BY HANNAN R. HUSSAIN
Hannan Hussain is a Masters of Public Policy student at the University of Maryland, College Park, specializing in International Security and Economic Policy.
Since mid-June, Pakistan’s government has revised its COVID-19 containment plan considerably.[i] It has moved from nationwide restrictions to a series of “smarter lockdowns” which take a locality-based approach to decelerating rampant infection rates. The approach targets some 500 confirmed “coronavirus hotspots” peppered across the country, adding newly reported areas by the day.[ii][iii] It is against this backdrop that daily COVID-19 cases have fallen from 12,100 around mid-June to well under 3,500 throughout most of July.[iv] That is a 71% decrease for the 11th hardest-hit country in the world. Initial headway is certainly evident. It should be noted that while the highest daily case rate peaked at 12,100, it averaged between 5,500 and 6,500 for most of June.
Pakistan’s reliance on multiple case-count methodologies is a key contributor to this difference. Statistical models devised by the Health Department Working Group of Punjab – Pakistan’s most populous province – forecasted cases to double “every two weeks”, speculating some three million cases in major cities last month.[v] However, these projections did not account for variations in Pakistan’s countrywide testing. As a result, the National Command and Operations Centre (NCOC) – the federal government’s newly established COVID-19 analysis arm – assumed a broader role in shaping the country’s testing methodology. It achieved this outcome by activating three parallel streams of tracing, testing and quarantine (TTQ) across all four provinces, and allowing daily COVID-19 infection trends to be contrasted with nationwide testing disparities in real time.[vi][vii][viii]
Previous research has shown that when low-income countries begin to construe health as a socially viable investment, as opposed to a cost to society, they appear to be in a stronger position to secure returns on health, especially once infectious diseases begin to decline by the decade.[ix]
Hence, to deliver on such a possibility, Pakistan must supplement its smart lockdown approach with numerous policy imperatives, such as scaling-up COVID-19 surveys that attempt to understand the symptomology of the disease in relation to age, gender, and comorbidities.[x]
On the other hand, Pakistan’s smart lockdown pivot is not without its challenges. First, there is a dire need for the government to transform the way it markets health as a public commodity. Prime Minister Imran Khan’s conflicting rhetoric on treating the pandemic as a passing affair, as opposed to a purely scientific pursuit, can easily discourage lasting public conformity to fundamental health precautions.[xi] Moreover, the government’s refusal to clarify recent gaps in COVID-19 testing, as well as marked variations in daily immunization visits, runs contrary to its belief of “contradiction-free” policy planning.[xii][xiii][xiv]
Ultimately, Pakistan’s month-long experiment in smart lockdowns affords a tangible starting point for breaking COVID-19 transmission chains. However, any degree of resistance to data transparency and informed rhetoric could easily dial back the country’s present and prospective gains.
[i] Qazi Hassan and Mohammad Khan, “’Smart lockdown’ begins in Karachi’s Covid-19 hotspots,” DAWN News, June 18, 2020. https://www.dawn.com/news/1564343
[ii] Asad Hashim, “‘Smart lockdown' in Pakistan to target 500 coronavirus hotspots,” Al Jazeera, June 23, 2020. https://www.aljazeera.com/news/2020/06/lockdown-pakistan-target-500-coronavirus-hotspots-200623072202544.html
[iii] Munawer Azeem and Mohammad Asghar, “Five Islamabad sectors still considered hotspots for coronavirus,” DAWN News, July 14, 2020. https://www.dawn.com/news/1568879/five-islamabad-sectors-still-considered-hotspots-for-coronavirus
[iv] See: Daily Cases for Pakistan “COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE),” Johns Hopkins University Coronavirus Resource Center. https://coronavirus.jhu.edu/map.html
[v] Ayesha Tanzeem, “COVID-19 Deaths, Patients Grossly Under-Reported in Pakistan,” Voice of America, June 18, 2020. https://www.voanews.com/covid-19-pandemic/covid-19-deaths-patients-grossly-under-reported-pakistan
[vi] Ikram Junaidi, “PM’s policies brought turnaround in Covid-19 situation: aides,” DAWN, July 27, 2020. https://www.dawn.com/news/1571341
[vii] “NCOC identifies 20 cities across Pakistan with potential Covid-19 hotspots,” DAWN, June 15, 2020. https://www.dawn.com/news/1563708
[viii] “Official COVID-19 Portal,” The Government of Pakistan. http://covid.gov.pk/stats/pakistan
[ix] “Report - Prioritizing health: A prescription for prosperity,” McKinsey Global Institute, July 8, 2020. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/prioritizing-health-a-prescription-for-prosperity
[x] Imran Ayub, “Survey of coronavirus-tested people launched across Pakistan to build ‘confirmative database’,” DAWN News, July 9, 2020. https://www.dawn.com/news/1567823
[xi] Zia ur-Rehman, Maria Abi-Habib and Ihsanullah Mehsud, “‘God Will Protect Us’: Coronavirus Spreads Through an Already Struggling Pakistan,” The New York Times, March 26, 2020. https://www.nytimes.com/2020/03/26/world/asia/pakistan-coronavirus-tablighi-jamaat.html
[xii] Benazir Shah, “Should Pakistan’s baffling COVID-19 test numbers ring alarm bells?,” Arab News Pakistan, June 27, 2020. https://www.arabnews.pk/node/1695756/pakistan
[xiii] Subhash Chandir et al., “Impact of COVID-19 lockdown on routine immunisation in Karachi, Pakistan,” The Lancet Global Health, June 29, 2020. https://doi.org/10.1016/S2214-109X(20)30290-4
[xiv] “PM Imran defends govt’s Covid-19 response, says there has been no ‘confusion’ or contradiction,” DAWN, June 26, 2020. https://www.dawn.com/news/1565156
PHOTO CREDIT: Free use image from Canva Pro.