Wellness

Test. Quarantine. Lockdown. Or Die.

The world is in the middle of a pandemic. The Coronavirus (Covid-19) has spread across the globe and the number of infected crossed 450 in Pakistan and three deaths occurred.

People did not seem to respond with too much alarm last night when the deaths were reported, but when the morning came, a sense of rushed alarm pervaded people. Maybe it’s because with the deaths, the reality of the situation hit home. Maybe it’s because today is when the Sindh government shut down all its administrative functions. Maybe it’s because tomorrow is Friday, and the obligatory Muslim prayers on Friday have not yet been canceled. If they are not cancelled tomorrow and Pakistan goes through with them, we do not know the scale of the vector for Coronavirus’ spread it can become. After tomorrow’s Friday prayers, a situation that may have been manageable, may tip out of control.

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The issue of mass testing has to be addressed first. The authorities have a limited number of tests, in the thousands, as well as a limited number of trained medical professionals to interpret the results. The number of medical professionals cannot be increased in a month, but countries in Europe are calling up medical students and retired medical professionals to help. Pakistan can ask for the same help; marshalled in the right direction.

Then we come to the issue of tests and medical equipment. Pakistan cannot quickly produce the tests right now. It should have the humility to ask for the importation of tests, it should approach the World Health Organisation (WHO) and countries that have tests like South Korea and China to send as many tests as possible. Pakistan should not just task its medical manufacturing sector with replicating these tests, as NUST is supposed to be developing a test that allows them to check for the Coronavirus. At this point I don’t know what I would think of duplication of effort because the objective is for Pakistan to begin testing its suspected Coronavirus patients quickly, which the provinces and federation are not doing due to lack of capacity and supply.

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In the face of the privileged hypochondriacs of Pakistan who, like in Karachi have thronged hospitals, and overworked doctors here, medical professionals have not been offering tests to everyone who asks for one in Pakistan, and restrict it according to their protocols. At the top of their protocols are, not to test anyone who has not traveled abroad. This combined with flu like symptoms or fever, push that person to the head of the line for a test. That was fine as long as there was not much domestic transmission of the disease. Considering a case in the last few days of transmission from Islamabad to Karachi, this is likely to change very fast. Tests must be arranged for, they must be in large quantities, and despite the hypochondriacs of Pakistan, they must be made available in large enough quantities, and freely enough, within days, to test the uncountable number of people in Pakistan who may be suffering from Coronavirus.

It would be a good time now, for health and financial reasons, to re-appropriate funds from the ministries that were made non-functional by the 18th Amendment and transfer that money to purchase the tests or speed up their domestic manufacture. This is an emergency, and the search for those infected with Covid-19 is like trying to plug a poisonous underground gas leak, in the dark: you need the equipment and you need to see what you are doing.

Now in regards to the issue of personal protective equipment (PPE) reports of it running out in hospitals have popped up across the country. This is the time to ask the public not to buy up this equipment and to ask its manufacturers to ramp up production (in safe environs for their workers) for delivery direct to the relevant hospitals and medical facilities, not for some middle men to sell. Our frontline healthcare workers deserve their safety under these trying and dangerous times. Import of health related PPE equipment should be allowed, as per a Sindh high court ruling.

The Sindh government has been following a clever, and correct strategy in its province to try and contain the spread of the disease, where it has carried out staggered shut-downs of sectors of society, where people congregate. After closing schools, and then extending the shutdown to inter-city commercial travel and all public facing commercial activities, the situation in Sindh is such that now only offices, and places where people work at private jobs (like offices and factories) are now what is left open, after it, itself closed all non-essential government departments. If in the next week, a lockdown of the province is what is required, this can easily be extended. A shutdown of the country is likely needed, because that is what is needed to prevent the further spread of the virus in the domestic population. For how long, it is difficult to assess, but it is at least needed at the level not to overwhelm the intensive care units (ICU’s) of this country’s meagre health system. Once they are overwhelmed, then people in other countries have been left to die.

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That is why it is vital that Friday congregation prayers be cancelled to prevent the domestic spread of Covid-19. Considering that Turkey, the Palestinian territories, Jordan, Egypt, Iraq, Sudan and Saudi Arabia have banned Friday prayers, it’s not a leap for Pakistan to also call them off. If not, then the domestic spread of Coronavirus will accelerate. In South Korea, one super-spreader went to Church and sped up the spread of the disease.

Even if that benchmark is reached, there is the threat of the return of the virus, at a later stage, among a vulnerable cluster in the population. That is why scaling up to mass testing as quickly as possible, is a vital necessity to protect the population from Covid-19.
Self-quarantine over the next month and a half, possibly even till May, is looking like a serious possibility. For the sake of the reader’s health, those of their family, friends, and especially their loved ones with vulnerable health due to age or previous illness, complying with quarantine is an act of humanity.

At this stage, leadership and unity are a sensible option. Denial of the scale of the problem helps no one. Duplication of effort is not what we need right now. Just as an example, the federal National Disaster Management Authority (NDMA) is requisitioning hotels to serve as quarantine facilities, while the provincial Sindh government is building Karachi’s quarantine facility in the Expo Centre. Non-cooperation between different arms of the government is not needed right now. Even the Sindh High court has asked the NDMA to co-operate with the Sindh government.

The time for ego is passed. The time for caring about each other is now.

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