AS the risk of a second wave of Covid-19 rises rapidly, a devil-may-care sense of complacency and invulnerability still grips the nation. It comes from a wrong belief that we have honed an indigenous expertise against the virus that is being praised globally.
But there is yet no rigorous technical study of our response. Thus, the ‘global praise’ consists only of dubious official reports about polite remarks made by foreigners in courtesy calls where diplomatic talk abounds or even casual, unsupported remarks. So Bill Gates in a call with the COAS supposedly praised our response to polio; the relevant news report is based on an ISPR press release. In 2015, Bill Gates apparently appreciated Imran Khan’s efforts against polio in KP even though we were among the few states that hadn’t uprooted polio. That news seems to have been based on a tweet by Jahangir Tareen.
No less a person than the WHO chief has praised our response. He identified many states which have invested well in public health over time, including Pakistan. But ironically, Pakistanis lament the pathetic neglect of public health even compared with some African countries, as official statistics show. He oddly also said that we won against Covid-19 by using our strong anti-polio system. That system ironically has failed to end even polio itself, more so under PTI. He cited Italy as a success story though it has one of the worst Covid-19 death rates.
Meanwhile, WHO’s own Covid-19 work faces critique. Such polite but dubious praise by foreign dignitaries exists in plenty in official press releases in many other areas earlier too but is no substitute for expert opinion contained in in-depth technical reviews. Thus, it’s naive to assign much weight to it, given that hard data paints another picture.
It is crucial we abandon our complacency.
Global data shows that around 60 states have a lower Covid-19 death rate than ours. Most of them have poor health systems too. So we don’t stand out globally or even regionally on this basis. Regionally, Bhutan and Sri Lanka stand out with rates of near-zero and 0.9/million. India has the worst rate (90) followed by the Maldives. Pakistan, Nepal, Bangladesh and Afghanistan cluster closely between 32 and 42. But even India’s rate is far below Peru’s of above 1,000. This shows that South Asia has largely been spared. We could argue that our success lies in averting a bigger disaster in that case numbers fell sharply after June, which were rising rapidly earlier. But here too we see a global pattern in many states where case numbers fell after May but are now increasing again, as in Pakistan.
Beyond numbers, a look at the various parts of our response reflects many issues. The Covid-19 response includes precautionary and tracking steps. Precautions include lockdowns and clear public health messaging by top officials about mask-wearing and social distancing. Our lockdowns hardly lasted a month and were unevenly enforced. Large crowds were allowed for religious events. Our messaging was contradictory, with the rulers carelessly dismissing the virus threat. Media reports suggest that mask-wearing and social-distancing efforts among people were very uneven.
Under tracking, the key first step is testing. Our testing rate of around two per cent of the total population so far ranks among the bottom 25pc states globally. The next step is contact tracing for persons testing positive. However, low testing rates obviously undermine contact tracing too, as it will not be done for positive but untested people. The final step is isolation of positive persons and even their contacts. No systematic data is available on the number of such persons. Anecdotal data, though, suggests weak effort. These big gaps on both precautionary and tracking efforts makes it unclear whether the fall in cases in June was due to a good response or part of some natural fall in many states. The rigorous data needed to answer this query is missing.
Public health entities think the coming second wave in the winter may be more deadly than the first one. Thus it is crucial that we abandon our complacency based on dubious praise and develop a comprehensive plan for dealing with it. The gaps identified above under both precaution and tracking can serve as a road map for developing such a plan. A clear and consistent message must come from the very top about the threat.
Public messaging about masks and social distancing has started but must be ramped up further via unconventional and creative means. The PTI and opposition leaders must provide strong role models in this regard. A calibrated lockdown plan must be developed as per evolving need. Testing must be ramped up and thorough contact tracing and isolation must follow it, with relevant figures made public. It may require much more than just luck to dodge the bullet a second time.
The writer is a political economist and heads INSPIRING Pakistan, a progressive policy unit.
Published in Dawn, November 3rd, 2020