Flatten the curve

PM seems to not be aware that it was exactly this attitude of apathy that got Italy in the position it is in today

The actions taken during this extraordinary moment in history will be scrutinised from every angle in the years to come. Public figures that downplayed the threat before it gorged on their healthcare systems will be cited as examples of inept leadership. Inaction will be the cardinal sin in the story of the coronavirus.

Around the world, experts are mobilising behind one phrase: “flatten the curve”.

This is the new war cry in the battle against one of the worst pandemics in human history.

The phrase refers to a graph created by the United States Centers for Disease Control and Prevention, which shows how delaying the spread of infection through proactive measures can limit the number of people requiring hospitalisation. The aim of this strategy is to make sure that hospitals and healthcare professionals can cope with the number of people requiring treatment.

Failure to do this results in a grim picture. Doctors forced to choose who gets to be put on a ventilator and who doesn’t; emergency workers facing a dilemma regarding who is sick enough to be taken to hospitals already at full capacity; exhausted doctors and nurses collapsing from mental and physical fatigue.

The picture is grim enough, but in our country, it can turn ghoulish in a heartbeat.

For a disease with the potential to cripple the lungs we have only 1,700 ventilators in the entire country. Our healthcare workers fear for their lives as they try to treat patients without having access to proper protective gear. According to some reports, there are only 15,000 N95 masks available in the country for medical workers.

In this backdrop, people needed to hear more from the Prime Minister than his patented “ghabrana nahin hai (no need to panic)”.

This was the time to be honest about what we are facing. An unprecedent public health emergency that will only get worse before it gets better. The harsh truth may hurt, it may run counter to the populist playbook that has worked so well for the Pakistan Tehreek-i-Insaf, but it would get people to appreciate just how serious the threat had become.

We didn’t get that; we got a line about the coronavirus being like the flu.

Yes, there was a reference to saving the elderly, but the speech played down the threat the country faces. That doesn’t help in achieving the social distancing that the Prime Minister was urging people to practise.

We should have heard about the Prime Minister’s strategy, his course of action. But we heard only about what he would not do: a lockdown.

It is hard to see how the Prime Minister expected proper social distancing to happen without a full lockdown. Not until schools, mosques, and public gatherings are completely halted can we come close to flattening the curve.

We can’t really afford indecisiveness right about now. But that is all we were getting from the federal government.

The mosque issue is a good example of this. The question of whether they should be closed became another inane subject on which the federal government refused to take a firm hand. Twisting itself into a pretzel to appease religious clerics, the government obtained a fatwa from Al Azhar University to suspend congregational prayer. Even with that in hand the President could only say that congregational prayer would be “restricted” to small groups. As if the coronavirus requires a minimum attendance before it decides to infect people.

As for the lockdown, the Prime Minister gave two reasons for not implementing it. First, he said that if the situation had been akin to what Italy was facing, he would immediately lock down the country. Second, he feared how this would affect those living below the poverty line.

The first argument is counter intuitive. Why wait till we have 2,000 cases a day before taking the best step available to flatten the curve? The Prime Minister seems to not be aware that it was exactly this attitude of apathy that got Italy in the position it is in today. Italy was slow to impose a full lockdown, choosing to do it in a piecemeal fashion. In the early days of the virus, the Italian government also tried to downplay the threat and asked the media to stop spreading panic. But by failing to communicate the severity of the threat it enabled many Italians to go out and socialise as if nothing was wrong.

The results are in front of us. Why refuse to learn from them?

The second argument is more compelling. There is no doubt that a lockdown would hurt those living below the poverty line the most. However, not imposing a lockdown may create a much bigger problem for the same people. The poor will suffer if the virus spreads to an extent that causes our healthcare system to implode. If the virus is not controlled it will disproportionately impact Pakistan’s poorest citizens who live in overcrowded areas, lack access to basic sanitation, and do not have hospitals equipped to handle the situation. This would mean a loss of human life that would parallel Italy.

What the government can do to help the poor is to impose a lockdown and implement its already approved economic stimulus package of Rs1 trillion. This flattens the curve while also helping the poor cope with the situation. The Punjab government has now also announced a Rs10 billion package for daily wage earners.

While the federal government continues to fail to comprehend the issue the provincial governments have risen to the occasion.

Sindh’s Murad Ali Shah has led an effort that no amount of partisan mudslinging can undermine. His government was the first to understand the gravity of the threat. Imposing a lockdown despite the federal government’s hand wringing and wasting little time in banning congregational prayers. Soon, other provinces would follow its example one way or another.

We can hope that this display of action will silence the voices that have been criticising the 18^th Amendment’s guarantee of provincial autonomy.

It is a good time to rethink our country’s priorities, where healthcare is an elite privilege rather than a right. For more than a year we have heard the PTI’s mantra of corruption being the biggest evil in Pakistan. While corruption is no doubt an issue, it is not the only one. The coronavirus shows us that.

When one day this threat ends — and it will end — we need to think more about investing in hospitals, schools, and our people rather than having enough nuclear missiles to decimate the world.

Published in The Express Tribune, March 31^st, 2020.

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