Pakistan teeters on the edge of potential disaster with the coronavirus

Madiha Afzal

As of March 26, coronavirus cases in Pakistan — the world’s fifth most populous country — climbed to 1,190; nine people have died. Pakistan currently has the highest number of cases in South Asia, more even than its far larger neighbor, India. In this densely populated country of more than 210 million, with megacities Lahore and Karachi each teeming with more than 10 million people, the government took important steps early to stop the spread of the disease, and each of its provinces implemented varying levels of lockdown in the past week as the number of cases rose.

But the country also gravely mishandled the return of coronavirus-infected pilgrims from Iran, and its prime minister has waffled on messaging and implementing a full, federally mandated lockdown. While many Muslim-majority countries, including Saudi Arabia, have cancelled communal prayers, Pakistan’s mosques remain open. The country’s health system — with dated and limited public health facilities, and costly private hospitals inaccessible to all but the rich — is woefully unprepared to deal with COVID-19 and its influx of critically ill patients. Doctors lack personal protective equipment; at least one of the nine victims so far is a doctor.

The consequences of letting the disease spread further would be devastating. And Pakistan’s initial coronavirus response is already exposing concerning political patterns — including the powerful army asserting competence over the civilian government— that will persist beyond the pandemic.

AN INFLUX OF CASES FROM IRAN

Before Pakistan had any cases of the virus, it made the decision to not allow 800 Pakistani students stranded in Wuhan, China to return to the country. Pakistan’s government did not want to risk them returning and spreading the disease at home, and it also hoped that the move signaled support for China at a time when it was embarrassed in front of the world. (Pakistan and China are steadfast allies; Pakistan is the flagship location for Beijing’s One Belt One Road.)

The country’s first coronavirus case, a returning pilgrim from Iran, was diagnosed on February 26 in Karachi. He was quickly isolated and his contacts traced. As of March 12, two weeks ago, Pakistan only had 21 confirmed cases of the virus. On March 13, the government announced a number of aggressive steps, including closing the country’s western border (with Iran and Afghanistan), shutting down all public and private educational institutions, and canceling the Pakistan Day parade set for March 23. A National Coordination Committee was set up to deal with the coronavirus on a federal level, and the National Disaster Management Authority was tapped to implement the response.

At the same time, the state prevailed on the Tablighi Jamaat, a pan-Islamic body that holds an annual religious gathering outside Lahore, to pack up and go home. It may have been too late: More than 150,000 people were gathered there until March 12, and a number of them were later diagnosed with coronavirus — some of them were diagnosed after they returned to Islamabad, and two Palestinian men who returned to Gaza became the first known coronavirus positive cases there.

In the days after these steps were announced on March 13, the problem of returning pilgrims from Iran ballooned. All returnees were “quarantined” together in reportedly squalid conditions at a camp in Taftan after crossing the border into Pakistan in remote Baluchistan. There was no testing, and those with symptoms were not isolated. Instead of containing the virus to those who had it, it spread to others at the camp, and people at the camp were also allowed to leave to shop at markets in the town. After two weeks, they were “returned” to their provinces. It is unclear what precautions were taken as they traveled, but they were tested by the provincial governments once they arrived, and those who tested positive were re-quarantined at centers created in those provinces. Thousands of returnees remain in quarantine centers across the country; a number of them have reportedly attempted escape. Nearly 600 returnees in total have tested positive.

https://www.brookings.edu/blog/order-from-chaos/2020/03/27/pakistan-teeters-on-the-edge-of-potential-disaster-with-the-coronavirus/