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Is Pakistan going to face COVID-19’s second wave in the coming winter?

Since the last week of September, hospitals in Karachi started receiving patients on a daily basis who were critically ill with COVID-19 symptoms and now in the second week of October 2020, some of the hospitals have started refusing patients who need ventilators for survival after getting tested positive for the coronavirus infection.

This is happening at a time when a vast majority of people in Pakistan believe that the threat of Covid-19 is over. Except for those whose relatives and loved ones require hospitalization, the majority thinks COVID-19 was a bad dream – which is over once and for all.

“We have started receiving COVID-19 patients whose condition appears to be very critical. The infection rate is rising in Karachi and this time we are seeing very sick patients whose survival often seems very difficult keeping in view their health condition,” said Dr. Asim Hussain, Chairman of the Ziauddin Group of Hospitals, while talking to this scribe in Karachi on Wednesday.

At this moment, said Dr. Hussain, he was not sure whether a second of COVID-19 had started affecting Pakistan. He, however, added that cases had definitely started rising and now educational institutes, wedding halls, and restaurants were being closed and sealed throughout Pakistan, which indicated that the situation was becoming serious.

“Now everybody has started reporting and pointing out at an increase in COVID-19 cases in Pakistan, even Punjab’s health minister has also conceded that cases are gradually on the rise, although they were reporting the least number of daily COVID-19 cases in their province. The same is the situation in Islamabad, Balochistan, and Gilgit-Baltistan, which require immediate attention and adoption of precautionary measures,” Dr. Hussain added.

Some other experts also point that COVID-19 cases had been on the rise in the country as the weather had started getting colder and people had abandoned all Standard Operating Procedures (SOPs), believing that they were either immune to the infectious disease or the virus had left the country.

“Last Friday, not a single person was wearing a mask at one of the largest mosques in Karachi where hundreds of people gather five times a day to offer prayers and hundreds on Friday afternoon to offer Jumma prayers. Everybody – from a three-year-old child to elderly people in their 70s and 80s – were standing in rows shoulder to shoulder, without any social distancing,” said Dr. Zeeshan Ansari, a pathologist and molecular scientist based in Karachi who is conducting research on the SARS-COV-2, which is the official name of coronavirus

He said despite a gradual rise in COVID-19 cases in Pakistan, schools were open and thousands of children are daily attending classes in small and crowded rooms, restaurants were buzzing with people of all ages enjoying the food without any fear, large gatherings were being held on the occasions of weddings and, most importantly, large rallies – both religious and political – had started taking place throughout the country as if there existed no lethal, infectious disease that had killed over a million people, including 6550 in Pakistan alone.

Have we really gotten rid of COVID-19 in Pakistan?

Special Assistant to Prime Minister (SAPM) on health Dr. Faisal Sultan says the threat of COVID-19 is not over yet for Pakistan.

He believes that crowded restaurants and weddings halls as well as large gatherings are a serious cause of concern for the authorities as people have started ignoring all the precautionary measures, including ensuing social distancing, wearing masks and avoiding social gatherings.

“Some countries of the world are facing the second wave of COVID-19, while some are still struggling grappling with the first wave. In Pakistan, if the situation remains same, we fear that strict restrictions could be imposed again to prevent the spread of the infectious disease once again,” Dr. Sultan added.

He, however, concedes that not only the cases are increasing, but also the percentage of positive COVID-19 cases. In Karachi, the ratio of positivity is on the rise and it is now around 5 per cent. Leading indicators too are on the rise, which means that the number of critical patients could also rise in the weeks to come if this trend continues.

“Neither the SOPs regarding restaurants are being followed nor are they being taken seriously by the people. We are reviewing the situation and soon some strict guidelines would be announced regarding the gathering of people at restaurants and wedding halls. At weddings and funeral gatherings, people come and greet the host, either to congratulate on marriage or offer condolence on death. This is a very risky situation and this can lead to the spreading of the virus to a large population,” Dr. Sultan added.

As life comes back to normality the way it was at the start of this year when hundreds were working in the crowded factories, universities were open and people were traveling in buses, trains, and vans that packed to the capacity, epidemiologists believe that COVID-19 is making a return and its cases would increase unprecedentedly in the coming winter as hardly 12 to 15% population of the country has yet contracted the infectious disease in Pakistan.

“A few days back, the World Health Organization (WHO) said it estimates that only 10% of world’s population has so far contracted the coronavirus infection while the former director of the Center for Disease Control (CDC) of United States, Dr. Tom Frieden, believes that the actual infections in the US, the most affected country with COVID-19 in the world is roughly 40 million, which is not more than 12% of the total population of the world,”

says Dr. Rana Jawad Asghar, a renowned health expert and epidemiologist said, wondering as to how 40 to 50% population could be immune to Coronavirus in Pakistan.

Claiming that the coronavirus infections have started rising in Pakistan like the rest of the world as the weather starts getting cold and dry in most parts of the country, Dr. Asghar says it is believed that this infection spread rapidly in countries where the weather remains cold and dry and even in the United States, it spread rapid-ly at meat processing plants where the temperature remains very low and dry conditions are maintained to preserve the meat, so in this winter, it is going to strike back as conditions would be favorable for the virus to multiply, spread and infect humans off guard.

“Israel is the first country to re-impose national lockdown. The UK has started seeing a steep increase in hospitalizations after a good interval. Similarly, new cases are increasing in France and Germany after an apparent control. It looks like the second wave has hit Europe,” he said and added that cases have “definitely started rising in Pakistan after the weather has started getting cold”.

“This is evident from the data from Islamabad and Sindh while Gilgit-Baltistan and Balochistan are already showing a higher number of daily COVID-19 cases as compared to other parts of the country. Unfortunately, it appears that Punjab is under-reporting the cases as they are in the habit of doing so for the last many years,” Dr. Rana believes.

He fears that difficult days are ahead, not only for the entire world but for the people of Pakistan also, especially at a time when they have thrown back their masks, started living in the pre-Covid era, and believing that nothing is going to happen to them. “This is very alarming situation,” Dr. Rana Jawad,” that by the time vaccine to prevent from COVID-19 will be available a lot of damage will have been done.”

“Development of one or two vaccines to prevent COVID-19 is at least two to three months away. Even after its development, its availability would take a few more months. Most importantly, convincing people to get vaccinated would be another uphill task. There is no proven treatment or antiviral drug available so far so the only option left is sticking to the preventive measures – wearing masks, avoiding social gatherings, maintain social distancing – but nobody is taking them seriously,” he added.

On the other hand, there are experts, especially Dr. Tahir Shamsi, a renowned hematologist, who believes that half of Pakistan’s population is now immune to COVID-19 and now it is a matter of few weeks when herd immunity would be achieved, and then there would be no need for even the vaccine as the majority of the would-be carrying COVID-19 antibodies, which would prevent them from infections and re-infections. But keeping in view that versatility of the coronavirus infection, which has killed millions of people around the globe but has largely spared Pakistani people for unknown reasons, nobody knows for sure what is actually going to happen in Pakistan

Article by: M. Waqar Bhatti

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