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M. Ziauddin

Editorial

Covid-19: Cost-benefit ratio of SOPs

It is so cost effective to escape from being infected by the deadly Covid-19 virus compared to the exorbitant cost of treating the disease once infected that it looks almost unbelievable. All that you need to do by way of prevention is to wear a face mask when out in the open, keep a safe distance from others, sensitize and/or wash hands frequently (The SOP —Standard Operating Procedure). So, by spending next to nothing you escape at least Rs. 50,000, the minimum required for treatment once infected but that too without any guarantee that that would save you from certain death.

Most of us did not follow the SOP, because of which hundreds were threatened, during the first wave, with loss of life and livelihood. It was also almost the same even during the second wave but the current wave, the third one, has posed higher risks to thousands.
As the second wave was tapering off the government unadvisedly announced ease in restrictions on February 24, 2021. Within a week the third wave had set in and it was all that it needed to find its foothold. The test-positivity ratio then reflected a steep increase, changing from 3.4 percent in February to 7.7 percent in March and accelerating further to 9.8 percent by the end of the second week of April and going up to 11 per cent by end April. The mortali- ty rate, on the other hand, declined from 3.4 percent in February to 1.8 percent in March. However, the absolute number of deaths went up, and 1,592 casualties in March 2021 were the second-highest since October last year.


The total number of new infections experienced a dramatic change from February to March 2021. A total of 90,403 patients were added to the health system. More worrying was the unabated acceleration in new infections as more than 60 thousand positive cases were recorded in the first two weeks of April alone.


A consistent reading of lack of compliance with SOPs through all the waves of the pandemic even at public offices and health facilities is a clear example of the trend. When the system of governance is reactive, lacks transparency, and is inconsistent in its decisions like implementation of lockdown, its credibility suffers a significant and perhaps irreparable loss.
But the good news is, a downward trend has been witnessed early May as both the positivity ratio and number of cases declined. National average compliance seems to have doubled from 34% on 25th April to 68% on 3rd may. We need to sustain and build on this compliance level specially till after Eid. Apparently, more people had started following the SOPs during the last few weeks perhaps after watching the video clips of the devastation that the virus has been causing in India.


However, experts believe that the number of cases may increase again if people violat- ed the coronavirus-related SOPs as they did during the Eid holidays last year.
The government has done right by banning intercity public transports, closing down parks and asking people to stay home. If these measures are implemented in letter and spirit, the downward trend in cases would continue. Otherwise, things can become worse.

Experts believe mutation in virus could be stopped only if circulation of the virus would be stopped. Since virus has been rapidly multiplying, it is feared that it may mutate to an extent where vaccine would become ineffective. So we need to achieve herd immunity at the earliest by vaccinating over 70pc population. Currently nearly 150,000 people were being vaccinated daily and the official target is said to be to reach 300,000 daily.
Pakistan would receive 19.82 million doses during the first half of the current year. Ninety-one per cent of these doses are purchased. The government signed deals for over 30 million doses. The population of Pakistan, which is currently eligible for vaccination, is 100 million out of 220 million because vaccines have only been approved for those above 18 years of age.

The government claims that the National Institute of Health will be able to produce soon three million doses per month of the single-dose CanSino Bio vaccine, thanks to Chinese help in maintaining the supply chain and helping with technology transfer.
The annual report of Human Rights Commission of Pakistan finds that the Covid-19 has left millions of vulnerable workers at risk of losing their livelihoods. And it has dealt a huge blow to educational institutions, with students compelled to attend online classes to the detriment of thousands in Balochistan, the tribal districts of Khyber Pakhtunkhwa, and Gilgit-Baltis- tan who have little or no access to reliable internet connections.

Ramping up supplies of personal protective equipment to shield healthcare workers makes perfect sense. The priority, however, should be to ensure that we can identify infected individuals and the people who were in contact with them and ensure that those with relatively mild symptoms can be diagnosed in testing centers or, ideally, at home rather than seek hospital care. To implement it, biotechnology companies, nonprofits, and international health organizations must join forces to develop and distribute low-cost testing tools.
It is a cause of extreme worry, meanwhile, that country’s legislative bodies have so far shown minimal interest in the pandemic. And the absence of local governments has, on the other hand, served as an impediment to extending the SOPs to grassroots.

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