Health Vs Wealth: A Great Debate
By N. Khan, N. Abas, E. Kalair, Comsat, 20/5/20
May 21, 2020 - 1:29:04 PM
Leaders left 220 million docile people on the mercy of herd immunity in Pakistan
Elected and Selected executives hold 25 million people live below poverty in Pakistan. They include daily wages workers, labor and self-employed people. There are 50 to 60 million family members who depend on their daily income. State is unable to afford their expenses.
Media claims the incumbents started lockdown when there were a few tens of cases and ended it when there were quite a few thousands of covid-19 cases. Government protects the interests of elites whose business had closed by lockdown. Poor workers will sacrifice their lives for rich’s profits.
Deep throat pundits says the poor depends on rich who cannot provide employment without productivity. However, analysts oppose westerns views on basis of their capitalist settings in which economy is preferred over health. Poor has to either with hunger or herd immunity.
Coronavirus reached in Karachi on 26 February and then spread to all places in Pakistan by 18 March 2020. Government started lockdown on 13 March 2020 when covid-19 cases were only 26 with zero deaths, and ended on 9 May 2020 when total corona cases had reached to 28,736 with 636 deaths. Public transport, rails, shopping malls and routine business were opened by 18 May 2020 [AN 2020l Ayaz 2020].
By 20 May, Pakistan conducted 414,254 tests in which 44,898 were found positive (10.84% positive rate). According to Prof. Javed Akram (VC UHS) 1% population (2.2 million) must be tested that at 10.84% infection rate equals to 238,370 cases. This number falls between UK (248,818) and Italy (226,699) that could not be confirmed due to low testing capacity. Corona virus has already affected more than 500 healthcare workers out of which several have died.
Prof. Atta Ur Rahman (World Known Scientist), Prof. Javed Akram (Vice Chance Health University) and Young Doctors Associations (YDA) begged incumbents to continue lockdown, but Government and Supreme Court ordered to end the lockdown throughout Pakistan. Who will be responsible for stimulated rise in infection cases and rampant rise in deaths during long hauled herd immunity experiment?
Millions of men, women and children, without wearing any face masks, flooded the markets like a super cyclone in all big cities. Doctors, anchors and scientists lament on developing severe situation in Pakistan. Government started lockdown when number of new cases (due to low number of tests) were in tens per day and ended it when number of daily new cases reached to thousands per day.
All countries are aware of herd immunity, but no elected leader could ever dare to leave the whole country to the mercy of pandemic. Supreme Court is not even ready to accept Covid-19 as pandemic despite the endorsement of world health organization (WHO). Friends of Pakistanis have chosen 220 million people of Pakistan to conduct a grand experiment of herd immunity. May friends of Pakistan want to use it as a pretext to lift lockdown in their own countries.
No community in distant past has chosen the option of herd immunity that overcomes disease after sacrificing lives of millions. Europe had to go for herd immunity due to absence of treatment of plague, like Civid-19 disease today, that killed half of European population a couple of centuries ago. It is brainchild of some smart people or companies to try herd immunity notion on people of Pakistan.
Scientists have discovered 14 strains of coronavirus worldwide. Dr. Ghazala told on TV that these strains attack different organs of victims. CDA and WHO are considering to expand symptoms of Covid-19 as various strains target different parts of human body. Number of strains continue rising over time as part of virus natural life cycle. Herd immunity experiment seems to be a mistake at this stage.
Hundreds and thousands of people are being tested positive as health authority escalated testing rate. Random testing shows 10% to 15% people are Covid-19 positive in large cities. Experts dis the government as well as judiciary decisions to end lockdown. It appears as if executives have left the people on mercy of herd immunity, which prevails after 60% to70% infection of population.
Scientists say the incubation period of Covid-19 contagion is 14 days. Covid-19 pandemic peters out if everybody on planet remain socially distant for two weeks. Medics and economists believe the soft lockdown does not contain contagion and hard lockdown asphyxiates economy. Computer intelligentsia claims the smart lockdown takes cares of DNA (health) as well as GDP (economy).
Lockdown is an effective strategy against spread of Covid-19, but it hurts economic activities. However, if you have to choose between health and economy, the earlier takes precedence. Government holds that a smart lockdown targets hotspots allowing economic activities. However, doctors argue that there is lockdown, or no lockdown, flexible lockdown does not prevent spread of infection diseases. Leaders face public health and national economy challenges in wake of Covid-19 Pandemic.
India and Pakistan are going to ease lockdown as Denmark, Germany, Switzerland and Austria are taking steps to end their lockdowns after curve flattening. India allows some retail shops, but Pakistan permitted industrial and commercial activities. Temporary layouts make up 78.3% of total unemployment in labor market in wake of Covid-19 Pandemic [Dean 2020].
Imran Khan, Prime Minister of Pakistan, believes the smart lockdown allows active intervention to launch targeted tracking, tracing, testing and quarantine mechanism with help of national security apparatus to stop the spread of COVID-19 by closing the areas of infected population clusters, while easing restrictions on economic activities under the safety guidelines. Security agencies used similar tactics in tracking, tracing and eliminating threats during war on terror [APP 2020].
Covid-19 pandemic has infected more than 5 million people out of which more than 2 million have recovered and more than 326 thousands have died worldwide. USA, UK, Spain, Belgium, Italy and France are the most affected countries. China did not supply data therefore it is not possible to estimate global infection rate. Assuming total 40 million tests worldwide the infection (total cases/ total tests) and death (total deaths/total cases) ratios are 10.86% and 6.74% respectively, which vary from 4% (Russia) to 24.15% (Brazil) and 0.9% (Russia) to 15.14% (France) individually.
On basis of deaths in closed cases the most affected countries are UK (>90%), Netherlands (>80%), France (31.84%) and USA (21.94%). The least affected countries, on basis of closed cases, are Russia (4.64%), Germany (4.99%) and Pakistan (7.51%). On the basis of total deaths/total cases ratios the most affected countries are France (15.14%), UK (14.43%) and Italy (13.97%). Similarly, the least affected countries, on basis of total deaths/total cases, are Russia (<1%), Pakistan (2.21%), India (3.25%), Germany (4.47%) and United States (5.92%).
All countries and places have been affected by covid-19, yet all people in ten countries have recovered, 29 countries conducted no tests at all and 37 countries had no death due to covid-19 at all. Global situation of Covid-19 pandemic is yet uncertain everywhere. Global collapse of economy is forcing leaders to go for smart lockdown. Total number of cases are rising at 45 degree angle worldwide. We know any projectile launched at 45 degree angle goes the longest distance.
Data Source: https://www.worldometers.info/coronavirus/worldwide-graphs/
A lockdown is an emergency measure to prevent spread of infectious and contagious diseases. There is hard lockdown, or no lockdown - however- a smart lockdown targets only hotspots in communities. Chinese hard lockdown in Wuhan very effectively blocked further transmission of disease. According to WHO the transmission rate (Ro) of Covid-19 disease is 1.4-2.5 that is more than flu (1.3) and SARS (2.0). However, several other studies claim Covid-19 transmission rates even from 2.2-4-3.58 to 3.6-4.0. Nevertheless, fatality rate of Covid-19 is less than SARS and MERS.
Incubation period of Covid-19 patients is 14 days. First week is asymptomatic period and symptoms appear in second week after which patient recovers or dies. However, some patients take lesser or more days. A four weeks hard lockdown should overcome this pandemic therefore Government of Pakistan has extended lockdown for another two weeks. First lockdown was hard and second is being said to be smart. However, testing rate is being escalated to estimate the spread of disease.
Hard lockdown restricts all rights and civil liberties, allowing essential travel for food and medicines. Hard lockdown blocks spread of pandemic successfully, but adversely affects economic lifelines due its total shutdown [John 2020]. Soft lockdown allows some rights and civil liberties including restoration of economic lifelines [Julan 2020]. However, spread of pandemic increases during soft lockdown. Smart lockdown is based on track and trace tactics and public cooperation to use some features of hard lockdown for hot spots, allowing economic lifelines to operate carefully [Mumjaz 2020].
Lockdown is a situation in which people are not allowed to enter or leave a building or area freely due to emergency. The lockdown is a time tested strategy to contain spread of epidemics. However, lockdown affects transport, industry, economy, education, religious, and social lifelines. Generally food and energy lifelines are not closed to maintain continuity of life.
A lockdown is an emergency protocol preventing people leaving a designated area. Lockdown is usually initiated by someone in a position of authority. There are dozens of countries on lockdown worldwide to contain Covid-19 outbreak. A strict lockdown does not let people come out of homes. However, a mild lockdown allows people to come out for food and medicines.
Pakistan, like all covid-19 hit countries, launched a strict lockdown nationwide to contain spread of contagion which resulted in low spread of coronavirus cases. However, after few weeks, traders, daily wagers and religious leaders started protesting against lockdown on economic and virtual basis. Weighing the delicate balance between hunger and covid-19 deaths, Government of Pakistan decided to replace strict lockdown by smart lockdown.
Term smart lockdown is based on definition of smart devices which are connected to other devices or networks through wireless protocols to operate interactively and autonomously. Smart devices have inbuilt decision capability depending on varying situations. Smart lockdown enforcing authorities keep eyes and ears open to ensure smooth functioning under standard operating procedures. Smart lockdown is a flexible strategy that can halt activities contributing to spread of epidemic.
All lifelines are important but economic lifelines are more important as the backup other lifelines. Donald Trump, US President, is also considering to open economic lifelines which have rendered zillions jobless. Developed countries also feel economic activities inevitable the situation of developing countries is already dilapidated. IMF, World Bank, G-7 and G-20 summits have helped developing countries to cope with Covid-19 Pandemic yet local economic activities are important for people.
Covid-19 has imparted trillion dollars losses to world economy. Growth rates of fast emerging economies have fallen down and weaker countries forecasting negative growth. Charity organizations have done well but feed zillions at home is a big crisis. Pakistan has 25% (55 million) people living below poverty line and Ehsaas Support Program could hardly reach 10 to 11 million people. Elite class does not recognize the difference between needy and beggars who bought shovels to pretend daily wagers.
Smart lockdown is a smart choice between preventing the spread of the deadly virus and ensuring public does not lose livelihood during the lockdown. The Centre for Economic Research in Pakistan (CERP) has envisioned the idea of smart lockdown allowing economic activities with safety procedures. The smart lockdown helps government make more informed, feasible and timely choices to contain the virus and letting the economic activities continue in Pakistan under national SOPs.
It allows movement of the young and healthy people while protecting the elders as they are more vulnerable to covid-19 disease. CERP advised to evolve sampling over time, from symptomatic testing to contact tracing and testing. It proposed screening of high-risk/high-impact people and then contact tracing and testing of front-line workers and law enforcement officials.
There is a need to adapt social distancing strategy instead of blanket lockdown, to contain the virus and continue economic and health activities. Authorities can impose lockdown in hotspots by ensuring delivery of food and medicines. Smart lockdown is likely to start by end of April 2020.
Sudden evolution of epidemic collapses health systems. Health authorities advise incumbents to proceed ahead by slow and selective testing of high impact people, quarantine, isolation, lockdown and lockdown strategies to elapse time to flatten the curve. Actual cases keep on increasing until natural herd immunity plays its role. A smart lockdown flattens the curve so as the epidemic does not overwhelm the health system capacity.1.
Lockdown restricts and delays spread of pandemic and slow testing rates allows incumbents to flatten the curve to avoid overwhelming of health lifeline. Health authorities started testing 500 people at start then increased testing rate to 1000 and 5000 gradually until covid-19 patients increased to 12,000 from 26 February to 30 April 2020. Pakistan decided to switch to smart lockdown from 1st May 2020 and escalate testing rate to 20,000 per day to track and trace covid-19 patients. Basic statistics show vulnerability of 17 million people out of which 250,000 are likely to be critical cases [Ashfaq 2020].
Health lifelines needs extraordinary care to increase its capacity over time to deal with unforeseen situations in future. Healthcare workers are front line soldiers in battle against pandemic so they must not have shortage of personal protective equipment (PPE) and medical facilities. There was acute abundance of doctors most of which have been recruited on ad hoc basis to deal with Cocid-19 pandemic.
Prime Minister, Imran Khan, faces corruption and as well as coronavirus epidemics. PTI front line workers have been accused to be involved in flour, sugar and power scams. Opposition has earned lot of money already to persuade traders and beneficiaries of corrupt practices to create artificial shortages. A new ordinance has been launched to confiscate hoarded goods with punishment up to 3 years.
PPP and PML (N) governments permitted many independent power plants (IPPs) at terms and conditions not acceptable worldwide. Many politicians had shares in power companies that is conflict of interest. Energy committee has pointed out loss of Rs.4802 billion in subsidies and circular debts. Covid-19 has led to repatriation of zillions of oversees workers that was main source of foreign exchange.
Despite limited resources government has distributed Rs.56.96 billion in 4,747,380 families at rate of Rs12000 per family. This is largest sum ever distributed direct to poor people in history of Pakistan. PTI government plans to increase testing capacity to determine spread of Covid-19 outbreak in Pakistan. It is likely the number cases may increase exponentially in May 2020. Government has sanctioned another Rs.75 billion stimulus package for daily wages workers.
Government believes an infinite lockdown is not solution as economic lifeline collapses, which supports health, energy and food chain lifelines. All governments worldwide are facing spiritual lifeline disruption issues. Theological forces demand end of lockdown in mosques, churches and temples.
Government of Pakistan has agreed to open mosques subject strict compliance to 20 conditions. If cases start increasing by not observing social distancing and other terms & conditions then mosques would be closed again. Spiritual lifeline at least provides mental refuge to people. KSA has banned Haj & Umra but democracy does not allow here to enforce orders.
Deserted streets, shuttered shops and closed restaurants reflect normal life on hold everywhere. London, New York and Moscow to Islamabad look like ghost cities. If the earth had tongue then it would have spoken “You become ill by your own mistakes, nature heals you”. You did not stop eating wild animals and burning fossil fuels, so nature has shut down the planet for repair.
World has grappled with Covid-19 pandemic that will take time to peter out. World is tired of burying Covid-19 victims and we are debating on opening mosques or not? Can our spiritual leaders not see the ban in Mecca and Medina? Look at Kabul who have no ventilators at all. India used Afghans do suicide attacks in Pakistan, now ignores their sufferings. They are looking towards China and Pakistan with hope to give her ventilators and PPEs.
Medical experts and analysts warn government to impose strict lockdown from fear of rise in coronavirus cases. A madrassa was quarantined after finding multiple covid-19 cases. All the seven members of a family in Islamabad found infected with coronavirus. The covid-19 was so far limited to big cities and slumps now shifting to villages too.
AN, Pakistan lifts lockdown amid jump in coronavirus cases, Arab News, 9 May 2020. https://www.arabnews.com/node/1671996/world
Ayaz C, Pakistan’s Top Court Ends Coronavirus Lockdown, VOA News, 18 May 2020. https://www.voanews.com/south-central-asia/pakistans-top-court-ends-coronavirus-lockdown
Dean B, The Pandemic’s Catastrophic Hit to the Labor Market, Ocnus.Net, 13 May 2020. http://www.ocnus.net/artman2/publish/Labour_9/The-Pandemic-s-Catastrophic-Hit-to-the-Labor-Market.shtml
APP, Smart Lockdown: A better option to combat COVID-19, The News, 4 May 2020. https://www.thenews.com.pk/print/653861-smart-lockdown-a-better-option-to-combat-covid-19
John S, Coronavirus: Wuhan emerges from the harshest of lockdowns, BBC, 8 April 2020. https://www.bbc.com/news/world-asia-china-52197054
Julan R, Coronavirus: Can Japan's 'soft lockdown' stop COVID-19? DW, 7 April 2020. https://www.dw.com/en/coronavirus-can-japans-soft-lockdown-stop-covid-19/a-53048921
Mumtaz A, PM pleads for smart lockdown instead of shutdown, The News, 24 April 2020. https://www.thenews.com.pk/print/648746-pm-pleads-for-smart-lockdown-instead-of-shutdown
Ashfaq A, Coronavirus: More than 50,000 COVID-19 patients expected in Pakistan by end of April, Gulf News, 5 April 2020. https://gulfnews.com/world/asia/pakistan/coronavirus-more-than-50000-covid-19-patients-expected-in-pakistan-by-end-of-april-1.70815880
Source: Ocnus.net 2020