Friday, May 15, 2020

Pakistan: Coronavirus, Lives and Livelihoods

Coronavirus infection rates and deaths in Pakistan are among the lowest in the world while the continuing lockdown is causing enormous damage to the nation's economy and livelihoods, according to government data. Health ministry data shows that fewer than a thousand lives have been lost to the disease in the country since the start of COVID19 infections more than two months ago. Meanwhile, millions of people in manufacturing, retail and the unorganized sectors are unemployed or underemployed. All of this is happening during Ramzan and Eid periods that account for bulk of retail sales in the majority Muslim country of 220 million. Pakistanis do not necessarily face the same level of risk from coronavirus as people living in America and Europe do.

Age Distribution of Covid Cases/Deaths in Pakistan. Source:

Age Factor in Covid19 Mortality:

Over 40% of all coronavirus deaths in Europe and America have occurred among the elderly living in nursing homes. Pakistanis age 60+ account for 19% of cases but 58% of deaths. Like US and Europe, older people are much more likely to die from coronavirus in Pakistan.  But average life expectancy in Pakistan is just 67 years and the median age in the country is only 22 years. The explanations offered for low death rates in South Asia include younger populations, more sunshinehigher temperature and humidity, universal BCG vaccinations etc. Yale researchers have argued in a recently published paper to consider universal mask adoption and increased hygiene measures as an alternative to complete lockdown.

March 2020 Manufacturing Data. Source: Pakistan Bureau of Statistics

Pakistan Manufacturing Data:

The March figures released by Pakistan Bureau Statistics confirm a precipitous drop of 22.95% in large scale manufacturing. This reflects halt in production in just the last one week of March 2020. April 2020 figures are almost certain to be a lot worse due to complete halt in production amid lockdown. It's spelling disaster for millions of employees and households linked to these industries. Government handouts can not replace household incomes generated from these industries.

While food production held up well in March, manufacturing of durables like air-conditioners, refrigerators, and deep freezers have plummeted. For example, production of refrigerators fell 34% from 86,107 in March 2019 to 56,449 in March 2020.  Number of television sets produced in March 2020 declined 34% to 19,790 from 30,788 in the same month last year.

Comparison of Confirmed Cases in Selected Countries. Source: Our World in Data

Coronavirus Infections and Deaths:

As of May 16, Pakistan has 38,755 cases and 834 deaths. These figures are among the lowest in the world. There are many theories explaining why Pakistan and the rest of South Asia have fared much better than America and Europe. To put it in perspective, there were 31 coronavirus related deaths in Pakistan where 4,000 people die on a regular day.  Any major change in daily death rates in recent weeks would not go unnoticed. While it is true that the testing rates in South Asia are low compared to America and Europe, the percentages of people testing positive and fatality rates in South Asia are also low. The explanations offered for low coronavirus infection and death rates in South Asia include more sunshinehigher temperature and humidity, younger demographics, universal BCG vaccinations etc.

Comparison of Coronavirus Deaths in Selected Countries. Source: Our World in Data

Pakistan COVID19 Death Rate Among World's Lowest 

Social Distancing Cost-Benefit Analysis:

In a recently published paper tiled "The Benefits and Costs of Social Distancing in Rich and PoorCountries", Yale researchers support universal mask adoption and increased hygiene measures as a alternatives to social distancing and complete lockdown.

Zachary Barnett-Howell and Ahmed Mushfiq Mobarak of Yale University argue that "social distancing policies are estimated to be less effective in poor countries with younger populations less susceptible to COVID-19, and more limited healthcare systems, which were overwhelmed before the pandemic". Here's an excerpt of the Yale paper:

"Poorer people are less willing to make...economic sacrifices. They place relatively greater value on their livelihood concerns compared to contracting COVID-19. Not only are the epidemiological and economic benefits of social distancing much smaller in poorer countries, such policies may exact a heavy toll on the poorest and most vulnerable. Workers in the informal sector lack the resources and social protections to isolate themselves and sacrifice economic opportunities until the virus passes. By limiting their ability to earn a living, social distancing can lead to an increase in hunger, deprivation, and related mortality and morbidity. Rather than a blanket adoption of social distancing measures, we advocate for the exploration of alternative harm-reduction strategies, including universal mask adoption and increased hygiene measures."


While coronavirus infections and death rates in Pakistan are among the lowest, the nation's economy and livelihoods are in serious jeopardy. With or without coronavirus pandemic, we take risks everyday when we leave our homes to go to work or school, theaters or playground, or shopping. Risks we face range from street crimes and road accidents to lightening strikes. We need to make similar assessments of risks from diseases which vary from place to place. Pakistanis do not necessarily face the same level of risk from coronavirus as people living in America and Europe do. The explanations offered for low coronavirus infection and death rates in South Asia include more sunshinehigher temperature and humidity, younger demographics, universal BCG vaccinations etc. There is a need to weigh the risk of catching coronavirus against the loss of livelihoods in places like Pakistan.  Yale researchers have argued in a recently published paper to consider universal mask adoption and increased hygiene measures as an alternative to complete lockdown.

Related Links:

Haq's Musings

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Vast Majority of Pakistanis Support Imran Khan's Handling of Covid19 Crisis

Pakistani-American Woman Featured in Netflix Documentary "Pandemic"

Can Pakistan Respond Effectively to Coronavirus Pandemic?

Can Pakistan Effectively Respond to Coronavirus Outbreak? 

How Grim is Pakistan's Social Sector Progress?

Pakistan Fares Marginally Better Than India On Disease Burdens

Can Imran Khan Lead Pakistan to the Next Level?

Democracy vs Dictatorship in Pakistan

Pakistan Child Health Indicators

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PTI Triumphs Over Corrupt Dynastic Political Parties

Strikingly Similar Narratives of Donald Trump and Nawaz Sharif

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Riaz Haq's Youtube Channel


Rashid A. said...

Testing data shows the THE CURRENT (NOT CUMULATIVE) infection rate in Pakistan is19%. Out of every100 tests done, 19 are positive!

Riaz Haq said...

Rashid: "Testing data shows the THE CURRENT (NOT CUMULATIVE) infection rate in Pakistan is19%. Out of every100 tests done, 19 are positive!"

There were 14, 878 tests and 1581 new confirmed cases in the last 24 hours...positivity rate of about 10.6%, according to

Cumulatively, there have been 359,264 tests and 38,799 confirmed cases...positivity rate of 10.8%.

Positivity rate is more a function of who's tested. Currently, only those with severe symptoms are tested in Pakistan.

A better indicator in low-test environment is coronavirus deaths. There were 31 covid deaths in the last 24 hours. Total number of deaths so far: 834

It's very hard to hide major daily death toll beyond Pakistan's normal mortality rate of 4000 deaths per day.

Riaz Haq said...

#NewYork State's Governor Andrew Cuomo: 12.2% Of #HealthCare Workers in #NewYorkCity Have #Coronavirus Infection, Lower Than 19.9% Of General Population in #NewYorkCity! The #facemask does work!! #COVID19

NEW YORK — ESSENTIAL workers, including law enforcement officers, health care workers and transit operators across New York state have lower infection rates of the coronavirus than the general population.

Gov. Andrew Cuomo said Wednesday that 14.2% of downstate transit workers, 12.2% of downstate health care workers and 10.5% of the New York Police Department were infected with COVID-19 based on antibody tests, which test a person's blood for COVID-19 antibodies, indicating that a person was infected and has since recovered.

The only exception to the trend was among members of the New York City Fire Department and emergency medical technicians. Just over 17% of those workers were infected with COVID-19.

Officials reported last month that 19.9% of people in New York City may have had the coronavirus and 12.3% of the general New York state population had it, based on antibody tests.

Across the rest of the state, 3.1% of a sample size of 2,750 state police officers were infected and 7.5% of a sample size of 3,000 members of the New York State Department of Corrections and Community Supervision tested positive for coronavirus antibodies.

Health officials report more than 338,485 cases of the coronavirus in New York and more than 1.37 million across the country with more than 82,800 deaths. Cuomo reported 166 new deaths in the state on Tuesday, a decrease from 195 the prior day.

Additionally, he said hospitalizations and people requiring a ventilator have both declined. New daily cases rose slightly on Tuesday, but the overall numbers are trending downward.

Cuomo also announced that about 60% of the about 100 children in the state showing symptoms of a COVID-19-related illness tested positive for the coronavirus and 40% tested positive for antibodies. Fourteen percent tested positive for both.

Seventy-one percent of children in the state with the illness were admitted to intensive care units and three have died.

Riaz Haq said...

Shanghai Electric distributes food

Shanghai Electric Group, the world's leading manufacturer and supplier of power generation and industrial equipment, has been providing regular food supplies to households living in villages located around its coal mining plant and power plant in Thar, a statement said on Thursday.

As the COVID-19 pandemic has affected the lives of millions of people globally, the worst-hit are the underprivileged, who are now also faced with the looming threat of food shortages, it added.

In Pakistan too, this is one of the major causes of concern for the authorities, especially in remote areas of Thar in Sindh.

Sino Sindh Resource (Pvt) Ltd and Shanghai Electric Engineering Consulting Company, with its branch office in Karachi, carried out the third stage of the provision of food supplies to around 800 households in villages located in area where the Thar Block-1 Integrated Coal Mine-Power project is located.

Riaz Haq said...

#Florida has been spared the predicted #coronavirus disaster. One theory holds that in #humid air, the virus-laden particles fall more quickly to the ground. #Sunshine helps the body produce vitamin D, which may be connected with good health/resilience.

According to one popular theory, that might be part of it: Floridians fared better because of the state’s tropical climate. Since COVID-19 emerged, scientists have wondered if the virus will experience seasonal fluctuations, dipping in the summer because it spreads less under hot and humid conditions. Some of the optimism is based on the behavior of flu viruses, which have a familiar seasonality. Similarly, Dr. George Rutherford, the head of the infectious disease and global epidemiology division at the University of California, San Francisco, said that human alpha coronaviruses—the ones that can cause common colds—peak in winter months. But no experts have claimed that the summer will save us.

A number of working papers suggest that the coronavirus does do worse under hot and humid conditions. “SARS-CoV-2 probably does have some temperatures it likes better,” said Dr. Larry Chang of Johns Hopkins Medicine. But, he added, “none of that is 100 percent, slam-dunk definitive.” Lab experiments have shown that the virus spreads more and survives better in cold and dry settings. Even with the flu and common cold, we don’t really understand the mechanisms that cause the viruses to stumble in the summer. But scientists have theories. SARS-CoV-2 is enveloped in a coat that may be broken down under heat or humidity, or under ultraviolet light from the sun, meaning it would no longer have the structure needed to be infectious. This degeneration also happens when it’s exposed to soap or just exists on its own for long enough.

Humidity, some experts have proposed, may also help because the virus is transmitted through droplets when you cough, breathe, or talk. One theory holds that in humid air, the virus-laden particles fall more quickly to the ground. Another theory says that low humidity can affect the respiratory tract’s cilia—microscopic structures that help clear dirt and mucus—thereby making us more susceptible to certain viral infections. Similarly, sunshine helps the body produce vitamin D, which may be connected with good health and resilience.

There’s another factor that generally helps summer slow the spread of disease: human behavior. People spend more time outdoors in the summer and less in enclosed spaces with other people. Children also get out of school in the summer, resolving one of the most reliably common methods the flu virus spreads. (The coronavirus may not follow this trend. We know children can become infected, but we don’t know how much they transmit the virus, so we don’t know how much a return to school will affect the numbers. “With influenza, elementary schools are massive factories,” Rutherford said. “But we have no evidence of that with this virus.”)

“The coronavirus is a very different virus, so we just don’t know yet,” said Dr. Dean Winslow, an infectious disease specialist at Stanford Health Care. He agreed that there was room for hope, but not too much, and he warned that we should be careful to make any assumptions about the virus. “I think a lot of us are reticent to make too broad of predictions because this virus has fooled us so many times,” he added.

Riaz Haq said...

#India’s #migrant workers will neither forget nor forgive the hunger and humiliation at #Modi's hands. Millions of them, some with wives and children, lost their #livelihood overnight because of the #coronavirus #lockdown and for no fault of theirs.

India lost its soul and moral compass during this Corona crisis. The union government and large sections of the rich and the privileged exposed themselves as uncaring, people with no heart and petty minds. Most rich industrialists did not bother to pay their workers through the first and second phases of the lockdown. Some rubbed salt by announcing that they voluntarily would be taking home 30% less than their annual pay packet of Rupees 15 Crore and more.

When pressure mounted and the Government finally relented and decided to allow special trains to take migrant workers back home, some state governments actually cancelled trains and withdrew requisition for trains. Builders had convinced the Karnataka Chief Minister that construction activities would suffer in the absence of construction workers. It was necessary to detain the workers, the builders’ lobby argued. BJP’s Bangalore South MP Tejaswi Surya described the cancellation of trains as a brilliant move and claimed it would help workers fulfil their dream.

Riaz Haq said...

#LOCKDOWNS have not altered the course of the #coronavirus pandemic but have devastated the global #economy, a study by JP Morgan has claimed. #jobs #livelihoods

A paper by Marko Kolanovic, a strategist at the investment bank, argued that governments were "spooked" into imposing lockdowns that were "late" or "inefficient".

The study shows the infection rates in numerous countries continuing to fall after lockdown were easedCredit: JP MORGAN
Countries around the world introduced lockdown measures as the number of coronavirus cases grew in the opening months of this year, and have seen infection rates fall significantly since.

Kolanovic claimed that numbers had declined because the virus "likely has its own dynamics" that are "unrelated to often inconsistent lockdown measures".

He cites as evidence a number of places whose infection rates, or "R" values, have continued to fall despite restrictions being lifted.

Denmark's infection rate has remained stabled following the reopening of schools and shopping centres near the end of last month.

As of May 18, its R value was estimated to be 0.6, compared to 0.7 on May 7.

An R value of one or greater indicates that the spread of the virus through a population is accelerating.

Germany has also eased measures and has seen its R value remain below 1.

The study includes graphs showing numerous other countries that have followed a similar pattern since easing their own lockdowns.

Partial lockdowns as well as social distancing guidelines remain in place in most countries, and German Chancellor Angela Merkel has said Europe could see a second wave of the virus if restrictions are lifted too quickly.

Kolanovic also expressed concern about the economic fallout from the lockdowns.

"Unlike rigorous testing of new drugs, lockdowns were administered with little consideration that they might not only cause economic devastation but potentially more deaths than Covid-19 itself," he claimed.

"At the same time, millions of livelihoods were being destroyed."

Already the economic impact of the virus has forced governments to pass significant bailout packages to help workers and businesses.

Riaz Haq said...

Amid #COVID19, #Pakistan looks to #China for economic boost. Projects like #diamerbhashadam , #Gwadar airport, #western #motorway being finalized as part of #CPEC, ahead of a visit by President Xi Jinping to #Islamabad. #coronavirus #economy via @scmpnews

Projects including a dam, airport and motorway are being finalised in the China-Pakistan Economic Corridor, ahead of a visit by President Xi Jinping
Prime Minister Imran Khan is keen to generate jobs for the country’s workers, 25 million of whom have been rendered jobless during the pandemic

After a two-year slowdown in the execution of the China-Pakistan Economic Corridor (CPEC) following the 2018 election of Imran Khan as prime minister, Pakistan officials are finalising proposals for new infrastructure projects worth billions, ahead of a state visit by Chinese President Xi Jinping this year.
According to recent statements by Pakistan’s CPEC Authority, which was established during Khan’s visit to Beijing last October, officials are close to wrapping up the “action plan” for the estimated US$8 billion ML-1 project to rehabilitate Pakistan’s rickety railway network.
It would be the single largest project of the CPEC, the first phase of which saw a collective US$19 billion of Chinese credit and investment poured into energy, motorway and other projects, said Chinese ambassador Yao Jing at a conference last year.

Asim Saeed Bajwa, the retired three-star general appointed as founding chairman of the CPEC Authority, said last month he expected to soon sign an agreement with the China Three Gorges Corp for the US$2.5 billion Kohala hydropower project, which would generate 1,124 megawatts of electricity.
Bajwa announced on May 7 that construction work had begun for a US$230 million airport at Gwadar, the site of a Chinese-developed and operated port on the Arabian Sea. Pakistan last month granted approval for the port to handle Afghanistan transit trade.

Bajwa said work on building a second motorway route through western Pakistan, to improve overland transit connectivity between Gwadar and China’s Xinjiang province, had accelerated. Contractors were recently invited to bid for the second section of motorway connecting the Karakorum Highway to Quetta, the administrative capital of Balochistan province, where Gwadar is located.

Andrew Small, author of the China-Pakistan Axis, said in the lead-up to Xi’s visit – which earlier this year was said to be happening in July – there had been a push from China and Pakistan to put together “a decent new package of projects, and also to ensure that any elements of the phase-one plans that had been stalled were pushed forward”.

The political stakes had been raised since CPEC was dragged into the “informational war” which erupted between Beijing and Washington last year, said Small, a Brussels-based senior fellow at the German Marshall Fund, a US think tank.
“Given the scrutiny that any visit from Xi would bring, and the need to convey a narrative of progress and success, there would always have been an effort of this sort,” he said.

Riaz Haq said...

#Coronavirus in #America: People 65+ years account for only 22% of cases but 80% of death. #Covid_19

Riaz Haq said...

Dr Wajiha Javed May 24, 2020

So far, a total of 2,174 people, across various industries’ head offices, banks, restaurants and hospitals, have been screened by Getz Pharma, including all of its own workers. The total positive cases were 8.6% in the general population. Most of these were ongoing infections at 7%, and only 1.5% had recovered.
In the high-risk frontline hospital workers, the seroprevalence of Covid-19 was assessed to be 11% (Getz Pharma plans to test 25,000 doctors and their families free of cost on a rolling basis). Families of positives contacts were also traced and their seroprevalence was found out to be 19%, making our secondary household attack rate at 19%, which is similar to what was found in studies in China, Taiwan and Spain.

Based on the study findings and keeping in view its target age group (18-65 years), the urban setting and a sample revolving around office/factory workers, the following conclusions can be drawn:

The 8% prevalence can be extrapolated to the 1 million registered working population of Karachi, meaning at least 80,000 infected cases in Karachi alone, with 70,000 being currently infected, unaware and spreading infection to those around them. If the assumptions hold true for the rest of Pakistan, of its 61.7 million registered workers, at least 4.9 million could already be exposed and infected.


The writer is an epidemiologist and head of public health and research at Getz Pharma


After Karachi's 8% positive covid infection shown by Getz study we have 6% positive Lahore infection proven through random testing of covid

Confirms the hypothesis to a large extent that virus spread in general population in Urban Pakistan adult population is around 5 million !

Riaz Haq said...

Riaz Haq: Wajiha: Thank you for responding to my tweet. You said.: "prevelance over 6 weeks of 15%'. Could you please elaborate? How many people were given the serological test? Demographics of those tested in terms of ages, regions, occupations, etc? Was it entirely random? What is the rate of error for the particular test you administered? I think you're something unique for Pakistan. I hope the public health professionals are paying attention to your valuable work.

Wajiha Javed:So data is on a rolling basis. So far it's 7000.but we are continuing to test and enroll. It's not excatly random as it's data from different companies who have employees from different walks of life. It includes banks, schools, restaurants, industries, textiles, factories, media and doctors
The age bracket was 18 to 65 years
All of khi was covered
It was higher among frobltlien workers (docs) and among families of positives. Secondary attack rate was around 19 percent

Riaz Haq said...

Pakistan’s Lockdown Ended a Month Ago. Now Hospital Signs Read ‘Full.’
Medical workers are falling ill in Pakistan at alarming rates as the country registers at least 100,000 new coronavirus cases since the lockdown was lifted.


On a recent day in the sprawling port city of Karachi, Ali Hussain and his brother shuttled between public hospitals, looking for help and receiving none. Mr. Hussain’s older brother had a severe cough and fever but had been unable to get a coronavirus test for days.

“We cannot afford the private hospitals, they are charging tens of thousands rupees,” said Mr. Hussain, who earned 20,000 rupees per month, about $121, working at a textile mill before the lockdown.

The World Bank projects that Pakistan’s economy will contract by 0.2 percent next fiscal year. Up to 18 million of the country’s 74 million jobs could be lost, according to the Pakistan Institute of Development Economics, an independent research firm set up by the government.

More immediately, Pakistan’s struggling health care sector is in deep crisis.


Pakistanis stricken by the coronavirus are being turned away from hospitals that have simply closed their gates and put up signs reading “full house.” Doctors and nurses are falling ill at alarming rates, and are also coming under physical assault from desperate and angry families.

When Pakistan’s government lifted its lockdown on May 9, it warned that the already impoverished country could no longer withstand the shutdown needed to mitigate the pandemic’s spread. But now left unshackled, the virus is meting out devastation in other ways, and panic is rising.

Before reopening, Pakistan had recorded about 25,000 infections. A month later, the country recorded an additional 100,000 cases — almost certainly an undercount — and the pandemic shows no signs of abating. At least 2,356 people have died of Covid-19, according to official figures released Thursday.

Pakistan is now reporting so many new cases that it is among the World Health Organization’s top 10 countries where the virus is on the rise. The W.H.O. wrote a letter criticizing the government’s efforts on June 7 and recommended that lockdown be reimposed, stating that Pakistan did not meet any of the criteria needed to lift it.

Riaz Haq said...

Coronavirus: Youthful Pakistan appears to avoid worst of pandemic
By Secunder Kermani
BBC News

With around 6,000 coronavirus deaths in a population of approximately 230 million people, Pakistan appears to have fared far better than most Western countries. The UK, for example, has recorded more than 41,000 deaths in a population of around 67 million. Cities in neighbouring India, such as Delhi and Mumbai, seem to have been worse affected.


Testing has been relatively low, and numbers are in fact decreasing. There are certainly many more coronavirus cases than the roughly 290,000 officially recorded, but the recorded drop in infections is substantiated by the fact that the proportion of tests that come back as positive has also been decreasing, as have hospital admissions.

Data obtained by the BBC from officials in the country's two largest cities, Karachi and Lahore, show that there was a significant rise in graveyard burials in June that can't be explained by coronavirus deaths alone.

For example, in Miani Sahib graveyard, the largest in Lahore, in June 2020 there were 1,176 burials this June, compared to 696 in June last year.

Only 48 of the burials this June were of officially recorded coronavirus patients. The rise is likely to be a combination of undetected coronavirus deaths, and patients suffering from other illnesses not getting treatment as hospitals were under such pressure.

Similarly, in Karachi, June 2020 saw significantly more burials than at any other time during the past two years.

However, in both cities burial figures appear to be returning to more normal rates. Even if some of the "excess deaths" are assumed to be the result of coronavirus, by international standards the mortality rate in Pakistan appears to be relatively low, though not quite as low as official data would suggest.

For leading Pakistani epidemiologist Dr Rana Jawad Asghar, the principal reason for this is Pakistan's young population. The average age in Pakistan is 22 years, compared to about 41 in the UK. The vast majority of deaths globally from the coronavirus have been of elderly patients.

Dr Asghar told the BBC that less than 4% of Pakistan's population is aged 65 and above, whereas in more developed countries the proportion is around 20-25%. "That is why we haven't seen that many deaths in Pakistan," he said.