should be equipped to follow that protocol.

Besides the health effects of Covid, the world was also warned about an economic recession. Governments the world over provided fiscal stimuli and used social safety nets to mitigate financial hardship of their citizens amidst mandatory lockdowns. Pakistan’s “smart lockdown” policy was successful in sustaining marginalised and low-income cohorts amidst the pandemic. Through Ehsaas Emergency Cash programme, Rs 179.8 billion was delivered as one-time emergency cash assistance to 14.8 million beneficiaries at risk of falling into extreme poverty. This meant helping over 100 million people or nearly half the country’s population. Pakistan ranked 4th globally in terms of the number of people covered and 3rd in terms of the percentage of population covered through a social protection programme. The pandemic is not over yet. We may have to provide emergency cash assistance to marginalised segments of the society in future too. In this context, Pakistan’s readiness to undertake such an initiative is assuring.

“Phenomenal hunger” and food insecurity was the third risk the world was warned against when Covid was declared a pandemic. A lesson one learnt amidst Covid is that countries that produced a significant portion of their food domestically suffered the least from disruption of global supply chains due to extended lockdowns or closure of international borders. We did not face food scarcity, but food inflation and hoarding remained a challenge. Fortunately, Pakistan did not face stagflation (high inflation and stagnant growth). However, a GDP growth of around 4.5 percent (last year’s final growth numbers are under 4 percent), when the petroleum prices are high, has its own problems. The number of new infections is expected to peak in February. Depending on how this unfolds, the government will have to tackle cost-push inflation by creating more livelihood options.

The fourth problem, about which there was no warning from by global institutions, was our experience with online education. Besides the quality of education imparted, there were issues ranging from digital inequality. This will likely aggravate if Omicron variant spread forces a return to online teaching.

So far, we have braved three waves of Covid-19. The biggest hurdle in containing the disease after ensuring the supply of vaccines is to persuade the people. With more than 100 million people administrated the vaccine, one can say that we are gradually overcoming vaccine hesitancy.

Social behaviours remain a challenge. Large gatherings of all types - social, political, religious, official - are a potential medium of spreading the infection. Those who have lost loved ones in this pandemic or survived the disease have been slightly more careful in following the SOPs. However, after October 2021, when the positivity rate started declining, many people have stopped following the SOPs. This is evident at weddings and political rallies.

No one around the world had an experience of living with a pandemic. Reported incidents of daily new cases of Covid and mortalities are not mere numbers. We are talking about families, relations, and precious lives that might have been saved if we were more careful in our social behaviours. For the safety and sake of our loved ones, let us not forget the lessons we learnt during the past two years.

The writer heads Sustainable Development Policy Institute and tweets @abidsuleri

Two years on: Policy assessment