THERE is now only one topic of conversation wherever one goes. The virus has landed in Pakistan, and the trajectories of other countries shows it can take up to a month from when the first case is reported to where we can say an outbreak has occurred. Iran reported its first case on Feb 19 and by March 11 it had 354 deaths and more than 9,000 confirmed cases. If they went from one to 9,000 confirmed cases in 21 days, it tells us that the rate of transmission can be very high and it is worthwhile to be prepared in our country as well. No doubt transmission was aided in Iran by the fact that the outbreak happened in Qom, a city that is visited by an estimated 20 million pilgrims per year.
Italy had its first reported case on Feb 15, only a few days before Iran. Yet by March 11, it had 10,149 reported cases with 631 reported deaths. This is a stupendous speed of transmission and has to be taken seriously. The common line that some people are finding comfort in, that this is all ‘media hype’ and the virus is no worse than the common flu, is dangerous complacency. Doctors in affected countries like Italy are warning that panic is better than complacency in the face of this virus, and its impact must not be underestimated.
The key concern is not the number of people who die from the infection. The key concern is the speed of transmission, and the fact that transmission can take place even when an individual shows no symptoms, making it near impossible to combat the virus through governmental measures alone. What is being pointed out repeatedly by doctors and healthcare professionals in the countries that are the hardest hit is that change in habits on the part of the people is essential to fight this virus.
One of the most important of these personal measures is self-quarantine for those who could have been exposed to the virus. The Sindh government has done an admirable job tracking down more than 2,000 people who returned to the country from Iran and testing over 1,000 from them who seemed more at risk. It is from these tests that the number jumped by eight only a few days ago. Hundreds are in quarantine, in their own homes, and local administration from the DC to the police, has been activated to follow up with individuals and families to see how many of them might be developing symptoms.
The key concern is not the number of people who die from the infection. The key concern is the speed of transmission.
There is not enough disclosure coming out from the other provincial governments at this point about how vigorous their efforts are at tracking down those who may have been infected. In China, authorities actually used their surveillance system with face recognition technology to track down those who had left the province of Wuhan in the days leading up to the lockdown, and found most of them to place under quarantine. We don’t have that capability here, but tracking those who have a travel history to countries that are in the middle of an outbreak should be common sense, and the provincial governments are the only ones that can do this.
Closure of schools is an extreme step and might be necessary, but it is hard to see how this step alone is expected to help. If schools are shut but malls and bazaars and cinemas and restaurants and cafes and offices and wedding halls are all open, then transmission is hardly likely to be contained. It is not certain yet whether we will come to a point where complete lockdown of the sort that Italy has just ordered or what China used to contain the spread of the virus will become necessary here, but there is a worryingly high number of experts warning that this is the only way if the transmission has gone past a certain point.
The habits that need to change are simple. All experts are saying frequent washing of hands is critical, and washing them thoroughly enough where each finger is individual scrubbed and the wrinkles over the joints are stretched out and cleaned from within. This is a real task to raise awareness around since most people in our society don’t wash their hands more than once a day, in many cases not even after using the toilet. Inculcating this habit, especially in cases where people may not have access to soap and water during the course of their workday, is going to be challenging.
Face masks do little good unless they are being used in specific contexts so people should avoid panic buying. Simply walking around town with a face mask is not likely to lower your chances of catching the infection by very much, and the World Health Organisation as well as independent experts say a mask is only necessary if you are infected or taking care of someone who is.
Finally we need to see more robust leadership around the issue. The number of reported cases is not spiking at a worrying rate at the moment, and most of the new infections seem to be from people who have travelled to a place where an outbreak has occurred. But if we move to the next phase, where there is direct local transmission, then the possibility of this turning into an outbreak will increase.
The prime minister needs to take the initiative and address the nation. Public service messages need to be made and distributed to all TV channels and radio. It is a little disheartening to note that we had a more robust public messaging campaign for the ridiculous dam fund than what we are seeing in this case. The time to prevent this from turning into an outbreak is now. To delay action, or be complacent in the face of this sort of a danger is to put the whole country at risk.
The writer is a member of staff.
Published in Dawn, March 12th, 2020