HYDERABAD: The steadily increasing trend in coronavirus pos­i­tivity ratio has worried doctors and civil administration as five more people died of coronavirus infection during last 24 hours at Liaquat University Hospital’s city branch.

The National Command and Operation Centre (NCOC) has put Hyderabad on top of the list of hotspots with 16.59 per cent positivity ratio among 11 districts of the country.

But Sindh CM’s Adviser on Law Murtaza Wahab disagrees with NCOC’s figures terming them incorrect in his tweet. “Ratio remained at 8.7pc approximately in the district,” he said.

The NCOC said Hyderabad had the highest positivity (16.59pc) ratio among 11 cities of Pakistan. It was followed by Multan (15.97pc), Gilgit (15.38pc), Muzaffarabad (14.12pc), Mirpur (11.11pc), Pesh­awar (9.69pc), Quetta (8.03pc), Islamabad (7.48pc), Karachi (7.12pc), Lahore (5.37pc) and Rawalpindi (4.63pc).

According to LUH’s focal person Dr Aftab Phull, the five victims included a 62-year-old resident of Sanghar, 70-year-old man from Unit-9 of Latifabad, 28-year-old resident of Hala Naka, 65-year-old man from Effendi Town and a 70-year-old man from Unit-9 of Latifabad. Currently, six patients were admitted to intensive care unit, nine in high dependency unit and three undertrial prisoners in isolation ward.

Hyderabad seemed to be bracing for the second wave of coronavirus infection after its rate had declined in July-August. Septe­mber onwards it started showing a surge. According to an official at Diagnostic and Research Labor­atory (DRL), the positivity ratio varied between 10pc to 12pc over the past few days. “Patients from other districts might be having tests done at our lab or through district health office (DHO) of Hyderabad because we have a tertiary level hospital,” he said.

NCOC had first placed Hydera­bad among other cities where new guidelines relating to standard operating procedures would be enforced from Nov 20. Under these guidelines, weddings would not be held in halls and marriage functions were to be concluded by 10pm.

Hyderabad has reported the highest number of coronavirus cases and over 100 deaths of infected patients in different government hospitals and at home since March when the virus outbreak was reported. Till Sept 15, 101 deaths were reported in Hyderabad.

Hyderabad Deputy Commis­sioner Fuad Ghaffar Soomro said: “Recommending imposition of ‘smart lockdown’ on union committee levels is one of the measures we can adopt to contain the virus’s spread. We have effectively handled the situation in the first wave”.

He said that no proposal for the smart lockdown had so far been forwarded to the government. “Closing restaurants and other spots may become inevitable if the rising trend of cases continues,” he said.

He attributed recent surge to larger turnouts of people in Muharram and Eid Miladun Nabi (PBUH) gatherings. “Huge human activity is seen on these occasions and it is apparently one of the reasons we are witnessing higher number of cases again,” he said.

‘Govt needs to have positivity ratio double checked’

Sindh health authorities, shared an official, had doubted results of DRL to some extent, believing the positivity ratio was incorrect. Under directives of Director General of Health Services Sindh Dr Irshad Memon, Hyderabad DHO had sent samples of some patients to Indus Hospital Karachi over the last couple of days.

“The positivity ratio, however, remains the same at above 10pc at both laboratories,” Dr Irshad Memon told Dawn on Monday evening. Around 600 to 700 samples’ results were still pending with Indus Hospital, it was learnt.

The DHO would again be sending samples to the DRL which topped list of laboratories conducting Covid-19 tests in Sindh. With a 5,000 per-day tests capacity, it was conducting around 4,500 tests on an average on a daily basis as per Sindh health department’s daily situation report on coronavirus.

“Entire Sindh is having PCR tests done at DRL yet doubts have been created and now health authorities will be reverting to us for tests again,” commented a laboratory official. “We are doing tests free of charge at DRL and have effectively handled load of tests during peak of coronavirus infection,” he said.

Plasma therapy discontinued over financial constraints

The DRL, which was chosen for conducting trial treatment of critically ill Covid-19 patients through convalescent plasma, has discontinued the therapy after decline in number of patients and increasing financial cost over the treatment.

Around 45 patients were given plasma therapy at high dependency unit of LUH and most patients had recovered. Some deaths were reported which could be attributed to belated decision on administration of plasma, according to doctors.

Noted haematologist Dr Tahir Shamsi, who proposed this treatment, declared the results of the therapy had been successful and submitted to Drug Regulatory Authority of Pakistan (DRAP).

DRAP’s Clinical Study Committee had allowed clinical trials of convalescent plasma for purpose of passive immunisation during Covid-19 pandemic. “It can only be restarted if DRAP allows,” he said.

LUMHS Vice Chancellor Prof Dr Bikha Ram said the plasma was being administered under supervision of DRL management. “If any critical patient needs the plasma we can provide it to save lives,” he said.

He conceded that the therapy was discontinued due to decline in number of critically ill patients and “financial cost”.

An official said that plasma therapy cost around Rs45,000 per patient and it was borne by DRL. “Sindh government has not provided its cost. So, discontinuation of the therapy is also due to financial reasons,” he said.

Published in Dawn, November 10th, 2020