Pakistan: Coronavirus, Lives and Livelihoods

Coronavirus infection rates and deaths in Pakistan are among the lowest in the world while the continuing lockdown is causing enormous damage to the nation's economy and livelihoods, according to government data. Health ministry data shows that fewer than a thousand lives have been lost to the disease in the country since the start of COVID19 infections more than two months ago. Meanwhile, millions of people in manufacturing, retail and the unorganized sectors are unemployed or underemployed. All of this is happening during Ramzan and Eid periods that account for bulk of retail sales in the majority Muslim country of 220 million. Pakistanis do not necessarily face the same level of risk from coronavirus as people living in America and Europe do.

Age Distribution of Covid Cases/Deaths in Pakistan. Source: covid.g...


Age Factor in Covid19 Mortality:

Over 40% of all coronavirus deaths in Europe and America have occurred among the elderly living in nursing homes. Pakistanis age 60+ account for 19% of cases but 58% of deaths. Like US and Europe, older people are much more likely to die from coronavirus in Pakistan.  But average life expectancy in Pakistan is just 67 years and the median age in the country is only 22 years. The explanations offered for low death rates in South Asia include younger populations, more sunshinehigher temperature and humidity, universal BCG vaccinations etc. Yale researchers have argued in a recently published paper to consider universal mask adoption and increased hygiene measures as an alternative to complete lockdown.

March 2020 Manufacturing Data. Source: Pakistan Bureau of Statistics

Pakistan Manufacturing Data:

The March figures released by Pakistan Bureau Statistics confirm a precipitous drop of 22.95% in large scale manufacturing. This reflects halt in production in just the last one week of March 2020. April 2020 figures are almost certain to be a lot worse due to complete halt in production amid lockdown. It's spelling disaster for millions of employees and households linked to these industries. Government handouts can not replace household incomes generated from these industries.

While food production held up well in March, manufacturing of durables like air-conditioners, refrigerators, and deep freezers have plummeted. For example, production of refrigerators fell 34% from 86,107 in March 2019 to 56,449 in March 2020.  Number of television sets produced in March 2020 declined 34% to 19,790 from 30,788 in the same month last year.

Comparison of Confirmed Cases in Selected Countries. Source: Our Wo...

Coronavirus Infections and Deaths:

As of May 16, Pakistan has 38,755 cases and 834 deaths. These figures are among the lowest in the world. There are many theories explaining why Pakistan and the rest of South Asia have fared much better than America and Europe. To put it in perspective, there were 31 coronavirus related deaths in Pakistan where 4,000 people die on a regular day.  Any major change in daily death rates in recent weeks would not go unnoticed. While it is true that the testing rates in South Asia are low compared to America and Europe, the percentages of people testing positive and fatality rates in South Asia are also low. The explanations offered for low coronavirus infection and death rates in South Asia include more sunshinehigher temperature and humidity, younger demographics, universal BCG vaccinations etc.

Comparison of Coronavirus Deaths in Selected Countries. Source: Our...

Pakistan COVID19 Death Rate Among World's Lowest 

Social Distancing Cost-Benefit Analysis:


In a recently published paper tiled "The Benefits and Costs of Social Distancing in Rich and PoorCountr..., Yale researchers support universal mask adoption and increased hygiene measures as a alternatives to social distancing and complete lockdown.

Zachary Barnett-Howell and Ahmed Mushfiq Mobarak of Yale University argue that "social distancing policies are estimated to be less effective in poor countries with younger populations less susceptible to COVID-19, and more limited healthcare systems, which were overwhelmed before the pandemic". Here's an excerpt of the Yale paper:

"Poorer people are less willing to make...economic sacrifices. They place relatively greater value on their livelihood concerns compared to contracting COVID-19. Not only are the epidemiological and economic benefits of social distancing much smaller in poorer countries, such policies may exact a heavy toll on the poorest and most vulnerable. Workers in the informal sector lack the resources and social protections to isolate themselves and sacrifice economic opportunities until the virus passes. By limiting their ability to earn a living, social distancing can lead to an increase in hunger, deprivation, and related mortality and morbidity. Rather than a blanket adoption of social distancing measures, we advocate for the exploration of alternative harm-reduction strategies, including universal mask adoption and increased hygiene measures."

Summary:

While coronavirus infections and death rates in Pakistan are among the lowest, the nation's economy and livelihoods are in serious jeopardy. With or without coronavirus pandemic, we take risks everyday when we leave our homes to go to work or school, theaters or playground, or shopping. Risks we face range from street crimes and road accidents to lightening strikes. We need to make similar assessments of risks from diseases which vary from place to place. Pakistanis do not necessarily face the same level of risk from coronavirus as people living in America and Europe do. The explanations offered for low coronavirus infection and death rates in South Asia include more sunshinehigher temperature and humidity, younger demographics, universal BCG vaccinations etc. There is a need to weigh the risk of catching coronavirus against the loss of livelihoods in places like Pakistan.  Yale researchers have argued in a recently published paper to consider universal mask adoption and increased hygiene measures as an alternative to complete lockdown.

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Comment by Riaz Haq on May 27, 2020 at 4:18pm

#India Faces Another Plague as #LocustsSwarm, adding to #Modi's multiple woes: Rising #coronavirus infections, a #heatwave hitting #Indian capital #NewDelhi, a recent killer #cyclone and 100 million people out of work. #unemployment #recession #Ladakh
https://www.nytimes.com/2020/05/27/world/asia/india-locusts-jaipur....

Scientists say it’s the worst attack in 25 years and these locusts are different.

“This time the attack is by very young locusts who fly for longer distances, at faster speeds, unlike adults in the past who were sluggish and not so fast,” said K.L. Gurjar, the deputy director of India’s Locust Warning Organization.

The locusts were flying in from Iran and Pakistan, blanketing half a dozen states in western and central India. Because most of the crops were recently harvested, the hungry swarms have buzzed into urban areas, eager to devour bushes and trees, carpeting whatever surface they land on.

On Monday, Jaipur, a sprawling city of 4 million and the biggest in the state of Rajasthan, was besieged. A blizzard of bugs flew over concrete buildings and the wealthier neighborhoods, swooping in on trees and plants, crossing graveyards and jewelry markets, attracted to the manicured golf course in the heart of the city.

After he saw what was happening, Mr. Doodi, the groundskeeper, yelled out to the caddies and other key personnel, urging them to make whatever loud noise they could to drive the bugs away. Some grabbed firecrackers. Others steel plates to bang on. Another person ran up to the roof of a maintenance building and started thumping on empty plastic containers, like drums.

Residents clamored to protect themselves and their flora, spilling onto the streets banging plates with spoons and jumping into parked cars to honk horns.

“I got out of my room and came out on my terrace at around 10 a.m. and saw a long shadow on the ground,” recalled Nikhil Misra, a lawyer in Jaipur. “I just stood still. It was something I had never seen in my lifetime.”

“I looked up and saw a cloud, not the cloud that gives you rainfall, but a cloud of locusts, thousands and thousands of them hovering over my head,” he said. “It was a silent attack. It was a strange kind of fear, as if being overtaken by aliens.”

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The Indian government wants to tackle this regionally and has offered to set aside some of its differences with Pakistan to provide the neighboring country with pesticide to spray on its side of the border. India has made the same offer to Iran, which responded positively, Indian officials said.

Indian scientists said that in a single day, a modest locust swarm can travel 200 kilometers and eat as much food as about 35,000 people.

Comment by Riaz Haq on May 27, 2020 at 6:59pm

Amid #COVID19 #lockdown, #Pakistan’s #textile #exports plummet 65% in April 2020 to $404 million from exports of $1,138.35 million in the same month of 2019. #economy #trade https://tribune.com.pk/story/2226611/2-pakistans-textile-exports-pl...

Textile enterprises have demanded that the government reopen all the textile industries along with the restoration of the zero-rated sales tax status as textile exports have been severely affected. In April 2020, textile exports declined 65% to $404 million against exports of $1,138.35 million in the same month of the previous year.

“This should set off alarm bells for the official quarters concerned,” remarked All Pakistan Textile Mills Association (Aptma) Punjab Zone Chairman Adil Bashir.

In the wake of a heavy fall in exports as well as domestic sales of textile products, Bashir demanded the restoration of the zero-rated status for the five major export-oriented sectors in order to give a boost to the textile industry in its endeavours to increase local production and exports, and save millions of jobs.
He urged the government to take serious measures to overcome the liquidity issues of the textile industry.

Sales of all major textile categories plummeted in April, with garments being the most affected. Cumulatively, textile exports dropped 3% year-on-year in the first 10 months of the current fiscal year to $10.82 billion, said JS Research analyst Ahmed Lakhani.

Some improvement is expected in May as shipping delays have been reduced. Moreover, buying countries were also gradually easing the lockdown, which should support demand recovery, he added. In the prevailing situation, it is pertinent to see what special incentives can be offered to the export-oriented sectors. On the other hand, “the risk remains that despite the incentives, a potentially severe second and third wave of Covid-19 can neutralise any impact from the government incentives,” commented the analyst.

The Aptma chairman said the trend of exports in April 2020 was very frightening as Pakistan’s annual shipments to EU countries and the US, exceeding $10 billion, were fraught with risks due to delay and cancellation of export orders after the coronavirus lockdown and liquidation or closure of many retail chains. Pakistan Cloth Merchants Association Secretary-General Arif Ismail urged the Sindh government to allow all textile and allied industries to resume operations and comply with the prescribed SOPs.

The Aptma chairman stressed that the textile industry was the backbone of the country with more than 60% of total exports and the largest employer with widespread employment for professionals, skilled and unskilled workers.

He said the zero-rated regime was introduced in 2005-06 with declared objectives of eliminating cash liquidity issues, wiping out refunds of billions of rupees stuck for long, avoiding unproductive waste of man-hours in chasing tax refunds and eliminating the additional cost borne on the filing and follow-up of refund claims.

Bashir stated that 17% of sales tax was imposed on the textile industry with effect from July 2019 with lofty claims of the Federal Board of Revenue (FBR) of processing refund claims within 72 hours through the newly developed FASTER software system.

FASTER still lacks basic provisions like Section 8B, eight-digit HS code, etc, which hampers the system.

He raised eyebrows over the working of FASTER system and stated that due to inherent weaknesses in the system a large number of taxpayers had not been able to even file Annex-H.

Comment by Riaz Haq on June 4, 2020 at 7:16am

WHAT DOES OUR SEROPREVALENCE STUDY TELL US?
Dr Wajiha Javed May 24, 2020

https://www.dawn.com/news/1559103/what-does-our-seroprevalence-stud...


So far, a total of 2,174 people, across various industries’ head offices, banks, restaurants and hospitals, have been screened by Getz Pharma, including all of its own workers. The total positive cases were 8.6% in the general population. Most of these were ongoing infections at 7%, and only 1.5% had recovered.
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In the high-risk frontline hospital workers, the seroprevalence of Covid-19 was assessed to be 11% (Getz Pharma plans to test 25,000 doctors and their families free of cost on a rolling basis). Families of positives contacts were also traced and their seroprevalence was found out to be 19%, making our secondary household attack rate at 19%, which is similar to what was found in studies in China, Taiwan and Spain.



Based on the study findings and keeping in view its target age group (18-65 years), the urban setting and a sample revolving around office/factory workers, the following conclusions can be drawn:

The 8% prevalence can be extrapolated to the 1 million registered working population of Karachi, meaning at least 80,000 infected cases in Karachi alone, with 70,000 being currently infected, unaware and spreading infection to those around them. If the assumptions hold true for the rest of Pakistan, of its 61.7 million registered workers, at least 4.9 million could already be exposed and infected.

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The writer is an epidemiologist and head of public health and research at Getz Pharma

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After Karachi's 8% positive covid infection shown by Getz study we have 6% positive Lahore infection proven through random testing of covid

Confirms the hypothesis to a large extent that virus spread in general population in Urban Pakistan adult population is around 5 million !

https://twitter.com/bilalgilani/status/1267410135279943682?s=20

Comment by Riaz Haq on June 4, 2020 at 11:02am

Riaz Haq: Wajiha: Thank you for responding to my tweet. You said.: "prevelance over 6 weeks of 15%'. Could you please elaborate? How many people were given the serological test? Demographics of those tested in terms of ages, regions, occupations, etc? Was it entirely random? What is the rate of error for the particular test you administered? I think you're something unique for Pakistan. I hope the public health professionals are paying attention to your valuable work.


Wajiha Javed:So data is on a rolling basis. So far it's 7000.but we are continuing to test and enroll. It's not excatly random as it's data from different companies who have employees from different walks of life. It includes banks, schools, restaurants, industries, textiles, factories, media and doctors
The age bracket was 18 to 65 years
All of khi was covered
It was higher among frobltlien workers (docs) and among families of positives. Secondary attack rate was around 19 percent

Comment by Riaz Haq on June 15, 2020 at 4:33pm

Pakistan’s Lockdown Ended a Month Ago. Now Hospital Signs Read ‘Full.’
Medical workers are falling ill in Pakistan at alarming rates as the country registers at least 100,000 new coronavirus cases since the lockdown was lifted.


https://www.nytimes.com/2020/06/15/world/asia/pakistan-coronavirus-...


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On a recent day in the sprawling port city of Karachi, Ali Hussain and his brother shuttled between public hospitals, looking for help and receiving none. Mr. Hussain’s older brother had a severe cough and fever but had been unable to get a coronavirus test for days.

“We cannot afford the private hospitals, they are charging tens of thousands rupees,” said Mr. Hussain, who earned 20,000 rupees per month, about $121, working at a textile mill before the lockdown.

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The World Bank projects that Pakistan’s economy will contract by 0.2 percent next fiscal year. Up to 18 million of the country’s 74 million jobs could be lost, according to the Pakistan Institute of Development Economics, an independent research firm set up by the government.

More immediately, Pakistan’s struggling health care sector is in deep crisis.

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Pakistanis stricken by the coronavirus are being turned away from hospitals that have simply closed their gates and put up signs reading “full house.” Doctors and nurses are falling ill at alarming rates, and are also coming under physical assault from desperate and angry families.

When Pakistan’s government lifted its lockdown on May 9, it warned that the already impoverished country could no longer withstand the shutdown needed to mitigate the pandemic’s spread. But now left unshackled, the virus is meting out devastation in other ways, and panic is rising.

Before reopening, Pakistan had recorded about 25,000 infections. A month later, the country recorded an additional 100,000 cases — almost certainly an undercount — and the pandemic shows no signs of abating. At least 2,356 people have died of Covid-19, according to official figures released Thursday.

Pakistan is now reporting so many new cases that it is among the World Health Organization’s top 10 countries where the virus is on the rise. The W.H.O. wrote a letter criticizing the government’s efforts on June 7 and recommended that lockdown be reimposed, stating that Pakistan did not meet any of the criteria needed to lift it.

Comment by Riaz Haq on July 16, 2020 at 9:46pm

#Pakistan #Ehsaas program funding raised from Rs144bn to Rs203bn to soften #COVID19 impact on poor. “It means that almost half of the population of the country will be covered under the program,” says program chief Dr Sania Nishtar- DAWN.COM

https://www.dawn.com/news/1569458

Amid adverse impact of the coronavirus on the poor and people belonging to low-income groups, the government has decided to enhance the Ehsaas Emergency Cash programme from Rs144 billion to Rs203bn.

Under the first phase of the programme [of Rs144 billion] 12 million families were provided four-month stipend of Rs12,000. Now with the increase in its funds the programme will facilitate around 17m families.

“It means that almost half of the population of the country will be covered under the programme,” said Special Assistant to the Prime Minister on Social Safety and Poverty Alleviation Dr Sania Nishtar at a press conference on Thursday.

“The scope of emergency cash programme has been expanded to reach out to around 16.9 million deserving families with the increased budget of Rs203 billion,” she added.

Accompanied by Information Minister Shibli Faraz, the SAPM said initially the programme was launched on April 9 with a budget of Rs144 billion for 12 million beneficiaries.

She, however, said 12.86 million beneficiaries across the country had so far received one-time cash assistance of Rs155.64bn through emergency cash initiative as in addition to Rs144bn over Rs10bn was distributed through other resources, including the Prime Minister Corona Fund.

“The government’s largest social protection programme, Ehsaas, has taken the lead in radically expanding social safety nets to help mitigate effects of Covid-19 within Pakistan,” she added.

Terming the programme a big success of the government, she said the programme was fully transparent, rule and merit based, and apolitical. “Sindh gains the most from this programme which shows its apolitical nature,” she said while giving an indirect reply to the allegation made by the ruling party in Sindh, Pakistan Peoples Party, that the province had been ignored and its people had not benefited from the scheme.

She said as compared to initiatives taken in other countries, the Ehsaas Emergency Cash Programme gained international recognition for disbursing in time cash assistance in a well organised manner and at a larger scale.

Dr Nishtar said digital capabilities developed over the past year as part of the Ehsaas strategy had positively been adopted in making emergency cash payments.

“Requests were sought through an SMS short code service; data analytics enabled eligibility ascertainment, using unique national identification numbers and drawing on the National Socioeconomic Registry and wealth proxies (travel, taxes, billing, assets ownership data and government employment status), and payments are biometrically verified,” she explained the process of payments made under the programme.

The beneficiaries who were eligible but facing problems in withdrawing money owing to faulty biometric identification were being paid out exclusively in the designated bank branches of partner banks.

Similarly, to ease out the payment process for families of deceased beneficiaries, Ehsaas has adopted a procedure under which the families of deceased beneficiaries are required to send out an application in her name (Dr Sania Nishtar) with Computerised National Identity Card (CNIC) details of their dead family member along with those of eligible family member straight to Ehsaas offices at Islamabad.

Ms Nishtar said Ehsaas has also launched ‘Ehsaas Emergency Cash — Know Your Status’ Portal to offer an easy window to people registered with Ehsaas Emergency Cash to check their eligibility. “All applicants who have registered themselves through 8171 or Prime Minister’s Labour Portal can now easily check their eligibility status by entering CNIC number on the portal,” she added.

Comment by Riaz Haq on August 28, 2020 at 9:36am

#Karachi soup kitchen has been serving hot meals for 20 years. It's been pushed to the limit in #Covid_19. It usually serves about 3,000 people a day, but in June, at the height of the #pandemic in #Pakistan, over 5,000 people showed up every day. #charity
https://www.businessinsider.com/pakistan-soup-kitchen-khana-gar-kar...


And now, in a country where 40% of the population lives below the poverty line, it has become a lifeline to thousands of struggling families during the pandemic.

At Khana Ghar, which translates to Food House, the day begins with workers rolling out dough to prepare a traditional bread called tandoori roti, which is baked in a clay oven. At lunchtime, the soup kitchen welcomes those who need a meal.

But the food is not totally free — Khana Ghar charges a token amount of 3 rupees per person, according to Parveen Saeed, who started the kitchen, which does not take a profit.

"The only logic behind it is that people are at least buying the food they are eating, so their self-respect remains intact," Saeed said. "When you give free food, people stop working. They think 'I'm getting free food for my family, and now they won't go hungry,' but when they buy it for 3 rupees, they will still work hard, earn the money, and feel like they are legitimately providing for their family."


This year, families have been talking more than ever. Make time to talk about your financial plans. Because the more we talk, the better we plan, protect and retire.

Saeed launched Khana Ghar back in 2002 after she moved to Surjani Town, a low-income neighborhood in Karachi.

A journalist by profession, she started to feed the poor after a tragic incident shook her world — a story of a local mother who killed her two children who she had been unable to feed.

"I asked her, why did you kill them?" Saeed said. "And she said one sentence: 'If your kids were hungry, you would kill them too.' That sentence can change your life, and it certainly changed mine."


"It takes me 30 minutes to get here. I walk here. I don't even have shoes, but thank God this place is here," Yameen said. "They take good care of me."

On a good day, Yameen earns 50 rupees, or 30 cents, selling plastic chairs.

But he has six children and is the only breadwinner in the family. He told us that his wife recently died from complications of COVID-19.

"I called the doctor, I called the ambulance, but my wife died in my arms," he said. "I am telling you the truth that I've really suffered."


Even death is costly these days, Yameen added, saying you need around 50,000 rupees to afford a proper funeral and burial.

Even during this trying time, Yameen says he can always count on a hot meal at Khana Ghar.

But the kitchen is being pushed to it limits. It usually serves about 3,000 people a day, but in June, at the height of the pandemic in Pakistan, over 5,000 people showed up every day.


"People said you're putting your life in danger, but we took all the precautions," she said. "We wore masks, gloves, sanitized, sprayed, and maintained social distance."

But she said that despite the challenges the soup kitchen did not stop serving food. "Poor people were telling us we will not die of the coronavirus, but what will eventually kill us is hunger," Saeed said.

With nearly 6,000 deaths in a population of 230 million people, experts say Pakistan has been spared the worst. The lockdown has mostly been lifted, and life is slowly going back to normal.

But hunger still persists. And although Parveen says that she's trying to do her best to help, it's not always enough.

Comment by Riaz Haq on September 29, 2020 at 9:24pm

WHO chief praises #Pakistan’s successful handling of #coronavirus #pandemic . In an Op Ed in the #UK’s “The Independent”, he writes: “Pakistan deployed infrastructure built up for polio to combat Covid-19” #COVID19 #PTI #ImranKhan | The Express Tribune https://tribune.com.pk/story/2266237/who-chief-praises-pakistans-su...

One million lives have been lost to coronavirus, but it's never too late to fight back

This milestone is a difficult moment for the world, but there are glimmers of hope that encourage us now and in the near future

Tedros Adhanom Ghebreyesus
@DrTedros

https://www.independent.co.uk/voices/coronavirus-deaths-cases-globa...

Pakistan deployed the infrastructure built up over many years for polio to combat Covid-19. Community health workers who have been trained to go door-to-door vaccinating children against polio have been redeployed and utilised for surveillance, contact tracing and care. This has suppressed the virus so that, as the country stabilises, the economy is also now picking up once again. Reinforcing the lesson that the choice is not between controlling the virus or saving the economy; the two go hand-in-hand.

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