The fourth wave of the pandemic has continued its upward trajectory in Pakistan, with 5,661 cases reported on 7 August – surpassing the highest number of daily cases (5,112) recorded on 29 April. Also on 7 August, Pakistan recorded 95 deaths from coronavirus, the highest single-day toll during the ongoing fourth wave of the pandemic.
The latest surge is blamed on the Delta variant, originally detected in India a few months ago, along with lax social attitudes and increased activity around Eidul Azha. The confirmed cases in Pakistan are 1,058,405 while 4,157 patients are in critical condition.
A total of 23,702 patients have died and 954,711 recovered from this disease. The government has so far conducted 16,336,171 tests across the country.
The number of patients is 361,458 in Punjab; 394,748 in Sindh; 147,026 in KP; 30,967 in Balochistan; 89,569 in Islamabad; 26,086 in Azad Jammu and Kashmir (AJK); and 8,551 in Gilgit-Baltistan.
According to National Command and Operation Centre (NCOC), currently compliance with Standard Operating Procedures (SOPs) is 56.4 percent in Islamabad; 46.6 percent in KP; 42.7 in AJK; 37.4 percent in GB; 38 percent in Punjab; and 33 percent each in Sindh and Balochistan.
Shortage of vaccine
There was a shortage of Sinopharm, Sinovac, and AstraZeneca vaccines in Karachi, as thousands of people started arriving at vaccination centres daily. The Health Department officials said vaccine reserves were exhausted at the Expo Centre, Dow Ojha Hospital, and Sindh Govern- ment Children’s Hospital, while supplies to inoculation centres at New Karachi, Liaquatabad, and Lyari were suspended. Vaccination centres were overrun after the govern- ment announced penalties for the unvaccinated people, including blocking mobile SIMs and non-entry to offices, restaurants, shopping malls, and transport.
New restrictions
The NCOC has announced revised restrictions for a number of cities as the fourth wave of the coronavirus contin- ues its momentum in the country.
The new restrictions, which would last till 31 August, were imposed in Rawalpindi, Lahore, Faisalabad and Multan in Punjab; Peshawar and Abbottabad in KP; Karachi and Hyderabad in Sindh (after the partial lockdown ended on 8 August); Muzaffarabad and Mirpur in AJK; Gilgit and Skardu in the GB; and Islamabad Capital Territory.
The decisions included scaling back market closure timings from 10pm to 8pm; closure of indoor dining (outdoor dining (till 10 pm), takeaway and delivery will continue); resumption of 50 percent work-from-home policy; public transport to operate with 50 percent occupancy; and two days in a week to be observed as safe days with provinces free to choose.
Deadline for ‘high risk’ sectors
The NCOC has decided to set a 31 August vaccination deadline for ‘high risk’ sectors. The students above 18 years of age, those working in the transport sector, public sector employees, law enforcement agencies, and staff working at hotels, restaurants, wedding halls, shopping malls and banks will have to get inoculated by this date.
Health experts have said the pace of vaccination should be further expedited to avoid the chances of creation of the vaccine-resistant virus. Whenever the number of cases started declining, a new variant of Covid-19 having a higher transmission rate emerged and then positivity started increasing again.
Covid-19 is comparatively a bigger virus and it has 39,000 positions for mutations and 20,000 positions for variations. The Delta (Indian) variant has emerged after two mutations and this is why it is called double mutant virus.
Increasing variants
Coronavirus constantly changes itself through mutation that is why its new variants have emerged in short span of time. Multiple variants of the virus that cause Covid-19 have been documented all over the world including the United States, India, the United Kingdom, South Africa and Brazil.
These include Alpha, Beta, Gamma, Delta, Epsilon and Lambda variants. Alpha variant was first detected in the United States in December 2020. It was initially detected in the United Kingdom.
Beta variant was first detected in the United States at the end of January 2021. It was initially detected in South Africa in December 2020.
Gamma variant was first detected in the United States in January 2021. It was initially identified in travellers from Brazil, who were tested during routine screening at an airport in Japan in early January.
Delta variant was first detected in the United States in March 2021. It was initially identified in India in December 2020.
Delta plus has also been detected in several other regions, including the United States, the United Kingdom, Portugal, Russia and China.
Japanese researchers have found that the Lambda variant, which was initially discovered in Peru and is now spreading throughout South America, is highly transmissible and more resistant to vaccines than the initial Covid-19 strain.
These variants seem to spread more easily and quickly than other variants, which may lead to more cases of Covid-19. An increase in the number of cases will put more strain on healthcare resources, lead to more hospitalizations, and potentially more deaths.
South Korea’s Disease Control and Prevention Agency said that it had recorded at least two cases of the new Delta Plus variant, which some experts believe to be more transmissible than the original delta variant that was first detected in India and has since thwarted plans for returning to normal life.
The ‘Plus’ in the variant’s name refers to its K417N spike protein mutation, which was also found in some sub-strains of the Alpha variant.
The health ministry informed that as long as the coronavirus is around and a good portion of the population is unvaccinated, the virus would continue to mutate.
Is booster dose needed?
As many as 80 percent of medical professionals and health experts at a recent conference in Islamabad said they had managed to get themselves inoculated with more than one vaccine against Covid-19 and its variants, amid a raging question by many if we really need a booster dose or a mix and match of vaccines to protect people against the dreadfully infectious disease.
Special Assistant to the Prime Minister on Health Dr Faisal Sultan has strongly opposed the idea of ‘top-up’ doses and maintained that at the moment there is no reason for allowing people to get an additional dose of the same or other vaccines when only a fraction of the country’s population has been vaccinated and millions of adults are still waiting for their first vaccination.
He said Covid-19 vaccines must only be used to inoculate the large segment of society still unvaccinated. A leading health expert and principal investigator of clinical trials of different Covid-19 vaccines, Prof Javed Akram has said no concrete data is currently available to support additional immunity by a mix and match of different vaccines or boosters to a fully vaccinated person and even the World Health Organization (WHO) is also opposing this idea.
Solution not an end
The pandemic is still far from over, but glimpses of its legacy are emerging. Up until now, whenever the world has thought the virus has been beaten back, a new variant has come storming back, more infectious than the last.
The medical experts warn that the last phase of the pandemic may be drawn-out and painful; and that Covid-19 would leave behind a different world. They say the vaccines, which so far have proved highly effective at preventing severe Covid-19 illness, are making their way into millions of arms each day and that is likely to have an impact in terms of keeping hospitalizations and deaths under better control.
There is a growing evidence that vaccines are effective, as real-world data from all over the globe validate the clinical-trial results by showing a sharp reduction in hospitalizations and deaths. Emerging evidence also indicates that vaccines likely reduce transmission considerably, though not to the same degree that they prevent severe disease.
More vaccines are coming as Johnson & Johnson’s one-shot vaccine appears to be highly effective against severe Covid-19 and received Emergency Use Authorization in the United States. Novavax’s vaccine is now in Phase III trials; preliminary results suggest it was highly effective against the coronavirus disease.
Some researchers say Covid-19 probably will become endemic, meaning it will always be around – without causing a public health emergency. They say the people should not count on the elimination of Covid-19, though the fact that the virus seems to be exclusive to humans does make eradication a possibility.
