The past two months have been the most challenging period of my professional career. Having spent time with COVID patients from close quarters, I would like to share my experience of the pandemic and what could be the way forward for the country.
This thread is not intended for doctors and medical practitioners so I would try my best to avoid medical jargon and not get technical. I would also refrain from discussing treatment here because it is not the appropriate platform for this discussion.
The role of the government so far:
The government of Pakistan has copped a lot of blame and criticism over the way they have handled the spread of COVID-19 and most of the criticism has been justified.
While the PM is right about the fact that our public cannot survive in a total lockdown situation for long, that does not justify the lack of coordination between the provinces and the federal government and the inability of the authorities to deal with the right wing.
As most of you know already, the Tabligh-i-Jamaat have played a big role in the spread of COVID-19 in Pakistan. On March 10, thousands of people attended the assembly in Raiwind. In addition, the government’s failure to ban congregational prayers have also contributed to the spread of the virus.
The spike in the number of cases and deaths over the last few days is a direct consequence of the country-wide Eid prayers which should have been banned, and the numbers are only going to increase over the next two weeks.
Mosques are extremely high risk because most people do not wear masks while praying and it is not possible to maintain social distancing. This pandemic has once again highlighted how the clergy are basically a state within a state.
Pakistan was in a rather unique position where it was hit by COVID-19 rather late and it already saw the damage it did to first world countries. There is no doubt at all that they could have done a lot more.
The public perception:
While the government have made mistakes, the nonchalant attitude of the masses have only made things worse.
Unfortunately, the majority of the public can be divided into 3 groups:
(1) “This is a conspiracy” group
(2) “nothing will happen to me” group
(3) “we will die anyway” group
Our nation has a natural tendency towards conspiracy theories. In spite of all that has happened around the globe, there are people who are still adamant that this is merely a hoax designed by the western media to malign China and create fear among the public. These people justify their irrationality by stating that they don’t know anyone who has caught this virus.
The latest conspiracy theory is that WHO pays hospitals thousands of dollars if they report COVID-19 deaths, which is why if you go to the hospital they will declare you positive even if you are not.
The second group is comprised of people who think they have special immunity towards COVID-19. This group mostly consists of young people who have convinced themselves that this virus is lethal only if you are old or weak.
It is indeed true that young and healthy people are low risk and most of the patients are middle age of elderly people, but we need to realize that low risk is not the same as no risk. Moreover, a young person is very likely to pass the virus to a vulnerable older person. We need to think of the whole community and not only for ourselves.
By taking precautionary measures, you are not only protecting yourself but people around you. Asymptomatic people carry the highest risk of spreading the virus, which is why it is absolutely crucial to think about the people around you.
The third group consists of people who do not believe that COVID-19 is a conspiracy and do not believe that they are invincible, but they are still casual about it. Their justification is that if it is their fate to die due to COVID-19, it will happen no matter how careful they are.
How to live with COVID-19 and the way forward:
COVID-19 will not go away any time soon and the world will have to move on. However, moving on and living with COVID-19 does not mean that we should not take precautions.
When the government ended the so-called smart lockdown before Eid, the public went into a frenzy and acted as if the pandemic was over. The markets were flooded and it appeared that people have no problem catching the virus as long as they could get their hands on new Eid clothes.
We have no choice but to adjust our lifestyle to a significant extent otherwise everyone of us will be infected eventually and we don’t know how many of us will die.
The anti-mask propaganda:
I can’t stress on this enough. It is absolutely necessary to wear masks regardless of the type/quality. The cheapest mask is still much better than no mask.
Unfortunately, a lot of people have bought into the nonsense that masks are not necessary unless you have tested positive which is absolutely wrong.
Wearing masks will decrease your chances of catching the virus and it will also protect other people if you are asymptomatic.
Use of hand sanitizers:
It is very important to understand that hand sanitizers should only be used by people when they are not at home, i.e. doctors on duty and people when they go to public places.
Please don’t waste sanitizers by using them at home. Simply washing your hands with soap - preferably an antibacterial one - is sufficient.
What measures can the government take to curb the spread at this stage?
Impose fines and penalties on people that do not wear masks. There has been considerable discussion on this matter but the government has yet to make a decision. We cannot afford indecisiveness and the government must act now.
SOPs should be more than just a buzzword. The government can use this word a dozen times but as long as they are unable to implement it effectively, things will only get better.
The government cannot enforce it to perfection but it can do a lot more to ensure compliance, and that will only happen if there are consequences for lack of compliance.
Karachi, Lahore and Peshawar are epicenters of COVID-19 in Pakistan. Both public and private hospitals are now saturated. Private hospitals were slow to open their doors to the pandemic and were only forced to do so when the public hospitals started to work at full capacity, but now even they are working at full capacity.
We are now reaching a point that we feared a month ago, and unless the public cooperates, things will only get worse. There can be no lockdown and things will move on, which is we all need to look after ourselves which will not only save our lives but also those of others.
