Thursday, April 2, 2020

Can Pakistan's TB Vaccination Program Help Reduce Impact of Coronavirus?

Can Pakistan's 88% BCG vaccination rate against tuberculosis (TB) help reduce the impact of coronavirus? A New York Institute of Technology study using data from 178 countries has concluded that both the incidence and mortality of COVID-19  are significantly lower in countries with BCG vaccination programs against TB. Will this study help prove Dawn News' alarming forecast of over 2 million confirmed cases by June 1 and 20 million actual infections wrong?

Pakistan's Dawn News Coronavirus Forecast


The study has found that the coronavirus has hit US and Italy which do not have universal BCG vaccination programs much harder than countries like Japan which do.  Scientists say it will take several months to get results from ongoing trials testing the BCG vaccine against COVID-19.
TB Vaccine May Lower Death Rates From COVID-19. Source: NYIT College of Osteopathic Medicine  

Scientists have speculated that BCG vaccine may boost the innate immune system not just against TB but also against a variety of other pathogens from invading the body or from establishing an infection. Here are some of the key findings of the study summarized below:

1. Countries that do not have a BCG vaccination policy against TB have seen 10X greater incidence and deaths from Covid-19 than the countries that do, according to a study of  data from 178 countries by New York Institute of Technology researchers.

2. BCG, or Bacillus Calmette-Guérin, is a vaccine for tuberculosis (TB). It is administered at birth in many developing countries that have historically suffered from the disease, such as India and Pakistan. Most of the developed nations, including US, Italy and the Netherlands do not have universal TB vaccination programs. Japan is among the few developed OECD nations that still do. The East Asian nation had some of the earlier cases, but the mortality is low despite not having adopted some the more stringent social distancing rules.

3. The study looked at Covid-19 instances and mortality for 15 days between March 9 and 24 in 178 countries and concluded that incidence of Covid-19 was 38.4 per million in countries with BCG vaccination compared to 358.4 per million in the absence of such a program.

4. The death rate was 4.28 per million in countries with BCG programs compared to 40 per million in countries without such a program. Out of the 178 countries studied, 21 had no vaccination program, while the status was unclear in 26 countries. The latter group was treated as not having a policy for the purpose of this study.

Scientists do not have data yet on the effect of BCG vaccination on coronaviruses in general or SARS-CoV-2 in particular, according to Reuters. There are also many BCG vaccines, with different capacities to protect against various TB strains. Scientists need to determine which BCG vaccines might have the best ability to boost the innate immune system to fight COVID-19.  Scientists say it will take several months to get results from ongoing trials testing the BCG vaccine against COVID-19.

Related Links:

Wednesday, April 1, 2020

A Tale of Pakistani-American Victim of Coronavirus in Silicon Valley

I have just learned that a close Pakistani-American friend of mine in Silicon Valley is recovering from the disease caused by COVID-19. He’s a 66 years old man. His age and gender put him in a relatively high-risk category for coronavirus infection. When he took his elderly mother to a local emergency room in early March, he had only one face mask which he gave to her. He thinks he may have been infected in the emergency room or during one of his multiple visits to two family members in local hospitals in the weeks leading up to his illness.  He is a man of deep faith. He bathed as required for ihram, the ritual Islamic purification during pilgrimage to Mecca, before going to the hospital. He said he was mentally prepared to die even before getting confirmation of his illness from the novel coronavirus.

He was driven by one of his daughters to a hospital after experiencing high fever, shortness of breath and severe headache just over a week ago. He took a shower before going to the hospital which brought his fever down by the time he got to the hospital. He was directed to a tent set up in the hospital parking lot for coronavirus testing. They checked his temperature and, at first, refused the test because his fever had come down. But then they relented and tested him. They took three samples of genetic material with long swabs inserted deep inside his throat and both nostrils. It was not at all a pleasant experience. He was the eighth person tested on that day.

A day after the COVID19 test my friend got a call to confirm that he had tested positive. His doctor asked him to isolate himself in a room at his home separate from his family. The doctor also told him to drink a lot of fluids, monitor his blood oxygen level and to come to the hospital immediately if the oxygen level dropped below 90%. It did go to 91% briefly but then came back up. He was miserable but his faith kept him going.  He took deep breaths to keep his blood oxygen level above 90%.

All members of his household were also quarantined within the house. Unable to leave home, they soon discovered that Instacart, Amazon Fresh and other grocery delivery services did not work for them. These companies were overwhelmed with massive orders volume. He and his family did not call me for help. One of his cousins delivered food and groceries the family needed.

Many of his friends and relatives started calling him the moment they found out he was ill. There were so many calls that he had to turn off his phone. He even missed important calls from his doctor because his phone was turned off.

His fever finally broke yesterday. It is now normal at 98 degrees but his doctor and the city of Fremont have asked him to continue his quarantine for another week. They say the period he’s been in quarantine doesn’t count because he took Tylenol. He's supposed to be symptom-free without any medication for 72 hours before ending his isolation.

Related Links:

Friday, March 27, 2020

Coronavirus: Pakistan's Exports Crash Amid Global Health Crisis

Pakistan Textile Industry was celebrating a big milestone with 20% jump in exports in February 2020 when coronavirus struck a heavy blow. Some western retailers canceled orders while others put them on hold as the virus spread to Western Europe and the United States in late February and early March. Then came the lockdown in Pakistan that shut down factories and halted transport in Pakistan.

Here's how Guido Schlossman, President and CEO of Synergies Worldwide, a global supply chain management firm with an office in Pakistan, summed up the situation for Sourcing Journal: “Most clients have either cancelled or put orders on hold...That would have huge ramifications and losses, and the fear is that most small factories may shut, whereas the mid and big factories will have huge financial liabilities and losses.” “Ninety-five percent of clients have either cancelled, put on hold or given new delivery dates ranging from 4-6 weeks delay to about 8-10 months,” Schlossman said. “That is how huge the holding period and losses would be for the factories.”

“All over Pakistan it’s a complete lockdown in all the provinces everywhere,” Hafiz Mustanser Ahmed, managing director of Lahore-based factory  U.S. Apparel and Textiles, told Sourcing Journal last week.U.S. Apparel & Textiles, which typically produces 100,000 garments a day, is seeing “huge, huge” order cancellations, Ahmed said.

“The transportation when it comes to taking the employees to the factories or the public transportation, it’s all 100 percent closed. All the factories are closed.” For now, moving goods back and forth between the ports and Lahore, Pakistan’s second-biggest textile manufacturing hub after Karachi, is still allowed, but there simply aren’t many goods to move, said Ahmed, whose factory produces denim bottoms for Levi’s, Target, H&M, J.Crew, Primark and Costco, to name a few.

Other Asian garment exporting nations face a similar situation. Bangladesh has issued stay-at-home orders and India has ordered a 21-day nationwide lock-down. The difference is that Pakistan exports had just begun to recover when the COVID-19 global pandemic struck. Now demand for apparel in the western markets is not likely to materialize for at least a month or two. Meanwhile, job losses in Pakistan are almost certain. A prolonged slump in the west will spell disaster for Pakistan's exports and delay the nation's economic recovery.

Pakistan's service economy will also suffer in a prolonged lock-down. 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).”


Related Links:

Haq's Musings

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Can Pakistan Effectively Respond to Coronavirus Pandemic?

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Are Pakistan's Garment Exports Cost Competitive With Bangladesh?

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Can Indian Economy Survive Without Western Capital Inflows?

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Chinese Yuan to Replace US $ as Reserve Currency?

Remittances From Overseas Pakistanis

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Thursday, March 26, 2020

World Media Highlight Pakistani-American's Paper on Coronavirus

Mainstream western and Indian media have widely covered a recent MIT paper by a Pakistani-American scientist at Massachusetts Institute of Technology (MIT) on the effects of heat and humidity on coronavirus pandemicDr. Qasim Bukhari, the lead author, is an alumnus of NED University located in Karachi, Pakistan. Dr. Yusuf Jamil, the paper's coauthor, is Indian-American originally from Kolkata, West Bengal. The paper is posted on Social Science and Research Network (SSRN). It has been mentioned in reports by New York Times, Washington Post, Time, Forbes, Times of India, The Hindu, India Today and many other publications. The paper shows that 90% of the coronavirus (COVID19 or 2019-nCoV) cases so far have occurred  in regions with absolute humidity between 4 and 10 grams per cubic meter. One possible reason is that the fatty outer layer of the virus has trouble surviving in high heat and humidity. The virus disintegrates when the fatty outer cover is gone in a way similar to how the soap and hot water destroy it. This may explain why there appear to be relatively few reports of local COVID-19 transmissions in places like Pakistan. Most of the known coronavirus cases in Pakistan appear to be those of the people who have come into the country from cold, dry places like northern Iran where the pandemic is raging. The rate of local transmission in Pakistan is not zero but relatively low.  Dr. Bukhari says that "there is indeed evidence that weather plays a role, but in no way we are suggesting that this role alone would be so decisive as to completely halt the spread of COVID."

Dr. Qasim Bukhari
Bukhari and Jamil:

The paper titled "Will Coronavirus Pandemic Diminish by Summer?" written by Dr. Qasim Bukhari and Dr. Yusuf Jamil explains that "several countries between 30N and 30S such as Australia, UAE, Qatar, Singapore, Bahrain, Qatar and Taiwan have performed extensive testing per capita and the number of positive 2019-nCoV cases per capita are lower in these countries compared to several European countries and the US".  "The relation between the number of 2019-nCoV cases and temperature and absolute humidity observed here is strong however, the underlying reasoning behind
this relationship is still not clear", they write.

Here's a brief Question/Answer version of the email exchange I had with Dr. Bukhari today:

RH: My understanding from the data I have seen from various sources is that the coronavirus transmission rates decline but do not necessarily go to zero in hot and humid weather. And the reason is that the fatty outer layer of the virus has trouble in heat and humidity. Is that accurate?

QB: That would be almost accurate. The only thing we dont know so far is, how much decline in growth rate we are talking about. It is definitely non-zero. The underlying reasons may be many or either of many. One reason could be the fatty outer layer reason that you mentioned. Other reason could be the antibacterial nature of sunlight, another reason could be low indirect transmission (through air) in high humidity.

Sounding a note of caution, here's what Dr. Bukhari wrote to me:

"There is indeed evidence that weather plays a role, but in no way we are suggesting that this role alone would be so decisive as to completely halt the spread of COVID. And anyway, the affect of this weather would only be relevant in humid hot countries. Please do share, but please use the right words that properly communicate that it is incredibly important to take precautions and quarantine measures even in the most humid hot regions, as the spread would keep on going without that, we have evidence from Singapore, Malaysia and Indonesia of this."

Over 90% of Coronavirus Cases So Far in Red Zone. Source: Dr. Qasim Bukhari and Dr. Yusuf Jamil 

Wang, Weifeng, Beihang and Ke Tang: 

There is similar work that has recently been published by a Chinese research team that included Jingyuan Wang, Kai Feng, Weifeng Lv of Beihang University, and Ke Tang from Tsinghua University. They studied 100 different Chinese cities that each reported more than 40 cases of COVID-19 from Jan. 21 to 23, 2020.

“In the early dates of the outbreaks, countries with relatively lower air temperature and lower humidity (e.g. Korea, Japan and Iran) saw severe outbreaks than warmer and more humid countries (e.g. Singapore, Malaysia and Thailand) do," the researchers wrote.

COVID-16 Transmission Rates Vs Temperature and Humidity

Here's an excerpt from the abstract published by the team:

"After estimating the serial interval of COVID-19 from 105 pairs of the virus carrier and the infected, we calculate the daily effective reproductive number, R, for each of all 100 Chinese cities with more than 40 cases. Using the daily R values from January 21 to 23, 2020 as proxies of non-intervened transmission intensity, we find, under a linear regression framework for 100 Chinese cities, high temperature and high relative humidity significantly reduce the transmission of COVID-19, respectively, even after controlling for population density and GDP per capita of cities. One degree Celsius increase in temperature and one percent increase in relative humidity lower R by 0.0383 and 0.0224, respectively. This result is consistent with the fact that the high temperature and high humidity significantly reduce the transmission of influenza. It indicates that the arrival of summer and rainy season in the northern hemisphere can effectively reduce the transmission of the COVID-19."

Some experts are pointing to the increased amount of UV rays from the sun the Northern Hemisphere will be subject to this time of year as a factor that could slow the virus, according to a story in AccuWeather.

Dr. Anthony Fauci On Effect of Weather:

Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID) who also serves on the White House coronavirus task force, has acknowledged that a change of season might affect COVID transmission rates.

Here's what he said at a recent White House briefing: “I think it (weather) very well might. And the reason I say that is that what we’re starting to see now in the Southern Hemisphere, in southern Africa and in the southern hemisphere countries, is that we’re having cases that are appearing as they go into their winter season. And if, in fact, they have a substantial outbreak, it will be inevitable that we need to be prepared, that we’ll get a cycle around the second time.”

Summary:

Mainstream US and Indian media have widely covered a recent MIT paper on the effects of heat and humidity on coronavirus transmission. Dr. Qasim Bukhari, the lead author and alumnus of NED University located in Karachi, Pakistan, has shared data showing that 90% of the coronavirus cases so far have occurred  in a regions with absolute humidity between 4 and 10 grams per cubic meter. Recent Chinese research is also showing that hot and humid weather may significantly slow down transmission of coronavirus or COVID-19. An increase of just one degree Celsius and 1% relative humidity increase substantially lower the (Covid-19  or 2019-nCoV) virus’s transmission, says a study published on March 10, 2020 by Chinese researchers. One possible reason is that the fatty outer layer of the virus has trouble surviving in high heat and humidity. The virus disintegrates when the fatty outer cover is gone in a way similar to how the soap and hot water destroy it. This may explain why there appear to be relatively few reports of local COVID-19 transmissions in places like Pakistan. Most of the known coronavirus cases in Pakistan appear to be those of the people who have come into the country from cold, dry places like northern Iran where the pandemic is raging. The rate of local transmission in Pakistan is not zero but relatively low. Dr. Bukhari says that "there is indeed evidence that weather plays a role, but in no way we are suggesting that this role alone would be so decisive as to completely halt the spread of COVID."

Related Links:

Monday, March 23, 2020

Pakistani-American Woman Featured in Netflix Documentary "Pandemic"

Dr. Syra Madad, Pakistani-American head of New York City’s Health and Hospitals System-wide Special Pathogens Program, is featured in a 6-part Netflix documentary series "Pandemic: How to Prevent an Outbreak". She had warned of a deadly pandemic in December, 2019, just days before China reported to the World Health Organization that it was treating dozens of patients for a novel virus of unknown origin.  We now know it as coronavirus or Covid-19. The series debuted in January 2020, but recent events have pushed it into Netflix’s “Top 10 in the U.S. Today.”

Dr. Madad says the novel coronavirus is "about 10 times more virulent than seasonal flu". “Whether it is somebody you come into contact with or touching door handles or something that’s a high touch surface,” she says. “We want to make sure we are applying everyday measures.”

Both COVID-19 coronavirus and the flu can be transmitted through water droplets in coughs or sneezes. However, tiny particles of COVID-19 may linger longer in the air even after the infected person leaves the room. It can also linger on different types of surfaces: up to one day on cardboard, and up to three days on wood and stainless steel, according to experts who have studied COVID-19.
Dr. Syra Madad

The cast of “Pandemic” includes government officials such as Dr. Dennis Carroll, director of the Emerging Threats Unit of USAID, to physicians in locations as far-flung as Oklahoma and India. It also features San Francisco researchers looking for a universal flu vaccine.

The series opens with a US government official standing in a field north of Pittsburgh, Pennsylvania, last fall beside a mass grave dating back to the 1918 Spanish flu pandemic that killed 50-100 million people. It then moves to a scene showing Dr. Syra Madad leading a simulation exercise of New York City's response to a future hypothetical outbreak.

Dr. Syra Madad, 34, is a devout Muslim. The Netflix series shows her praying at her home in Long Island, New York. She says, "I live and breathe being a Muslim. It shapes my daily life. I don't drink I don't eat meat that's not halal.....I do no harm and I help others".

Dr. Madad takes breaks to say her prayers at the Islamic Center of New York University. Before entering the prayer room, Madad stops to perform wudu, and washes her mouth and face as well as her feet, according to a Washington Post report.

Dr. Syra Madad Speaking at NIH, Islamabad, Pakistan

The last time she visited Pakistan was in August 2018. She took time out to speak at the National Institute of Health, Islamabad, on Emergency Preparedness and Response to Public Health Emergencies, like Ebola and CCHF outbreaks.

On December 27th 2019, Dr. Syra Madad co-wrote a Washington Post op ed with Ronald A. Klain, former White House Ebola response coordinator in Obama Administration, warning lawmakers that a vital federal program to fight deadly pandemics was set to expire in May of 2020 and urged Congress to renew funding for the system that helps keep Americans safe from a sudden epidemic. “Failure to act would be penny-wise but pound-foolish,” it read. “The day will come when a dangerous pathogen will arrive in the United States once again.”  A few days later, the government in Wuhan, China, reported to the World Health Organization that it was treating dozens of patients for a novel virus of unknown origin. We now know it as coronavirus or Covid-19. It has caused a deadly pandemic that is raging around the world with devastating consequences.

Related Links:

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Can Pakistan Effectively Respond to Coronavirus Pandemic?

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Saturday, March 21, 2020

World Happiness Report 2020: Pakistan is the Happiest Nation in South Asia

The World Happiness Report continues to rank Pakistan as the happiest nation in South Asia for several years now. The country ranks 66th among 153 nations surveyed for the World Happiness Report 2020. India ranks 144, Bangladesh 107, Nepal 92, Sri Lanka 130, Maldives 87 and Afghanistan 153. China ranks 94th.  Finland tops the list followed by Denmark second and Switzerland 3rd in the world.  The report warns that the COVID-19 global pandemic poses "great risks for some of the main supports for well-being, most especially health and income".




Pakistan has moved up in happiness ranking to 66th in 2020, up from  67th last year and 75th in 2018.  Meanwhile, India's ranking has fallen to 144 this year, down from 140 last year and 133 in 2018. It appears that Prime Minister Modi's divisive policies are contributing to declining happiness in India.

Pakistan Ranks 66. Source: WHR2020
WHR Ranking Criteria. Source: WHR2020

The rankings are based on data collected in the years 2018 and 2019. Researchers asked people to evaluate their own levels of happiness, and considered six other factors: GDP per capita, social support, healthy life expectancy, freedom to make life choices, generosity, and freedom from corruption, according to the report released Friday.

Each of the bars is divided into seven segments, showing WHR research efforts. The first six sub-bars show how much each of the six key variables is calculated to contribute to that country’s score, relative to that in a hypothetical country called “Dystopia”, so named because it has values equal to the world’s lowest national averages for 2017-2019 for each of the six key variables.

Unhappy India. Source: Times of India

People in major Pakistani cities are not particularly happy. For example, Karachi ranks 117th and Lahore 122nd among 186 cities in the world. However, Pakistani cities still report greater happiness than Indian capital of New Delhi at 180 and Sri Lankan Colombo 170. Kathmandu ranks higher at 105.

The World Happiness Report 2020 has been produced by John F. Helliwell, Richard Layard, Jeffrey D. Sachs, and Jan-Emmanuel De Neve.  Commenting on the report, lead author John Helliwell said, "The happiest countries are those 'where people feel a sense of belonging', where they trust and enjoy each other and their shared institutions. There is also more resilience, because shared trust reduces the burden of hardships, and thereby lessens the inequality of well-being."

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Friday, March 20, 2020

Chinese Study: Hot and Humid Weather to Reduce Spread of Coronavirus

An increase of just one degree Celsius and 1% relative humidity increase substantially lower the (Covid-19) virus’s transmission, says a study published on March 10, 2020 by Chinese researchers. In an earlier 2009 study published in the Proceedings of the National Academy of Sciences, researchers had found that high absolute humidity can help kill flu virus particles in a given environment.

A team of Chinese researchers unveiled the results of their study last week that looked at how temperature and humidity may affect the transmission of COVID-19, the illness caused by the new coronavirus. It showed that coronavirus transmission rates decline with increased temperatures and humidity. This may explain why there appear to be few reports of local COVID-19 transmissions in places like Pakistan. Most of the known coronavirus cases in Pakistan appear to be those of the people who have come into the country from cold, dry places like northern Iran where the pandemic is raging. The rate of local transmission in Pakistan is not zero but relatively low.

At the same time, small-scale clinical studies in China and France are indicating that chloroquine (Resochin) and its variant hydroxychloroquine (HCQ) are effective in treating coronavirus patients.  Both of these drugs are manufactured in Pakistan. These developments are showing light at the end of the tunnel.
COVID-16 Transmission Rates Vs Temperature and Humidity

New Chinese Study: 

The research team included Jingyuan Wang, Kai Feng, Weifeng Lv of Beihang University, and Ke Tang from Tsinghua University. They studied 100 different Chinese cities that each reported more than 40 cases of COVID-19 from Jan. 21 to 23, 2020.

“In the early dates of the outbreaks, countries with relatively lower air temperature and lower humidity (e.g. Korea, Japan and Iran) saw severe outbreaks than warmer and more humid countries (e.g. Singapore, Malaysia and Thailand) do," the researchers wrote.

Here's an excerpt from the abstract published by the team:

"After estimating the serial interval of COVID-19 from 105 pairs of the virus carrier and the infected, we calculate the daily effective reproductive number, R, for each of all 100 Chinese cities with more than 40 cases. Using the daily R values from January 21 to 23, 2020 as proxies of non-intervened transmission intensity, we find, under a linear regression framework for 100 Chinese cities, high temperature and high relative humidity significantly reduce the transmission of COVID-19, respectively, even after controlling for population density and GDP per capita of cities. One degree Celsius increase in temperature and one percent increase in relative humidity lower R by 0.0383 and 0.0224, respectively. This result is consistent with the fact that the high temperature and high humidity significantly reduce the transmission of influenza. It indicates that the arrival of summer and rainy season in the northern hemisphere can effectively reduce the transmission of the COVID-19."

Some experts are pointing to the increased amount of UV rays from the sun the Northern Hemisphere will be subject to this time of year as a factor that could slow the virus, according to a story in AccuWeather.

Infections Rate Drop With Higher Temp and Humidity. Source: JP Morgan


Possible Treatments For COVID-19 Patients:

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.”

Resochin (chloroquine) made by Bayer Pakistan

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

Anti-Malarial and Antibiotic Combo:

A new French study by Philippe Gautret et al recently published in the International Journal of Antimicrobial Agents has found early evidence that the combination of hydroxychloroquine (HCQ), a popular anti-malaria drug known under the trade name Plaqenuil, and antibiotic azithromycin (aka Zithromax or Azithrocin) could be effective in treating the COVID-19 coronavirus and reducing the duration of the virus in patients.

French Study Results


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:

Recent Chinese research is showing that hot and humid weather will significantly slow down transmission of coronavirus or COVID-19.  An increase of just one degree Celsius and 1% relative humidity increase substantially lower the (Covid-19) virus’s transmission, says a study published on March 10, 2020 by Chinese researchers. At the same time, small-scale clinical studies in China and France are indicating that chloroquine and its variant hudroxychloroquine are effective in treating coronavirus patients. Both of these developments are showing light at the end of the tunnel.

Related Links:

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:

Saturday, March 7, 2020

Women's Day: Gender Gap in Education Narrowing in Pakistan

Women's education, literacy and labor force participation levels remain low in Pakistan but the gender gap is declining in terms of literacy rates and mean years of schooling, according to Pakistan Labor Force Survey 2017-18.  There is about one year gap between men and women in terms of education attained. On average, a Pakistani male born after 1995 will leave school in 8th grade. A female born at the same time will leave in 7th grade.

At a recent Islamabad event organized as part of the World Bank's "Girls Learn, Women Earn" campaign,   Mr. Illango Patchamuthu, World Bank Country Director for Pakistan, said increasing years of schooling helps women become more productive members of society.






Pakistan Labor Force survey provides information on the country's labor force characteristics. It is based on a representative sample of 43,361 urban and rural households. For this purpose, total sample size is evenly distributed into four sub samples, each to be enumerated in a given quarter.

Mean Years of Schooling in Pakistan. Source: Labor Force Survey 2017-18


As of 2017-18, the overall literacy rate in Pakistan is 62.3%. Among males above age 10, 72.5% are literate. Females in the same age group are at 51.8%, trailing 20.7% behind their male counterparts. The percentage of women participating in the labor force is 24.9 as compared to 82.7 for men.

History of Literacy in Pakistan


Educational Attainment in Pakistan. Source: Labor Force Survey 2017-18

At a recent Islamabad event organized as part of the World Bank's   "Girls Learn, Women Earn" campaign,   Mr. Illango Patchamuthu, World Bank Country Director for Pakistan, said increasing years of schooling helps women become more productive members of society. He said: “Every additional year of schooling for a girl increases her future earnings by up to 10%. Pakistan can use the untapped economic potential of women in the workforce and estimates indicate this can boost the economy by up to 30%, by empowering women and girls to expand their skills, access to information, mobility, and access to finance and assets.”

Prime Minister Imran Khan's government has launched two programs with the aim of particularly helping underprivileged women: Ehsaas and Kifaalat. These programs are headed by Dr. Sania Nishtar, a highly accomplished woman named special assistant to the prime minister. Speaking at  "Girls Learn, Women Earn", Dr. Nishtar said:

“Government of Pakistan’s Ehsaas program has a very serious intent to drive forward the agenda of women empowerment. Ehsaas stringently follows fifty percent rule across the board for women inclusion in all Ehsaas initiatives including interest free loans, scholarships and asset transfers".

 "Likewise, Kafaalat that has recently been launched by the Prime Minister will ensure financial and digital inclusion of 7 million disadvantaged women across Pakistan who will now benefit from the monthly stipend of Rs. 2,000 along with access to bank accounts and affordable smart phones,” she added.

Related Links:

Haq's Musings

South Asia Investor Review

Pakistani Woman Designer Wins Global Industrial Design Award

Pakistan's Saadia Zahidi Leads WEF's Gender Parity Effort

Status of Women in Pakistan

Microfinancing in Pakistan

Gender Gap Worst in South Asia

Status of Women in India

Female Literacy Lags in South Asia

Land For Landless Women

Are Women Better Off in Pakistan Today?

Growing Insurgency in Swat

Religious Leaders Respond to Domestic Violence

Fighting Agents of Intolerance

A Woman Speaker: Another Token or Real Change

A Tale of Tribal Terror

Mukhtaran Mai-The Movie

World Economic Forum Survey of Gender Gap

Wednesday, March 4, 2020

Silicon Valley Congressman Ro Khanna Defeats Pro-Modi Challenger

Congressman Ro Khanna has won 65% of all votes cast to deal a heavy defeat to pro-Modi candidate Ritesh Tandon in primary elections in California's 17th district that covers part of Silicon Valley. Khanna angered many of his Indian-American constituents last summer when he criticized Prime Minster Narendra Modi's Hindutva politics and joined US Congress's Pakistan Caucus. Vast majority of Hindu Americans, including those in Silicon Valley tech community, are solidly supporting Mr. Modi in spite of his Islamophobic legislation like CAA and his government's extended lock-down in Kashmir and brutal anti-Muslim actions in India.

California 17 Election Results: 

Incumbent Congressman Ro Khanna received 46,657 votes or 65,1% of the votes cast in CA17 district in yesterday's primary elections. His main challenger Ritesh Tandon trailed far behind with 17,337 votes or  24.2% of all votes cast, according to New York Times.

California 17th Congressional District Results. Source: New York Times

Khanna thanked his supporters in a tweet yesterday after "beating Ritesh Tandon who ran on Islamophobia and right wing nationalism in India".

Congressman Ro Khanna with Pakistan Prime Minister Imran Khan on Capitol Hill
Ritesh Tandon, an Indian-American technology entrepreneur, said Khanna "has turned his back on our allies all over the world, including the nation of my birth, India by siding with India’s enemies like Pakistan on key security issues”, according to Indica News.


Khanna Rejects Hindutva:

L to R: Ro Khanna, Riaz Haq
Congressman Ro Khanna (D-Fremont) tweeted the following on Aug. 29: “It’s the duty of every American politician of Hindu faith to stand for pluralism, reject Hindutva, and speak for equal rights for Hindus, Muslims, Sikhs, Buddhist & Christians.”  On August 17, Khanna became the first Indian-American to join US Congress's Pakistan caucus headed by Democratic Congresswoman Shiela Jackson of Texas and Republican Congressman Jim Banks of Indiana. Khanna's decision to join Pakistan caucus came after he met Pakistani Prime Minister Imran Khan during his July visit to Washington. After his July meeting with Khan Khanna tweeted: "Honored to meet PM Imran Khan. We spoke Hindustani, and I shared that my grandfather, an Indian freedom fighter with Gandhi, always had a hope for reconciliation. South Asian Americans of my generation hope for peace in the subcontinent in the 21st century."


Pakistani-American Support:

Congressman Ro Khanna has received support from Pakistani-American community for his courageous and principled stand on issues affecting South Asia. He regularly attends community events organized by Pakistani-Americans in Silicon Valley. I met him at a dinner hosted at the house of a Pakistani-American family that owns local Mirchi restaurant in Fremont. He assured the community he would continue to work to address issues such as Islamophobia that affect Muslims in America.

Summary:

Indian-American Congressman Ro Khanna has dealt a heavy defeat to his pro-Modi challenger Ritesh Tandon in California primary elections. Khanna has joined US Congress's Pakistan Caucus and rejected Hindutva. His actions have angered Hindu American supporters of Indian Prime Minister Narendra Modi.  Cracks are beginning to appear in the Hindu American community. Democrats from the Progressive Wing of the Party are finding it increasingly difficult to support Prime Minister Modi as he ferociously pushes his hateful Hindutva agenda to target minorities. Vast majority of Hindu Americans, including those in Silicon Valley tech community, are solidly supporting Mr. Modi in spite of his Islamophobic legislation like CAA and his government's extended lock-down in Kashmir and brutal anti-Muslim actions in India.

Related Links:

Haq's Musings

South Asia Investor Review

Imran Khan in Washington

Modi's Extended Lockdown in Indian Occupied Kashmir

Lynchistan: India is the Lynching Capital of the World

Hinduization of India

Brievik's Hindutva Rhetoric

Indian Textbooks

India's RAW's Successes in Pakistan

Riaz Haq Youtube Channel

VPOS Youtube Channel