Yes, you guessed it. This too is about the pathogen. But not the pathogen-pathogen. It’s about the government’s performance.
Please note that I said government’s performance. I am being deliberately misleading to make a basic point that social media criticism and memes are missing out: Counting out Gilgit-Baltistan and Azad Jammu and Kashmir, Pakistan has four provincial governments and a federal government.
Welcome to post-18th Amendment Pakistan. It devolved health to the provinces; then Sindh, KPK and Punjab passed resolutions under article 144 and asked the federal government to regulate some areas in the sector. Result: DRAP Act 2012.
Situation: there’s fog about who’s to do what. Be that as it may, the long, initial radio silence from the Centre cannot be defended. Provinces waited, Sindh being the prime example, while Islamabad remained absent.
Memes in Pakistan can be hilarious; one can enjoy them, especially when one has nothing else (or not much else) to do. But they are what they are: exaggerated fun and invective, sometimes abusive. They are also often, though not always, politically-driven. And when not politically-motivated, they can be a wit’s expression of what (s)he thinks is happening. They are like late-night tequila shots at the bar.
Come morning, one needs to get into a crisp white shirt and be sober for day’s work.
So, let’s see how we have fared. For that, it’s important to see how much-better healthcare and policy systems have fared.
One, even as there has been much discussion of a pandemic since 2010, no one was expecting such a spread. Word was there, but governments still faltered in their response. As it is, it’s spread, though not the morbidity rate, has been on the scale of the 14th century Black Death and the 1918 Spanish influenza.
Two, some states, with much deeper coffers, more stable political systems, more advanced industrial base, much better R&D, better healthcare systems were/are better placed to deal with it; others, not so much. In other words, before making comparisons, one need to be clear about capacity. No one is his right mind will race a Ferrari with a Suzuki FX or even entertain the thought of making that comparison. Yet, that’s precisely what we are doing here, for the most part.
Three, to further put things in a perspective, the Ferraris we just talked about, haven’t fared too well either. In fact, some of them have been hit the hardest.
Four, no country in the world has complete information on the number of people infected, no one can perform full testing and no epidemic curve is error-free.
As of now, according to World Health Organisation, “many uncertainties remain as to certain epidemiological, seroepidemiological (related to identifying antibodies in the population), clinical and virological characteristics of the virus and associated disease. Studies to assess these characteristics in different settings are critical to furthering our understanding. They will also provide the robust information needed to refine forecasting models and inform public health measures.”
Five, there are two broad models before us: China and South Korea. Neither is replicable. China’s lockdown of 13 cities and 60 million people is only possible in China (I will count out DPRK because that society has been under a lockdown since the 50s); South Korea is educated, disciplined, has big data and mega technology. It responded early and had the capacity for aggressive testing. Another example is Singapore. To compare a city-state with a highly-educated and disciplined population with more complex societies is, again, a terrible comparison. Others, including Pakistan, have gone for partial lockdowns and are struggling with testing capacity.
There are other points of departure but these should suffice.
Let’s get to where we are.
One, our society is neither very educated nor very disciplined and this is putting it mildly. In other words, we aren’t very good at following directions.
We don’t have the big data and mega technology a la South Korea. Singapore is a bad example with about 5.6 million; Lahore is 11.13 million, for example. So, there!
Any analysis has to bear in mind the constraints.
Another criticism has been about testing. Testing capacity is crucial and it is increasing. As per official figures, we are conducting 1200 tests per day and this will increase exponentially in the next two weeks. In the next three weeks we should have the technology to start producing testing kits here.
Tests in clusters. That’s happening. There’s no way that the system can test everyone. The policy is to watch out for an an outbreak, lockdown that area and test. That’s what’s happened at Bara Kahu and Shehzad Town in Islamabad, as also in Raiwind and some areas along the Grand Trunk Road.
Secondly, the policy on an original mistake has been reversed. Wherever people were testing positive, the law enforcement would go there and put the infected in hospitals. That wasn’t smart. Self-isolation is what is now being done, both because it prevents the spread and because not everyone testing positive needs to be hospitalised.
But self-isolation is not an option in low-income families where on an average we have about four to five people to a room. You can’t ask people to go to a quarantine room because most just don’t have such rooms. That’s where non-hospital quarantine centres come in. Hotels, mosques, marriage halls etc. That’s happening too.
Another issue is the projection of the spread. If we go by the global trend with reference to the number of the tested versus the number of suspected, our ventilators will be outnumbered by the number of patients in a span of max two months. But, and I have checked this with government sources, data categorically show that we are not getting that 1 to ten hospitalised to suspected ratio.
There’s been much criticism of the prime minister. Khan’s view has been and is that a total lockdown will create a number of other problems in relation to jobs, daily wages, shortages etc. This concern cannot be dismissed lightly. What’s fair is his initial nonchalance about the threat.
A lockdown is basically meant for two reasons: one, to restrict the spread early and two, related to one, get the time to help detect the prevalence of the disease and find curative methods. if one cannot do the second, the first cannot be sustained beyond a certain point.
So, here’s the dilemma: we don’t have the healthcare system capacity to say that we could deal with the spread no matter what its extent. Even advanced countries cannot do that. The challenge, therefore, is to prevent the spread without killing the economy because then we get into other problems like panic buying, hoarding, food shortages, daily wagers going without food, social anger, possibility of riots etc.
Secondly, because of Centre’s initial absence, provinces have had to act. Sindh wants to continue with the lockdown; Punjab is still reluctant to go that far. This will continue. The NCC is now regularly meeting and is trying to create consensus on certain fundamental policy points. That clarity on the broad policy direction is important.
A word about inbound travellers. The government is trying to open up gradually. It is focusing on those who need to return, whose visas have expired, and many who are stranded. The government, say sources, is preparing to test the inbound passengers. But it faces a problem. Every test done on an inbound passenger is one test less domestically. This is why it is still stringent on preventing outside traffic. Of course, this has created problems for various stranded Pakistanis, but this is a choice to be made, given the calculus.
There has been much demand for smart testing, data-based analysis, projection curves, epidemic curve. Good news is that all this is happening. Bad news: it’s going to be imperfect, there will be errors, the capacity is stretched and getting numbers is not easy. Consolation news: it’s the same even for those in the Ferrari.
Corollary: This is going to be messy; it won’t be very neat and regimented. Those who are looking for neatness should forget the virus and focus on military drills!
Meanwhile, we might just be saved for other reasons and immunities. The curve is not that steep.
Now we can go back to the memes and poor government performance!
The writer is former News Editor of The Friday Times and is so bored that he might actually start watching sappy Pakistani soaps! He reluctantly tweets @ejazhaider
Please note that I said government’s performance. I am being deliberately misleading to make a basic point that social media criticism and memes are missing out: Counting out Gilgit-Baltistan and Azad Jammu and Kashmir, Pakistan has four provincial governments and a federal government.
Welcome to post-18th Amendment Pakistan. It devolved health to the provinces; then Sindh, KPK and Punjab passed resolutions under article 144 and asked the federal government to regulate some areas in the sector. Result: DRAP Act 2012.
Situation: there’s fog about who’s to do what. Be that as it may, the long, initial radio silence from the Centre cannot be defended. Provinces waited, Sindh being the prime example, while Islamabad remained absent.
Memes in Pakistan can be hilarious; one can enjoy them, especially when one has nothing else (or not much else) to do. But they are what they are: exaggerated fun and invective, sometimes abusive. They are also often, though not always, politically-driven. And when not politically-motivated, they can be a wit’s expression of what (s)he thinks is happening. They are like late-night tequila shots at the bar.
Come morning, one needs to get into a crisp white shirt and be sober for day’s work.
So, let’s see how we have fared. For that, it’s important to see how much-better healthcare and policy systems have fared.
One, even as there has been much discussion of a pandemic since 2010, no one was expecting such a spread. Word was there, but governments still faltered in their response. As it is, it’s spread, though not the morbidity rate, has been on the scale of the 14th century Black Death and the 1918 Spanish influenza.
Two, some states, with much deeper coffers, more stable political systems, more advanced industrial base, much better R&D, better healthcare systems were/are better placed to deal with it; others, not so much. In other words, before making comparisons, one need to be clear about capacity. No one is his right mind will race a Ferrari with a Suzuki FX or even entertain the thought of making that comparison. Yet, that’s precisely what we are doing here, for the most part.
Three, to further put things in a perspective, the Ferraris we just talked about, haven’t fared too well either. In fact, some of them have been hit the hardest.
Four, no country in the world has complete information on the number of people infected, no one can perform full testing and no epidemic curve is error-free.
As of now, according to World Health Organisation, “many uncertainties remain as to certain epidemiological, seroepidemiological (related to identifying antibodies in the population), clinical and virological characteristics of the virus and associated disease. Studies to assess these characteristics in different settings are critical to furthering our understanding. They will also provide the robust information needed to refine forecasting models and inform public health measures.”
Five, there are two broad models before us: China and South Korea. Neither is replicable. China’s lockdown of 13 cities and 60 million people is only possible in China (I will count out DPRK because that society has been under a lockdown since the 50s); South Korea is educated, disciplined, has big data and mega technology. It responded early and had the capacity for aggressive testing. Another example is Singapore. To compare a city-state with a highly-educated and disciplined population with more complex societies is, again, a terrible comparison. Others, including Pakistan, have gone for partial lockdowns and are struggling with testing capacity.
There are other points of departure but these should suffice.
Let’s get to where we are.
One, our society is neither very educated nor very disciplined and this is putting it mildly. In other words, we aren’t very good at following directions.
We don’t have the big data and mega technology a la South Korea. Singapore is a bad example with about 5.6 million; Lahore is 11.13 million, for example. So, there!
Any analysis has to bear in mind the constraints.
Another criticism has been about testing. Testing capacity is crucial and it is increasing. As per official figures, we are conducting 1200 tests per day and this will increase exponentially in the next two weeks. In the next three weeks we should have the technology to start producing testing kits here.
Tests in clusters. That’s happening. There’s no way that the system can test everyone. The policy is to watch out for an an outbreak, lockdown that area and test. That’s what’s happened at Bara Kahu and Shehzad Town in Islamabad, as also in Raiwind and some areas along the Grand Trunk Road.
Secondly, the policy on an original mistake has been reversed. Wherever people were testing positive, the law enforcement would go there and put the infected in hospitals. That wasn’t smart. Self-isolation is what is now being done, both because it prevents the spread and because not everyone testing positive needs to be hospitalised.
But self-isolation is not an option in low-income families where on an average we have about four to five people to a room. You can’t ask people to go to a quarantine room because most just don’t have such rooms. That’s where non-hospital quarantine centres come in. Hotels, mosques, marriage halls etc. That’s happening too.
Another issue is the projection of the spread. If we go by the global trend with reference to the number of the tested versus the number of suspected, our ventilators will be outnumbered by the number of patients in a span of max two months. But, and I have checked this with government sources, data categorically show that we are not getting that 1 to ten hospitalised to suspected ratio.
There’s been much criticism of the prime minister. Khan’s view has been and is that a total lockdown will create a number of other problems in relation to jobs, daily wages, shortages etc. This concern cannot be dismissed lightly. What’s fair is his initial nonchalance about the threat.
A lockdown is basically meant for two reasons: one, to restrict the spread early and two, related to one, get the time to help detect the prevalence of the disease and find curative methods. if one cannot do the second, the first cannot be sustained beyond a certain point.
So, here’s the dilemma: we don’t have the healthcare system capacity to say that we could deal with the spread no matter what its extent. Even advanced countries cannot do that. The challenge, therefore, is to prevent the spread without killing the economy because then we get into other problems like panic buying, hoarding, food shortages, daily wagers going without food, social anger, possibility of riots etc.
Secondly, because of Centre’s initial absence, provinces have had to act. Sindh wants to continue with the lockdown; Punjab is still reluctant to go that far. This will continue. The NCC is now regularly meeting and is trying to create consensus on certain fundamental policy points. That clarity on the broad policy direction is important.
A word about inbound travellers. The government is trying to open up gradually. It is focusing on those who need to return, whose visas have expired, and many who are stranded. The government, say sources, is preparing to test the inbound passengers. But it faces a problem. Every test done on an inbound passenger is one test less domestically. This is why it is still stringent on preventing outside traffic. Of course, this has created problems for various stranded Pakistanis, but this is a choice to be made, given the calculus.
There has been much demand for smart testing, data-based analysis, projection curves, epidemic curve. Good news is that all this is happening. Bad news: it’s going to be imperfect, there will be errors, the capacity is stretched and getting numbers is not easy. Consolation news: it’s the same even for those in the Ferrari.
Corollary: This is going to be messy; it won’t be very neat and regimented. Those who are looking for neatness should forget the virus and focus on military drills!
Meanwhile, we might just be saved for other reasons and immunities. The curve is not that steep.
Now we can go back to the memes and poor government performance!
The writer is former News Editor of The Friday Times and is so bored that he might actually start watching sappy Pakistani soaps! He reluctantly tweets @ejazhaider