Can Pakistan Effectively Respond to Coronavirus Pandemic?

Pakistani public health system's ability to deal with Covid19 pandemic is increasingly being questioned with the number of confirmed coronavirus cases spiking in the country. The current hotspot is in southern Sindh province where the provincial government is taking the lead in fighting its spread by shutting schools, closing restaurants and shopping malls and banning large gatherings such as weddings and conferences. The federal government has closed Pakistan's western border with Iran where the coronavirus pandemic is raging. Pakistan Civil Aviation Authority has started screening all incoming passengers and stopped flights to and from several countries hit by the pandemic. Pakistani health experts are advising people with flu-like symptoms to self-isolate in their homes. The best known treatment for the severely ill is Resochin, the anti-malarial antiviral made by Bayer Pakistan. Hydroxycholroquine (HCQ), made by Getz Pakistan, is also reportedly effective in treating Covid19.

Coronavirus Global Pandemic

Is Pakistan Ready?

Pakistan is among only 6 countries in the world that have taken the steps they need to evaluate their ability to withstand a global pandemic, according to a 2017 report sponsored by the World Bank. The 6 countries named in the report are: Eritrea, Finland, Pakistan, Saudi Arabia, Tanzania and the United States.

Covid19 Coronavirus. Source: US CDC
Pakistan's ability to deal with a pandemic is now being tested by the coronavirus. The current hotspot for it is in southern Sindh province where the provincial government is taking the lead in fighting its spread by shutting schools, closing restaurants and shopping malls and banning large gatherings such as weddings and conferences. The federal government has closed Pakistan's western border with Iran where the coronavirus pandemic is raging. Pakistan Civil Aviation Authority has started screening all incoming passengers and stopped flights to and from several countries hit by the pandemic. Pakistani health experts are advising people with flu-like symptoms to self-isolate in their homes.

Pakistan is ramping up coronavirus testing and setting up isolation wards at many hospitals in Sindh and across the country. More testing accounts for the spike in confirmed cases. The best known treatment for the severely ill is Resochin, the anti-malarial antiviral made by Bayer Pakistan.

In response to a recent request by Pakistan's Express Tribune newspaper staff, World Health Organization Executive Director Dr. Michael J. Ryan said Pakistan has great capacity in public health but he also talked of challenges posed by the Coronavirus pandemic. “Pakistan has a highly mobile population with mega cities and undeserved people,” he said.  “So there is a great challenge facing Pakistan. But Pakistan has also demonstrated time and again with dengue, polio and other diseases how all of the government and society’s approaches can be made to work.”

Dr. Palitha Gunarathna Mahipala, World Health Organization (WHO) representative in Pakistan, also lauded Pakistan's response to Covid19 pandemic, according to The News. He said,  “Pakistan has timely come up with one of the world’s best National Response Program against COVID-19 and it is being implemented very effectively. Authorities are doing their job and now it is the responsibility of the people to follow the instructions and take preventive and precautionary measures to avoid contracting the viral disease.”

The World Bank report titled "From Panic and Neglect to Investing in Health Security: Financing Pandemic Preparedness at a National Level" was written by experts from the World Bank,  the World Health Organization, the International Monetary Fund, the African and Asian development banks, and finance officials from various governments. The report included estimates of the economic damage various epidemics had done. For example, the viral pneumonia SARS — which ultimately killed only 774 people — shrank China’s gross domestic product by 0.5 percent in 2003. The report also broke down costs on a per capita basis. A major flu pandemic, for example, would cost Afghanistan only $12 per citizen, India $31, Pakistan $28 and the United States $248.

Social Distancing:

The current hotspot is in southern Sindh province where the provincial government is taking the lead in fighting its spread by shutting schools, closing restaurants and shopping malls and banning large gatherings. The federal government has closed Pakistan's western border with Iran where the coronavirus pandemic is raging. Pakistan Civil Aviation Authority has started screening all incoming passengers and stopped flights to and from several countries hit by the pandemic.

Italian experience with coronavirus has shown that even a well-developed public health system in a rich European country can be overwhelmed by rapidly growing pandemic such as Covid19.  The best way to handle the situation is to cut the infection rate by keeping people about 6 feet apart. This is being called "social distancing".

Social Distancing to Limit Infection Rates 

Based on what the United States has learned from what is happening in Italy, major cities and states in America are taking steps to reduce large gatherings of people. Offices, schools, restaurants and shopping centers are closed with shelter-in-place orders in Silicon Valley and the larger 6-county San Francisco Bay Area.

Herd Immunity:

Herd immunity develops when a large percentage of population is infected or vaccinated. Dr. Arindam Basu, Associate Professor of Epidemiology and Environmental Health at University of Canterbury, has recently written an article in The Conversation arguing that it is "unethical and potentially dangerous" to wait for herd immunity to develop in the absence of a vaccine.  It could result in hundreds of thousands or even millions of deaths among the most vulnerable segments of the population such as the elderly and the immune-compromised.


Pakistan's Assistance to China:

Chinese President Xi Jinping has thanked Pakistan for its support during coronabirus outbreak in his country. "China is deeply grateful for Pakistan's support. Facts have proved once again that China and Pakistan are true friends who share weal and woe and good brothers who share each other's joys and sorrows. The special friendship is a historical choice, and is deeply rooted in the hearts of the two peoples," said Xi.

Resochin (Chloroquine) Produced by Bayer Pakistan 

At the peak of the outbreak in February, Bayer Pakistan exported to China 300,000 tablets of Resochin (Chloroquine) that proved effective in treating coronavirus infections and saving lives in Wuhan. Resochin is an antiviral drug used for treating malaria. Chloroquine is manufactured by not just Bayer but several other drug companies as well.  China and many other countries discontinued its production years ago.   Several Pakistani pharmaceutical companies also manufacture HydroxyChloroquine which has lower toxicity and fewer side effects. The United Kingdom has banned hoarding and export of both of these drugs. In addition, Pakistan donated 7,000 surgical masks to China at the peak of the coronavirus outbreak.  A recent paper titled "An Effective Treatment for Coronavirus (COVID-19)"  by James M. Todaro, MD and and Gregory J. Rigano, Esq. has published data showing the efficacy of familiar anti-malaria drugs Chloroquine and Hydroxychloroquine for treatment of and as prophylactic against COVID-19.
In Vitro Efficacy of Chloroquine(CQ) vs Hydroxychloroquine (HCQ) Against COVID19. Source: Nature

Recently, Chinese research (reported in Clinical Trials Arena) reported that “data from the drug’s [chloroquine] studies showed ‘certain curative effect’ with ‘fairly good efficacy’ … patients treated with chloroquine demonstrated a better drop in fever, improvement of lung CT images, and required a shorter time to recover compared to parallel groups. The percentage of patients with negative viral nucleic acid tests was also higher with the anti-malarial drug… Chloroquine has so far shown no obvious serious adverse reactions in more than 100 participants in the trials… Chloroquine was selected after several screening rounds of thousands of existing drugs. Chloroquine is undergoing further trials in more than ten hospitals in Beijing, Guangdong province and Hunnan province.”

A small French study found only 25% of COVID19 patients who took it for 6 days still had the virus while 90% of those who had not taken it still had Covid-19.


HCQ (Hydroxychloroquine) Manufactured by Getz Pakistan


Economic Impact of Coronavirus Pandemic:

Service sector accounts for  50% of the world GDP and 54% of Pakistan's GDP.  Social distancing will significantly impact the services, particularly retail, restaurants, travel, transport and education sectors. Imran Khan has expressed fear that the pandemic will devastate the economies of developing countries.

“My worry is poverty and hunger," Khan said. "The world community has to think of some sort of a debt write-off for countries like us, which are very vulnerable, at least that will help us in coping with (the coronavirus).”

Summary:

Pakistan is among only six countries in the world that have taken the steps they need to evaluate their ability to withstand a global pandemic, according to a 2017 report sponsored by the World Bank. The current hotspot is in southern Sindh province where the provincial government is taking the lead in fighting its spread by shutting schools, closing restaurants and shopping malls and banning large gatherings. The federal government has closed Pakistan's western border with Iran where the coronavirus pandemic is raging. Pakistan Civil Aviation Authority has started screening all incoming passengers and stopped flights to and from several countries hit by the pandemic.  The best known treatment for the severely ill is Resochin, the anti-malarial antiviral made by Bayer Pakistan.  Dr. Michael Ryan and Dr. Palitha Gunarathna Mahipala of the World Health Organization (WHO) have talked of challenges Pakistan faces but also praised the steps it has taken to fight coronavirus pandemic.

Here's the latest Coronavirus Pandemic Update:

https://youtu.be/vE4_LsftNKM




Related Links:

Comments

Riaz Haq said…
#Coronavirus Portal Launched in #Pakistan. Current snapshot shows 646 cases. #COVID19 https://covidwatch.pk


https://st2.ning.com/topology/rest/1.0/file/get/4193378256?profile=original
Riaz Haq said…

#Pakistan locks down province, bans international flights as #coronavirus spreads. PM #ImranKhan is urging people to stay at home but remain calm, saying that “panicking is more dangerous for us than coronavirus.” #COVID19 https://www.washingtonpost.com/world/pakistan-locks-down-province-bans-flights-as-coronavirus-spreads/2020/03/22/9757707a-6be2-11ea-abef-020f086a3fab_story.html

With the number of coronavirus cases in Pakistan soaring to more than 700 in the past few days, officials there have banned all international flights and have requested that security forces help institute a full lockdown in Sindh province, where a majority of cases have been reported. A third death from the virus was reported Friday.

Most of those found to be infected are Shiite pilgrims from Sindh who returned from visiting shrines in neighboring Iran, where the virus has already killed more than 1,500. Most reentered Pakistan via a single border crossing in Baluchistan province. A similar problem is affecting next-door Afghanistan, where tens of thousands of refugees have recently flooded back from Iran.

Pakistani Prime Minister Imran Khan, facing public panic, has stopped short of declaring a nationwide lockdown but has asked all citizens to self-quarantine for two weeks. This past week, Khan came under strong criticism after playing down the threat in a nationwide address. He said that people should not “run to hospitals” to get tested and that 90 percent of those testing positive would “recover easily.”

On Friday, with several hundred new cases reported, Khan told a group of TV anchors that he hoped the coming of hot and dry weather would mitigate the outbreak. He urged people to stay at home but remain calm, saying that “panicking is more dangerous for us than coronavirus.” He said he was still reluctant to impose a nationwide lockdown because it would harm the working poor.

“We don’t want to try and save people from corona but they end up dying due to hunger and poverty,” Khan said. Pakistan, a Muslim-majority country of 210 million, has a high poverty rate, with about one-quarter of the populace earning less than $2 per day.

But in Sindh, a vast and impoverished region of close to 50 million, officials decided to impose a total lockdown beginning Sunday night. Chief Minister Murad Ali Shah was in discussions with army and police officials Sunday night and was expected to formally enlist their help to ensure public compliance with the lockdown.-----------------------------------------

As of this weekend, health officials said a 3,000-room quarantine center has been set up in Multan, a city in Punjab, for infected pilgrims who returned from Iran. They said it has 171 isolation rooms. After screening there, patients will be sent to a new general hospital for treatment, they said.
Riaz Haq said…
"Many people blame the coronavirus epidemic on globalization, and say that the only way to prevent more such outbreaks is to de-globalize," writes Yuval Noah Harari, the author of Sapiens. "Just the opposite. The real antidote to epidemic is not segregation, but rather cooperation"


https://time.com/5803225/yuval-noah-harari-coronavirus-humanity-leadership/


Epidemics killed millions of people long before the current age of globalization. In the 14th century there were no airplanes and cruise ships, and yet the Black Death spread from East Asia to Western Europe in little more than a decade. It killed between 75 million and 200 million people – more than a quarter of the population of Eurasia. In England, four out of ten people died. The city of Florence lost 50,000 of its 100,000 inhabitants.
In March 1520, a single smallpox carrier – Francisco de Eguía – landed in Mexico. At the time, Central America had no trains, buses or even donkeys. Yet by December a smallpox epidemic devastated the whole of Central America, killing according to some estimates up to a third of its population.

In 1918 a particularly virulent strain of flu managed to spread within a few months to the remotest corners of the world. It infected half a billion people – more than a quarter of the human species. It is estimated that the flu killed 5% of the population of India. On the island of Tahiti 14% died. On Samoa 20%. Altogether the pandemic killed tens of millions of people – and perhaps as high as 100 million – in less than a year. More than the First World War killed in four years of brutal fighting.



In the century that passed since 1918, humankind became ever more vulnerable to epidemics, due to a combination of growing populations and better transport. A modern metropolis such as Tokyo or Mexico City offers pathogens far richer hunting grounds than medieval Florence, and the global transport network is today far faster than in 1918. A virus can make its way from Paris to Tokyo and Mexico City in less than 24 hours. We should therefore have expected to live in an infectious hell, with one deadly plague after another.
However, both the incidence and impact of epidemics have actually gone down dramatically. Despite horrendous outbreaks such as AIDS and Ebola, in the twenty-first century epidemics kill a far smaller proportion of humans than in any previous time since the Stone Age. This is because the best defense humans have against pathogens is not isolation – it is information. Humanity has been winning the war against epidemics because in the arms race between pathogens and doctors, pathogens rely on blind mutations while doctors rely on the scientific analysis of information.

Riaz Haq said…
Mass Religious Gathering In Pakistan Leads To Fresh Concerns Over COVID-19 Spread

https://www.npr.org/sections/coronavirus-live-updates/2020/03/23/820043866/mass-religious-gathering-in-pakistan-leads-to-fresh-concerns-over-covid-19-sprea

The first two cases of coronavirus infection in the Gaza Strip, a war-shattered territory with a fragile health system, were confirmed over the weekend in Palestinian men who attended a mass religious gathering 10 days ago in Pakistan, according to an Islamabad-based Palestinian diplomat.

The diplomat, Ahmed Rabi, says the men were part of a two-day gathering that ended March 12 in eastern Pakistan. The gathering of the Tablighi Jamaat, a global conservative Muslim missionary group, brought together tens of thousands of Muslim preachers from some 80 countries and has raised concerns about the virus' spread in Pakistan and beyond.

The group, founded nearly a century ago in India, has millions of followers and proselytizes around the world. Preachers on missions sleep in mosques and make door-to-door visits.

A longtime Pakistani Tablighi Jamaat member, Arif Rana, said the gathering was canceled on March 12 because of rain — attendees sleep in the open. But Azhar Mashwani, on the Punjab chief minister's staff, said on Twitter that it ended because of coronavirus fears. Most attendees were Pakistani, but at least a few thousand came from other countries, Rana told NPR.

In Pakistan, four people in the southern province of Sindh who attended the gathering were infected with the virus, the provincial government reported. Other Pakistani provinces do not provide a detailed breakdown of coronavirus cases, so the national number may be higher.

Five preachers from Kyrgyzstan stayed in a mosque in Islamabad after attending the Tablighi Jamaat gathering and have also tested positive, said a senior health official who did not want to be named because he was not authorized to speak to the press.

On Twitter, Muhammad Hamza Shafqaat, the deputy commissioner of Islamabad, accused the Kyrgyz group of "criminal carelessness" because "they knew that one of them had symptoms and they kept on roaming around."

Concerns have also been raised in Southeast Asia about infection after a Tablighi Jamaat gathering outside Kuala Lumpur, Malaysia, in late February and early March. Malaysian media reported that more than half of the country's known coronavirus cases were traced to the gathering. Preachers who attended also spread the virus to Brunei and Thailand, the New York Times reported, saying the gathering created "the largest known viral vector in Southeast Asia."

Tablighi Jamaat leaders in Pakistan had dismissed earlier calls by the Punjab provincial government to cancel their event, saying they believed those calls were motivated by anti-religious bias.

"Every other year, something or other happens which makes people afraid of getting together," Rana said. "We just focus on action, on deeds, and Allah protects."

Now, he said, for the first time in the group's history, they were curtailing activities such as weekly meetings, "until thing[s get] better."
Riaz Haq said…
A group of volunteers from Pakistan, who call themselves Pakistan Against COVID-19 – Volunteers (PAC-V), have announced plans to use cutting edge 3D printing to produce affordable ventilators, respiratory valves and other essential equipment at a large scale.

According to a report in The News, the group of volunteers from across Pakistan had earlier this month come together to develop affordable solutions to combat COVID-19 and manufacture medical equipment using 3D printing technology in the country.

The volunteers are doctors, biomedical professionals, engineers, academics, diaspora, resource mobilisers and other smaller groups, who aim to make use of 3D printing to manufacture ventilators, valves and required equipment for the frontline response to the cornonavirus.


The group has announced that the first 3D ventilator prototype will be ready for testing within two weeks. The 3D printing process builds a three-dimensional object from a computer-aided design model (CAF), usually by successively adding material layer by layer, and is also called additive manufacturing.

The group has announced that it is seeking support from the nation to scale up the initiative for a larger impact on the health industry that requires resources and facilitation at different levels of the government.


https://www.thenews.com.pk/print/633189-volunteers-come-together-to-develop-affordable-solutions-for-pandemic
Riaz Haq said…
Pakistan’s top hematologist and transplant surgeon says that the blood of recovered patients of COVID-19 – the mysterious respiratory illness caused by the novel coronavirus – could be used to slow the spread of the deadly contagion which has killed nearly 10,000 people and sickened tens of thousands others worldwide.

“The body of a COVID-19 patient creates antibodies to fight off the virus. These antibodies in the blood of a recovered patient could be used to boost the immunity of the newly infected people,” Dr Tahir Shamsi, the head of National Institute of Blood Diseases, told The Express Tribune in an interview.

In medical lexicon, this technique is called “passive immunisation” which was introduced in 1890, he added. This technique is used when there is a high risk of infection and insufficient time for the body to develop its own immune response, or to reduce the symptoms of ongoing or immunosuppressive diseases.


https://tribune.com.pk/story/2179772/1-passive-immunisation-can-save-covid-19-patients-pakistans-top-hematologist/?amp=1
Riaz Haq said…
The first National Center for Virology is being recently established as a part of the International Center for Chemical and Biological Sciences at the University of Karachi, in collaboration with the Wuhan Institute of Virology and three German institutions, Eberhard Karls-University of Tuebingen, Tuebingen University, and Medidiagnost. Wuhan is the very city in China from where the coronavirus first started. The Wuhan Institute of Virology is administered by the Chinese Academy of Sciences (CAS), the most powerful scientific organization in China, and it is the leading centre for virus research in China.

The need to set up a top class centre for virology was felt by the scientific leadership of the International Center for Chemical Biological Sciences several years ago, reflecting their foresight. The International Center for Chemical and Biological Sciences now houses some 17 buildings spread over about 70 acres of land with some 600 students enrolled for PhD. It has been internationally awarded many international prizes and awards and is now the Unesco Center of Excellence, providing training to many scientists from other countries, including Germany.

The centre has been built through a number of private-public partnerships starting with the Husein Ebrahim Jamal Foundation that has set up a number of research centers in the institution, including the now famous H E J Research Institute of Chemistry. The Panjwani Center for Molecular Medicine was later established by the Panjwani Foundation and has already established excellent standards. Other donors include the Searle company led by Rashid Abdullah saheb. I also donated funds to it for setting up the Jamil ur Rahman Center for Genomics Research established in my father’s name.

After returning from Cambridge University in 1973, I have spent all my life in its development. It is now led by Prof Iqbal Choudhary, a leading research scientist of Pakistan. The buildings of the Virology Center have been constructed and Special Biosafety level 3 (BSL-3) facilities are being established in it, needed for research where work is performed with viruses and other agents that may cause serious or potentially lethal diseases through inhalation and that may contaminate the environment. A non-lethal form of Covid-19 was imported by this Karachi Center earlier this year, and work started in earnest to find a cure for this lethal disease.



https://www.thenews.com.pk/print/630787-coronavirus-and-pakistan
Riaz Haq said…
“Currently, there are 1600 beds available in nine hospitals with three in Punjab, two in Sindh, two in Islamabad and Rawalpindi, one each in Quetta and Gwadar, one in Khyber Pakhtunkhwa, and two in Gilgit Baltistan.” Moreover, one ward in all the major hospitals had been specified as an isolation facility, he added.

The total number of ventilators available across the country for critically-ill coronavirus patients are 1,700. Amid the drastic shortage and advance booking of ventilators globally, Pakistan has managed to get around 800 ventilators with the help of China. But the government is contacting several companies to increase the number to 6,000, the chairman of NDMA said.

There are currently 12 million masks available in Islamabad, Lahore and Karachi, and another 12 million have been booked. Around 100,000 masks were available in Peshawar and 50,000 in Balochistan. About 12,500 suits are available for health workers. Nearly 2,000 laser thermometers are available at different entry points while another 30,000 would be imported from China. There are some 15,000 N-95 masks available in stock, mainly for medical staff while 50,000 more would be available shortly. Meanwhile, the Chinese tech company, Alibaba, has also donated 50,000 masks to Pakistan.

Pakistan has also established 1200 single bed-with separate bathroom accommodation at 3 entry points at the western border, which can be increased to 1,000 if needed. The total quarantine beds available in the country are 23,557 and some 2,942 isolation beds. There are 215 hospitals with isolation centres and 15 testing facilities.


https://gulfnews.com/world/asia/pakistan/pakistan-draws-up-contingency-plan-to-fight-coronavirus-1.70540804
Riaz Haq said…
#Pakistan Cuts Interest Rates, Sets $6 Billion To Offset #Economic Impact Of #CoronaVirus for Poor Households,100 $630 million tax rebate for #export sector & $600 million to aid small and midsize businesses (#SMEs) & #agriculture sector. #ImranKhan #PTI https://www.rferl.org/a/pakistan-cuts-interest-rates-sets-6-billion-to-offset-economic-impact-of-virus/30507290.html

Prime Minister Imran Khan on March 24 said up to 200 billion rupees ($1.26 billion) of the aid would go as payments to laborers to help families to counter the adverse effects caused by COVID-19.

Funds will also go to food and energy subsidies and on measures to boost agriculture, Khan said.

Separately, the State Bank of Pakistan announced it was slashing its key interest rate from 12.5 percent to 11 percent, a week after the rate was reduced from 13.25 percent.

The moves come as countries around the world intensify measures to rescue their economics in the face of dramatically reduced demand due to the coronavirus epidemic.

Khan also told reporters that there would be a 15-rupee (about $0.10) decline per liter in the price of gasoline and diesel.

Other measures included a 100 billion-rupee ($630 million) tax rebate for the export sector, with a similar amount to be set aside to aid small and midsize businesses and the agriculture sector.

Low-income families will receive cash payments of 3,000 rupees ($19) a month for the next four months.

Taxes on items such as sugar and wheat will be reduced or eliminated, and the government will also provide assistance to users of electricity and to medical workers.

"We will have to protect poor and make sure they have food on the table," Khan told the news conference.

The prime minister said more than 1 trillion rupees ($6.3 billion) will be taken from the government's coffers to fund the aid and stimulus packages.

The government has confirmed 906 cases of coronavirus infection with seven deaths, although most experts caution that the true number of cases in any country is impossible to determine because of a lack of testing.

Hospitals in the capital and other cities have reported long lines of people attempting to get tested for the potentially deadly disease.

Pakistan has suspended all international flights to and from the country, while provincial governments have imposed lockdowns in several cities in a bid to stem the spread of the virus.

Even before the crisis, Pakistan's finances had been in a precarious situation.

In July 2019, Islamabad turned to the International Monetary Fund for a $6 billion bailout package and has since been attempting to exhibit more disciplined financial policies to satisfy the Washington-based lender's requirements.
Riaz Haq said…
Passenger train service halted in #Pakistan till March 31. Pakistan #Railways operates 142 trains daily on its 1,885-km-long tracks to ferry some 700 million passengers every year. #Coronavirus fears had already reduced ridership. #COVID19 #lockdown https://tribune.com.pk/story/2183068/1-pakistan-railways-suspend-passenger-train-services-across-country/

The Pakistan Railways on Tuesday announced that all passenger train services would be suspended till March 31 to curb the spread of coronavirus infections.

Taking effect from midnight, all passenger trains will remain suspended owing to the growing number of COVID-19 cases in the country, while cargo trains will continue to function according to their schedule.

Passengers who have already booked seats will be accommodated in trains of their choice when the services resume, according to a statement issued by the Pakistan Railways.
In case tickets are unavailable, they will receive a full refund.

The move to suspend the services came after Prime Minister Imran Khan’s approval.

Earlier in the day, Railways Minister Sheikh Rashid told the media that the suspension of all passenger train services was on the cards but the final decision would be made by the prime minister.

He added that he had recommended to the prime minister to give a relief package to the railways and continue paying salaries of its employees while the services remained suspended.

On Saturday, the minister had announced the suspension of 42 trains by April 1 to restrict the spread of COVID-19 in the country.

The minister said trains would be suspended in phases, adding that the notification of the suspension would remain in effect till the first half of the holy month of Ramazan.

The trains suspended in the first and second phases included Khushhal Express, Akber Express, Sindh Express, Ravi Express, Shah Latif Express and Rohri Express. Jinnah Express, Bolan Express, Moinjo Daro Express, Thal Express, Marvi Express, Samman Shakir Express, Faisalabad Express, Musa Pak Express and Chenab Express.

The Pakistan Railways operates 142 trains on its 1,885-km-long tracks to ferry some 700 million passengers every year, which means that some 200,000 people travel by trains every day. However, because of the coronavirus spread, the number had declined.
“Due to the current situation the number has declined to 165,000 passengers per day,” the minister said.
Riaz Haq said…
#Pakistani #Coronavirous Survivor Returning From #Qom, #Iran: "My treatment in (#Karachi) isolation ward was excellent. The doctors and paramedical staff handled me in a highly professional way.... I made a swift recovery". #COVID2019 https://tribune.com.pk/story/2183876/1-tales-survival-became-pakistans-first-covid-19-patient/

I went to Iran on February 6 on a pilgrimage along with three of my close friends and some other pilgrims. We visited the holy shrines in the cities of Qom, Mashhad and Tehran and returned to Pakistan on Feb 20.

By then, the coronavirus outbreak had hit Qom – and hit it hard. Back in Karachi, I didn’t have any symptoms associated with COVID-19 respiratory disease. No fever, no cough, no shortness of breath, absolutely nothing. Still, I visited a local hospital a day after my return for blood work on the recommendation of our family physician.

The CBC report came out normal – or perfect I should say. Since there was no abnormality, I rejoined the university and attended classes for the next couple of days. A doctor, in the meantime, told me that the novel coronavirus doesn’t show up in blood through simple CBC – and that I need to take a swab test for this purpose.

This is when I started feeling dizziness and weakness. On Feb 25, I had cold sensation in my hands and feet. I also started coughing and feeling nauseated. The symptoms raised a red flag. Interestingly, I didn’t feel shortness of breath until then.

The symptoms were tell-tale. And my dad advised me to consult a doctor immediately. However, the hospital where I have had my CBC didn’t have kits to test me for the novel coronavirus. So, my father took me to Aga Khan Hospital, one of the best hospitals in the city, where I was diagnosed with the COVID-19 disease. That’s how I became the first corona-positive case in Pakistan.

Immediately after my diagnosis, I was sent to the isolation ward where my treatment began. I was diagnosed at an initial stage which is why the mysterious pathogen had not infected my respiratory system.

Medics assuaged my fears. They said the COVID-19 mortality rate is less than 1% and that it causes complications only among the elderly or those with a compromised immune system. “Since the immune system of the young patients is strong, I’ve good chances to recover completely,” one of my doctors told me at the time.

My treatment in the isolation ward was excellent. The doctors and paramedical staff handled me in a highly professional way. I was, however, not allowed to see my family and relatives, which was understandable since the virus is highly contagious. Officials from the World Health Organization also enquired about my case.

I made a swift recovery. They tested me three times to make sure the virus is completely out of my system. And finally the hospital allowed me to go home. Now, I’m feeling very good. Or I shall say I’m feeling perfect.

The sad part of the entire episode was that my personal details were leaked to the media by God knows who, which created a lot of problems for me and my family. My photo was all over the social media and I became a pariah.

Soon after my diagnosis, my entire family was tested for the coronavirus and luckily all of them tested negative. The screening was then extended to my friends who accompanied me on the trip to Iran and also the people who I had interacted with after my return to Pakistan.
Riaz Haq said…
#Pakistan daily wagers struggle to survive in #coronavirus lockdown. #PTI govt giving Rs. 12,000 ($75) to low-income earners as part of $940m economic stimulus. Pak has 119,000 hospital beds in isolation wards & adding 162,000 beds for quarantine #COVID19 https://aje.io/zdbdr

Other provinces and regions are following a largely similar model, with Sindh province, which has the highest number of cases - at least 410, enforcing a stricter lockdown with full city shutdowns mandated between 8pm and 8am every night, starting on Wednesday.

"A lockdown is not a curfew," PM Khan reiterated in a news conference on Tuesday evening. "When you enforce a curfew, what will your poorest segment of society do?"

Shireen Khan, and more than a dozen others who were waiting for work beside him, however, say that the "lockdown" may as well be a curfew, because no one is offering them work.

"A lockdown is necessary [to control the virus outbreak]," he says. "But we need to be taken care of as well."

Rising number of cases
On Wednesday, Pakistan's countrywide tally of cases stood at 1,005, with 14 patients having recovered and seven fatalities, according to government data. The number of cases has more than tripled in a week.

Authorities have been scrambling to control the spread of the virus, although they do not yet appear to be at a level that could overwhelm Pakistan's fragile healthcare system.

On Wednesday, PM Khan reiterated that he has been delaying announcing a countrywide shutdown to safeguard the economic interests of the poorest Pakistanis, who he says need to work to earn a living.

Observers, however, say that work has already dried up with the current level of restrictions.

"The wider concern that a slowdown in economic activity would knock people's daily wages off, would evaporate the work that daily wagers do, that is already coming to fruition," says Mosharraf Zaidi, a senior fellow at the Tabadlab policy think-tank.

"Daily wage labourers require sites and opportunities that demand their skills or input. But when there is a lockdown, all economic activity, construction activity […] all of those activities have been suspended."

On Wednesday, however, the government announced it would be disbursing 12,000 rupees ($75) to low-income earners, affecting an estimating 67 million people, as part of a $940m economic stimulus package.

Healthcare specialists say there is cause for concern if the number of coronavirus cases spikes in the densely populated South Asian nation of more than 200 million.

"We're on a very low scale, in terms of infrastructure," says Dr Shamail Daud, a healthcare management specialist. "Healthcare is very disintegrated and not very high in terms of quality or dealing with high levels of critical care for patients, which is unfortunately an outcome of COVID-19."

While there are a limited number of ventilators available countrywide, Daud says a bigger problem could be a lack of enough doctors to operate them in the event of a spike in cases.

"Other than the functionality of the ventilators, the staff that actually works with it, the critical care staff [...] is very limited," he warns. "In every city, there is a shortage. […] The issue is not about the machines themselves, it is about the people who can make them work."

Earlier this week, several doctors told Al Jazeera that there are not enough personal protective equipment (PPE) kits to go around, leaving many front-line healthcare workers without adequate protection.

On Wednesday, Lieutenant General Muhammad Afzal, chairman of Pakistan's National Disaster Management Authority (NDMA), said the government was working on procuring more PPE and other medical equipment. The country needed more than 4,000 additional ventilators, Afzal told the press, but manufacturers were no longer taking additional orders.

Riaz Haq said…
An official handout released on the instruction of the minister of defense production said that the country’s ordinance factories had “attained the capability to produce 25,000 Face Masks and 10,000 liters of Hand Sanitizers on a daily basis.”
The official statement described its new production potential as “a landmark achievement and a proud moment for the entire nation.”
“Special cloth has been used in production of Face Masks, that makes it re-usable after wash,” the statement said, adding that in view of the current situation, wherein the country was fighting novel coronavirus, Pakistan’s defense related production capability “had been diverted toward mass production of Face Masks and Hand Sanitizers.”
“The laudable efforts by Pakistan Ordnance Factories will indeed complement the ongoing national drive to fight COVID-19,” it continued while promising “further breakthrough” in “the near future.”
Pakistan’s security forces have already been playing their role in preventing the spread of the dreaded virus in the country by activating the network of their hospitals across the country to deal with the problem.

https://www.arabnews.pk/node/1647331/pakistan
Riaz Haq said…
The newly- formed Corona Experts Advisory Group (CEAG) in its first meeting on Tuesday has warned the public against the unsupervised usage of Chloroquine and Hydroxichloro-quine, saying the drug could cause serious side effects/untoward reactions.”

https://www.dawn.com/news/1543479

The CEAG in its first meeting on Tuesday deliberated the opinion of using Chloroquine and Hydroxichloroquine for prophylaxis of COVID-19 based on current available evidence,” reads a meeting document.

An official said the CEAG issued the warning after numerous complaints that a majority of the people was using the drug for the prevention of the coornavirus disease and self-medication in this regard was going unchecked.

He added the CEAG also showed its utter displeasure on the unchecked usage of social media where self-proclaimed doctors suggest the self-medication. This may cause a new ‘ health disaster’ if not stopped immediately, the meeting said.

“The committee is of the opinion that there is insufficient scientific evidences to advise Chloroquine and Hydroxichloroquine for prophylaxis (prevention) of the COVID-19”, reads the document.

The CEAG also issued guidelines for the protection of the frontline health professionals attending coronavirus patients at the public hospitals across the Punjab province.

It issued three levels of the prevention - general pre-examination triage/OPDs, triage centres for corona general wards and isolation wards/ICUs, and HDUs to be adopted by health professionals during treatment of the patients.

The CEAG has declared mandatory use of surgical masks for the entire staff working at all healthcare facilities of Punjab.

It has directed the staff working at OPDs of infectious diseases and OPDs of respitary care, endoscopic examination rooms must upgrade their surgical masks to medical protective masks (N 95).

The CEAG has declared mandatory usage of the protective face screen based on level III protection while collecting respiratory specimens from suspected and confirmed patients.

It declared that the surgical masks are disposable and may be used for six hours provided it does not get wet.

“The life of N95 mask is eight days (eight hours duty per 24 hours with two hours break) provided if they do not get soiled and are used by the same user”, read the new guidelines.

They CEAG issued guidelines to disinfect the operation threathres, sample collection rooms and other areas where the suspected and confirmed patients are attended or kept.

The body has strictly directed the health professionals and heads of the teaching and other institutions to follow these guidelines strictly in letter and spirit to prevent them from the coronavirus.
Riaz Haq said…
Pakistan Reaches 1,000 Cases Faster Than Italy (4:32 p.m. HK)

https://business.financialpost.com/pmn/business-pmn/u-s-agrees-to-stimulus-deal-death-toll-at-18900-virus-update

The South Asian nation reached more than 1,000 cases in 29 days, two days before Italy, according to data compiled by Bloomberg. People who visited neighboring Iran for a pilgrimage make up most of Pakistan’s cases. Iran outpaced both nations to reach the 1,000 mark in 13 days.

Rush for Trump-Backed Drug Sparks India Export Ban (4:30 p.m. HK)

India banned exports of a malaria drug backed by U.S. President Donald Trump amid a run on supplies globally, even as scientists continue to search for conclusive evidence of the medicine’s effectiveness against the novel coronavirus. Exports of hydroxychloroquine will be limited to fulfilling fully paid existing contracts, while certain shipments on humanitarian grounds may also be allowed.

Separately, a small study found Hydroxychloroquine to be no more effective than conventional care. The report published by the Journal of Zhejiang University in China showed that patients who got the medicine didn’t fight off the new coronavirus more often than those who did not get the medicine.
Riaz Haq said…

#American editor of Washington Post:”We each underwent a temperature scan at the #Islamabad airport. We also had to fill out a form asking if we’d been in China or Iran, two countries hit hard by covid-19..Nobody checked us on arrival at #JFK” #coronavirus https://www.washingtonpost.com/outlook/2020/03/25/coronavirus-quarantine-new-york-pakistan-airport/

“Are you guys being quarantined?” asked one friend after another after my husband and I arrived back in Washington this past weekend from an eight-day trip to Pakistan.

In fact, while we’ve decided to self-quarantine for two weeks out of concern about the covid-19 pandemic, no government official ever told us to do so — it just seemed like the right thing to do. Nor did we receive any sort of screening at the airport when we returned to the United States, despite flying into New York — the epicenter of the U.S. outbreak, with over 25,000 reported cases and more than 200 deaths as I write this.

The disconnect between the illness’s mounting human toll and this seemingly lax approach to incoming international air passengers has opened our eyes to the federal government’s insufficient response to the coronavirus and caused us to ask why our country, with its vast resources, seemingly can’t — or won’t — take the coronavirus as seriously as it should.

When we arrived in Pakistan on March 13, we each underwent a temperature scan at the Islamabad airport. We also had to fill out a form asking if we’d been in China or Iran, two countries hit hard by covid-19, during the previous 14 days. We were asked to check boxes indicating if we had a fever, cough or shortness of breath. Though 2 a.m. was probably a low-traffic arrival time, it was a painless, organized process, not a major inconvenience.

So we were shocked when we arrived Saturday at New York’s John F. Kennedy International Airport to discover that no covid-19 screening measures or advisories about quarantining awaited us. We simply got off the plane and proceeded to the U.S. citizens’ line, as if returning from any normal overseas trip. We did our customs declaration (Are you bringing in any food?) at an electronic kiosk. The U.S. Customs and Border Protection officer who scanned our passports (and who was wearing gloves) asked us a couple of questions about where we’d been and what we’d done in Pakistan. My husband was kept back for a few minutes of additional questioning, which appeared to be motivated more by security concerns than health. No one said a word about quarantines.
Riaz Haq said…
Passengers arriving at #Toronto Airport comparing #coronavirus screening with airports in #Pakistan: #COVID2019 Screening in Pakistan much more thorough than in #Canada

https://www.facebook.com/ehtesham.a.nezami/videos/10218751232545222/
Riaz Haq said…
Egypt's Al-Azhar Ulema issues fatwa permitting Friday prayers’ suspension in #Pakistan, amending Azaan (call to prayer) with words ‘Salaat Fi Buyut-e-kum’, meaning ‘pray in your homes’ instead of the usual ‘come to prayer’. #Coronavirus #SocialDistanacing https://www.dawn.com/news/1543801

Egypt’s Al-Azhar has issued a fatwa on the request of President Dr Arif Alvi permitting suspension of Friday prayers to control the spread of deadly coronavirus across Pakistan.

“I am thankful to Grand Imam Shaikh of Al-Azhar and Supreme Council for responding to my personal request to provide guidance to us with regard to Farz Jamaat and Juma prayers in mosques during coronavirus attack,” the president said in a tweet on Wednesday.

President Alvi through Egypt’s ambassador in Pakistan had sought guidance from Al-Azhar institution, an authority on Islamic injunctions, for a word on the suspension of congregational prayers at mosques amid spike in coronavirus cases.
Riaz Haq said…
“A net increase of around 15% in internet usage was witnessed since last week as the country fights against coronavirus,” the Pakistan Telecommunication Authority (PTA) said in a press release. “The increase has been observed due to increased online activities by educational institutions and businesses and, ‘work from home’ policy adopted by individuals and organizations,” it added.

Seeking to allay concerns about internet speeds and bandwidth, the PTA said there was sufficient capacity to meet the growing demand. “There is sufficient internet capacity available in the country to meet the growing demands of the future. PTA has been closely monitoring the internet usage patterns so as to ensure that fast and efficient telecom services remain available to the consumers in this difficult time,” it said.

Part of this increase is no doubt attributable to government offices and politicians moving to video conferencing for meetings in a bid to encourage social distancing and avoid leaving their homes. Just this week, opposition parties held a conference call to discuss the strategies on how to deal with the COVID-19 outbreak. The State Bank of Pakistan has also encouraged the use of digital payments and e-banking to avoid unnecessary visits to banks.

Also on Thursday, media streaming website Netflix announced it had removed the highest bandwidth streams in Pakistan to reduce traffic so that more users can avail the service. In a statement, VP Content Delivery at Netflix Ken Florance said: “Given the crisis, we’ve developed a way to reduce Netflix’s traffic on telecommunications networks by 25 percent while also maintaining the quality of our service. So consumers should continue to get the quality that comes with their plan—whether it’s Ultra-High, High or Standard Definition. We believe that this will provide significant relief to congested networks and will be deploying it in Pakistan for the next 30 days.”


https://www.newsweekpakistan.com/pakistans-internet-usage-jumps-as-people-stay-home/
Riaz Haq said…
#China sends to #Pakistan 15,000 personal protective equipment (PPE) suits, 500,000 surgical masks, 50,000 N95 masks, 50,000 test kits and 20 ventilators to fight #coronavirus. #COVID2019. https://gulfnews.com/world/asia/pakistan/china-sends-tonnes-of-medical-aid-to-pakistan-to-fight-covid-19-1.70663601

On Friday morning, trucks full of medical supplies were unloaded at the border as the teams from both sides braved the harsh weather and snow. Meanwhile, a plane carrying 50,000 coronavirus testing kits also arrived in Karachi on March 27. This was the second bulk consignment sent by China’s Alibaba and Jack Ma Foundation within days. On March 25, the foundation sent 500,000 surgical masks and 50,000 N95 respirators to Pakistan. Sindh Chief Minister Murad Ali Shah, Consul General of China Li Bijian and other officials received the supplies at Karachi airport.

---------------------

On March 26, Yan Chen, managing director of Challenge Group of Companies from China called on Prime Minister Imran Khan to donate 15,000 protection suits for Pakistani doctors and paramedical staff on the frontline battling the pandemic. To meet the increasing demand for protective gear, China will help produce the protection suit in Pakistan’s city of Lahore, said the Chinese Ambassador to Pakistan, Yao Jing. Chinese government and leadership is committed to support Pakistan in combating Covid-19 as their top priority, the ambassador added.

----------------
Pakistan will receive around 20 tonnes of medical goods and 20 ventilators on an urgent basis from China this week, said Chairman National Disaster Management Authority (NDMA), Lt. Gen. Mohammed Afzal, during March 27 media talk. Additionally, two more planes would bring 100 tonnes of urgently needed medical equipment from Beijing and Chengdu next week.

------------

Full gear for 30,000 ICU workers
There are currently 194,000 medical health practitioners in Pakistan, of which 30,000 work in ICUs. “These 30,000 medical practitioners working in ICUs will be equipped with complete medical kit by April,” he said. Each box will contain face-shields, goggles, two N95 and 30 surgical masks, hand wash kit.

The number of beds in the intensive care unit (ICUs) in Pakistan currently is 19,670. The capacity of quarantine facilities has also been enhanced from 500 beds to 162,000 now. Pakistan’s Covid-19 command and control centre has also booked 1,795 three-star and four-star hotels where 40,000 patients can be accommodated if required.

There are nearly 2200 ventilators available in public hospitals. The number of the imported ventilators will reach to 1,000 by April 10 to 15, the NDMA chief said. This number would rise to 2,000 to 3,000 by April 25 and the officials expect to enhance it to 8,000 and 10,000 by May.

Pakistan would have enough medical equipment, including personal protection kits, by April 5 to improve the safety of the health officials working on the frontline, said Health Minister Dr Zafar Mirza.

Top 3 priorities
Pakistan’s top three priorities under the Covid-19‬ strategy, according to NDMA chairman: ‬

1. Medical gear for doctors & health workers

2. Ventilators & supplies for treatment of patients

3. Coronavirus testing kits

Popular posts from this blog

Is Pakistan's Social Sector Progress Hopeless?

Digital BRI: China and Pakistan Building CPEC Info Expressway With Fiber, 5G

Blowout Concerns Delay Confirmation of Pakistan Offshore Oil Discovery