PESHAWAR: With five more deaths of Covid-19 patients, four in Peshawar and one in Swat, the number of fatalities increased to 98 in Khyber Pakhtunkhwa as the number of patients rose to 1,864 with 71 new cases on Sunday.

Experts believe that non-observance of national guidelines regarding social distancing rules is causing rise in Covid-19 cases as well as deaths from the infection.

The health department’s report said that 30 more patients recovered during the last 24 hours, taking count of total healed patients to 515 in the province so far.

“The social distancing, especially in mosques and hujras, is not observed. Very casual response of the community is seen in the marketplaces.

Health seeking behaviour, late arrival to hospitals and burial issues may be a cause of highest positivity and mortality in KP,” Prof Ziaul Haq, the dean of public health and pro vice-chancellor of Khyber Medical University, told Dawn.

Five more die of Covid-19; number of patients reaches 1,864 with 71 new cases in KP

He said that people should be clearly informed that the health system was already under immense pressure and further burden could force its collapse if they did not take the voluntary social distancing seriously.

On March 26, federal government issued social distancing guidelines during Covid-19 epidemic to break the transmission chain of the virus through person-to-person contact and reduce the risk of becoming infected during the pandemic.

It said that preventive measures played an important role in limiting spread of a communicable disease and could help to reduce the transmission of infection and unnecessary burden on healthcare facilities.

“Stay home when there is no urgent need to go out. Avoid physical contact with others as much as possible. And stay away from handshakes,” it said. However, people have not taken it seriously and a result confirmed cases and deaths from the virus are increasing.

According to the latest report of World Health Organisation, Peshawar accounted for six per cent of nationwide case load after Karachi with 14 per cent and Lahore with 22 per cent. Peshawar, with a population of five million, has 576 cases of the total 1,793 and 52 deaths of the province-wide 98. Every fifth person in the city has tested positive, the highest rate in the country.

The case fatality rate (CFR) in Peshawar is 8.7 per cent, the highest in any city of Pakistan. It has 53pc of the KP’s total deaths. KP has 5.2 pc CFR, the highest by any province in the country. The nationwide CFR is 2.1 pc. Swat is also among 10 most Covid-19 burdened districts with three pc of nationwide cases. It has 153 cases and 11 deaths.

Prof Ziaul Haq said that Pakistan had a weak health system that did not have the capacity to absorb the Covid-19 related morbidity and mortality.

“There is no public health structure in Pakistan. As a public health professional, I strongly recommend formation of a “public health authority” in Pakistan, run by professionals and work under the department of local government instead of the department of health. Only then they can focus on the preventive and promote model rather than curative,” he said.

KP has improved the laboratory tests but it is still low -- 662 versus 4,016 in Islamabad. The districts have to spend a lot of resources to send the sample to the only few laboratories and therefore only selective samples are sent. There is need of setting up more laboratories in all divisions of the province.

All the medical teaching institutions, district headquarters hospitals, tuberculosis centres, general universities and private sector should play a proactive role.

There is continuous influx of pilgrims and members of Tableeghi Jamaat having high positivity. The confusion regarding isolation and quarantine centres still persists.

There are many quarantine centres in the province, mainly established and run by the district administration. High risk people are picked and hosted there but within the quarantine centres or the quarantine areas the SOPS of infection prevention and control may not be properly followed that can increase the transmission and positivity. “As a result, the CFR may further dramatically increase,” said Prof Zia.

Published in Dawn, April 27th, 2020