Declining COVID19 Reproduction Rate in Pakistan Now Among the World's Lowest

London's Imperial College estimates that COVID19 pandemic in Pakistan is "on course to fade out", a testimony to Prime Minister Imran Khan's government's effective handling of the the ongoing global health crisis.  At just 0.74, the effective coronavirus reproduction rate (Rt) in Pakistan is among the lowest in the world. An Rt of less than 1 indicates each infected person is infecting fewer than one person.  Only Italy (0.63), Netherlands (0.62), Canada (0.50) and Spain (0.02) have lower reproduction rates than Pakistan's. However, this is no time to relax. Pakistanis need to continue to take all precautions, including wearing face masks, to ensure that COVID19 fades out in the country.

COVID19 Effective Reproductive Rate. Source: Imperial College, London, UK

Pakistan's coronavirus transmission rate is lowest in its region. Neighboring India's Rt is 1.14, Iran's 1.12, Bangladesh 0.96 and Afghanistan's 0.93 are all significantly higher than Pakistan's 0.74.

COVID19 Effective Reproductive Rate. Source: Imperial College, London, UK

The latest numbers vindicate Pakistan government's "smart lockdown" strategy of requiring face masks and selective lockdowns of hotspots. Pakistan's strategy has been aimed at balancing lives and livelihoods in the middle of a deadly pandemic that has infected more than 11 million people globally, and claimed over 4,500 lives in Pakistan and more than half a million lives around the world. Developed western nations, particularly US and UK, have been among the worst affected by it.

akistan COVID19 Weekly Death Decline to 577 Now From Peak of 869 Last Week

Weekly COVID19 deaths in Pakistan have declined to 577 this week from 869 last week. To put it perspective, about 4,000 Pakistanis died everyday from various causes before the current pandemic.

Positive Test Rate Declines to 1 in 6.36 (15.7%) From Peak of 1 in 4.47 (22.3%) on June 4, 2020

The number of people testing positive in Pakistan has declined to 1 in 6.36 (15.7%) from the peak of 1 in 4.47 (22.3%) on June 4, 2020.

From the beginning of the pandemic, Pakistan's strategy has been aimed at balancing lives and livelihoods. The latest numbers vindicate Pakistan government's "smart lockdown" strategy of requiring face masks and selective lockdowns of hotspots. However, this is no time to relax. Pakistanis need to continue to take all precautions, including wearing face masks, to ensure that COVID19 fades out in the country.
Talk4Pak host with Faraz Darvesh discusses this subject with Misbah Azam and Riaz Haq:

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Riaz Haq said…
From @Seckermani

In Karachi, we got figures for burials in 32 government graveyards

June 2019 - 2,375 burials

June 2020 - 3,594 burials

June 2020, official Covid burials (in these graveyards) - 118


Caveat: An official told us some families hide their Covid death certificate from graveyard admin because of stigma, so it's likely more than 118 of those burials were of officially confirmed Covid deaths

There were approx 729 recorded coronavirus deaths in June 2020 in Karachi


Also worth noting the rise in burials in Karachi only becomes statistically significant in June - coinciding with a surge in coronavirus cases and deaths.
Riaz Haq said…
The official data available on the deaths caused by covid-19 and other diseases or accidents has once again raised concerns regarding the true coronavirus death toll of Pakistan.

Journalist Secunder Kermani, correspondent of BBC News, posted a series of tweets on the official data he obtained on overall deaths, including coronavirus fatalities, in Lahore, Karachi, and Balochistan.

The journalist while mentioning the data of Karachi, noted that according to the data obtained from 32 government graveyards, 2,375 people were buried in June 2019. In June 2020, the data shows that 3,594 people were buried, including 118 people died of coronavirus. He said that in June 2019, the bodies processed at morgues by Edhi foundation were 1,090. While in June this year, 3,064 (of which 813 official covid-19 patients) bodies were processed.

“We haven’t managed to get detailed data from other places, though registered deaths from Baluchistan also show a rise: February 2020 – 220 March 2020 – 261 April 2020 – 315 May 2020 – 667 June 2020 (excl Quetta) – 641 (Presumably this is rather incomplete given low figures),” he added.
Riaz Haq said…
Replying to
Pre-pandemic mortality rate in #Pakistan was 4000 daily deaths avg. Questions: Is change statistically significant due to #COVID? If so, how much, where locally/nationally? What’s the positive tests trend? Up or down? Are cemeteries overwhelmed anywhere?
Riaz Haq said…
#India Surpasses #Russia In Reported #Coronavirus Infections. Now stands 3rd after #US, #Brazil. India's #death toll from #COVID19 crossed 20,000 & total caseload now exceeds 700,000, both tallies rising at their fastest pace since the #pandemic began.

Over the weekend, India reported its highest-ever single-day spike in infections with nearly 25,000 new cases in a 24-hour period. The Taj Mahal and other monuments originally scheduled to reopen to tourists Monday now remain closed indefinitely.

The latest spike has been powered in part by rising numbers of infections in a handful of southern Indian states, including Karnataka, Telangana and Tamil Nadu. India is also testing more, with nearly 250,000 COVID-19 tests being administered daily, according to Health Ministry data.

The hardest-hit areas are still India's largest cities, New Delhi and Mumbai. Hospitals there are overcrowded, and makeshift medical wards have been hastily constructed in convention centers.

In March, India imposed one of the earliest, strictest lockdowns in the world, at a time when its total cases were relatively low, numbering in the hundreds. The lockdown may have slowed the virus's spread, but it also left at least 100 million people unemployed, some of them left starving.

nationwide lockdown was eased in early June to try to revive the economy. While schools remain closed, most businesses and public transit have since resumed, except for areas with high concentrations of COVID-19 cases. But individual state governments have been reimposing their own restrictions.

Even though India ranks third in terms of total coronavirus cases, it ranks eighth in terms of fatalities, according to Johns Hopkins University.
Riaz Haq said…
#Pakistan #COVID19: Decline in Daily Positive Test Rate and Biweekly Confirmed Deaths Continuing.
Riaz Haq said…
#Pakistan Sees Drop in #Covid19 patients’ inflow at hospitals. Dr. Sultan: “I have talked to health minister of Punjab Yasmin Rashid and she also told me that the inflow of patients, at hospitals. Fewer people showing up for tests at mobile vans parked"

Federal Minister for Planning, Development and Special Initiatives Asad Umar has said that all the circumstantial evidence indicates a drop in patients’ inflow at hospitals despite the recent increase in the number of Covid-19 tests across the country.

But the positive development has enhanced the worries of the decision makers, as they feared that people might stop taking precautionary measures against the highly contagious virus with the slight improvement in the situation.

While talking to Dawn, Minister for Planning, Development and Special Initiatives Asad Umar said the number of daily tests, which had dropped to around 20,000 [during last week], was again increased to around 25,000 across the country.

“However, the inflow of the patients has decreased. Though Sindh has not given us proper feedback, the feedback given by Punjab, Balochistan, Khyber Pakhtunkhwa and Islamabad shows that the inflow of the patients has reduced,” he said.

“There are four different parameters through which it can be identified that if the spread of the virus has been reduced. In other words, the system exhibits its situation through number of daily positive cases, number of admitted patients, number of patients on ventilators and number of deaths. All four parameters have been showing positive signs as numbers are decreasing,” he said.

The minister said the anecdotal evidences were also showing that number of coronavirus cases had been on the decline.

“I have talked to health minister of Punjab Yasmin Rashid and she also told me that the inflow of patients, at hospitals, has reduced. On Monday, during the meeting of the National Command and Operation Center (NCOC) Dr Faisal Sultan [Focal Person to PM on Covid-19] said he used to see crowds at the mobile testing van which remains outside his house. However, for the last few days people hardly came there to get themselves tested for the deadly virus,” he said.

While replying to a question, the minister said he was very happy over the situation but at the same he was also worried that people might stop following the SOPs due to the decrease in cases. “Every person should strictly adopt precautionary measures, because otherwise there will be another spike of cases in coming days,” the minister said.

Over the past 24 hours, the country reported 2,711 coronavirus cases and 100 more deaths, taking the national tally of new cases to 208,358 and death toll to 4,254.

Media coordinator of Pakistan Institute of Medical Sciences (Pims), Islamabad, Dr Waseem Khwaja said 75pc beds, dedicated for Covid-19 patients, were vacant at Pims. “There are 212 oxygenated beds and 25 ventilators in the hospital, but only 56 Covid-19 patients are admitted (on Sunday) of which 10 are on the ventilators,” he said.

According to the data available on the government website, during the last week the number of tests conducted in Sindh on a daily basis dropped from 10,000 to 6,458 on June 25 and 5,103 on the following day. There was an opinion that the daily tally of confirmed cases had also declined because of the reduction in number of tests. While during the last two days Sindh witnessed an increase in number of Covid-19 tests, the national tally of new cases remained less than those being confirmed in mid-June. On June 27 and 28, Sindh conducted over 11,000 tests and 9,144 tests, respectively. Yet the number of new cases that had surged to almost 7,000 a day in the country by the mid of June reduced by 40 per cent to around 4,000 a day.
Riaz Haq said…
#COVID19 risk depends on blood type: Data from #China, #Italy & #Spain shows people with type A blood have 45% higher risk of having severe COVID-19. On the other hand, having Type O blood is associated with a 35% reduced risk of the disease. #coronavirus

In this population, having Type A blood was associated with a 45% increased risk of having severe COVID-19. On the other hand, having Type O blood was associated with a 35% reduced risk of the disease. Those relationships held up whether the Italian and Spanish patients were analyzed separately or together.
No other blood groups were associated with a greater or lesser risk of the disease. In addition, blood type did not seem to be linked to the risk of needing to be put on a mechanical ventilator.

The study design did not allow researchers to make any determination about whether blood type was associated with the risk of coronavirus infection, or, if infected, the risk of becoming severely ill.
“The hope is that these and other findings yet to come will point the way to a more thorough understanding of the biology of COVID-19,” Dr. Francis Collins, a geneticist and director of the National Institutes of Health, wrote on his blog. “They also suggest that a genetic test and a person’s blood type might provide useful tools for identifying those who may be at greater risk of serious illness.”

How does that line up with other research?
At least two other groups have looked for links between blood type and COVID-19 risk and found similar results.

The first inkling that blood type might have something to do with disease riskcame in March from researchers in China, who compared 2,173 COVID-19 patients in three hospitals in Wuhan and Shenzhen to more than 27,000 “normal people.” They found that people with Type A blood had a 21% greater risk of the disease than their counterparts with other blood types, and that people with Type O blood had a 33% lower risk.
Riaz Haq said…
India’s coronavirus epidemic is now growing at the fastest in the world, increasing 20% over the last week to more than 1.4 million confirmed cases, according to Bloomberg’s Coronavirus Tracker.

Infections in the South Asian nation of 1.3 billion people have reached 1.43 million, including 32,771 deaths, India’s health ministry said, with daily cases close to a record 50,000 on Monday. India is only trailing the U.S. and Brazil now in the number of confirmed infections, but its growth in new cases is the fastest.

Maharashtra, Tamil Nadu, Andhra Pradesh and Karnataka are among the states where the maximum number of daily cares are being reported. The world’s second-most populous country has been ramping up testing, with 515,472 samples taken on Sunday, according to the Indian Council of Medical Research.

Still, India and Brazil have some of the world’s lowest testing rates, with 11.8 tests and 11.93 tests per 1,000 people respectively, compared to the U.S. with 152.98 tests per 1,000 and Russia with 184.34, according to Our World in Data, a project based at University of Oxford in the U.K.
Riaz Haq said…
Excepts of Wall Street Journal Story Why Youthful, Conservative Pakistan Is a Coronavirus Bright Spot

Two months ago, Pakistan was drawing unfavorable Covid-19 comparisons with Brazil

"Major hospitals report beds are freeing up in previously overflowing coronavirus wards, even in Pakistan’s biggest and hardest-hit city, Karachi," the Wall Street Journal said in a report from Islamabad. "The tally of patients on ventilators has halved over the past month," it adds.

"This is all happening as Pakistan’s neighbours to the east and west — India and Iran — are still reporting that infection rates are climbing steadily," the Journal said.

Even more surprising, the report added, was how the progress in Pakistan — where coronavirus was spreading out of control some two months ago — came after Prime Minister Imran Khan resisted the World Health Organization's (WHO) advice, declaring in May that lockdowns are too costly for the poor and reopening the economy.

"We charted the tough course between a strict lockdown and completely opening up," Dr Faisal Sultan, an infectious diseases physician brought in by PM Imran Khan as his adviser for COVID-19.

The report about Pakistan’s success comes when even the US — a superpower with enormous resources at its disposal — struggles to control the pandemic, with 4.7 million cases and 157,000 deaths.

PM Imran started wearing a mask in public

Pakistani health officials have not declared a win, the report said, adding they worry that progress could be undone, particularly with the current Eid-ul-Azha holiday and the upcoming Muharram, both of which traditionally attract public gatherings across the country.

Relatively low testing levels in Pakistan have also raised questions about the scale of the decline, the Journal noted, but quoted medical experts as saying that the turnaround trend is clear. Tellingly, the proportion of tests coming back positive has more than halved, it said, citing official figures.

Pakistan locked its economy down in March, early on in its outbreak, which kept the virus from spreading widely while the population stayed home, the WSJ stated. However, after the restrictions were lifted in May, many Pakistanis celebrated the end of the fasting month of Ramazan with shopping sprees and visits to family, unleashing a burst of infections.

The rapid spread jolted people into changing their behavior, with more mask-wearing, hand-washing, and maintaining social distance, Dr Sultan was cited as saying. The preventive messages increased from the government and public service campaigns.

The prime minister also started wearing a mask in public, the report highlighted


Just 4% of Pakistan’s population is over 65 — compared with 16% in the US and 23% in Italy, according to United Nations data. The average age in Pakistan is 22, more than a decade younger than Brazil, and 25 years younger than Italy, noting also that there are no bars and nightclubs.

There are also no institutionalised homes for the elderly, sites of deadly outbreaks elsewhere. Women tend not to go out of the home to work, meaning the workforce is overwhelmingly made up of men who are mostly young, it was pointed out.
Riaz Haq said…
Slim chance of second #Covid_19 wave in #Pakistan. 36% of the workforce in #Karachi, the country’s largest city and commercial capital, have already developed #immunity against the COVID-19, according to #antibodies study. #coronavirus

The latest study by Pakistan's leading blood diseases institute suggests there is a slim chance of a second wave of the novel coronavirus here, further strengthening the government's policy of reopening of businesses.

The cross-sectional study conducted from May to July at the National Institute of Blood Diseases (NIBD) Karachi, has been published by the Oxford University Press's Journal of Public Health.

Titled, “Challenges in acquiring herd immunity for COVID-19,” the study conducted by a team of microbiologist, hematologists and pathologists, led by Dr Samreen Zaidi, includes nearly 1,700 people from three groups – health care, community and industrial workers.

It included adult male and female participants, who ranged in age from 18 to 60.

The study conducted to assess antibodies levels in diverse a group of residents to comprehend prevalence in the community, revealed that 36% of the workforce of Karachi, the country’s largest city and commercial capital, have already developed immunity against the COVID-19.

"This study has been instigated to evaluate the seroprevalence of anti-SARS-CoV-2 antibodies in different healthcare and community population from Karachi and with the aim of assessing the importance of seroprevalence in these groups," the report said.

The overall seroprevalence or the immunity rate, it added, is found to be 36% with highest positivity in industrial employees (50.5%), whereas only 13% of health care workers tested positive.

Moreover, the community that comprised of healthy blood donors and walk-in patients for antibody testing had a 34% positivity rate.

Seroprevalence is the incidence of a disease or illness within a distinct population at one time, as measured by serology tests.

The seroprevalence rate, the study pointed out, identified in the US population varies from 1.9 to 6.9%, which is very low compared to Pakistan.

The seropositivity rates reported were 10.8% and 5.0% from Switzerland and Spain, respectively.

Herd immunity

The study showed that one-third of Karachi's industrial population developed immunity against the COVID-19, which is still far from the 60% to 70 herd immunity that is needed.

"In addition, if we consider acquiring 60% of seroprevalence in next couple of months, then herd immunity is not far from reality provided the antibodies did not decline with time," the report said. "The present study raises the possibility that if 36% of adult population of Karachi is supposed to be seropositive, then we can hypothesize that in the next 2–3 months 60% of general population will become seropositive [immune].”

However, according to Dr. Samreen Zaidi, follow up studies show that the seroprevalence rate has reached 60%, as per expectations.

"We, on the basis of a gradual drop in cases, and other relevant factors, assume that there are low chances of a second wave of coronavirus, " Zaidi told Anadolu Agency.

However, she acknowledged "assumptions are assumptions."

"The only limitation with this study is that our sample size is small. Therefore, we have recommended a further and wide-ranging research on the government level to double check the results of this study," she maintained.
Riaz Haq said…
Your #Coronavirus Test Is Positive. Maybe It Shouldn’t Be. In 3 sets of data in #Massachusetts , #NewYork and #Nevada , up to 90% of people testing positive for #COVID19 carried barely any virus. Low virus load may not be contagious.- The New York Times

Some of the nation’s leading public health experts are raising a new concern in the endless debate over coronavirus testing in the United States: The standard tests are diagnosing huge numbers of people who may be carrying relatively insignificant amounts of the virus.

Most of these people are not likely to be contagious, and identifying them may contribute to bottlenecks that prevent those who are contagious from being found in time. But researchers say the solution is not to test less, or to skip testing people without symptoms, as recently suggested by the Centers for Disease Control and Prevention.


In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found.

On Thursday, the United States recorded 45,604 new coronavirus cases, according to a database maintained by The Times. If the rates of contagiousness in Massachusetts and New York were to apply nationwide, then perhaps only 4,500 of those people may actually need to isolate and submit to contact tracing.

One solution would be to adjust the cycle threshold used now to decide that a patient is infected. Most tests set the limit at 40, a few at 37. This means that you are positive for the coronavirus if the test process required up to 40 cycles, or 37, to detect the virus.

Tests with thresholds so high may detect not just live virus but also genetic fragments, leftovers from infection that pose no particular risk — akin to finding a hair in a room long after a person has left, Dr. Mina said.


Instead, new data underscore the need for more widespread use of rapid tests, even if they are less sensitive.

“The decision not to test asymptomatic people is just really backward,” said Dr. Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health, referring to the C.D.C. recommendation.

“In fact, we should be ramping up testing of all different people,” he said, “but we have to do it through whole different mechanisms.”

In what may be a step in this direction, the Trump administration announced on Thursday that it would purchase 150 million rapid tests.

The most widely used diagnostic test for the new coronavirus, called a PCR test, provides a simple yes-no answer to the question of whether a patient is infected.

But similar PCR tests for other viruses do offer some sense of how contagious an infected patient may be: The results may include a rough estimate of the amount of virus in the patient’s body.

“We’ve been using one type of data for everything, and that is just plus or minus — that’s all,” Dr. Mina said. “We’re using that for clinical diagnostics, for public health, for policy decision-making.”

But yes-no isn’t good enough, he added. It’s the amount of virus that should dictate the infected patient’s next steps. “It’s really irresponsible, I think, to forgo the recognition that this is a quantitative issue,” Dr. Mina said.

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