Rizwan Ghani
MAY is going to be a difficult month. The numbers are going to decide if center and provinces got their policies right. But there are media reports that testing is being deliberately reduced to depict a decrease in number of coronavirus cases which is a foolish approach because number of deaths cannot be hidden. So the officials should clearly give their Covid-19 strategy: test, track and quarantine (TTQ) or test, track and treat (3T) policy because quarantine is not a treatment and it doesn’t not allow opening of the economy. South Korea has used 3T policy successfully from day one and since February no case of coronavirus has been reported there. On April 15, 2020 the country held general election in which 44 million people turned up to vote. Our government is also easing the lack down but there are serious concerns that our exit strategy could fail and country could be looking at China like situation because the current numbers are almost the same as they were in China at early stages of the epidemic. WHO is already warning countries about early lockdown exits including anticipated second wave as leaders face tough calls on economy, unemployment and domestic violence.
The best route in our case is to adopt South Korea approach. China made Covid-19 national test policy in January in which the coronavirus Nucleic Acid Test (NAT) price including reagents and other consumables was set at 160 Yuan (Rs3638= NAT=40 Yuan/Rs910, reagent and consumables 120 Yuan /Rs2750 per person or $23(Rs.3700). Twenty two centers were dedicated for making the NAT kits and reagents and by March they were producing 4.26 million testing kits which are being used for local testing and exports. By 9 April 2020, the kits were improved and giving results in 45 minutes with storage and transportation at room temperature with 99 percent accuracy rate with 60 sample analysis per hour (New test kits give answers within 45 minutes, 16 April 2020, China Daily). In addition to China Covid-19 swab based NAT tests, a UK based company has developed two-minute self administered US FDA approved saliva based Curative test being used by US air force also just requiring saliva sample from inside the mouth. It has the same accuracy as the nasal swab test (NST) and the results are available within 72 hours (UK turndown offer of 10,000 tests a day four weeks ago, 29 April 2020, the Guardian).
On policy level, China used a blended guided prices with market regulated prices and testing in public and private setups helped control the epidemic and prepared the country to be ready for the next wave. It was observed that private sector put public interest before their profits. The airlines and ground transport helped by providing free delivery of test kits and equipment on urgent basis (Why is the cost of Covid-19 test very low in China? 24/4/2020, China Daily). The availability of different kinds of tests including self testing protects other persons, medical staff and reduces need of PPE by 90%, and facilitates government to end/ease lockdowns and restart economies cautiously. Accordingly, our government needs to use 3T policy to trace, test and treat Covid-19 positive persons so that like South Korea, Pakistan can cautiously reopen its economy. In this regard PM needs to give a clear strategic Covid-19 policy covering number of dedicated centers producing testing kits, their national price, testing centers for NAT kits, result-centers for self administered home kits. A complete map of testing centers across the country along with locations, working hours, per person prices, and availability of test results should be made public (website, APP) including treatment options for the Covid-19 positive cases.
South Korea did half million tests for a total population of 51 million and it is free of Covid-19 for the last 60 days. By that standard, we need to conduct around 2.5 million tests to make the country Covid-19 free. Our first Covid-19 relief package cost the tax payers Rs1.2 tn ($8bn) in direct cost which in fact is a debt. The other packages of billions of rupees are in the offing. The economy has suffered and almost 12 million people have lost their jobs and the numbers are growing. Had government planned properly, it could have save precious lives, millions of jobs, billions of dollars and the economy itself. Regarding potential treatments of Covid-19, WHO has announced that Remdesivir, unlicensed broad spectrum antiviral is not effective for serious Covid-19 cases (23 April 2020 The Guardian) . However, China and Japan have used Favipiravir (antiviral drug) to treat Covid-19 patients who tested negative within 4 days of treatment and 91 percent showed improvement on chest imaging whereas in the control group it took 11 days to test negative (Potential treatments for Covid-19, 19 March 2020). Therefore, our govt needs to stop all funding, subsidy and relief programs except the ongoing program for 1.2 crore people and divert the funds to 3T policy on emergency basis and continue until permanent cure is found so that it can stop further loss of precious lives, save tax money, and restart economy in June as Pakistan’s Covid-19 Strategy. The Supreme Court was right in drawing the attention of the government towards its Covid-19 policy. We need to focus on other vaccinations being missed including polio etc to avoid further misery. Uniform policy, speed and honesty will win the race. Finally, time will show that had UK (Exercise Cygnus ) and US (Crimson Contagion) leaderships were aware of the pandemic as early as 2017 and they lied to their publics. Ignorance, corporate culture, forcing rationing of testing instead of free for all testing, ravaging of NHS and home care system and lack of cooperation with international community has contributed in unfolding tragedies right in start both in UK and US. South Korea investment in public healthcare paid off in Covid-19 crisis which they strengthened after Sars and Mers.
—The writer is senior political analyst based in Islamabad.
