EARLIER this month, the federal government announced that it would ramp up Pakistan’s Covid-19 testing capacity to conduct 25,000 tests per day by April end. It is therefore disturbing to note that not only are we nowhere near achieving this target, but that the number of tests being done per day has declined in the past week in Punjab, Khyber Pakhtunkhwa, Balochistan and the Islamabad Capital Territory. While the PPP’s Nafisa Shah speculated that the reduced rate of testing may be politically motivated, Special Assistant to the Prime Minister on Health Dr Zafar Mirza said in an interview that testing would increase significantly once the federal government’s test, track and quarantine policy is implemented. However, the absence of a definitive explanation for missing this target does not augur well, and Dr Mirza’s suggestion that tests may be declining due to fewer suspected cases betrays a degree of complacency in the federal government’s handling of the crisis. Each day that Pakistan isn’t pushing its testing capacity to the limit increases the risk of the situation spiralling out of control, as even asymptomatic carriers can spread the virus to others, with major consequences for both lives and livelihoods.

Time — hard-bought with myriad collective and individual sacrifices made under lockdown — cannot be squandered. We must move past this phase, but in order to do so policymakers urgently need an accurate picture of the issue to prevent a rush on our already overburdened healthcare systems. The politicised nature of the lockdown debate has distracted from a key issue — intensive ramping up of testing and critical care capacity in order to gradually reopen the economy. Countries that implemented early lockdowns with effective messaging and mass compliance, in addition to scaling up their national health response, especially testing, are now beginning to ease restrictions. Those that botched both or either of these measures are seeing hundreds of patients die each day. There is little evidence to suggest that Pakistan would be an outlier to this trend.

While we cannot build an exceptional healthcare system overnight, we can and must improve our testing capacity. A few examples of small-scale universal testing at private organisations not only indicate a high rate of infection but also show that most people were unsuspecting carriers. The extent to which public policymakers can base conclusions on these data sets is limited, but the fact that the country on the whole has been unable to intensively scale up testing in the past few weeks is a serious handicap. Our public health experts argue that the current official figures represent only the tip of the iceberg. We are nowhere near testing enough of our population to see the peak of the curve, let alone flatten it. However, as Dr Mirza himself noted, perhaps a more reliable indicator would be to look at death rates, which no rhetoric can obscure. It is growing.

Published in Dawn, April 30th, 2020