Saturday, August 21, 2021

Has Pakistan Achieved Herd Immunity Against COVID19?

How widespread are coronavirus infections and vaccinations in Pakistan? Has Pakistan achieved herd immunity or close to achieving it?  The latest IHME (Institute for Health Metrics and Evaluation) report on Pakistan (dated August 19, 2021) claims that "about 81% of the population have been infected, and about 65% are immune to the Delta variant". It says that the "cases and deaths are declining in Pakistan, but the situation remains fragile".      

The report defines two types of coronavirus variants: escape and non-escape. The escape variants include Beta (B.1.351), Gamma (P.1) and Delta (India) variants while non-escape variants are the original ancestral virus and Alpha (UK) variant.  The report projects Pakistan reaching 75% to 90% immunity to various COVID19 variants through a combination of infections and vaccinations by the end of 2021. 

Immunity to COVID Variants in Pakistan. Source: IHME

The IHME August 19 COVID19 results briefing on Pakistan also warns: "If mobility increases and mask wearing declines as cases are declining (people let down their guard), cases could surge again".  Here is the summary of the IHME report:

"Cases and deaths are declining in Pakistan, but the situation remains fragile. We estimate that about 81% of the population have been infected, and about 65% are immune to the Delta variant (accounting for cross-variant protection). If mobility increases and mask wearing declines as cases are declining (people let down their guard), cases could surge again."

If the IHME modeling of COVID19 in Pakistan is correct, it raises hope that Pakistan is nearing an end to the current pandemic that has badly hurt its people and its economy. Achieving this goal will require that Pakistanis continue to implement the following 5 strategies recommended by IHME. 

1) Increase vaccination through outreach and perhaps vaccine mandates from employers and making it easy to get vaccinated; 

2) Reduce the risk of major transmission if schools are to open through appropriate use of mitigation measures including universal masking, sufficient distancing of students, and periodic testing of all students; 

3) Support hospital systems that will be under severe stress in the next 4–6 weeks; 

4) Implement mask mandates in states or communities with major surges in hospitalization; and 

5) Maintain surveillance on breakthrough infection by type of vaccine and time since vaccination – as well as adequate testing for vaccinated and unvaccinated – in order to accurately track the evolution of the epidemic".

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8 comments:

Shams N. said...

The true picture behind the US & other no-mask and other mandates such as "UK open for tourism (Forbes)" is the determination of the following (New York TImes, based on data collected by US CDC). Vaccination helps, but even without vaccination, rates of symptoms are as follows.

1. More than 80% of the population gets Covid or its variants' infection and never see its symptoms.

2. Another 15% of the population do get Covid symptoms but never feel the need to go to a hospital (spend time resting / sleeping and get okay).

3. The remaining 5% are hospitalized, and 3% recover.

4. The 2% who die are to be considered collateral damage in war against a new flu. These are the old people, sick people, immuno-compromised people, who could not fight Covid. Similar in nature to the common cold that kills the sick & the weak. That's me, you, and my other friends in this post.

The previous model of this situation is the Pacific Islanders (Fiji, Samoa, others) who had never seen influenza and had zero immunity to it. Then the white man arrived there with his influenza and measles to which he had become immune. Hundreds of thousands of Pacific Islanders (NCBI article), including their royalty died, but eventually the entire population developed its own immunity and their race still flourishes.

For the common good of 95% of the population, 98% if counting the 3% recovering, and to keep the economy moving, world-wide governments have decided to fight it and move on. But they do not want to be so blunt in claiming it that way. And that' politics, your forte.

Donald Trump said the same in March 2020 (Forbes), and lost elections for that despite his absolute ACE management of economics, and his push for Covid vaccine development, masks & ventilator manufacturing, and hospitalization support (Operation Warp Speed, STUNT).

My bluntness may keep me from becoming president of the independent Republic of Sindh, but I will be okay if I just see that reality and not play it.

Riaz Haq said...

Shams: "15% of the population do get Covid symptoms but never feel the need to go to a hospital (spend time resting / sleeping and get okay)..... The remaining 5% are hospitalized, and 3% recover"

The issue is the ability of a country's healthcare system to handle the 5% who need hospitalization.

If the 5% of a large population in India or Pakistan need care within a short period of time, you see people gasping for breath and dying on the streets. We saw it happen in India earlier this year.

The mitigation actions like masking and social distancing help in flattening the curve to prevent the hospitals from being overwhelmed. If a country fails like India did, you end up with a lot of dead people on the streets lacking even burial and/or cremation services.

Anonymous said...

Though I don't like you I do not wish death to innocent Pakistanis.

This sort of we have achieved herd immunity bravado is dangerously similar to what we experienced in India in Feb/March before the disaster in April/May..

If you have only Chinese vaccines as mass vaccination options cansino is better than sinopharm..

Riaz Haq said...

Anon: "This sort of we have achieved herd immunity bravado is dangerously similar to what we experienced in India in Feb/March before the disaster in April/May.."

You have either not read the entire post or not understood it.

Please try again.

Riaz Haq said...

Dr Jayaprakash Muliyil, epidemiologist and chairperson, Scientific Advisory Committee, National Institute of Epidemiology:

"Most of us have been infected naturally and this produces robust immunity which lasts years. There is evidence that immunity gained from natural infection would last a lifetime. I hope immunity from vaccination also lasts that long."

https://timesofindia.indiatimes.com/city/bengaluru/third-covid-wave-is-stretch-of-someones-imagination-top-epidemiologist/articleshow/85676611.cms


Dr Jayaprakash Muliyil categorically ruled out the need for booster doses (of COVID vaccine).

Riaz Haq said...

Share (in percent) of fully vaccinated population in #Bangladesh, #India, #Pakistan & #Iran. #COVID19 #CovidVaccine https://ourworldindata.org/coronavirus/country/pakistan?country=~PAK


https://twitter.com/haqsmusings/status/1435749980178829316?s=20

Riaz Haq said...

#Pakistan has administered at least 64,554,859 doses of #COVID #vaccines so far. Assuming every person needs 2 doses, that’s enough to have vaccinated about 14.9% of the country’s population. #VaccinationCovid https://graphics.reuters.com/world-coronavirus-tracker-and-maps/countries-and-territories/pakistan/


Riaz Haq said...

IIF: #Pakistan’s #economy resilient to #Covid_19. Policy response includes emergency health spending, a food security program, temporary tax deferrals, subsidized loans to house-holds, & deferrals of loan payments. Need structural reforms for higher growth https://gulfnews.com/business/pakistans-economic-outlook-improves-but-challenges-remian-iif-1.82135252

Dubai: Pakistan’s economy has remained largely resilient to COVID-19 with policy response to the pandemic has limiting economic contraction and the country is poised for a 4 per cent GDP growth in the financial year 2021- 22, according to the Institute of International Finance (IIF).

“The authorities have deployed a comprehensive set of policy responses that have helped to limit the contraction in real GDP to 0.5 per cent in FY 2019/20. The crisis-mitigating measures included emergency health spending, a food security programme, temporary tax deferrals, subsidized loans to house-holds, and deferrals of loan payments,” said Garbis Iradian, Chief Economist, MENA, IIF.


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Accommodative policy
Monetary policy remains accommodative as inflationary pressures have eased in recent months. The policy rate remained unchanged at 7 per cent from July 2020 to August 2021 and supported the recovery. Urban core inflation remained broadly stable at 6.9 per cent in July 2021 (yoy) as compared with headline inflation of 8.7 per cent, which was driven by the upward adjustment in electricity tariffs in the context of higher global oil prices

The State Bank of Pakistan (SBP) recently noted that the recent price pressures were “largely supply-driven and transient” and expects average CPI inflation to decline to slightly below 8 per cent in FY 2021/22 as compared with 10.7 per cent in FY 2019/20.


Improving external position
The external position has strengthened supported by the continued surge in worker’s remittances. The deterioration in the trade deficit, on the back of the sharp increase in imports, has more than offset by the continued surge in workers’ remittances.

Remittances increased by 29 per cent in FY 2020-21 driven by both domestic and international factors. Domestically, the authorities reduced the threshold for eligible transactions from $200 to $100 under the Reimbursement of Telegraphic Transfer (TT) Charges Scheme, promoted usage of formal and digital channels, and restricted cross border travel in the wake of COVID-19.

Internationally, fiscal stimulus in developed and emerging economies enabled Pakistanis living abroad to send more money home. Saudi Arabia, the UAE, USA, and the UK are the main source of remittance inflows.

“The current account deficit narrowed from by one percent-age points of GDP to 0.7 per cent of GDP in fiscal year 2020/21. Net capital inflows were again well above the current account deficit, leading to a substantial increase in official reserves to the equivalent of 3.3 months of import coverage, the highest since 2016,” said Iradian.

Public finances
Pakistan’s public finances have improved substantially. The narrowing of the deficit in FY 2020/21 to 7.1 per cent of GDP was supported by continued recovery in tax revenues and prudent spending, which fell by 2 per cent in real terms. The budget for the FY 2021/22 envisages further narrowing of the overall fiscal deficit to 6.3 per cent of GDP, supported by revenue-enhancing reforms and further expenditure rationalization. Public debt, the IIF expects will remain elevated at 88 per cent of GDP by June 2022.


Growth outlook
Sustained GDP growth hinges on further progress in re-forming the economy.

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The current gross investment to GDP ratio remains low at around 15 per cent of GDP. Experience from most emerging and developing economies show that raising growth to at least 5 per cent would require much higher investment to GDP ratio.

The IIF has noted that security concerns pose a downside risk following the Taliban’s seizure of power in Afghanistan.