Can Pakistan Effectively Respond to Coronavirus Pandemic?

Pakistani public health system's ability to deal with Covid19 pandemic is increasingly being questioned with the number of confirmed coronavirus cases spiking in the country. The current hotspot is in southern Sindh province where the provincial government is taking the lead in fighting its spread by shutting schools, closing restaurants and shopping malls and banning large gatherings such as weddings and conferences. The federal government has closed Pakistan's western border with Iran where the coronavirus pandemic is raging. Pakistan Civil Aviation Authority has started screening all incoming passengers and stopped flights to and from several countries hit by the pandemic. Pakistani health experts are advising people with flu-like symptoms to self-isolate in their homes. The best known treatment for the severely ill is Resochin, the anti-malarial antiviral made by Bayer Pakistan. Hydroxycholroquine (HCQ), made by Getz Pakistan, is also reportedly effective in treating Covid19.

Coronavirus Global Pandemic

Is Pakistan Ready?

Pakistan is among only 6 countries in the world that have taken the steps they need to evaluate their ability to withstand a global pandemic, according to a 2017 report sponsored by the World Bank. The 6 countries named in the report are: Eritrea, Finland, Pakistan, Saudi Arabia, Tanzania and the United States.

Covid19 Coronavirus. Source: US CDC

Pakistan's ability to deal with a pandemic is now being tested by the coronavirus. The current hotspot for it is in southern Sindh province where the provincial government is taking the lead in fighting its spread by shutting schools, closing restaurants and shopping malls and banning large gatherings such as weddings and conferences. The federal government has closed Pakistan's western border with Iran where the coronavirus pandemic is raging. Pakistan Civil Aviation Authority has started screening all incoming passengers and stopped flights to and from several countries hit by the pandemic. Pakistani health experts are advising people with flu-like symptoms to self-isolate in their homes.

Pakistan is ramping up coronavirus testing and setting up isolation wards at many hospitals in Sindh and across the country. More testing accounts for the spike in confirmed cases. The best known treatment for the severely ill is Resochin, the anti-malarial antiviral made by Bayer Pakistan.

In response to a recent request by Pakistan's Express Tribune newspaper staff, World Health Organization Executive Director Dr. Michael J. Ryan said Pakistan has great capacity in public health but he also talked of challenges posed by the Coronavirus pandemic. “Pakistan has a highly mobile population with mega cities and undeserved people,” he said.  “So there is a great challenge facing Pakistan. But Pakistan has also demonstrated time and again with dengue, polio and other diseases how all of the government and society’s approaches can be made to work.”

Dr. Palitha Gunarathna Mahipala, World Health Organization (WHO) representative in Pakistan, also lauded Pakistan's response to Covid19 pandemic, according to The News. He said,  “Pakistan has timely come up with one of the world’s best National Response Program against COVID-19 and it is being implemented very effectively. Authorities are doing their job and now it is the responsibility of the people to follow the instructions and take preventive and precautionary measures to avoid contracting the viral disease.”

The World Bank report titled "From Panic and Neglect to Investing in Health Security: Financing Pandemic Preparedness at a National Level" was written by experts from the World Bank,  the World Health Organization, the International Monetary Fund, the African and Asian development banks, and finance officials from various governments. The report included estimates of the economic damage various epidemics had done. For example, the viral pneumonia SARS — which ultimately killed only 774 people — shrank China’s gross domestic product by 0.5 percent in 2003. The report also broke down costs on a per capita basis. A major flu pandemic, for example, would cost Afghanistan only $12 per citizen, India $31, Pakistan $28 and the United States $248.

Social Distancing:


The current hotspot is in southern Sindh province where the provincial government is taking the lead in fighting its spread by shutting schools, closing restaurants and shopping malls and banning large gatherings. The federal government has closed Pakistan's western border with Iran where the coronavirus pandemic is raging. Pakistan Civil Aviation Authority has started screening all incoming passengers and stopped flights to and from several countries hit by the pandemic.

Italian experience with coronavirus has shown that even a well-developed public health system in a rich European country can be overwhelmed by rapidly growing pandemic such as Covid19.  The best way to handle the situation is to cut the infection rate by keeping people about 6 feet apart. This is being called "social distancing".

Social Distancing to Limit Infection Rates 

Based on what the United States has learned from what is happening in Italy, major cities and states in America are taking steps to reduce large gatherings of people. Offices, schools, restaurants and shopping centers are closed with shelter-in-place orders in Silicon Valley and the larger 6-county San Francisco Bay Area.

Herd Immunity:

Herd immunity develops when a large percentage of population is infected or vaccinated. Dr. Arindam Basu, Associate Professor of Epidemiology and Environmental Health at University of Canterbury, has recently written an article in The Conversation arguing that it is "unethical and potentially dangerous" to wait for herd immunity to develop in the absence of a vaccine.  It could result in hundreds of thousands or even millions of deaths among the most vulnerable segments of the population such as the elderly and the immune-compromised.

Pakistan's Assistance to China:

Chinese President Xi Jinping has thanked Pakistan for its support during coronabirus outbreak in his country. "China is deeply grateful for Pakistan's support. Facts have proved once again that China and Pakistan are true friends who share weal and woe and good brothers who share each other's joys and sorrows. The special friendship is a historical choice, and is deeply rooted in the hearts of the two peoples," said Xi.

Resochin (Chloroquine) Produced by Bayer Pakistan 

At the peak of the outbreak in February, Bayer Pakistan exported to China 300,000 tablets of Resochin (Chloroquine) that proved effective in treating coronavirus infections and saving lives in Wuhan. Resochin is an antiviral drug used for treating malaria. Chloroquine is manufactured by not just Bayer but several other drug companies as well.  China and many other countries discontinued its production years ago.   Several Pakistani pharmaceutical companies also manufacture HydroxyChloroquine which has lower toxicity and fewer side effects. The United Kingdom has banned hoarding and export of both of these drugs. In addition, Pakistan donated 7,000 surgical masks to China at the peak of the coronavirus outbreak.  A recent paper titled "An Effective Treatment for Coronavirus (COVID-19)"  by James M. Todaro, MD and and Gregory J. Rigano, Esq. has published data showing the efficacy of familiar anti-malaria drugs Chloroquine and Hydroxychloroquine for treatment of and as prophylactic against COVID-19.

In Vitro Efficacy of Chloroquine(CQ) vs Hydroxychloroquine (HCQ) Ag...

Recently, Chinese research (reported in Clinical Trials Arena) reported that “data from the drug’s [chloroquine] studies showed ‘certain curative effect’ with ‘fairly good efficacy’ … patients treated with chloroquine demonstrated a better drop in fever, improvement of lung CT images, and required a shorter time to recover compared to parallel groups. The percentage of patients with negative viral nucleic acid tests was also higher with the anti-malarial drug… Chloroquine has so far shown no obvious serious adverse reactions in more than 100 participants in the trials… Chloroquine was selected after several screening rounds of thousands of existing drugs. Chloroquine is undergoing further trials in more than ten hospitals in Beijing, Guangdong province and Hunnan province.”

A small French study found only 25% of COVID19 patients who took it for 6 days still had the virus while 90% of those who had not taken it still had Covid-19.

HCQ (Hydroxychloroquine) Manufactured by Getz Pakistan

Economic Impact of Coronavirus Pandemic:

Service sector accounts for  50% of the world GDP and 54% of Pakistan's GDP.  Social distancing will significantly impact the services, particularly retail, restaurants, travel, transport and education sectors. Imran Khan has expressed fear that the pandemic will devastate the economies of developing countries.

“My worry is poverty and hunger," Khan said. "The world community has to think of some sort of a debt write-off for countries like us, which are very vulnerable, at least that will help us in coping with (the coronavirus).”

Summary:

Pakistan is among only six countries in the world that have taken the steps they need to evaluate their ability to withstand a global pandemic, according to a 2017 report sponsored by the World Bank. The current hotspot is in southern Sindh province where the provincial government is taking the lead in fighting its spread by shutting schools, closing restaurants and shopping malls and banning large gatherings. The federal government has closed Pakistan's western border with Iran where the coronavirus pandemic is raging. Pakistan Civil Aviation Authority has started screening all incoming passengers and stopped flights to and from several countries hit by the pandemic.  The best known treatment for the severely ill is Resochin, the anti-malarial antiviral made by Bayer Pakistan.  Dr. Michael Ryan and Dr. Palitha Gunarathna Mahipala of the World Health Organization (WHO) have talked of challenges Pakistan faces but also praised the steps it has taken to fight coronavirus pandemic.

Here's the latest Coronavirus Pandemic Update:

https://youtu.be/vE4_LsftNKM

Related Links:

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Comment by Riaz Haq on November 13, 2020 at 7:35am

#Pakistan's first robot-operated #COVID19 testing mobile lab opens in #Islamabad. The lab requires only 6 people in all shifts to operate as it uses 5 liquid handling robots and can process up to 2,000 tests each day. #coronavirus #pandemic https://www.deccanherald.com/international/world-news-politics/paki... @deccanherald


At least 2,304 new cases were detected after conducting 36,932 tests across the country, showing an alarming positivity rate of 6.32 per cent, it said.

Comment by Riaz Haq on November 21, 2020 at 7:51am

#Pakistan okays locally developed #AI software that uses chest X-ray to detect #Covid in under a minute. It "shall employ Convolutional Neural Networks to predict [presence of] Covid-19 in suspected individuals" #ArtificialIntelligence #coronavirus https://www.dawn.com/news/1591603

Drug Regulatory Authority of Pakistan (Drap) Chief Executive Officer Asim Rauf on Saturday said the body has granted approval to a locally invented software that can "detect the coronavirus infection in a person's lungs within a minute".

According to the certificate of registration granted by Drap, a copy of which is available with Dawn.com, the Cov-Raid — which has been developed by the National Electronics Complex of Pakistan — "shall employ Convolutional Neural Networks to predict [presence of] Covid-19 in suspected individuals" by using X-rays and it has been approved for "secondary detection" of the virus.

The Cov-raid website says the artificial intelligence (AI) technology was developed by "creating a data repository of chest X-rays (CXR) for Covid-19 or non-Covid-19 detection", adding that the software "requires a chest X-ray image as an input for the detection of Covid-19 positive or negative patients in less than one minute".

"The algorithm has been trained on more than 35,000 CXRs (data authentication done through multiple certified radiologists and PCR reports)," it said.

According to the description posted on the website, the technology "can be path-breaking to conduct screening of a large number of patients in a limited time".

The Drap CEO also said that the device would "greatly help" in the treatment of virus patients.

"This [technology] is available in only a few countries in the world. Pakistan will supply the Cov-raid technology to various countries," he disclosed.

The software will soon be available across the country, he added.

A similar algorithm was developed by a team of researchers at the University of Minnesota in the United States last month "that can evaluate chest X-rays to diagnose possible cases of Covid-19 within seconds".

"[The] model learns from thousands of X-rays and detects Covid-19 in seconds, then immediately shows the risk score to providers who are caring for patients," Ju Sun, who led the team, said.

Another such software was developed in China earlier this year by Axial AI which analysed Computed Tomography (CT) imagery in seconds.

Comment by Riaz Haq on November 25, 2020 at 11:05am

India ranks 34th in global Covid resilience survey, placed below Pakistan and Bangladesh
According to the Covid Resilience Ranking by Bloomberg, 12 Asian countries have scored better than India in handling the coronavirus pandemic.

https://theprint.in/india/india-ranks-34th-in-global-covid-resilien...


India has been ranked 34th among 53 countries in the world that have handled the coronavirus pandemic most effectively, according to a Covid Resilience Ranking by Bloomberg.

The survey was published Tuesday and gives India a resilience score of 58.1, way below top performer New Zealand which has a score of 85.4. Pakistan, with a score of 61.7, has performed better than India and was ranked 27th, whereas Bangladesh, with a score of 64.2, was placed at the 24th position.

---------------

Effective testing and tracing is a hallmark of almost all the top 10, embodied in South Korea’s approach. The country approved home-grown diagnostic kits within weeks of the virus’s emergence, pioneered drive-through testing stations and has an army of lightning-fast contact tracers who comb through credit card records and surveillance camera footage to track down clusters. Like Japan, Pakistan and other parts of Asia, Korea has drawn on recent epidemic experience after suffering an outbreak of Middle East Respiratory Syndrome, or MERS, in 2015.

In contrast, developing countries like Pakistan and Bangladesh have benefited from their relative remoteness. Their populations are also much younger on average, which has helped hold down their overall mortality rates. Limited testing and poor-quality data obscures the picture in these places, though under-reporting of cases and deaths is occuring everywhere.

https://www.bloomberg.com/graphics/covid-resilience-ranking/?sref=4...

Comment by Riaz Haq on December 26, 2020 at 6:33pm

#Grocery stores go online to survive #COVID19 in #Pakistan where grocery retail space, estimated by #tech industry insiders to be worth over $50 billion annually, is dominated by ‘karyana’ stores, often like a hole in the wall. #ecommerce
https://aje.io/rhncx via @AJEnglish

https://www.aljazeera.com/economy/2020/12/25/to-survive-pakistans-c...

Pakistan’s traditional grocery stores survived COVID by quickly recognising the changing needs of their customers, while app-based grocers have seen spectacular growth.

“Lahore went into lockdown on March 23. For March, April and May our business jumped by 50 to 70 percent month on month,” says Ahmad Saeed, CEO and co-founder of GrocerApp, which delivers products to the eastern city of Lahore and to Islamabad.

Before the pandemic, Saeed says, the app’s orders were growing at a steady 20 percent per month.

“I think the pandemic has pushed e-commerce years ahead – the shift that was going to take millions of dollars by investors, the pandemic has pushed it a lot,” he says.

At first, as lockdowns came into effect often with little warning, Saeed says his business struggled to meet demand.

“We realised that to cater to this demand we need to cut back to the basics of our offerings,” he says. “We realised that in the pandemic, people would realise it was okay if we didn’t have all the varieties of different products, but we needed to make sure that we do not run out of the basics.”

GrocerApp also limited the size of orders of basics like flour, rice and other necessities to prevent possible hoarding by customers.

Today, the app is back at full strength, having grown its operations to keep up with the rising demand. It now offers more than 4,000 products in Lahore. The firm expanded to cater to Islamabad in September, and Saeed says it has seen strong growth there, too.

“We launched Islamabad on September 1, and in three months, Islamabad has scaled to a point that it took Lahore two and a half years to get to,” he says.

Jarrar Shah, CEO and founder of 24Seven, a rival to GrocerApp that also serves Lahore, said his business saw similar challenges in the early days of the pandemic.

To take advantage of the spike in demand, and to ensure his company met all its orders, he changed its business model from being a digital marketplace for other stores to opening its own warehouse and fulfilling almost all its orders itself.

“When [the Lahore lockdown] happened, we started this warehouse in two weeks flat,” he says. “The lockdown was very strict initially, police were everywhere, they wouldn’t even let us deliver.”

The pandemic and lockdowns saw demand “shoot up”, and the business had to adapt, he says.

“When COVID happened, our baselines kind of shifted. Where we thought it would take the country or ecosystem three or four years to get to where people were using online and adopting it, COVID kind of brought that three-year thing overnight.”

‘With their own hands’
But not everyone is convinced Pakistan’s e-grocery boom is here to stay.

Javed Anwar is the manager at Sauda Sulf, one of the largest grocery stores in the F-11 neighbourhood of Islamabad, and says while the company’s decision to launch a website and Whatsapp-based grocery delivery service helped it survive, he is unconvinced it will lead to substantive changes in customer behaviour.

“People in Pakistan, they want to shop for themselves,” he says, sitting at a till in the store. “This trend [of online shopping] is not here in Pakistan yet. [For] groceries, customers have a mentality that they want to buy it themselves, with their own hands.”

Anwar says Sauda Sulf saw a peak of up to 250 orders a month through its website during the lockdown, but as restrictions eased over the summer, those orders dropped, too.

“In that time, [the apps] were very useful. When there was an emergency, to get those services [that you needed],” he says. “[But] there is an interaction [with the customer], and you cannot have that interaction online.”

Comment by Riaz Haq on December 31, 2020 at 10:47am

#Pakistan to purchase 1.2 million #COVID19 #vaccine doses from Sinopharm. China approved a COVID-19 vaccine developed by an affiliate of state-backed pharmaceutical giant Sinopharm on Thursday, its first approved shot for general public use. https://news.yahoo.com/pakistan-purchase-1-2-million-044319918.html... via @YahooNews

"The Cabinet Committee has decided to initially purchase 1.2 million doses of the vaccine from the Chinese company Sinopharm, which will be provided free of cost to frontline workers in the first quarter of 2021," Pakistani Minister for Science and Technology Chaudhry Fawad Hussain said on Twitter.

The minister told Reuters the purchase would be of the vaccine candidate developed by Sinopharm's Beijing Institute of Biological Products.

Sinopharm has another candidate, developed by the Wuhan Institute of Biological Products, which is also in phase III trials.

Pakistan earlier this month approved $150 million to buy COVID-19 vaccines, initially to cover the most vulnerable 5% of the population, but did not announce which one it would procure, saying it could tap more than one source.

"If the private sector wants to import any other internationally-approved vaccine, it can," Hussain said on Thursday.

The country of 220 million is in the midst of another spate of infections, with 58 deaths on Wednesday taking its death toll past 10,000. It also reported 2,475 new infections, taking the total to 479,715.

Pakistan is currently running phase III clinical trials for CanSino Biologics' vaccine candidate, Ad5-nCoV, led by the government-run National Institute of Health.

Hassan Abbas of AJ Pharma, CanSino's local representative, told Reuters on Wednesday that recruitment for the trial will be completed in 10 days.

"Preliminary results will be shared 4 or 5 days after recruitment is completed, and these will include the efficacy of the vaccine," Abbas said, adding that thus far there have been no serious side effects.

AJ Pharma is one of five companies that have applied for a license to distribute the vaccine in Pakistan once approved, he added.

Comment by Riaz Haq on January 1, 2021 at 12:34pm

Defying fears & skepticism, thousands in #Pakistan volunteer for #Chinese #COVID19 #vaccine trials. Chinese manufacturer CanSino Biologics is offering to provide its vaccine at a favorable cost and distribute it on a “priority basis.” #CoronavirusStrain https://www.washingtonpost.com/world/asia_pacific/pakistan-coronavi...


For years, Pakistan's effort to wipe out the wild polio virus has been thwarted by public fears of foreign vaccines, largely fanned by Islamic clerics and others who warned that polio drops were part of a Western plot to sterilize the Muslim masses.

Today, pockets of resistance to the polio vaccine persist, and Pakistan remains one of only two countries, alongside Afghanistan, where polio has not yet been eradicated.

And yet thousands of Pakistanis, from college students to retirees, have volunteered to be test subjects in coronavirus vaccine trials at five urban hospitals. Since September, about 13,000 of 18,000 volunteers have participated in trials for a Chinese vaccine called CanSino. No serious side effects have been reported, and health officials hope to finish the trials and start distributing vaccines by March.

Still, even these volunteers, eager to help while Pakistan faces a resurgence of coronavirus cases and a race against time to begin public inoculations, said they had to overcome personal doubts, frightening social media rumors and opposition from their own families.

“I was aware of people talking about conspiracies, about some chip being inserted into the body, about birth control. Some in my family told me not to do it, but I didn’t care,” said one government employee in his 30s who enrolled in September. “My heart told me to do it. I just pray to God that we get rid of this fatal disease.”

The participant was among eight volunteers recently interviewed by phone in Islamabad and Karachi. All said they had heard the vaccines might be harmful but decided to sign up anyway. All spoke on the condition of anonymity, saying hospital officials had instructed that their identities be kept confidential. Each volunteer is paid $50.

Vaccines from China represent Pakistan’s best hope for inoculating its 233 million citizens in the coming year, officials say. A deeply impoverished country with a tiny health budget, Pakistan has limited hospital space, and many areas have only rudimentary health facilities.


Since the virus first hit, Pakistan has turned to China, its largest foreign economic partner and most important political ally, for help. In the spring, Beijing provided medical equipment and protective gear and sent doctors to help respond to the outbreak. Pakistani officials said the Chinese manufacturer CanSino Biologics is now offering to provide its vaccine at a favorable cost and distribute it on a “priority basis.”

While Pakistan has seen a lower number of coronavirus infections and fatalities than many countries — far fewer than the United States and neighboring India, for example — a new wave of cases has surged in the past several months. On Wednesday, Pakistan passed 10,000 deaths nationwide, and infections rose to 477,000, according to the national health ministry.

Comment by Riaz Haq on January 16, 2021 at 7:59am

#Pakistan approves #AstraZeneca #COVID #vaccine for emergency use, the first #coronavirus vaccine to get approval. Pak would get vaccine from multiple sources, including "tens of millions" of doses under an agreement with #China's CanSinoBio https://news.yahoo.com/astrazeneca-covid-vaccine-gets-approval-1133... via @YahooNews


AstraZeneca's COVID-19 vaccine has been approved for emergency use in Pakistan, the health minister said on Saturday, making it the first coronavirus vaccine to get the green light for use in the South Asian country.

Pakistan, which is seeing rising numbers of coronavirus infections, said its vaccines would be procured from multiple sources.

"DRAP granted emergency use authorisation to AstraZeneca's COVID vaccine," the health minister, Faisal Sultan, told Reuters.

Approval has been given to get more than a million doses of Sinopharm's vaccine from China, he said.

"We are in the process to obtain Western origin and other vaccines both via bilateral purchase agreements as well as via the COVAX facility," he said.

The Chinese vaccine is awaiting approval from the Drug Regulatory Authority of Pakistan (DRAP), which has received and reviewed its data.

Pakistan is speaking to a number of vaccine makers, and Sultan said the country could get "in the range of tens of millions" of vaccine doses under an agreement with China's CanSinoBio.

The vaccine company's Ad5-nCoV COVID-19 candidate is nearing completion of Phase III clinical trials in Pakistan.

Efficacy is a key factor, said Sultan. "We have and are watching the evolving stories around efficacy of a number of vaccines."

Sultan said preliminary results of the Cansino may come in by mid-February. He added that Pakistan was considering to engage with Russia's Sputnik V vaccine.

Pakistan reported 2,432 new coronavirus infections and 45 deaths on Friday, taking the total number of cases to more than 516,000 and deaths close to 11,000.

"Our aim is that the bulk of the population will be covered free," the minister said, adding that private sectors could also be allowed once supply was available to an authorized company.

Sultan added that Pakistan had adequate cold chain facilities for most kinds of vaccines.

Comment by Riaz Haq on January 28, 2021 at 10:36am

To gauge the relative performance of countries at different points in the pandemic, this Interactive tracked six measures of COVID-19 in the 98 countries for which data was available.


https://interactives.lowyinstitute.org/features/covid-performance/#...

The period examined spans the 36 weeks that followed every country’s hundredth confirmed case of COVID-19, using data available to 9 January 2021. Fourteen-day rolling averages of new daily figures were calculated for the following indicators:

Confirmed cases
Confirmed deaths
Confirmed cases per million people
Confirmed deaths per million people
Confirmed cases as a proportion of tests
Tests per thousand people
An average across those indicators was then calculated for individual countries in each period and normalised to produce a score from 0 (worst performing) to 100 (best performing). Collectively, these indicators point to how well or poorly countries have managed the pandemic in the 36 weeks that followed their hundredth confirmed case of COVID-19.

of the average performance over time of countries in managing the COVID-19 pandemic in the 36 weeks following their hundredth confirmed case of the virus. In total, 98 countries were evaluated, based on the availability of data across the six indicators used to construct this Index. *


Pakistan with an average score of 36.9 ranks 69 among 98 countries. New Zealand (score 94.4) tops the rankings. Among Pakistan's neighbors, Sri Lanks (score 76.8) ranks 10, Bangladesh (score 24.9) ranks 84, India (score 24.3) ranks 86 and Iran (score 15.9) ranks 95. Brazil ranks at the bottom with a score of just 4.3.

Comment by Riaz Haq on March 1, 2021 at 4:26pm

Safe reopening of #mosques: #Pakistan's success in controlling #COVIDー19 has been underreported. Pak initially restricted congregational prayers to 3 to 5 mosque employees, incl the imam, muezzin and maintenance staff, and closed it to general public. https://www.dailysabah.com/opinion/op-ed/safe-reopening-of-mosques-...

During the initial enforcement of these measures, the government consulted with these senior Islamic scholars regarding the closure of the mosques to ensure a successful implementation of social distancing during the lockdown.

They came to an agreement to restrict the congregational prayers to three to five mosque employees, including the imam, muezzin and maintenance staff, and thus agreed to close the mosques to the general public while keeping them internally functional.

This agreement was a remarkable display of flexibility and maturity on the part of these scholars, showing that they were cognizant of the gravity of the situation while at the same time ensuring that the functioning of this vital institution was not completely suspended.

Key to distancing
From a medical/epidemiological perspective, social distancing measures can only work when everyone observes them.

Therefore, the effectiveness of social distancing is not based on an incremental, graduated model but on an almost binary all-or-nothing model. If everyone observes the measures, only then are they effective; otherwise, it is as if no one is observing them. The drastic spikes in cases in certain Western countries bear testimony to this.

With the passage of time, two things became apparent: On the one hand, the incidence of new cases and the mortality rate in Pakistan were much lower than figures being reported in the rest of the world, especially those in neighboring India.

On the other hand, the cumulative economic burden of the lockdown on the country as a whole and more specifically on the poorest sections of society and daily wage workers seemed to be increasingly unsustainable.

As a result, the government announced new lockdown directives and regulations in April due to Pakistan's specific situation. Under these directives, large sectors of society, industry and services were reopened.

This was based on the rationale that Pakistan (with its widespread poverty and daily wage workers who cannot withstand a prolonged complete lockdown without starving) could not afford to lock down completely like for example a Western country with a solid welfare state, subsidies, grants and benefits could and that the number of deaths due to starvation and disease in such a lockdown would likely be as much or far more than the projected deaths due to COVID-19.

Coupled with the governments' gross inability to sufficiently provide for the immobilized and jobless poor workers in a lockdown and compensate them for what they would face or even feed them at the basic level during this time, the Pakistani government seemed to have been led to come to a conclusion: They relaxed the lockdown and opened up all of these sectors.

This would have been in addition to what they saw as the long-term collapse of the economy if a complete lockdown were to be prolonged, which, in a country like Pakistan, would likely cause hundreds of thousands of additional deaths in the medium term.

Now, one may debate the rationale behind these governmental directives and agree or disagree with them – as people indeed have – and with lengthy arguments on both sides, but it needs to be borne in mind that Pakistan is far from having the ideal state of affairs that wealthier nations find themselves in.

Comment by Riaz Haq on March 14, 2021 at 7:11pm

7 Countries to Benefit From a COVID-19 Technology Access Pool - BORGEN

Chile, Dominic Republic, Indonesia, Mozambique, Pakistan, Sudan and Tunisia.

https://www.borgenmagazine.com/covid-19-technology-access-pool/

Several pharmaceutical companies have joined the Solidarity Call to Action, the World Health Organization’s (WHO) initiative to share research among public and private entities via a COVID-19 technology access pool. This essential movement aims to eliminate economic obstacles to accessing a vaccine. Thus far, 40 WHO Member States have joined the Solidarity Call to Action, with more on the way. The increasing membership suggests a possible global commitment to open research and tech sharing to nations that are lacking technologically. Here is a closer look at seven countries that would benefit from a global commitment to a COVID-19 technology access pool.


COVID-19 ravaged densely populated cities in Pakistan. Economists project its poverty rate, which had decreased extraordinarily throughout much of the last decade, will soar in the pandemic’s wake. The UN recommended that “making essential health services available to those in need and protecting health systems” should be prioritized. Certainly, the global community’s prioritization of a COVID-19 technology access pool aligns with the UN’s goals and suggestions for Pakistan.

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