Saturday, July 25, 2020

COVID19 in Pakistan: Smart Lockdown Brought About Declining Infections

Pakistan has seen a rapid decline in its COVID19 test positivity rates over the last several weeks. The country has seen a fall in positivity rate from over 22% in June to below 10% now, and excluding Sindh, near 5% for the rest of the country. Neighboring India has positivity rate at 12.1% and rising.  There has been significant decline in hospitalizations and fewer patients in critical care.  Pakistanis need to continue to take all precautions during Eid ul Azha holidays, including wearing face masks, to ensure that COVID19 fades out in the country.

Test Positivity Rate: 

There has been a significant fall in coronavirus test positivity rate from over 22% in June to below 10% now, and excluding Sindh, near 5% for the rest of the country. Neighboring India has positivity rate at 12.1% and rising.

Test Positivity Rates in India and Pakistan. Source: Our World in Data

Biweekly Death Rates: 

Pakistan has seen 38% decline in biweekly deaths while neighboring India has experienced 43% jump in biweekly deaths.

Change in Buweekly CIVID19 Deaths in India and Pakistan


Health Chief Dr. Zafar Mirza's Interview: 

What has brought this about? Is it just Pakistan's good fortune? Why is it so different from the situation in neighboring India where the infections are rising?  Is it the result of a series of deliberate interventions by Pakistan's government led by Prime Minister Imran Khan? What are the key factors contributing to falling coronavirus transmission rate in the country? Here are some  of Pakistan's Health Chief Dr. Zafar Mirza's answers to these questions that came to light in a recent interview with Pakistani journalist Bilal Lakhani:


1. There were 50 different interventions with 2300 smart lockdowns covering 47 million people based on data driven evidence of disease spread.

2.  Significant change in people's behavior with large percentage wearing masks and taking other precautions to prevent transmission.

3. A fall in positivity from over 22% to below 10%, and excluding Sindh, near 5% for the country.

4. Significant decline in hospitalizations and fewer patients in critical care.

5. The government staying the course while ignoring the mass hysteria for total nationwide lockdown like India's stirred up in the media came mainly from the well-fed rich and the upper middle class. The voices of the ordinary people and daily wage earners were not part of public discourse reported by the media.

Summary:

Pakistan has seen a rapid decline its COVID19 test positivity over the last several weeks. The country has seen a fall in positivity rate from over 22% in June to below 10% now, and excluding Sindh, near 5% for the rest of the country. Neighboring India has positivity rate at 12.1% and rising. At just 0.74, the effective coronavirus reproduction rate (Rt) in Pakistan is among the lowest in the world. An Rt of less than 1 indicates each infected person is infecting fewer than one person.  Only Italy (0.63), Netherlands (0.62), Canada (0.50) and Spain (0.02) have lower reproduction rates than Pakistan's. However, this is no time to relax.  Pakistanis need to continue to take all precautions during Eid ul Azha holidays, including wearing face masks, to ensure that COVID19 fades out in the country.

Here's Bilal Lakhani's video:

https://youtu.be/CEafplkFuUc





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Riaz Haq said...

Ministry’s spokesperson Wang Wenbin told a regular daily briefing in Beijing that the four regional countries would resume the cross-border flow of people in an orderly manner and with certain conditions.

The spokesperson was asked about Monday’s video conference on Covid-19 between foreign ministers of China, Pakistan, Afghanistan and Nepal. This meeting was initiated and chaired by Chinese Foreign Minister Wang Yi.

“Yesterday, Chinese Foreign Minister Wang Yi hosted this foreign ministers meeting … The four parties exchanged views and reached consensus on joint fight against Covid-19 and resuming economic and social development,” spokesperson Wang Wenbin said.

“We believe as partners and neighbours, the four countries have reached fruitful outcomes, including timely sharing of information and joint fight against pandemic,” he said. “We will resume cross-border flow of people in orderly manner when certain conditions are met and we will discuss setting up of fast track and green channel,” he added.

Wang Wenbin emphasised that in the face of tackling pandemic, all parties should strengthen “joint prevention and control, uphold our people’s health, promote resumption of work and production, facilitate trans-border trade, ensure people’s livelihood until the four countries prevail over the virus”.

“We believe in solidarity and the cooperation is the most powerful weapon,” he said. “We should adhere to the multilateralism and community with the shared future for mankind, support World Health Organization’s leading role and upholding regional and global public health security.”

The spokesperson emphasised that the four parties should strengthen information, communication, policy coordination and cooperation in action. “We stand ready to work with other parties in terms of testing diagnose, treatment and research of vaccine and medicine and we will assist the three countries in improving their capacity building of public health,” he added.

Wang Wenbin reiterated that after a vaccine was deployed, it would become a “global public good” and improve the accessibility of these countries. “The four countries appreciate this and said they are ready to strengthen cooperation with China,” he added.

He said, the four countries would also reach standard operation procedure for border control, information sharing, academic prevention and emergency response. “We agreed to strengthen Belt and Road Initiative (BRI) cooperation to boost economic and social recovery besides upholding stability, supply and industrial chain.”

Riaz Haq said...

#Pakistan is "crushing the curve" by deft management of #Covid_19, says #Health Chief @zfrmrza who just quit government. “We had a peak of 153 deaths on June 20 and in last 24 hours we had just 20 deaths. This is 87% reduction in Covid-19 related deaths". https://tribune.com.pk/story/2257258/technology-works-pakistan-effectively-fights-covid-19


When many countries in the world are reporting thousands of cases a day, Pakistan seems little to worry about this pandemic as on Wednesday the National Command and Operation Centre (NCOC) reported only 1,879 patients admitted to 734 hospitals across the country.

As per latest daily, more than 245,000 patients recovered so far across Pakistan making it a significant count while only 227 ventilators have been occupied across the country out of 1,859 vents allocated for Covid-19.

All this was made possible due to improving testing capacity as 1,909,846 tests have been conducted so far with 21,256 tests in just last 24 hours. Only 936 new cases were reported across the country during last 24 hours while 21,256 tests were conducted in a day.

Pakistan had move away from the past practice of normal manual level of tackling the pandemic to technology evidence based method as this model had worked well in China.

Terming the Pakistan’s early success in controlling Covid-19, as ‘crushing the curve’, Special Assistant to Prime Minister on National Health Services Dr Zafar Mirza, who has resigned from the post earlier today, said: “Alhamdulillah, we have the lowest number of deaths in Pakistan due to Covid-19 in last three months.”

He added: “We had a peak of 153 deaths on June 20 and in last 24 hours we had just 20 deaths. This is 87% reduction in Covid-19 related deaths. Due to the government’s effective strategy the cases of coronavirus are decreasing and the situation is improving in the country.”

Pakistan relied on technology and understanding. Its decision making was based on information and reliable data of NCOC. The practice of data collection, correlation, collation and informed decisions making helped in containment efforts.

“Our strategy was based on speedy testing, contact tracing and isolation, ensuring services to admitted patients and observing shortages and immediately addressing these shortages through use of domestic technology,” an official at the Health Ministry said.

The NCOC moved scientifically and identified top 30 cities as Covid-19 hotspots with max Infected using auto trace and NITB maps. At an average 3-8 million population with 10-30% of infected people remained under 300-500 smart lockdowns (SLDs) on rolling basis since adoption of this policy in entire country.

Riaz Haq said...

India’s #COVID19 Fallout Collides With A Shaky Economy. #Trump & #Modi vying for the title of world's fastest-growing epidemic. #India’s 20% jump in infections over the last week to 1.4 million puts Modi’s nation on top in terms of velocity.
via @forbes https://www.forbes.com/sites/williampesek/2020/07/29/indias-covid-19-fallout-collides-with-a-shaky-economy/

The bromance between Donald Trump and Narendra Modi features the kind of rivalry no world leader wants: the title of fastest-growing Covid-19 epidemic anywhere.

Advantage, Indian Prime Minister Modi. With 4.2 million confirmed cases under his belt, U.S. President Trump’s nation is far ahead in an absolute sense. But India’s 20% jump in infections over the last week to 1.4 million puts Modi’s nation on top in terms of velocity.

And that’s the last thing Asia’s third-biggest economy needs as 2020 unravels before our eyes.

As the year began, India was seen growing at least 5%. Now, it’s seen contracting by roughly that amount–at best. Worse, perhaps, that could turn out to be overly optimistic considering the dire state of global demand and the pre-existing conditions that New Delhi brought into this pandemic.

The biggest is a dysfunctional economy that Modi was slow to address in the 68 months before India confirmed its first Covid-19 case. The most dangerous ailment being a banking system burdened with bad loans and a government looking the other way as symptoms of credit dislocations intensified.

Riaz Haq said...

#India’s #IT giants are shedding thousands of jobs as they enter “survival mode”. Top 5 #Indian #technology firms have cut 11,000 jobs amid #COVID19 #pandemic https://qz.com/india/1886157/ via @qzindia

https://twitter.com/haqsmusings/status/1288857159938109451?s=20

Indian IT bigwigs have shed people in thousands in the last three months.

The staff headcount at the largest player in the sector, Tata Consultancy Services (TCS), fell by over 4,700 between March and June, when coronavirus started gripping the country. Rivals Infosys, Wipro, and Tech Mahindra, too, posted a decline in net employee headcount.

Overall, five of the biggest firms in the $200 billion industry lost nearly 11,000 employees.

The ambiguity brought about by the pandemic pushed these big businesses into survival mode, experts say.

“Many of the sectors like manufacturing, where IT companies had sales pitches done, (the) business had to be put on hold for at least a quarter,” said N Shivakumar, managing director at management consulting firm ResourceTree. “Post the initial confusion, many firms realised they have to conserve a lot of energy, money, and infrastructure because if (the) business loss is going to happen, it’s going to be a very big issue for them to survive.”

However, not all hope is lost. TCS hasn’t scrapped its plans to hire 40,000 fresh college graduates this year. Experts say hiring will bounce back in the second half of the year since these firms likely have large cash reserves to tide over the slump. And once the economy picks up, new technologies will find takers across various sectors from banking and financial services to healthcare.

Riaz Haq said...

A Friendship, #COVID19 Pandemic and a Death Beside the Highway After #Modi's #Lockdown The photograph of Amrit, an "untouchable" (#Dalit), and Mohammad Saiyub, a #Muslim, came like a gentle rain from heaven on #India’s hate-filled public sphere. #Hindutva https://www.nytimes.com/2020/07/31/opinion/sunday/India-migration-coronavirus.html?smid=tw-share

By Basharat Peer
Mr. Peer is a staff editor in Opinion.

DEVARI, India — Somebody took a photograph on the side of a highway in India.

On a clearing of baked earth, a lithe, athletic man holds his friend in his lap. A red bag and a half empty bottle of water are at his side. The first man is leaning over his friend like a canopy, his face is anxious and his eyes searching his friend’s face for signs of life.

The man is small and wiry, in a light green T-shirt and a faded pair of jeans. He is sick, and seems barely conscious. His hair is soaked and sticking to his scalp, a sparse stubble lines the deathlike pallor of his face, his eyes are closed, and his darkened lips are half parted. The lid of the water bottle is open. His friend’s cupped hand is about to pour some water on his feverish, dehydrated lips.

I saw this photo in May, as it was traveling across Indian social media. News stories filled in some of the details: It was taken on May 15 on the outskirts of Kolaras, a small town in the central Indian state of Madhya Pradesh. The two young men were childhood friends: Mohammad Saiyub, a 22-year-old Muslim, and Amrit Kumar, a 24-year-old Dalit, which refers to former “untouchables,” who have suffered the greatest violence and discrimination under the centuries-old Hindu caste system.

Over the next few weeks, I found myself returning to that moment preserved and isolated by the photograph. I came across some details about their lives in the Indian press: The boys came from a small village called Devari in the northern Indian state of Uttar Pradesh. They had been working in Surat, a city on the west coast, and were making their way home, part of a mass migration that began when the Indian government ordered a national lockdown to prevent the spread of the coronavirus. Despite our image-saturated times, the photograph began assuming greater meanings for me.

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Fifty-one days into the lockdown, on May 14, the two friends were restless, running out of savings and certain that they needed to get home somehow. Amrit met some workers from their region in Uttar Pradesh who had negotiated with a truck driver to drive them home. They would have to pay 4,000 Indian rupees, or $53, each. They agreed.

The truck driver would wait for the workers at a secluded spot on NH-48, the highway, which they would follow north. The two friends packed a bag each, locked their room and set out at 9 p.m. They walked 15 miles through the humid night with about 60 other workers to the designated place on the highway and waited. The truck arrived at 2 a.m.

The workers completely filled the bed of the truck, packed together like sheep. Twelve men were still left, Amrit and Saiyub among them. They were asked to climb into a balcony-like space above the driver’s seat. The journey began. “We could feel the breeze and we were going home,” Saiyub recalled. They caught snatches of sleep while sitting cramped together and repeated their conversations about the pandemic, the loss of work and the solace of home.

Riaz Haq said...

Excepts of Wall Street Journal Story Why Youthful, Conservative Pakistan Is a Coronavirus Bright Spot

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

https://www.wsj.com/articles/why-youthful-conservative-pakistan-is-a-coronavirus-bright-spot-11596297600

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

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


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


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

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

PM Imran started wearing a mask in public

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

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

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

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

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

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

There are also no institutionalised homes for the elderly, sites of deadly outbreaks elsewhere. Women tend not to go out of the home to work, meaning the workforce is overwhelmingly made up of men who are mostly young, it was pointed out.

Riaz Haq said...

#India’s daily new cases & deaths world’s highest.India’s death toll, at 814, was way higher than #fatalities reported in the day in #Brazil (572) and the #US ( 568). 49,134 fresh #coronavirus cases on Monday, higher than the US (48,622) http://toi.in/RymdhZ/a24gk via @timesofindia

Riaz Haq said...

8 Dead After #Fire Breaks Out At #Covid19 Hospital In #Modi's Home State of #Gujarat, Among 10 Worst Hit With over 65,000 coronavirus cases so far. #India has 19 lakh #coronavirus cases & over 39,000 have so far died from highly infectious disease. https://www.ndtv.com/india-news/8-dead-after-fire-breaks-out-at-covid-19-hospital-in-ahmedabad-news-agency-pti-2274924

Eight people have died after a huge fire broke out at a private hospital for coronavirus patients in Gujarat's Ahmedabad early Thursday morning.
As the blaze broke out at the Shrey Hospital in Ahmedabad's Navrangpura area at around 3 AM, eight fire engines and 10 ambulances of the fire department were rushed to the site. Five men and three women - admitted to the ICU ward - died.

About 45 patients were admitted to the 50-bed hospital at the time of accident; rest of them have been rescued and shifted to Sardar Vallabhbhai Patel Institute of Medical Sciences and Research, a civic hospital in the city, an official said.

Prime Minister Narendra Modi condoled the deaths in his home state. "Saddened by the tragic hospital fire in Ahmedabad. Condolences to the bereaved families. May the injured recover soon. Spoke to CM @vijayrupanibjp Ji and Mayor @ibijalpatel Ji regarding the situation. Administration is providing all possible assistance to the affected (sic)," he tweeted this morning.

Riaz Haq said...

Twelve months since the #Modi government announced the repeal of #India’s #Article370, communications are still slow, arrests are routine, and the #CoronavirusPandemic rages on. India had largely run out of prison space in the region. #Kashmir #Pakistan https://foreignpolicy.com/2020/08/04/kashmir-article-370-blackout-arrest-covid-pandemic-modi/

It has been one year since Indian Prime Minister Narendra Modi made good on a long-standing electoral promise and announced the repeal of Article 370 from the Indian Constitution, doing away with some of the autonomies that had previously been granted to Indian-administered Kashmir. Combined with a near-total blackout of communications and the deployment of tens of thousands of troops to the region, Kashmir seemed primed for chaos.

In the 12 months since, the region has remained on edge. Communications are still slow, arrests are routine, and now the coronavirus pandemic threatens to throw Kashmir, and India, into an even deeper tailspin. To explain how India got here—and what comes next—we gathered our top reads.

In the immediate aftermath of the repeal of Article 370, one of the biggest questions was the extent to which violence would follow. Presumably worried about that same issue, the Modi government sent in scores of troops and rushed to arrest nearly anyone it thought might make trouble. “According to an AFP report,” Kashmir Walla’s Yashraj Sharma wrote in September, “one district magistrate said that at least 4,000 people had recently been arrested and booked under the Public Safety Act, which allows government to detain any person above the age of 16 without a trial for two years.” As a result, he said, India had largely run out of prison space in the region.

Even if the arrests kept violence down in the short run, many experts argued, they would surely create more over time. Speaking to the reporter Soumya Shankar, one young Kashmiri pointed out that “once innocent boys are picked up and tortured on baseless suspicions, they join the militancy in reaction. Then they’re declared terrorists by the state and gunned down.” In a December article, the Kashmiri journalist Fahad Shah offered numbers to confirm that expectation: “In Kashmir, spending time in jail can strengthen a young person’s resolve to get revenge. Many of the jailed, who were never part of any protest, decide to join them when they are released. Others who are taken in for small crimes, such as throwing stones, become radicalized in jail. An internal analysis on militancy from the Indian Army found that 83 percent of local youth who had joined a militant organization had a ‘record of stone-pelting.’” The 2019 crackdown, he argued, “thus points to a further meltdown—be it next year, the one after, or the one after that.”
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On the anniversary of the repeal of Article 370, things don’t look much better for India or Kashmir. Internet access in the area is still slow, which, according to Ali, is hampering the battle against the COVID-19 pandemic. “The Indian government will not restore the high-speed internet despite the pressing need for the population to stay informed about the coronavirus pandemic,” he wrote in April. Meanwhile, “the region is also grappling with a shortage of doctors. There is one doctor for every 3,866 people in the region, according to a 2018 report by the Jammu and Kashmir health ministry. That ratio falls short of the WHO norm (one doctor per 1,000 people) and India’s nationwide average (one doctor per 2,000 people).” To date, Jammu and Kashmir have seen over 22,000 confirmed cases.