Pakistan is literally surrounded by the fearsome Covid-19 disease caused by the SARS-CoV-2 virus and although it is not a modern version of the Bubonic plague, the terror it has generated in our collective psyche is akin to that created by the medieval pestilence. It was declared a “Public Health Emergency of International Concern” by the United Nations on January 30, 2020. Given the gravity of the situation, Pakistan immediately needs to put in place a comprehensive preventive and curative model to contain the damage caused by the virus. Whilst several precautionary measures to prevent the virus from going on a destructive rampage have been taken, efforts to arrest the spread of the disease must be intensified.
According to mathematical models designed by American researchers, the basic reproductive number (Ro) of Covid-19 is 2.3 meaning each infected person can infect 2.3 persons. Clearly, extraordinary measures are required to combat this monstrosity. Pakistan’s plan to respond to the pandemic should encapsulate a well-coordinated national effort to educate the masses, test as many people as possible, identify the affected, set up effective quarantine areas in all major hospitals and special spaces in the cities and control the disease via effective medical intervention. All hospitals should have an Emergency Response Plan ready to be executed.
A full-blown national awareness campaign should be immediately launched by the federal government. Print, electronic and social media should be efficiently used to educate people about the disease’s prognosis and the preventive measures they need to take in order to avoid being infected and becoming agents of infection. Given the gamut of our socio-cultural proclivities to huddle together, this mass awareness campaign assumes greater importance. Social distancing measures should, therefore, be adopted and people should be asked unequivocally to avoid others. The state should boldly take appropriate measures in this regard under Section 3 of the Public Health (Emergency Provisions) Ordinance, 1944, Section 144 of the Criminal Procedure Code, 1898, and Sections 269, 270 and 271 of the Pakistan Penal Code, 1860. A special ordinance regarding the prevention of the spread of the virus containing penal provisions should be promulgated by the government.
A national health emergency should be declared by the federal government. A taskforce consisting of officials from the Federal Ministry of National Regulations and Services, the Ministry of Finance, the National Disaster Management Authority (NDMA), the four provincial Disaster Management Authorities, Punjab, Sindh, Balochistan, K-P and G-B and provincial Health Departments should be created so that the ebb and flow of the pandemic in the length and breadth of the country could be observed.
Testing as many people as possible is the key to any curative response to the disease. The South Korean model could be followed whereby samples were collected at 50 drive-through clinics across South Korea. Drivers remain seated in their cars and answer a brief questionnaire after which their temperature is recorded and nasopharyngeal aspiration is done. Mobile testing stations should also be set up for random home visits. The data collected by these tests would allow experts to understand the clusters of infected patients and the trajectory of the outbreak in different areas. This could create demographic maps that could allow the authorities to employ resources in those areas and isolate others to keep them safe.
Specialised equipment required to deal with the disease like masks and gowns, nasopharyngeal swabs and RNA extraction kits should be purchased directly from the local or international market by temporarily suspending the tedious Public Procurement Rules, 2004 (PPRA). A special purchase committee comprising senior officials of the Ministry of Finance, Economic Affairs Division and the office of the Auditor General of Pakistan should be constituted by the PM for the purpose.
We need to act as time is of the essence.
Published in The Express Tribune, March 25th, 2020.