Premature optimism

Updated June 26, 2020

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REPORTS that Covid-19 cases in Pakistan have been falling in recent days should be viewed with caution. According to data released by the National Command and Operation Centre, the past few days witnessed between 4,000 to 5,000 daily cases as compared to mid-June which saw between 5,000 and 7,000 cases.

If reviewed without context, these figures do look promising. However, the same period in which coronavirus cases supposedly declined also witnessed a sharp reduction in tests. Where authorities had conducted north of 31,000 in a single day around mid-June, in the past few days the numbers have fallen to below 25,000. In fact, according to one NCOC press release on June 25, the total number of tests was below 22,000.

While officials are eager to pat themselves on the back and are marvelling at what they claim is the success of ‘smart lockdowns’ or achievement of ‘herd immunity’, the celebrations are premature if not entirely unjustified.

The true picture of Pakistan’s Covid-19 infections can be understood through simple calculations. One likely factor behind the fewer positive cases is that fewer people are being tested. The focus of the authorities should not be on the number of people testing positive, but rather on the number of tests being done and the percentage of total tests versus total positive cases in a single day. This percentage mid-June was between 18pc and 22pc, which meant that 18 to 22 out of every 100 people tested were Covid-19 positive. In the last five days, that percentage has been recorded at between 16pc to 20pc — a 2pc reduction which can hardly be claimed as a victory when testing was reduced by a third.

One official suggested that although there is no policy to have fewer tests, the fact that tests are being reduced simply on account of “fewer people coming to the hospital with symptoms” cannot be the basis upon which to claim success.

As we know, and much like the global trend for Covid-19 cases, community transmission is rampant. Testing must be ramped up; in the case where fewer suspected Covid-19 patients are seeking tests at hospitals, it must be done in communities to assess how widespread the infection is. A reduction in testing at this stage, when the government and healthcare experts fear a peak around mid-August, is unacceptable. Authorities must make good on their commitment to increase testing to 100,000 daily and sustain this over a prolonged period. Only then can victories and losses be documented.

Published in Dawn, June 26th, 2020