Rashid A Mughal
NO one predicted the degree of damage and so quick and sudden spread of Coronavirus on our globe. The Researchers, medical experts, health-care gurus were all flabbergasted. The politicians and leaders were initially watching helplessly before they could devise a plan and strategy to deal with this invisible monster. City after city and country after country were being affected. The scariest part of COVID-19 is that there is no known treatment or vaccine for it and hence the death rate kept rising in geometrical progression where it surfaced. Italy, France, Britain, Spain, Germany in Europe were worst affected after China, where it originally affected a Laboratory technician in Wuhan on 17 November 2019. There were large number of cases in Iran and it subsequently surfaced in Pakistan in March 2020. By 30th November there were more than 2500 confirmed cases of Coronavirus in Chinese city of Wuhan which surprised the health experts and WHO which officially declared a health emergency on 30th December. But it was not before 11 March 2020 that WHO declared it a pandemic.
There is no doubt that the crisis, which still continue, are unprecedented but what is remarkable is the response from health professionals — doctors, nurses, technicians, administrative and other hospital staff, who, without caring for their own life, did everything possible to save others. In Lombardy, Italy where people were falling and dying on the streets, presenting a scary and horrible picture, the health workers worked overtime and without rest to look after the sick and in many cases they themselves became victim of this deadly virus. New York and Los Angeles in USA were the biggest centres of Covid-19 when it reached American shores. It was extremely terrifying to see more than 2000 people dying every day in these cities. The hospitals presented a shocking and nerve shaking picture. It was difficult to watch on TV, affected people dying in the corridors of the hospitals and truck-load of corpses being taken for mass burial. But the courage, resilience, determination and boldness shown by the doctors, nurses, paramedics, technicians and other supporting staff is something which cannot be described. It is simply superb and superlative. They, in fact, are the true heroes and their contribution to the cause of humanity can never be forgotten.
The role of health care personnel in Pakistan is equally commendable as they, in spite of shortage or non-availability of equipment, worked day and night to fight the virus and did their best to save the lives of those affected. Public health systems are already over stretched long before the pandemic, with a ratio of one doctor to 963 people and one hospital bed to 1,608 people. Shortage of trained medical staff is estimated at 200,000 doctors and 1.4 million nurses, and universal health coverage is nonexistent. Nearly 42 million children are now out of school, while 17 million children under five are missing routine vaccinations. An additional 2.45 million people — beyond an existing 40 million — now suffer food insecurity, according to a study. While the poverty rate declined by 40% over the last two decades to 24.3% in 2015, the IMF projects a sharp reversal, with up to 40% of Pakistanis living below the poverty line in COVID-19’s viral wake. Real GDP growth is expected to slow by 3% , with downturns in services and manufacturing. Agriculture will also suffer due to lockdowns and disruption in transportation, logistical support, labour, and access to inputs for the next planting season.
While COVID-19 leaves Pakistan’s government with a few good options, some steps could minimise harm to lives and livelihoods. The Prime Minister’s fear about the toll of lockdowns is well-justified. Yet the economy is unlikely to start moving unless the authorities keep the virus at bay. Adopting the smart lockdown strategy might avoid the pain of a prolonged lockdown while still saving lives. This could mean allowing provinces, if medical experts so advise, to lock down entire cities and urban districts for short periods, instead of limiting them to partial closures. More broadly, the government should guide the country’s response but give provinces leeway to devise policies tailored to local needs. Bolstering the provinces’ health capacity – particularly testing – should remain a top priority. Emergency assistance to families that fall under the poverty line and unemployed workers remains critical. COVID-19 testing, tracing, communication and dissemination of knowledge needs to be improved. These rules also apply to the organization of the health care system itself. Wholesale reorganizations are needed within hospitals (for example, the creation of COVID-19 and non COVID-19 streams of care). In addition, a shift is urgently needed from patient-centred models of care to a community-system approach that offers pandemic solutions for the entire population (with a specific emphasis on home care). The need for coordinated actions is especially acute right now in Pakistan.
A lesson that can be drawn from the European and American experience is the importance of systematic approaches and the perils of partial solutions. The Italian government dealt with the COVID-19 pandemic by issuing a series of decrees that gradually increased restrictions within lockdown areas (“red zones”), which were then expanded until they ultimately applied to the entire country. In New York and Los Angeles, the Mayors of these cities showed exemplary leadership qualities to meet the biggest challenge of their life against and invisible enemy. However Covid-19 has now taught us that an effective response to the virus needs to be orchestrated as a coherent system of actions taken simultaneously. The results of the approaches taken in China and South Korea underscore this point. While the public discussion of the policies followed in these countries often focuses on single elements of their models (such as extensive testing), what truly characterizes their effective responses is the multitude of steps that were taken at once.
Testing is effective when it’s combined with rigorously contact tracing, and tracing is effective as long as it is combined with an effective communication system that collects and disseminates information on the movement of potentially infected people, and so forth. Some countries seem to have suffered from two data-related problems. In the early onset of the pandemic, the problem was data paucity. More specifically, it has been suggested that the widespread and unnoticed diffusion of the virus in the early months of 2020 may have been facilitated by the lack of epidemiological capabilities and the inability to systematically record anomalous infection peaks in some hospitals in some countries.
— The writer is former DG (Emigration) and consultant ILO, IOM.
