WHO says Pakistan meets no pre-requisites for easing restrictions, recommends 'intermittent lockdown'

Published June 9, 2020
The letter, penned by Dr Palitha Mahipala and dated June 7, stated that the coronavirus has spread to almost all districts in the country, with major cities making up a majority of national cases. — Reuters
The letter, penned by Dr Palitha Mahipala and dated June 7, stated that the coronavirus has spread to almost all districts in the country, with major cities making up a majority of national cases. — Reuters

The World Health Organisation (WHO) — in a letter addressed to Punjab Health Minister Dr Yasmin Rashid — has recommended that the country impose an "intermittent lockdown" to curb the spread of Covid-19, noting that the country doesn't meet any prerequisites for lifting restrictions as was done on May 1 and then on May 22

The letter dated June 7 has been penned by Dr Palitha Mahipala, WHO Country Head for Pakistan, and states that the coronavirus has spread to almost all districts in the country, with major cities making up a majority of national cases.

"Government intervention on April 12 detailing social distancing measures, including movement restrictions, closure of schools and businesses, international travel restrictions, and geographical area restrictions were instituted with the aim of limiting the spread of the disease."

However, the partial relaxation of restrictions on May 1, followed by a complete relaxation on May 22, has caused the rate of infection to increase, the letter noted.

A screenshot from the letter showing the daily increase in Covid-19 cases.
A screenshot from the letter showing the daily increase in Covid-19 cases.

According to WHO recommendations, any government that wishes to lift lockdown restrictions must meet a set of conditions. The letter noted that so far, Pakistan has not met any of the conditions which include:

  • Disease transmission is under control
  • Health systems can "detect, test, isolate and treat every case and trace every contact"
  • Hot spot risks are minimised in vulnerable places
  • Schools, workplaces and other essential places should have preventive measures
  • The risk of importing new cases can be managed
  • Communities are fully educated, engaged and empowered to live under a new normal

"The positivity rate is high, the surveillance system is weak, there is limited capacity to provide for critical patients and the population is not ready to adapt to change in behaviour," the letter stated, adding that Pakistan's reproductive number (R), which is an estimate for the number of individuals infected by each carrier, is also greater than 1.

A graph from the letter shows the current reproductive time for Pakistan.
A graph from the letter shows the current reproductive time for Pakistan.

The WHO recommended that strategic decisions should be taken to either tighten or loosen public health measures. "These difficult decisions will require the need to balance the response directly to Covid-19 which includes intermittent lockdowns of targeted areas."

Stressing the need for ramping up testing capacity beyond 50,000 tests per day and strengthening public health measures, the WHO recommended that the government enforce a "two weeks on, two weeks off strategy" as it offers the smallest infection curve.

Pakistan's coronavirus cases surpassed the 100,000 mark last week. As of June 9, more than 110,000 Covid-19 cases and 2,000 deaths have been reported.

'Need to ensure implementation of SOPs'

Commenting on the letter, Rashid said that it was important to remember that the recommendations were for the entire country, not just for Punjab.

She expressed these views while speaking at a press conference in Lahore earlier today. "I have been telling you since day one that the number of cases [in the province] are increasing, no data is being hidden.

"The main thing that they have said is to ensure implementation of standard operating procedures (SOPs). This discussion has already taken place. In his last meeting, the Punjab chief minister stressed on taking action in areas where there are violations.

"The current situation, whatever WHO says, right now we can also treat patients. The purpose of a lockdown is to prevent flooding of hospitals. We have a contingency plan [...] right now we have the capacity [to treat patients] and will increase it in the next 10 to 15 days."

She added that whatever the WHO had said was correct and that the government would "consider" it. It has already been proposed to lockdown areas where a large number of cases are being reported but this decision will be taken by the cabinet committee, she concluded.

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