Wednesday, March 18, 2020

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:

27 comments:

Sabahat A. said...

HCQ is no longer available in Pakistan.

It is now in short supply

Riaz Haq said...

Sabahat:n "HCQ is no longer available in Pakistan."

Pakistan should immediately ban export and hoarding of HCQ (hydroxychloroquine) and Resochin (chloroquine).

And local manufacturing plants in Pakistan should ramp up production.

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...

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...

#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

Riaz Haq said...

Coronavirus Testing in Pakistan (2,000) vs India (14,500) is about the same per capita as of March 19. Pakistan has ramped up testing and the latest figure from NIH Pakistan is over 13,000 tests (vs 27,000 in India) as of March 28, 2020.

https://ourworldindata.org/coronavirus-testing-source-data

https://www.nih.org.pk/wp-content/uploads/2020/03/COVID-19-Daily-Updated-SitRep-28-Mar-2020.pdf

https://icmr.nic.in/sites/default/files/whats_new/ICMR_website_update_27March_9AM_IST.pdf

Number of cases in Pakistan is probably higher than India because of large numbers of people traveling between Pakistan and Iran which is a coronavirus hotspot. Testing in Pakistan is mainly targeted at that group and their family members and contacts in Pakistan.

So far, vast majority of coronavirus infections are among people who came in from Iran. There are a lot fewer local transmissions in Pakistan.

Riaz Haq said...

#Economic activities in #Pakistan continue as some retailers still buying. “Pakistan is expected to achieve some 50% export target this month (March)..US retail chain Costco is still taking supplies.." Govt trying to make sure #agriculture unhurt. #exports https://tribune.com.pk/story/2185785/2-economic-activities-continue-countries-take-orders/

The rice industry, whose exports are worth $2 billion a year, has also managed to operate. The government will not charge demurrages for delay in clearance of import and export containers at ports.

However, many other industries and services sector, except for the essential ones, will bear losses of billions of rupees due to lockdown in almost the entire country to contain the coronavirus pandemic. The Express Tribune tries to estimate damages to the national economy. “Pakistan is expected to achieve some 50% export target this month (March),” Pakistan Business Council (PBC) CEO Ehsan Malik said.

“The US retail chain Costco is still taking supplies from around the world. Besides, many Asian countries remain operational,” he said.

Pakistan’s average exports came in slightly lower than $2 billion a month in the first eight months (Jul-Feb) of the current fiscal year, according to the Pakistan Bureau of Statistics (PBS).

“We are trying to make sure, in collaboration with the government, that those export industries continue to operate whose orders have not been delayed and cancelled by the international buyers,” Malik said. The list of employees of the export industries and those which are considered essential industries and services have been provided to the government and the law enforcement agencies are letting them commute between factories and homes.

These industries include food, pharmaceutical, textile and fast moving consumer goods like soaps, shampoos and detergents, which also come under the essential goods category.

“Essential food and pharmaceutical industries cannot operate in isolation and that is why we have taken permission from the government to let the packaging and printing industry operate as well,” Federation of Pakistan Chambers of Commerce and Industry (FPCCI) President Anjum Nisar said.

“Soap and sanitiser manufacturing industries also come under essential goods manufacturers since we need the two products to protect people from coronavirus,” he said.

Malik voiced fear that exports may gradually drop to a very low level in the next three to four months, but stressed that they would gradually return to normal by December 2020. Besides, non-essential industries and services would be badly hit by the lockdown. Many big industrial units including the three Japanese car manufacturers (Toyota, Honda and Suzuki), big textile and cement-makers including Gul Ahmed, Interloop and Lucky Cement have stopped production, according to a private TV channel.

Giving a rough estimate as to how the lockdown would impact the overall economic activity, Malik said, “One-third of the industrial production may be impacted and the share of industrial production in the overall GDP (gross domestic product) stands at around 18%.”

The share of wholesale and retail stands at around 18-20% in GDP. “It may come down by around 20%.”

The share of services sector (like doctors, bankers, lawyers, barbers, tailors and cobblers) has increased to around half of GDP over a period of time. “A majority of them may feel the heat of the melting economy except for the financial sector,” he said. Malik said the agriculture sector, whose share in GDP stood at around 50%, would remain unhurt since the government was making sure that the ready-to-harvest wheat crop was procured to achieve food security.

The State Bank of Pakistan (SBP) revised down its projection for economic growth to 3% last week compared to 3.5% before January 2020.

Riaz Haq said...

#China sends medical personnel, supplies to #Pakistan to combat #coronavirus. Pakistan has 1,408 confirmed cases, including 11 deaths from the illness it causes, #COVID19. Most of the infected people in Pak are travelers returning from neighboring #Iran. https://ti.me/2vUL5RG?utm_source=twitter.com&utm_medium=social&utm_campaign=social-share-article

Most people infected by the virus only experience mild symptoms, such as fever and cough, and recover within a few weeks. But the virus can cause severe respiratory illness and death, particularly in older patients or those with underlying health problems.

Pakistan has closed its borders with both Iran and Afghanistan, but has come under widespread criticism for its initial lax response to the virus.

Even as the pandemic spread to the country, Pakistani authorities allowed tens of thousands of Islamic clerics from around the world to congregate for three days outside the eastern city of Lahore. Some 200 of the clerics are now quarantined at the site of the gathering, a sprawling compound belonging to an Islamic missionaries group, Tableeghi Jamaat.

Many of the visiting clerics at the conference returned to their home countries, some of them carrying the coronavirus. The first two reported cases in the Gaza Strip attended the three-day gathering in Pakistan, and are now under quarantine in Gaza. Other linked cases have emerged elsewhere in the Middle East and Central Asia.

Pakistan Prime Minister Imran Khan has refused to impose a countrywide lockdown saying it would devastate the country’s poor, but ordered non-essential businesses closed, including restaurants, money changers and wedding halls.

As of Saturday, the government still had not ordered mosques closed nationwide, instead relying on recommendations to worshippers not to gather for weekly Friday prayers. Pakistani officials are reluctant to defy local hard-line Islamic leaders, who can whip up mobs to protest any perceived insults to religion. Some of these clerics have taken to social media to urge the faithful to fill the mosques, saying it is their religious obligation.

Pakistan’s federal health authorities say the outbreak is so far concentrated in Punjab province, with 490 confirmed cases there, and Sindh province, which has 457 confirmed infections. Other cases are spread throughout several other regions, including the capital, Islamabad.

Health authorities in the country’s northwestern Khyber Pakhtunkhwa province reported one additional death Saturday, a woman in the district of Dir. Ajmal Wazir, a spokesman for the provincial government, said the woman fell sick after returning from a pilgrimage to Saudi Arabia, before dying in a government hospital where she tested positive for the coronavirus.

In Iran, officials have repeatedly insisted they have the outbreak under control, despite concerns it could overwhelm the country’s health facilities.

Iran’s government has faced widespread criticism for not acting faster to contain the virus. Only in recent days have authorities ordered nonessential businesses to close and banned travel between cities — long after other nations in the region imposed sweeping lockdowns.

Riaz Haq said...

#Pakistan Converts Hundreds of Hotels Into Quarantine Centers. 1,795 3-star and 4-star hotels, with 42,000 single-bed rooms ready to use as #quarantine centers for #coronavirus suspected cases. Also locked 6 hotels with 5-star facilities. #Covid_19 https://www.voanews.com/science-health/coronavirus-outbreak/pakistan-converts-hundreds-hotels-quarantine-centers

Pakistan has converted hundreds of hotels into temporary quarantine centers, one of several urgent steps to ensure its traditionally ill-prepared public health care system can deal with the coronavirus pandemic.

The rapid response, critics say, is unusual in the wake of limited resources facing the cash-strapped country.

Islamabad’s close ally, Beijing, has also stepped in to deliver critical medical staff and supplies to help in limiting the effects of the pandemic. 

Pakistani officials said Friday that the number of confirmed cases of coronavirus had risen to at least 1,300, and at least 11 people had died, since the country detected its first case a month ago. 

The number of infections are the highest in South Asia, though Pakistani officials insist the spread is “very slow” compared with rates in other countries.

Chinese aid, struggling health care system

On Friday, China and Pakistan briefly opened their only overland crossing, known as the Khunjerab Pass, 4,700 meters above sea level, to transfer urgent medical supplies from the Chinese side, such as test kits, ventilators, face masks and protective suits.

Chinese private organizations, such as the Alibaba and Jack Ma foundations, have donated hundreds of thousands of face masks, tens of thousands of test kits, and protective suits. 

“We are ready to provide whatever assistance and support to Pakistan. In China we believe in that if you give me a drop of water, I will dig a spring for you,” Yao Jing, Beijing’s ambassador to Islamabad, said in a video message. 

When the coronavirus first emerged last year in Wuhan, in China’s Hubei province, Pakistan was among the first nations to respond, delivering critical medical supplies to its neighbor and staunch ally.

Critics fear that Pakistan’s strained public health care system, with a history of failing to contain infectious disease and marred by neglect, lack of funds and nepotism, is already strained and not in a position to tackle a major outbreak. 

Prime Minister Imran Khan said his government had launched a massive effort to establish new hospitals and boost capacity of existing health facilities to prepare for such a scenario.

The head of Pakistan’s National Disaster Management Authority (NDMA) said Thursday that the process of importing medical equipment had also been set in motion.

General Muhammad Afzal told reporters that, until a month ago, Pakistan had fewer than 500 “so-called” quarantine beds, but the number has since been increased to 162,000.

“This is because we have also booked roughly 1,795 three-star and four-star hotels, with a collective capacity of 42,000 single-bed rooms, to use them as quarantine centers. We have also locked six hotels with five-star facilities if needed,” Afzal said. 

The number of intensive care units in hospitals around Pakistan has risen from 700 just a couple of weeks ago to about 20,000, Afzal said. 

The general said two transport aircraft would be sent to China on Saturday to bring back roughly 100 tonnes of medical equipment. 

The Chinese assistance, Afzal said, includes “walk-thorough testing technology” that will be deployed next week to conduct mass testing in Pakistani cities with higher infections.

Riaz Haq said...

Society has stopped for #coronavirus, but does it have to? Yale's Dr. Katz proposes identifying & quarantining ONLY those who are most vulnerable, and saving coronavirus tests and potential future treatments for them, end #lockdown for the rest. #economy https://riverdalepress.com/stories/society-stopped-coronavirus-counterpoint-covid-katz-cuomo-yale,71525#.XoD-Ee7sVHM.twitter

"I fear our (current) efforts will do little to contain the virus, because we have a resource-constrained, fragmented, perennially underfunded public health system," Katz said. "Distributing such limited resources so widely, so shallowly and so haphazardly is a formula for failure."

The current plan of keeping everyone at home actually puts the most vulnerable — like those who are sick, or grandparents — in a much more precarious position. Because everyone, from all generations, are likely under one roof and interacting with each other, Katz said, the chances of the virus spreading among single families rises exponentially.

"As the virus is already circulating widely in the United States, with many cases going undetected, this is like sending innumerable lit matches into small patches of tinder," Katz said. "Right now, it is harder, not easier, to keep the especially vulnerable isolated from all others — including members of their own families — who may have been exposed to the virus."

This was an element that seemed to have caught Cuomo's attention, especially as some of his own immediate family — like daughter Cara — have returned home in the midst of the coronavirus crisis.

"Isolate people, but isolate the vulnerable people," Cuomo said, sharing his interpretation of Katz's proposal. "Don't isolate everyone, because most people are not vulnerable to (coronavirus). And if you isolate all people, you might be actually exposing the most vulnerable people by bringing in a person who is healthier, and stronger, and who may have been exposed to the virus."

Doing that — focusing on a "much smaller" portion of the population — could allow "most of society to return to life as usual, and perhaps prevent vast segments of the economy form collapsing," Katz said.

"Healthy children could return to school, and healthy adults go back to their jobs. Theaters and restaurants could reopen, though we might be wise to avoid very large social gatherings like stadium sporting events and concerts."

While Cuomo says he is looking for ways to bring society back to some normalcy, he doesn't regret his actions so far in trying to slow the spread of the coronavirus throughout the state.

"But I think there is a line," the governor said. "A spot where those to lines cross. You have to identify it, and that is what we're going to start to work through."

And the sooner that work can begin, the better.

"At some point you have to open the valve," Cuomo said, "because that is oxygen for the economy. Because this is not sustainable."

Riaz Haq said...

As #Coronavirus Attacks #Pakistan, Volunteers Rush Out To Help. Some set up a #quarantine ward for a public hospital, , others make free protective suits for medics and individuals like Pirzada distribute #food. #COVID19 https://www.npr.org/sections/coronavirus-live-updates/2020/03/30/823783027/as-the-coronavirus-rips-through-pakistan-volunteers-rush-out-to-help

Until last week, Ahsan Pirzada ran a law firm in the Pakistani capital. But on March 22, when businesses shut down across Islamabad, thousands of low-wage Pakistanis lost their jobs, he decided to act.

He raised thousands of dollars through his friends and Facebook acquaintances to buy food. He converted his office into a storehouse and made ration packs with flour, rice, sugar, lentils, milk and cooking oil.

"This is enough for a family of four to five people to survive for 14 days," says Pirzada. He gestures to 35 food packs piled in a friend's pickup truck that he is going to deliver to a nearby slum.

Pakistanis pride themselves on their volunteer culture, and days into countrywide shutdowns to halt the spread of the new coronavirus, citizens have sprung into action.

Pakistan has registered 18 deaths from COVID-19 and has identified 1,650 cases of infection, according to government figures, but officials say the number of people with the coronavirus could be as high as 12,000.

One woman, Irum Mumtaz, set up a quarantine ward for a public hospital, run by volunteers. An entrepreneur, Umer Hussain, makes free protective suits for medics. Individuals like Pirzada distribute food. So do leftist groups like Corona Solidarity Campaign and the Robin Hood Army. A Pakistani nonprofit, The Citizens Foundation, does the same but on scale, using its network of 1,600 low-cost schools to aid 700 villages and slums.

But this pandemic poses unprecedented challenges: Pirzada only has a flimsy mask because there's a global shortage of protective gear. And in previous distributions, people crowded around him. "They're in desperate straits," he says. "They will come close and they will try to grab onto you. You can ask them to stay at a distance, but it doesn't work."

This time, Pirzada tries something new: He and other volunteers will put the rations in a church inside the slum. Then they'll call each designated family to pick up their share.

Pirzada parks near the church and volunteers start unloading the rations. People immediately crowd around, and keep entering the church, despite efforts to keep them out. One woman tugs at Pirzada's sleeve, demanding food. "Please wait five minutes, mother!" Pirzada says. "I've been waiting 10!" she snaps.

Another woman lingers outside, hoping for food, but she's not on Pirzada's distribution list of 35 families. Shabana — she only has one name — says her brothers are out-of-work taxi drivers and they need food.

Pirzada says he'll make another distribution soon. As for his personal safety: another volunteer group will donate him protective gear.

Riaz Haq said...

Bend it like #SanFrancisco Bay Area: Doctors see flatter curve after 2 weeks of #SocialDistance. 6 Bay Area counties in #California first in #US to enforce order requiring residents to stay at home to fight #coronavirus. #SiliconValley #FlattenTheCurve https://www.politico.com/states/california/story/2020/03/30/bend-it-like-the-bay-area-doctors-see-flatter-curve-after-2-weeks-of-social-isolation-1269663

SAN FRANCISCO — State leaders and doctors are cautiously optimistic that the Bay Area's early moves to lock down residents two weeks ago have prevented surges of coronavirus patients from overwhelming the region's health care capacity thus far.Six Bay Area counties were first in the country to adopt aggressive tactics with an enforceable March 16 order requiring residents to stay at home. Gov. Gavin Newsom quickly followed with a statewide order three days later restricting the state's 40 million residents from all but essential activities.After 14 days — the outermost period at which symptoms are believed to emerge post-infection — doctors at area hospitals are now reporting fewer cases than they expected to see at this point, and officials credit the lockdown with stemming the tide of patients they feared would flood into emergency rooms.Northern California offered a rare glimpse of optimism Monday as the U.S. recorded its most coronavirus deaths in one day and Washington, D.C.-area jurisdictions — Maryland, Virginia and the District of Columbia — issued their first enforceable stay-at-home orders. Health officials across the nation are eyeing the Bay Area as a bellwether to determine the effects of social distancing, since the region's policies were replicated in various states and cities in subsequent days.The Bay Area's primary goal two weeks ago was to slow the growth of serious cases, buying public officials and hospitals enough time to increase the number of hospital beds, respirators and staff necessary to handle a coronavirus surge."We believe very strongly the stay-at-home order has helped advance our efforts in reducing the stress on the system that we believe would have already materialized in more acute ways had we not advanced those protocols when we did," Newsom said Monday in his daily press conference.While officials remain adamant that people stay home and adhere to social-distancing guidelines — the Bay Area Monday extended its stay-at-home order to May 1 — they also are praising residents for following orders and expressing optimism that the measures will continue to work.

Riaz Haq said...

#COVIDー19: #Pakistan rapidly setting up new labs, buying ventilators, testing kits. Pak #test capacity has been enhanced from 30,000 to 280,000 and would be further enhanced to 900,000 by 
mid April plus 3,000 #ventilators, 100,00 #PPEs. #coronavirus https://gn24.ae/9a39b49b12f7000

Pakistan is rapidly increasing its capacity to strengthen the health sector to cope with coronavirus pandemic by setting up new labs, buying ventilators, testing kits and protective kits. The government has announced the new initiatives to contain the spread of the virus, which has infected more than 1,800 people in Pakistan so far.

The country has received 10 ventilators from China last week along with thousands of masks and testing kits. “China is sending another shipment which includes 16 ventilators and 5000 protection equipment set that will be delivered to doctors, nurses and paramedics fighting in the front line against the pandemic” Chairman of National Disaster Management Authority (NDMA), Lt. Gen. Mohammed Afzal announced.

Pakistan to receive 1,000 ventilators in coming weeks
Pakistan has ordered nearly around 3000 ventilators from around the world and expects to receive at least 1200 within the next 10 days, NDMA chief informed during the March 30 press briefing. Furthermore, Pakistan would receive around 150 more ventilators next week, which have been donated by different countries. There are currently 2200 ventilators available in public hospitals for the critically ill patients.

Testing kits capacity enhanced

Pakistan’s testing capacity has been enhanced from 30,000 to 280,000 and would be further enhanced to 900,000 by
mid April, the officials said on Tuesday. A day earlier, nearly 20,000 testing kits were dispatched to Sindh province, 5000 to Punjab, 4800 to
Balochistan while there are 37,000 kits available to be provided as required and necessary. The country has performed nearly 15,000 coronavirus tests since the outbreak, according to Health Minister Dr Zafar Mirza.

Protective gears and thermal gates
Pakistani officials are hopeful that nearly 100,000 Personal Protective Equipment (PPE)
 — the key medical gear — would arrive by April 6. Meanwhile, another order of 100,000 PPE sets is expected to arrive by mid April. Pakistan has also procured nearly 100 walk-through thermal gates to be placed at airport gates. Pakistan would have enough medical equipment, including personal protection kits, by April 5 to improve the safety of the health workers, officials say.

Testing labs to be increased to 50
To improve the testing capacity, NDMA is working in close collaboration with NIH to increase the existing number of coronavirus testing labs from 14 to 50 in next 20 days, according to the NDMA chief. The new testing labs would be set up in Islamabad, Karachi, Rawalpindi, Muzaffarabad, Mirpur, Rawalakot, Abbotabad, Sargodha, D I Khan, Gujrat and Bahawalpur in Punjab, two more in Sindh and Balochistan each, to cover a wider population.


Training programme for laboratory specialists
Pakistan is also beginning a training program for the paramedics and laboratory staff to overcome the shortcomings. Initially, NDMA would recruit 100 lab technicians with expertise in molecular biology. “We will offer 6-month contract to these lab technicians and if the program is successful then it will help overcome laboratories gaps for testing patients,” NDMA chief added.

All health workers in ICU to be immediately equipped
At least 16,700 PPE suits are being delivered to hospitals across the country. The government officials have assured that all of the 30,000 medical health practitioners working in intensive care unit (ICUs) would be equipped with a complete medical kit by early April. They would each be provided a set of face-shields, goggles, two N95 and 30 surgical masks, hand wash kit. Meanwhile, the number of beds in the intensive care unit (ICUs) has been increased to 19,670. The capacity of quarantine facilities has also been enhanced to 162,000 now.

Riaz Haq said...

The law of generosity combatting #coronavirus in #Pakistan. Amid the #COVID19 pandemic, #Pakistanis are bonding together to assist the less fortunate in a unique and inspiring way. Specifically, many are offering zakat (#Muslim #charity) http://www.bbc.com/travel/story/20200331-the-law-of-generosity-combatting-coronavirus-in-pakistan?ocid=ww.social.link.twitter via @BBC_Travel

Outside grocery stores in Karachi, a remarkable scene has been unfolding over the past two weeks. Instead of rushing home after shopping to avoid being exposed to coronavirus, many Pakistanis are pausing outside to offer food, money or other charity to the many people on the street with no “place” to shelter-in-place. These generous offers are often accompanied with a request to the recipient: “Pray that [the coronavirus] ends soon.”

Like many nations, Pakistan has imposed strict containment measures in response to the global coronavirus pandemic, including closing schools, banning public gatherings and shuttering all businesses that don’t sell groceries or medicine. But unlike some other countries that have ordered similar measures, the effects of a prolonged lockdown here could have much more dire economic – and potentially fatal – consequences.

In a recent coronavirus-related address to the nation, Pakistan’s prime minister, Imran Khan, stated that “25% of Pakistanis cannot afford to eat two times a day.” As the country issues more stringent lockdown measures and forces people to stay home, many daily wage earners here – from street-food vendors to shoe-shiners – now haven’t earned a rupee in weeks, and they’re going hungry.

In the same televised address, Khan summed up Pakistan’s grave reality: "If we shut down the cities… we save them from corona[virus] at one end, but they will die from hunger on the other side … Pakistan does not have the conditions that are in the United States or Europe. Our country has grave poverty."

But it also has hope.

Amid the pandemic, Pakistanis are bonding together to assist the less fortunate in a unique and inspiring way. Specifically, many are offering zakat, the traditional Muslim charity tax, for daily wage earners who have no paid leave, health insurance or financial safety net.

In Arabic, “zakat” translates to “that which purifies”, and, according to the Five Pillars of Islam, it is one of the most important religious duties for Muslims. This mandatory alms-giving is calculated at 2.5% of a person’s annual excess wealth. Strict parameters exist outlining the nisab,or threshold, beyond which a Muslim’s assets become liable for zakat, as well as who is eligible to receive it. Stemming from the belief that this world is transient and all is bestowed from the benevolence of the Creator, zakat upholds the idea that those less fortunate have a share in everything the community temporarily owns.

Riaz Haq said...

Millions of daily wage earners in #Pakistan are in desperate need of help during #coronavirus lockdown. Please make #US tax-deductible charitable donations online to: Edhi and Hidaya Foundations. Edhi has a #COVID19 fund. Links: https://edhi.org/usa/ https://www.hidaya.org/