Lockdowns may not be enough in themselves: some policy prescriptions for governments in Pakistan
By Lalarukh Ejaz
Pakistan has over 1,100 coronavirus cases as of the writing of this piece. And the numbers could be 5-10 times higher than that because not enough people are being tested.
However, given Pakistan's scant resources spent on health, the future could be frightening, not least because there doesn't seem to be much testing going on. Because of scarce resources like test kits, provincial governments in Pakistan have focussed for the timebeing on testing those who had a specific travel history (China, Pakistan, Gulf, Saudi Arabia, Italy, UK, etc).
The provincial governments and nor the federal government has been really forthcoming on the matter of testing - and it would be fair to assume that even now when cases have crossed 1,100, testing is being done for those with a travel history, their contacts, or those who have been in contact with someone who tested positive for coronavirus.
Sindh province has taken the lead in fighting the pandemic. It closed its educational institutions a month ago - on Feb 27 - well before other parts of the country. It also has embarked on a proactive approach to screening and quarantining those with symptoms, and testing at least far more than the other provinces have done so far.
No wonder then that the approach used by Sindh has been followed by allowed other provinces, even those ruled by the ruling party. This point is significant because Prime Minister Imran Khan has repeatedly said that he is against a lockdown arguing that it will be disastrous towards the very poor and vulnerable segments of society.
The argument against the PM's point of view is quite strong. For starters, when people are being asked to voluntarily go into self-isolation then it can be argued who will be hiring the services of the daily wage earners. Furthermore, if no lockdown measures are undertaken and the virus gets out of control, then the more vulnerable segments of society, to which most daily wage earners and the poor would belong to, are likely to be among the worst affected.
The reason for a lockdown is to stop the spread of the virus, by reducing physical contact between people and thereby between those infected and others (given that the coronavirus can be passed on by someone who is not showing any symptoms).
However, a lockdown in of itself is not sufficient to stamp out the disease from a population. As the head of the World Health Organization, Dr Tedrom Adhanom Ghebreyesus, said on March 25, when a lockdown is in place, a country has to attack the spread of the virus. This he said has to be done by tracing all infections, isolating them, testing their contacts and doing this till community spread is halted.
This is the only way forward. While a lockdown is in place, the government increases its testing capacity, isolates and treats all those who have tested positive, and trace and test their contacts as well. At the same time, it increases the capacity of its health service by hiring more doctors, nurses, medics and providing all of them personal protective equipment. It also needs to increase the tools to treat such diseases like ventilators and also work towards increasing the number of beds that are available for Covid-19 patients.
When a lockdown is accompanied by such measures, it will be a far better option than to not enforce a shutdown and ask the general population to self-isolate on its own because modelling suggests that an absence of a lockdown and no aggressive approach by a government could end up infecting over half of a country's population - and that would translate into 2-4 million deaths.
The writer is an Assistant Professor at the Institute of Business Administration, Karachi and has a Phd from the University of Southampton. Twitter @lalarukhejaz
By Lalarukh Ejaz
Pakistan has over 1,100 coronavirus cases as of the writing of this piece. And the numbers could be 5-10 times higher than that because not enough people are being tested.
However, given Pakistan's scant resources spent on health, the future could be frightening, not least because there doesn't seem to be much testing going on. Because of scarce resources like test kits, provincial governments in Pakistan have focussed for the timebeing on testing those who had a specific travel history (China, Pakistan, Gulf, Saudi Arabia, Italy, UK, etc).
The provincial governments and nor the federal government has been really forthcoming on the matter of testing - and it would be fair to assume that even now when cases have crossed 1,100, testing is being done for those with a travel history, their contacts, or those who have been in contact with someone who tested positive for coronavirus.
Sindh province has taken the lead in fighting the pandemic. It closed its educational institutions a month ago - on Feb 27 - well before other parts of the country. It also has embarked on a proactive approach to screening and quarantining those with symptoms, and testing at least far more than the other provinces have done so far.
No wonder then that the approach used by Sindh has been followed by allowed other provinces, even those ruled by the ruling party. This point is significant because Prime Minister Imran Khan has repeatedly said that he is against a lockdown arguing that it will be disastrous towards the very poor and vulnerable segments of society.
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| Prime Minister Imran Khan - file photo |
The argument against the PM's point of view is quite strong. For starters, when people are being asked to voluntarily go into self-isolation then it can be argued who will be hiring the services of the daily wage earners. Furthermore, if no lockdown measures are undertaken and the virus gets out of control, then the more vulnerable segments of society, to which most daily wage earners and the poor would belong to, are likely to be among the worst affected.
The reason for a lockdown is to stop the spread of the virus, by reducing physical contact between people and thereby between those infected and others (given that the coronavirus can be passed on by someone who is not showing any symptoms).
However, a lockdown in of itself is not sufficient to stamp out the disease from a population. As the head of the World Health Organization, Dr Tedrom Adhanom Ghebreyesus, said on March 25, when a lockdown is in place, a country has to attack the spread of the virus. This he said has to be done by tracing all infections, isolating them, testing their contacts and doing this till community spread is halted.
This is the only way forward. While a lockdown is in place, the government increases its testing capacity, isolates and treats all those who have tested positive, and trace and test their contacts as well. At the same time, it increases the capacity of its health service by hiring more doctors, nurses, medics and providing all of them personal protective equipment. It also needs to increase the tools to treat such diseases like ventilators and also work towards increasing the number of beds that are available for Covid-19 patients.
When a lockdown is accompanied by such measures, it will be a far better option than to not enforce a shutdown and ask the general population to self-isolate on its own because modelling suggests that an absence of a lockdown and no aggressive approach by a government could end up infecting over half of a country's population - and that would translate into 2-4 million deaths.
The writer is an Assistant Professor at the Institute of Business Administration, Karachi and has a Phd from the University of Southampton. Twitter @lalarukhejaz
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