TO lockdown or not to lockdown. That appeared to be the question, this past week, once again as the PTI government in the centre decided to ease the lockdown to allow some economic activity. There was a storm of protest as many felt this was an unwise step.

There is a widespread opinion that the lockdown should continue — medical experts such as Dr Abdul Bari of The Indus Hospital also feel that a month-long lockdown is the bare minimum.

Pakistan’s lockdown — announced with small differences within provinces — began around the end of March. By April 14 it was extended (albeit not uniformly), and hence began the debate, especially as it appears as if Sindh and Punjab are following two different policies.

Perhaps it is important to remember that experts suggest a lockdown not because it can end a virus, but only to slow down its spread. As the oft-used phrase goes, countries need to flatten the curve; few are aiming to squash it! The policy is meant to buy time for the health services and to put in place other measures that can help us cope better with the virus.

Keeping Pakistan’s overall capacity and financial situation in mind, one cannot assume that all the measures needed are in place, and yet the policy is being changed.

Economists are voicing their concern over the adverse effects of a lockdown in developing states.

But the change might be provoked by other factors. In the days since Pakistan implemented the lockdown, the debate over lockdowns has widened and a number of (development) economists seem to be voicing their concern over the adverse effects of a lockdown in developing countries. One such piece, ‘Poor countries need to think twice about social distancing’ published on Foreign Policy’s website, argued that poorer countries may not be able to afford lockdowns and that such policies may not be as effective as they are elsewhere.

The writers state: “Because there is ample evidence that the economic costs of distancing — especially the burden on the poor — are a lot higher, a serious assessment is urgently required to determine what other measures could effectively save lives while minimising losses in aggregate welfare.”

They also wrote: “An equally effective social distancing policy is predicted to reduce coronavirus-related mortality by 1.3 million people in the United States and 426,000 in Germany. Such a policy would only save 182,000 people in Pakistan and 102,000 in Nigeria.”

A blog on The Times of India’s website quotes economics Nobel laureate Angus Deaton: “countries with strong administrations and health systems could enforce social spacing, comprehensive testing, isolation… [to] check the epidemic. But in poor countries with weak administrative and medical capacity, shutdowns would not check the disease. … [T]he disease would spread despite shutdowns.”

In fact, the growing debate includes some voices that are not entirely convinced of the lockdowns in the West either. Elizabeth Bogan, a professor at Princeton who admits that hers is a contrarian position, has also raised questions about the hardship caused by the lockdown in an interview to the podcast Policy Punchline. She says: “California closed all its restaurants except for take-out. The restaurant business in California employs 1,830,000 people according to restaurant.org. That’s 11 per cent of California’s employment. Probably about a million of them have lost their jobs. How will they pay their rent? How sick will they be from stress? How much will their children suffer? Even if the government plans to compensate them it will be a mess. Many live on tips and there may not be records of what they usually make.”

Her argument, as some others (eg ‘India’s response to coronavirus can’t be based on existing epidemiological models’ in The Print), is also that there is not enough data to judge how much damage the virus will cause. She points out: “Deaths/cases have little meaning if you are getting case data only based on testing the very sickest patients. What if those without symptoms or with only mild flu-like symptoms who had Covid-19 were not tested, as we know was the situation? Then the deaths predicted from the very sick only sample would be grossly too large compared to the infected population.”

Those in Pakistan have also highlighted this debate. The News recently published more than one opinion piece on the need for a ‘smart lockdown’. The Pakistan Institute of Development Economics has also written about it and recommended a policy that “contains the infection and also allows some basic level of economic activity. A model developed by a group of scientists recommends an intermittent lockdown: 10 days of lockdown and four days of work per fortnight. The basic notion behind this is that, ‘In this way, the virus replication number, ie the number of people infected by each infectious person, drops below one — the magic number that causes the epidemic to decline’.”

It appears that this debate is one factor behind the federal government’s change in policy. The Sindh government is also considering this because it is meeting traders and others to finalise the SOPs for businesses to open even as it is pushing for a stricter lockdown.

Perhaps what is also driving the government is the realisation that there is not much of a lockdown in the poorer parts of the bigger cities or the rural areas, even as it has robbed people of their earnings. Also, their decision to seal off high-risk areas in Khyber Pakhtunkhwa and Islamabad seems to have paid off, which is a policy that will be followed in the days to come. Sindh, too, had decided to do this in Karachi.

However, it must be acknowledged there is no clear-cut policy that is guaranteed to show the desired results — ensure the lives of people as well as their financial well-being — because no one seems to know enough about the disease or the impact of the lockdown. It is possible that the numbers grow so much in the coming days that the government imposes another lockdown. Only in hindsight will we be able to judge the policy decisions being made now. Even then, there may be no clear-cut answer. Says Borgan of the Spanish flu, “The cities with the interventions flattened the curve, but didn’t reduce the cases or death rates significantly overall.”

The writer is a journalist.

Published in Dawn, April 21st, 2020