Pakistani doctors wear face masks as they leave the Aga Khan hospital where a patient suspected of having contracted coronavirus was admitted, in Karachi, Pakistan, Thursday, Feb. 27, 2020. (AP Photo/Fareed Khan) — Copyright 2020 The Associated Press. All rights reserved.

In the fight against Covid-19, these bright, young Pakistanis are coming together and improvising

Pakistan's youth is coming up with quick and useful strategies, some of which can also be implemented at low costs.
Published March 24, 2020

Pakistan is currently going through one of the biggest challenge it has encountered since the country's inception and while Covid-19 has led to intense fear and despondency among the public, there are still those who are trying to bring together the country's collective expertise and knowledge to ensure that we fight this fight in the strongest manner possible.

Along with our healthcare workers, our law enforcement agencies, our sanitary workers, and all the other Pakistanis working to provide essential services to the public, the country's youth and its students are also not far behind, with some of them coming up with quick and useful strategies, some of which can also be implemented at low costs.

Bringing together scientists, mobilising efforts

One of these platforms is a group of over 3000+ young scientists from all over Pakistan who have come together on a virtual network called Scientists Against COVID-19 Pakistan (SACP-19).

"There is an astounding number of people who are ready to volunteer and assist with the effort," says Mohammad Ismail, a 25-year-old bio-technologist who started the platform with people like Peshawar-based physiology student Adil Salim, Karachi-based microbiologist Sadia Khalil and Lahore-based research immunologist Maryam Ahmed a week ago. "We want universities and labs in Pakistan to donate their equipment for use to scale up testing. This is something that's already happening in the US," says Ismail. However, he added, there was a "disconnect" between various sectors in Pakistan which makes executing such ideas more challenging here.

At the moment, while there is oodles of energy, lots of fresh ideas, and ambition and passion to fight against the Covid-19 pandemic, there appears to be no specific plan in place to put these young minds to use.

Ismail and his friends are getting not more than three to four hours of sleep, and are busy organising this unwieldy group and forming smaller clusters, based on each member's expertise, getting them to connect, brainstorm, and come up with ways to help Pakistan get through these difficult times.

"Our's is a race against time," says Ismail, as he screens the upcoming new names of microbiologists, engineers, data scientists, and even videographers and vloggers, who need to work in tandem and not in silos. "It's overwhelming but we have a great team and we work well," he says enthusiastically over the telephone. He is also liaising with officials from district governments asking how he and the group can be of help to the latter.

Manning the helpline, helping at isolation centres

From L to R: Ali Aahil Noorali, Anam Noor Ehsan, Kaleem Ahmed, Faiza Urooj, and Muhammad Huzaifa Zafar.
From L to R: Ali Aahil Noorali, Anam Noor Ehsan, Kaleem Ahmed, Faiza Urooj, and Muhammad Huzaifa Zafar.

Another group is the Student Taskforce Against Covid-19 (Stac-19) started by final year medical students at the Aga Khan University Hospital. This group has turned into a community of over 500 members and these members comprise not only young doctors but also non-medical students.

"The challenge is managing the rapid growth of our task force," admits one of its founders, Kaleem Ahmed. He adds: "It's novel and interesting to see this implosion in just a week. We are not turning anyone away but are trying to offer tasks in batches so everyone remains engaged while ensuring that no one gets burnt out."

Manning the Covid-19 helpline at the AKUH is one of the things Stac-19 does. "For this, only the students from AKU or its employees who have been trained to respond to callers in a scientific manner are allowed," says Ahmed.

He says the taskforce will also be assisting the AKUH and the Sindh government in "contact tracing". This means "tracking and determining the status of those in contact with a Covid-19 patient and to counsel them about the 14-day period of isolation that needs to be observed", he explains.

The taskforce is also helping the Pakistan Medical Association in identifying volunteers to help out at Karachi's Expo Centre isolation ward.

Collecting protective equipment for medical workers

One very critical group is the Karachi-based First Response Initiative of Pakistan. It comprises of over 400 medical students who have come together through its CombatCorona campaign and they are busy collecting Personal Protective Equipment (PPE) for healthcare workers.

"We were able to collect up to 100 PPEs over the weekend and plan on distributing them to Dr Ruth K M Pfau Civil Hospital, the Jinnah Postgraduate Medical Centre (JPMC) and Abbasi Shaheed Hospital," says the organisation's vice president, Rajaa Fatima, who is a final year student at the Dow University of Health Sciences.

"Each PPE kit can cost from between Rs1,000 to Rs 7,000 depending on the kind needed. Our estimate is that we need a minimum of 150 for each of the three hospitals," she says.

But this challenge, too, may get sorted out.

Enabling connections, innovating for ventilators, non-contact thermometers

A volunteer group in Islamabad called Pakistan Against Covid-19 — Volunteers group (Pac-V) is providing a line to those manufacturing the material for as well as the suppliers of PPE kits to provide paraphernalia at nominal rates or free of cost.

Dr Bilal Siddiqui, a 39-year-old mechanical engineer, of the Pac-V, and his team is working on a prototype for a ventilator using 3D printing technology. "We are trying to come up with an ICU grade ventilator," he tells Dawn.com. While it may take longer, another 10 days or so, it is what we will need most for critical Covid-19 patients," he says.

Dr Bilal Siddiqui.
Dr Bilal Siddiqui.

In a new development, they are also testing if a hospital ventilator already in use can be hooked to multiple patients like they are doing in the US. The Shaukat Khanum Memorial Cancer Hospital and Research Centre is doing the testing in this regard and "if that works, we will be producing a network of pipes that can be latched to one machine and we will be home-free, for a bit," says the engineer.

But producing ventilators is just one part of the solution. Siddiqui says his team can quickly come up with non-contact thermometers as soon as they get the sensors that have already been ordered from the US and are on their way. "The prototype is ready and we have already fielded them to a few health facilities. Because these thermometers are in short supply, the prices have suddenly jacked up from Rs3,500 to Rs 35,000. We can produce these in bulk and aim to get them at everyone's doorstep in between Rs1,000 to 1,500 a piece."

What started with Siddiqui and his team of five has expanded to 500 people that include not just engineers but individuals "great at crowd sourcing" as well as putting in their funds. "There are three clusters of engineers right now in Karachi, Islamabad, and Lahore and we are continuously in touch," he says, adding that it was overwhelming that instead of just a triple helix with interactions between academia (educational institutions), private entities/the industry, and the government (NDMA, Pakistan Engineering Council), other members of the public as well as members of the Pakistani diaspora were backing the group.

"There are some 20 or so farms spread across Pakistan doing 3D printing already and this does not require a lot of space. We can give them our designs, free of cost, and they can start making the ventilators; the hospitals can check the quality control," Siddiqui tells Dawn.com.

But where is the money?

"If we can manage to collect Rs 300,000 in just two days, does it look like a problem?" Siddiqui asks quizzically, saying money was the least of his problems. Time is more of a worry, he says. "We just need to get this done urgently as this is time-sensitive," says the sleep-deprived young man.

Technology to detect high risk patients

In Karachi, 40-year old information technology expert Salman Khan has been working in the healthcare sector for two years now. He joined Pac after returning from the UK and offered to help through his app Kwickdoctor.com that connects the public to consultants, doctors, pharmacies, laboratories and even delivers prescriptions at your doorstep.

What he offers may sound something futuristic. By using artificial intelligence, he says he can create proof of concept and make algorithms through deep data study. And so using gadgets like smart phones and smart watches, people like him "and there are quite a few such people in Pakistan", can help mitigate and control the spread of the disease here, he claims.

"It's all very simple, but for all this we need to get our hands on big data, lots of it, that needs to calculate through algorithms and we can get a fairly accurate picture in seconds," says Khan, giving an example of how through a smart phone, a smart watch on a wrist, and the way the human pulse behaves, one can detect high risk patients.

"It will mean we can solve the problem of limited screening kits. And the phones using digital forms and chatbots with clickable options can help speed up the process, as we can track where the person has been."

Khan says South Korea managed to stem the spread of Covid-19 using the same technology. Since the outbreak, he says, there is more and more traffic on his website with consultants and people wanting to get registered. "Digital care got a real boost like never before as neither the doctors nor the general public want to get exposed to the virus," he says.

Along with all of these bright young people putting in their fair share, in order to fight Covid-19, Pakistan also needs people who are courageous but who may not necessarily be tech savvy. "I'm not worried about finding this cohort," says Khan foreseeing the need of an "army of such people".

Ismail adds that his group is also training people on bio-safety so that they can then be deputed to areas where, if they are exposed, know how to take care of themselves. "As biologists trained in the lab, we understand the risks associated with this situation and want to work towards making sure that everyone understands what proper PPE protocols are and how to follow them, whether they are screening, testing, or treating patients," he says.