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900,000 Americans Estimated To Have Died From COVID-19, Study Says

By Sara Boboltz

Public health experts agree that official COVID-19 death tolls are undercounts, but there is disagreement over how high the actual tolls are.

Around 905,000 Americans may have died from COVID-19, according to a new study that arrived at a substantially higher number than the official government tally of 577,000 U.S. deaths.

In India, where the coronavirus is maxing out hospital beds and leaving would-be patients gasping for air, the real number of deaths may be 654,400, three times the official toll.

Worldwide, COVID-19 deaths are nearing 7 million, the study says, more than double the reported number.

While public health experts agree that the actual number of people who have died of COVID-19 is higher than the numbers reported by the U.S. Centers for Disease Control and Prevention and similar agencies in other countries, it is not clear how much higher the real toll may be.

The new estimates come from the University of Washington’s Institute for Health Metrics and Evaluation, where researchers looked at a variety of existing data sets and studies and used statistical modeling to arrive at their results ― which are being updated daily. IHME Director Dr. Chris Murray said in a video released alongside the report that it marks “a major change” in how his institution is thinking about the pandemic’s impact.

“As terrible as the COVID-19 pandemic appears, this analysis shows that the actual toll is significantly worse,” Murray added in a statement. “Understanding the true number of COVID-19 deaths not only helps us appreciate the magnitude of this global crisis, but also provides valuable information to policymakers developing response and recovery plans.”

IHME projects that nearly 950,000 Americans will have died from COVID-19 by September, and the global death toll will top 9.4 million.

IHME, a research institute that makes policy recommendations on issues in global health, was founded by the Bill and Melinda Gates Foundation in 2007.

The institution’s previous model for projecting COVID-19 deaths in the U.S. received criticism in the epidemiological community last April, as the pandemic was just taking off. Some thought IMHE’s model overestimated potential U.S. deaths: IHME initially projected that 38,000 to 162,000 people might die in the U.S. by the time the pandemic tapered off, which experts had hoped it would do by fall 2020.

In its most recent report, IHME researchers included in their estimates deaths believed to be “caused directly by” the coronavirus, “not deaths caused by the pandemic’s disruption to health care systems and communities.” The researchers cited extremely limited testing and uneven reporting practices in many high-income countries over the first months of the pandemic as part of the reason they sought to analyze death tolls. Other countries, such as Russia and Ecuador, have seen a wide discrepancy between expected death rates and actual death rates, suggesting that reporting has been incomplete throughout the pandemic.

Russia’s official COVID-19 death toll sits just above 100,000 people, but IHME researchers believe it is closer to 600,000. Mexico’s official toll of 217,000 deaths is estimated to be 400,000 under the true number.

The gap is smaller in the United Kingdom, where the official count is about 150,000 people, but IHME estimates it is actually around 210,000.

Underreporting has been particularly problematic in Eastern Europe and Central Asia, Murray said. Some localities only report COVID-19 deaths that occur in hospitals or to people with confirmed diagnoses, and the difficulty of accessing health care contributes to inaccurate tallies.

https://www.huffpost.com/entry/coronavirus-death-toll-900000-americans_n_60954012e4b0ae3c687d78fa

Why Did It Take So Long to Accept the Facts About Covid?

By Zeynep Tufekci

A few sentences have shaken a century of science.

A week ago, more than a year after the World Health Organization declared that we face a pandemic, a page on its website titled “Coronavirus Disease (Covid-19): How Is It Transmitted?” got a seemingly small update. The agency’s response to that question had been that “current evidence suggests that the main way the virus spreads is by respiratory droplets” — which are expelled from the mouth and quickly fall to the ground — “among people who are in close contact with each other.” The revised response still emphasizes transmission in close contact but now says it may be via aerosols — smaller respiratory particles that can float — as well as droplets. It also adds a reason the virus can also be transmitted “in poorly ventilated and/or crowded indoor settings,” saying this is because “aerosols remain suspended in the air or travel farther than 1 meter.”

The change didn’t get a lot of attention. There was no news conference, no big announcement.

Then, on Friday, the Centers for Disease Control and Prevention also updated its guidance on Covid-19, clearly saying that inhalation of these smaller particles is a key way the virus is transmitted, even at close range, and put it on top of its list of how the disease spreads.

There was no news conference by the C.D.C. either.

But these latest shifts challenge key infection control assumptions that go back a century, putting a lot of what went wrong last year in context. They may also signal one of the most important advancements in public health during this pandemic.

If the importance of aerosol transmission had been accepted early, we would have been told from the beginning that it was much safer outdoors, where these small particles disperse more easily, as long as you avoid close, prolonged contact with others. We would have tried to make sure indoor spaces were well ventilated, with air filtered as necessary. Instead of blanket rules on gatherings, we would have targeted conditions that can produce superspreading events: people in poorly ventilated indoor spaces, especially if engaged over time in activities that increase aerosol production, like shouting and singing. We would have started using masks more quickly, and we would have paid more attention to their fit, too. And we would have been less obsessed with cleaning surfaces.

Our mitigations would have been much more effective, sparing us a great deal of suffering and anxiety.

Since the pandemic is far from over, with countries like India facing devastating surges, we need to understand both why this took so long to come about and what it will mean.

Initially, SARS-CoV-2 was seen as a disease spread by respiratory droplets, except in rare cases of aerosol transmission during medical procedures like intubation. Countertops, boxes and other possible fomites — contaminated surfaces — were seen as a threat because if we touched them after droplets fell on them, it was believed the virus could make its way to our hands, then our noses, eyes or mouths.

The implications of this were illustrated when I visited New York City in late April — my first trip there in more than a year.

A giant digital billboard greeted me at Times Square, with the message “Protecting yourself and others from Covid-19. Guidance from the World Health Organization.”

First, “Hygiene” flashed, urging me to wash my hands, “practice respiratory hygiene,” avoid touching my face and wear a mask when necessary. Next, “Social distancing” told me to avoid close contact with people (illustrated by people separated by one meter), avoid shaking hands and stay home if unwell. Then “Medical help” advised me to follow local medical protocols. I was stunned that the final instruction was “Stay informed.” That billboard neglected the clearest epidemiological pattern of this pandemic: The vast majority of transmission has been indoors, sometimes beyond a range of three or even six feet. The superspreading events that play a major role in driving the pandemic occur overwhelmingly, if not exclusively, indoors.

The billboard had not a word about ventilation, nothing about opening windows or moving activities outdoors, where transmission has been rare and usually only during prolonged and close contact. (Ireland recently reported 0.1 percent of Covid-19 cases were traced to outdoor transmission.)

Mary-Louise McLaws, an epidemiologist at the University of New South Wales in Sydney, Australia, and a member of the W.H.O. committees that craft infection prevention and control guidance, wanted all this examined but knew the stakes made it harder to overcome the resistance. She told The Times last year, “If we started revisiting airflow, we would have to be prepared to change a lot of what we do.” She said it was a very good idea, but she added, “It will cause an enormous shudder through the infection control society.”

This assumption that these larger droplets that can travel only a few feet are the main way the disease spreads is one of the key reasons the W.H.O. and the C.D.C. didn’t recommend masks at first. Why bother if one can simply stay out of their range? After the C.D.C. recommended masks in April 2020, the W.H.O. shifted last June, but it first suggested ordinary people generally wear masks if physical distancing could not be maintained, and still said health care workers performing screenings in the community did not need to wear masks if they could stay that single meter away from patients. The W.H.O. last updated its mask guidance in December but continued to insist that mask use indoors was not necessary if people could remain separated by that mere meter — this time conceding that if ventilation might not be adequate, masks should be worn indoors, regardless of distancing.

In contrast, if the aerosols had been considered a major form of transmission, in addition to distancing and masks, advice would have centered on ventilation and airflow, as well as time spent indoors. Small particles can accumulate in enclosed spaces, since they can remain suspended in the air and travel along air currents. This means that indoors, three or even six feet, while helpful, is not completely protective, especially over time. To see this misunderstanding in action, look at what’s still happening throughout the world. In India, where hospitals have run out of supplemental oxygen and people are dying in the streets, money is being spent on fleets of drones to spray anti-coronavirus disinfectant in outdoor spaces. Parks, beaches and outdoor areas keep getting closed around the world. This year and last, organizers canceled outdoor events for the National Cherry Blossom Festival in Washington, D.C. Cambodian customs officials advised spraying disinfectant outside vehicles imported from India. The examples are many. Meanwhile, many countries allowed their indoor workplaces to open but with inadequate aerosol protections. There was no attention to ventilation, installing air filters as necessary or even opening windows when possible, more to having people just distancing three or six feet, sometimes not requiring masks beyond that distance, or spending money on hard plastic barriers, which may be useless at best. (Just this week, President Biden visited a school where students were sitting behind plastic shields.)

This occurred throughout the world in the past year. The United States has been a bit better, but the C.D.C. did not really accept aerosol transmission until October, though still relegating it to a secondary role until its change on Friday, which put the risk infection from inhaling these tiny particles first on its list of means of transmission. The scientific wrangling, resistance and controversy that prevented a change in guidance stem from a century of mistaken assumptions whose roots go back to the origins of germ theory of disease in the 19th century.

Until germ theory became established in the 19th century, many people believed that deadly diseases like cholera were caused by miasma — stinking fumes from organic or rotting material. It wasn’t easy to persuade people that creatures so small that they could not be seen in a seemingly innocent glass of water could be claiming so many lives.

This was a high-stakes fight: Getting the transmission mechanisms of a disease wrong can lead to mitigations that not only are ineffective but also make things worse. During the 19th century, fearing miasma, Londoners worked hard to direct their stinky sewers into the nearby Thames River, essentially spreading cholera even more.

But clear evidence doesn’t easily overturn tradition or overcome entrenched feelings and egos. John Snow, often credited as the first scientific epidemiologist, showed that a contaminated well was responsible for a 1854 London cholera epidemic by removing the suspected pump’s handle and documenting how the cases plummeted afterward. Many other scientists and officials wouldn’t believe him for 12 years, when the link to a water source showed up again and became harder to deny. (He died years earlier.)

Similarly, when the Hungarian physician Ignaz Semmelweis realized the importance of washing hands to protect patients, he lost his job and was widely condemned by disbelieving colleagues. He wasn’t always the most tactful communicator, and his colleagues resented his brash implication that they were harming their patients (even though they were). These doctors continued to kill their patients through cross-contamination for decades, despite clear evidence showing how death rates had plummeted in the few wards where midwives and Dr. Semmelweis had succeeded in introducing routine hand hygiene. He ultimately died of an infected wound.

Disentangling causation is difficult, too, because of confusing correlations and conflations. Terrible smells frequently overlap with unsanitary conditions that can contribute to ill health, and in mid-19th-century London, death rates from cholera were higher in parts of the city with poor living conditions.

Along the way to modern public health shaped largely by the fight over germs, a theory of transmission promoted by the influential public health figure Charles Chapin took hold.

Dr Chapin asserted in the early 1900s that respiratory diseases were most likely spread at close range by people touching bodily fluids or ejecting respiratory droplets, and did not allow for the possibility that such close-range infection could occur by inhaling small floating particles others emitted. He was also concerned that belief in airborne transmission, which he associated with miasma theories, would make people feel helpless and drop their guard against contact transmission. This was a mistake that would haunt infection control for the next century and more. In modern medical parlance, respiratory transmission routes are divided between the larger droplets, associated with diseases that spread at close distance, and the smaller aerosols (sometimes also called droplet nuclei), associated with diseases like measles that we know can spread at long distance and are usually highly contagious. Indeed, studies showing that respiratory diseases spread more easily in proximity to infected people seemingly confirmed the role of droplets. It was in this context in early 2020 that the W.H.O. and the C.D.C. asserted that SARS-CoV-2 was transmitted primarily via these heavier, short-range droplets, and provided guidance accordingly.

But from the beginning, the way the disease was spreading around the world did not fit this theory well. In February 2020, after an infected person was found to have boarded the cruise ship Diamond Princess, hundreds of people trapped on board for weeks were infected, including 567 of the 2,666 passengers, who were largely confined to their rooms and delivered food by masked personnel — hard to explain solely with droplet-driven transmission. (Hitoshi Oshitani, a Japanese virologist who played an important role in his country’s response to the epidemic, said it was this ship outbreak that helped convince him this was airborne — and it’s why Japan planned around airborne transmission assumptions from as early as February 2020.)

Then there were the many superspreader events around the world that defied droplet explanations. In March 2020 in Mount Vernon, Wash., 61 pandemic-aware people showed up to a choir practice and sang with some distance between them in a large space, were provided hand sanitizer and left the doors open, reducing the need for people to touch the handles. But 53 of them were confirmed or strongly suspected to have contracted Covid-19 anyway, and two died. Long-distance transmission was being documented as well: One study from China in April 2020, clearly documenting transmission from beyond one meter, had video evidence showing the initially infected person had not come very close to those he infected, and there were no common surfaces touched. Epidemiological studies and examples kept pouring in, too, all of them showing that Covid-19 was spreading primarily indoors and clusters were concentrated in poorly ventilated spaces. And when outdoor transmission did occur, it was often when people were in prolonged close contact, talking or yelling, as with construction workers on the same site. The disease was also greatly overdispersed, sometimes being not very contagious and other times dramatically so. Large-scale studies showed that more than 70 percent of infected people did not transmit to any other person, while as few as 5 percent may be responsible for 80 percent of transmissions through superspreading events. Despite databases documenting thousands of indoor superspreader incidents, I’m not aware of a single confirmed outdoor-only case of superspreading. None of this could be explained easily if the disease were “primarily transmitted between people through respiratory droplets and contact routes,” as the W.H.O. had said, since those larger, heavier particles would behave the same indoors as outdoors, would be largely indifferent to ventilation and would not be conducive to so much superspreading.

Finally, it was clear from early on that people who weren’t yet sick or coughing or sneezing — which produce a lot more droplets — were transmitting and that things correlated with aerosol emissions like talking, yelling and singing were associated with many of the outbreaks. Amid the growing evidence, in July, hundreds of scientists signed an open letter urging the public health agencies, especially the W.H.O., to address airborne transmission of the coronavirus.

That month, after the open letter, the W.H.O. updated its guidance to say that “short-range aerosol transmission” from infected people in poorly ventilated spaces over time “cannot be ruled out” but went on to say that “the detailed investigations of these clusters suggest that droplet and fomite transmission could also explain human-to-human transmission within these clusters” and that close contact could still be the reason, “especially if hand hygiene was not performed and masks were not used when physical distancing was not maintained.”

Evidence kept accumulating. Transmission was documented in adjacent rooms in a quarantine hotel where people never interacted. Several hospital workers were proved to have been infected despite strict contact and droplet precautions. Viable virus was found in air samples from hospital rooms of Covid-19 patients who hadn’t had aerosol-generating procedures and in an air sample from an infected person’s car. The virus was found in exhaust vents in hospitals, and ferrets in cages connected only via shared air infected each other. And so on.

There were quibbles with each study: Was the sampled virus infective enough? (It is hard to catch the viruses from the air without destroying them.) Could some fomite connection have been missed? Still, it kept getting harder to deny the role of aerosols as a major factor. Last October, the C.D.C. published updated guidance acknowledging airborne transmission, but as a secondary route under some circumstances, until it acknowledged airborne transmission as crucial on Friday. And the W.H.O. kept inching forward in its public statements, most recently a week ago.

Linsey Marr, a professor of engineering at Virginia Tech who made important contributions to our understanding of airborne virus transmission before the pandemic, pointed to two key scientific errors — rooted in a lot of history — that explain the resistance, and also opened a fascinating sociological window into how science can get it wrong and why. First, Dr. Marr said, the upper limit for particles to be able to float is actually 100 microns, not five microns, as generally thought. The incorrect five-micron claim may have come about because earlier scientists conflated the size at which respiratory particles could reach the lower respiratory tract (important for studying tuberculosis) with the size at which they remain suspended in the air. Dr. Marr said that if you inhale a particle from the air, it’s an aerosol. She agreed that droplet transmission by a larger respiratory particle is possible, if it lands on the eye, for example, but biomechanically, she said, nasal transmission faces obstacles, since nostrils point downward and the physics of particles that large makes it difficult for them to move up the nose. And in lab measurements, people emit far more of the easier-to-inhale aerosols than the droplets, she said, and even the smallest particles can be virus laden, sometimes more so than the larger ones, seemingly because of how and where they are produced in the respiratory tract.

Second, she said, proximity is conducive to transmission of aerosols as well because aerosols are more concentrated near the person emitting them. In a twist of history, modern scientists have been acting like those who equated stinky air with disease, by equating close contact, a measure of distance, only with the larger droplets, a mechanism of transmission, without examination.

Since aerosols also infect at close range, measures to prevent droplet transmission — masks and distancing — can help dampen transmission for airborne diseases as well. However, this oversight led medical people to circularly assume that if such measures worked at all, droplets must have played a big role in their transmission. Other incorrect assumptions thrived. For example, in July, right after the letter by the hundreds of scientists challenging the droplet paradigm, Reuters reported that Dr. John Conly, who chairs a key W.H.O. infection prevention working group, said that there would be many more cases if the virus was airborne and asked, “Would we not be seeing, like, literally billions of cases globally?” He made similar claims last month. And he is not the only member of that group to assert this, a common assumption in the world of infection control well into 2021.

However, Dr. Marr pointed out, there are airborne diseases, like measles, that are highly contagious and others, like tuberculosis, that are not. Moreover, while SARS-CoV-2 is certainly not as infectious as measles on average, it can be highly infectious in the superspreading events driving the pandemic.

Many respiratory viruses carried by aerosols survive better in colder environments and lower relative humidity, Dr. Marr said, again fitting the pattern of outbreaks around the world, for example, in many meatpacking plants. Plus, some activities produce more aerosols — talking, yelling, singing, exercising — also fitting the pattern of outbreaks globally.

Why did it take so long to understand all this?

One reason is that our institutions weren’t necessarily set up to deal with what we faced. For example, the W.H.O.’s Infection Prevention and Control (I.P.C.) global unit primarily concentrates on health care facilities. Many of the experts they enlisted to form the Covid-19 I.P.C. Guidance Development Group were hospital-focused, and some of them specialized in antibiotic-resistant bacterial infections that can spread wildly in health care facilities when medical personnel fail to regularly wash their hands. So this focus made sense in a prepandemic world. Hospitals employ trained health care workers and are fairly controlled, well-defined settings, with different considerations from those of a pandemic across many environments in the real world. Further, in some countries like the United States, they tend to have extensive engineering controls to dampen infections, involving aggressive air-exchange standards, almost like being outdoors. This is the opposite of modern office and even residential buildings, which tend to be more sealed for energy efficiency. In such a medical environment, hand hygiene is a more important consideration, since ventilation is taken care of.

Another dynamic we’ve seen is something that is not unheard-of in the history of science: setting a higher standard of proof for theories that challenge conventional wisdom than for those that support it.

As part of its assessment of the virus’s spread, the W.H.O. asked a group of scientists last fall to review the evidence on transmission of the coronavirus. When reviewing airborne transmission, the group focused mostly on studies of air samples, especially if live virus was captured from the air, which, as mentioned above, is extremely hard. By that criterion, airborne transmission of the measles virus, which is undisputed, would not be accepted because no one has cultivated that pathogen from room air. That’s also true of tuberculosis. And while scientists, despite the difficulties, had managed to capture viable SARS-CoV-2 in three studies that I’m aware of, the review noted that the virus was detected only intermittently in general, disputed whether the captured live virus was infective enough and ultimately said it could not reach “firm conclusions over airborne transmission.” The lead author and another senior member of the research group previously said they believed transmission was driven by droplets. The skepticism about airborne transmission is at odds with the acceptance of droplet transmission. Dr. Marr and Joseph Allen, the director of the Healthy Buildings program and an associate professor at Harvard’s T.H. Chan School of Public Health, told me that droplet transmission has never been directly demonstrated. Since Dr. Chapin, close-distance transmission has been seen as proof of droplets unless disproved through much effort, as was finally done for tuberculosis.

Another key problem is that, understandably, we find it harder to walk things back. It is easier to keep adding exceptions and justifications to a belief than to admit that a challenger has a better explanation. The ancients believed that all celestial objects revolved around the earth in circular orbits. When it became clear that the observed behavior of the celestial objects did not fit this assumption, those astronomers produced ever-more-complex charts by adding epicycles — intersecting arcs and circles — to fit the heavens to their beliefs.

In a contemporary example of this attitude, the initial public health report on the Mount Vernon choir case said that it may have been caused by people “sitting close to one another, sharing snacks and stacking chairs at the end of the practice,” even though almost 90 percent of the people there developed symptoms of Covid-19. Shelly Miller, an aerosol expert at the University of Colorado Boulder, was so struck by the incident that she initiated a study with a team of scientists, documenting that the space was less full than usual, allowing for increased distance, that nobody reported touching anyone else, that hand sanitizer was used and that only three people who had arrived early arranged the chairs. There was no spatial pattern to the transmission, implicating airflows, and there was nobody within nine feet in front of the first known case, who had mild symptoms.

Galileo is said to have murmured, “And yet it moves,” after he was forced to recant his theory that the earth moved around the sun. Scientists who studied bioaerosols could only say, “And yet it floats.”

So much of what we have done throughout the pandemic — the excessive hygiene theater and the failure to integrate ventilation and filters into our basic advice — has greatly hampered our response. Some of it, like the way we underused or even shut down outdoor space, isn’t that different from the 19th-century Londoners who flushed the source of their foul air into the Thames and made the cholera epidemic worse.

Righting this ship cannot be a quiet process — updating a web page here, saying the right thing there. The proclamations that we now know are wrong were so persistent and so loud for so long. It’s true that as the evidence piled on, there was genuine progress and improvement, especially as of late. Even before the change in language last week, for example, the W.H.O. published helpful guides on ventilation, first in July and updating it in March. Recently, though the organization’s documents have lagged, more of its officials have started giving advice compatible with aerosol transmission, emphasizing things like close mask fit — which matters little for droplet transmission — and ventilation — which matters even less. All this is good, but nowhere near enough to change the regulations and policy bundles that had already been put in place around the world. And the progress we’ve made might lead to an overhaul in our understanding of many other transmissible respiratory diseases that take a terrible toll around the world each year and could easily cause other pandemics.

So big proclamations require probably even bigger proclamations to correct, or the information void, unnecessary fears and misinformation will persist, damaging the W.H.O. now and in the future. Scientists have responded. In just the past few weeks, there has been a flood of articles published about airborne transmission in leading medical journals. Dr. Marr and other scientists told me the situation was very difficult until recently, as the droplet dogma reigned. I co-wrote one of those papers, published in The Lancet last month, arguing that aerosols may be the predominant mode of transmission for SARS-CoV-2, a step farther.

I’ve seen our paper used in India to try to reason through aerosol transmission and the necessary mitigations. I’ve heard of people in India closing their windows after hearing that the virus is airborne, likely because they were not being told how to respond. Plus, there are important questions for what this means for higher-risk settings, like medical facilities. The W.H.O. needs to address these fears and concerns, treating it as a matter of profound change, so other public health agencies and governments, as well as ordinary people, can better adjust.

The past year has revealed how crucial the agency is, despite being hampered by chronic underfunding, lack of independence and attempts to turn it into a political football by big powers. Like other public health organizations, many of its dedicated staff members work tirelessly under difficult conditions to safeguard health around the world. Maintaining its credibility is essential not just for the rest of this terrible pandemic but in the future. It needs to begin a campaign proportional to the importance of all this, announcing, “We’ve learned more, and here’s what’s changed, and here’s how we can make sure everyone understands how important this is.” That’s what credible leadership looks like. Otherwise, if a web page is updated in the forest without the requisite fanfare, how will it matter?

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بلاول بھٹو کی مختلف ممالک کے سفارتکاروں سے ملاقات

 پیپلز پارٹی کے چیئرمین بلاول بھٹو زرداری سے کراچی میں مختلف ممالک کے

سفارتکاروں نے ملاقات کی ہے۔

ترجمان بلاول ہاؤس کے مطابق بلاول بھٹو سے امریکا، افغانستان، سعودی عرب، بحرین، عمان اور اٹلی کے سفارتکاروں نے ملاقات کی۔

ترجمان کے مطابق ملاقات میں وزیراعلیٰ سندھ سید مراد علی شاہ اور وزیراطلاعات سندھ ناصر حسین شاہ بھی شریک تھے۔

اس موقع پر بلاول بھٹو نے دوست ممالک کے سفارتکاروں کے اعزاز میں افطار ڈنر کا اہتمام کیا۔

افطار ڈنر میں پی پی کی نائب صدر شیری رحمان اور سیکریٹری اطلاعات شازیہ مری شریک تھیں جبکہ وزیراعلیٰ سندھ سید مراد علی شاہ، وزیرتعلیم سعید غنی اور وزیراطلاعات ناصر شاہ بھی موجود تھے۔

بلاول بھٹو کے افطار ڈنر میں امریکی قونصل جنرل رابرٹ سلبرسٹین اور اٹلی کے قونصل جنرل ڈینیلو گیئورڈانیلا، سعودی عرب کے قونصل جنرل بندر فہد الدائل اور متحدہ عرب امارات کی سفارت کار مریم العزیزی موجود تھیں۔

اس افطار ڈنر میں افغانستان کے سفارت کار عبدالرحمان قاضی زادہ اور بحرین کے قونصل جنرل یاسر عیسیٰ ایجان الہدیدی، عمان کے سفارت کار محمد ناصر حماد المبسالی اور قطر کے قونصل جنرل مشال ایم الانصاری بھی شریک ہوئے۔

بلاول بھٹو نے دوست ممالک کے سفارت کاروں کے درمیان دلچسپی کے دو طرفہ امور پر تبادلہ خیال کیا گیا۔

چیئرمین بلاول بھٹو زرداری اور دوست ممالک کے سفارت کاروں کا دوطرفہ تعلقات میں اضافے اور باہمی تجارتی روابط مزید مضبوط کرنے پر اتفاق کیا۔

https://jang.com.pk/news/923323

بلاول بھٹو کی زیر صدارت پنجاب کےصوبائی عہدیداران کا وڈیولنک اجلاس

 

چیئرمین پیپلزپارٹی بلاول بھٹو زرداری کی زیر صدارت پنجاب کےصوبائی عہدیداران کا وڈیولنک اجلاس ہوا، اجلاس میں پی پی پی وسطی پنجاب کے صدر قمر زمان کائرہ، جنرل سیکریٹری چودھری منظور شریک ہوئے۔

ویڈیو لنک اجلاس میں سیکرٹری اطلاعات حسن مرتضیٰ، سیکرٹری جنرل نیر بخاری بھی موجود تھے، اجلاس میں سیاسی صورت حال بالخصوص پی پی پی پنجاب کے تنظیمی معاملات پر تبادلہ خیال کیا گیا۔

اس موقع پر پی پی پی پنجاب کےصوبائی عہدیداران کا کہنا تھا کہ ہماری تقرری کو 3 سال مکمل ہوچکے ہیں، خواہش ہے کہ وسطی پنجاب میں پارٹی کی تنظیم نو کی جائے۔

اگلے 3سال کیلئے نئے عہدیداروں کے تقرر کے سلسلے میں وسطی پنجاب کے عہدیداران نے استعفے پیش کردیے۔

اعلامیہ کے مطابق بلاول بھٹو نے قمر زمان کائرہ،چودھری منظور اور حسن مرتضیٰ کے استعفے منظور کرلیے۔

https://jang.com.pk/news/923336

#OP-ED - #Covid and the Age of Ignorance

Ignorance is bliss, as the saying goes. Though the global pandemic has taught us that there is a very fine line between ignorance and indifference. Covid-19 represents one of the world’s worst health emergencies in recent history, and most certainly the most devastating any of us will endure in our lifetimes. Yet social media is full of images of the so-called educated classes carrying on as normal. There are dance practices and international trips. And seemingly no regard for quarantine.

What is it, therefore, about having a collective human conscience that we are finding so difficult to cultivate? Can the blame for this rest solely with you or I?

Let us rewind to this time last year when Prime Minister Imran Khan described this virus as “just a bit more than flu” that “kills only old people”. This was followed by Asad Umar, the then federal minister for Planning, Development and Special Initiatives, comparing the number of Covid-related deaths to road accident fatalities. Time and time again, the government pushed ahead with the narrative that it could ill-afford a full lockdown since this would be catastrophic for daily wage earners. Certainly, economic considerations are not to be ignored but it is highly irresponsible to send such mixes messages in a country prone to conspiracy theories.

Last year, Saudi Arabia closed the doors of the Holy Kaaba to worshippers; underscoring how the Muslim world grasped the magnitude of the situation. Not so in Pakistan where clerics and scholars did not see fit to encourage the faithful to pray at home. We can and must ask people to be self-reflective and think about how their own individual actions impact the lives of those around them. But what of those in power? Are we to absolve them from failing to present a clear narrative from the onset?

National governments with their mixed messages may have failed us. But we, too, bear responsibility for how we move ahead; as individuals, as families and societies. This will not be over for anyone unless it is over for everyone

Covid-19 was never just a case of “the flu”. But our political parties used this deadly virus as a means of political scoring, with the opposition hosting jalsa after jalsa, pulling in crowds with hardly a single mask in sight. That this happened in defiance of the government’s ban on public rallies underscores the impotency of the ruling PTI. Nowhere was this clearer than when tens of thousands flocked to the funeral of Khadim Rizvi, the late TLP (Tehreek-e-Labbaik) leader.

If the ‘Age of Ignorance’ has taken root in Pakistan – the situation is tragically even worse in neighbouring India, which is facing the collapse of its entire healthcare system. Families are left to watch their loved ones die on the streets and in front of hospital gates, while their own Modi Sarkar is busy petitioning Twitter to delete negative tweets daring to call out the BJP government over its utter mismanagement of the pandemic, despite pressing ahead with the recent Bengal elections.

Covid has spread like wildfire, exposing devastating gaps in the healthcare infrastructure of so many countries around the world. Additionally, it has also revealed mass apathy. We seem to have evolved into such creatures of habit that our ability to adapt to unprecedented crisis has become almost non-existent. In the past, action was required to defend our country, family and home. Now, it seems that the best remedy is to sit still.

Sri Lanka is currently in the grip of an emergency. The country observed Aluth Avurudu (Sinhalese and Tamil New Year) some two weeks ago. The result from cluster groups formed to celebrate the festivities has been 1,500 new Covid cases a day. Given that the country has a total population of just 20 million, the Army has had to step in to physically make 10,000 new beds to offset the unavoidable burden on the healthcare system; ICUs are already at full capacity. Incredibly, this has not been sufficient to stop people from enjoying Colombo night-life as they gather on the beaches of Unawatuna, pretending that their wealth and privilege will somehow immunise from Covid. The people of Pakistan and India suffer high illiteracy rates and are, therefore, in urgent need of constant and consistent messages from their respective leaderships about required SOPs. The same cannot be said of Sri Lanka.

Will it take a specific level of destruction and tragedy to stop us in our tracks, mid-dance, and make us realise that we do not want to be remembered as those who lived in the Age of Ignorance? For in a day and age when we could have done more by doing very little – we have chosen instead to fulfil our short-term needs for communal celebration and activity over long-term collective health benefits and safety.

Yes, national governments with their mixed messages may have failed us. But we, too, bear responsibility for how we move ahead; as individuals, as families and societies. This will not be over for anyone unless it is over for everyone. We must break this cycle of apathy, and develop the empathy required for history to remember us kindly.

#Pakistan - Squeezing the salaried class

Dr. Usman W. Chohan

Pakistan’s salaried class serves the role of a steadied backbone in our otherwise rough-and-tumble economic life. Their salaries are subject to taxation that offers the slimmest modicum of tax effort in a country with a worryingly small tax base and unsound fiscal health. The salaried class are in fact an easier target for revenue collection than other sources, because they sell their professional labour within an observable and formalised system.

Yet the problem with taxing the salaried class excessively is that they offer but a narrow base, and what Pakistan needs is breadth of tax collection, rather than depth—which is to say, one cannot really squeeze the salaried class much further than they already are, above all because salaries in Pakistan do not rise at the same rate as inflation. This is a problem in most emerging markets, but is particularly acute in Pakistan, since our inflation rate remains persistently high, thereby shrinking the buying power of salary-earning households at an increasing rate.

The question of squeezing the salaried class has become a bone of contention between the government and the IMF. As part of its stringent demands, the IMF has prodded the government to consider additional tax impositions for the upcoming FY2021-22 on the already struggling salaried class. It wants the government to extract a further Rs. 176 billion, which would raise the total amount gutted from the salaried class to Rs. 305 billion, more than double the present Rs. 129 billion. The IMF argues that this additional money could help reduce the budget deficit, or be channelled towards development expenditures for the poor—as if the salaried class wasn’t carrying the burden of the poor already, who are unable (not to mention: unwilling) to shoulder the burden of sustaining the nation. It should be noted that the salaried class’ tax burden already shot up in the earlier fiscal year (FY19-20) by a whopping 70 percent, from Rs 76 billion to the 129 billion now under discussion.

The government is mindful of the burden placed upon the narrow base of the salaried class, and the Federal Board of Revenue has raised objections to the IMF’s proposal, offering instead a counteroffer of raising the tax burden on the salaried class by only Rs10 billion, especially given that the inflation rate continues to remain high. The Prime Minister has himself met with IMF officials and insisted that they back away from certain stringent conditionalities, including this but also energy prices and certain types of tax areas including education, agriculture, and healthcare. Yet the resumption of the $6 billion Extended Fund Facility has meant that negotiations are tough. This EFF negotiation is especially dismal when seen in the wider international context where there is too much money sloshing around, unable to earn any returns. The global economy actually has a surplus of dollars pumped in by the large stimulus measures throughout the developed world, particularly the US, and yet Pakistan is having to squeeze its stoic salaried class just to comply with stipulations for a measly $6 billion?

This is not to suggest that the government should continue with its tax reform efforts. After all, the scope for tax reform is enormous in Pakistan, and some areas where the government is laying emphasis are important ones, such as simplifying the tax code, reducing the numbers of rates, reducing tax credits, decreasing the number of slabs, and increasing progressivity. The Centre for Aerospace & Security Studies (CASS) has worked recently on taxation reform proposals in Pakistan, and so have other research institutions. There is of course much more still that would help make Pakistan’s system conform to the principles of ideal taxation, but that is a bigger project and it certainly doesn’t involve breaking the back of the salaried class. The biggest measure that would help the fiscal architecture would be to expand the tax base in a progressive manner, so that there is less reliance on the slim bracket decent folk who earn salaries that cannot keep up with inflation in any case. Given the weight that the salaried class in Pakistan carries, in fiscal terms relative to other cohorts of the population, they should in fact be given a preferential outlook rather than a discriminatory one.

https://nation.com.pk/07-May-2021/squeezing-the-salaried-class

#Pakistan reports 4,298 #coronavirus cases in a day

 

• 140 coronavirus fatalities reported over the past 24 hours.
• Total number of coronavirus cases crosses 850,000 mark. 
• Total death toll has climbed to 18,677. 

Pakistan continues to report a large number of coronavirus cases across the country, with 4,298 people testing positive for the virus, with 140 people succumbing to the infection.

The country passed the grim milestone of 850,000 cases in total while the total death toll has climbed to 18,677. 

The total number of recoveries reported across the country stand at 747,755 while the active number of cases have risen to 83,699. 

Pakistan's coronavirus positivity ratio stands at 9.58%.

As Eid approaches, Dr Faisal Sultan warns Pakistanis of a 'very risky period'

Special Assistant to the Prime Minister on Health Dr Faisal Sultan on Thursday warned Pakistanis of a "very risky period ahead" as Ramadan comes to an end and the days of Eid-ul-Fitr holidays approach.

"We are today in the midst of the third wave of Covid-19 pandemic and while there may be very initial signs of some stability (in the third wave), these are very early days and this is a very risky period for us as the holy month of Ramazan is going to end and Eid is approaching," he said during a webinar.

He called on microbiologists and scientists to keep warning people about the dangers of the coronavirus and encourage them to keep following the standard operating procedures for safety against the infection.

The webinar, titled SOPs and vaccination: Solution for the Covid-19 Pandemic, was attended by microbiologists, molecular biologists, medical professionals and students from Pakistan as well as abroad.

Speaking about Punjab, Dr Sultan said the curve is flattening in Punjab and the same was the case in Khyber Pakhtunkhwa. However, he said coronavirus cases were on the rise in Sindh due to low compliance of SOPs by the masses, adding that now was not the time to get complacent as Pakistan still had more than 5,200 in critical care.

"Covid-19 cases may rise again if precautions are not taken during this critical period when we are seeing the last days of the holy month of Ramazan and Eid is a festive season," he said. 

https://www.geo.tv/latest/349109-pakistan-reports-4298-coronavirus-cases-in-a-day

Bilawal Bhutto warns Pakistan approaching another flour crisis, slams govt over wheat prices

Apr 29, 2021 

The PPP chairman also underscored the prices of fertilisers, seeds, pesticides, agricultural machinery and electricity that have gone up by 150 per cent.

Pakistan Peoples Party (PPP) chairman Bilawal Bhutto-Zardari has warned that the country is moving towards another flour crisis as there are only less than 20 days of wheat stock left available in the country.

In a statement issued by the PPP Media Office on Wednesday, Bilawal slammed the federal government for fixing the wheat purchase price at INR1,800 per 40 kg, alleging that the government was making a false claim that it had increased the subsidy price up to 400 per cent, Dawn reported.

He claimed that the increase was only 28 per cent as the government had raised the purchase price from INR 1,400 to INR 1,800. He said that his party would not allow the oppression of farmers in Sindh and the relief price would be INR 2,000 per 40kg in the province.

"Today, for the first time in the history of the country, the support price of wheat is not the same in all the provinces and Imran Khan is responsible for this oppression of the farmers of Punjab, Khyber Pakhtunkhwa and Balochistan," he alleged.

The PPP chairman also underscored the prices of fertilisers, seeds, pesticides, agricultural machinery and electricity that have gone up by 150 per cent.Reminding the people that the federal government had already created two wheat crises in three years, he said that it was due to the poor planning of Prime Minister Imran Khan's Pakistan Tehreek-i-Insaf (PTI) government that today only two to two-and-a-half weeks of wheat stock was available in the country.

"If the crisis is not dealt with, the country may once again face a shortage of flour," he said.

According to Dawn, Bilawal lamented that Pakistan, which was known as a wheat-producing country, is now importing wheat, adding that the ruler of Pakistan (Imran Khan) was unfortunately not even familiar with "alphabets of the word agriculture". Meanwhile, in a separate statement, PPP's parliamentary leader in the Senate Sherry Rehman expressed concern over the government's plan to split Pakistan International Airlines (PIA) into two companies, Dawn reported. "The Tabahi Sarkar (destructive government) has literally crashed PIA by compromising several Pakistani pilots with clean licences, got the airline grounded in EU capitals after the 'Licencegate', sold PIA assets abroad via crony shell firms and are now cannibalising 'old PIA' to create new business ventures. This is a new low," she said.

Around 2,000 PIA employees had been forced to take voluntary redundancy and now the plan was to lay off half of its 14,000 employees, the Senator added.

"Why did the government recently mislead the people by claiming PIA losses have been brought down? If this was the case then what losses are they talking about now? The national flag carrier posted a net loss of US $226 million (INR 34.6 billion) in 2020, its loan has caused an overall loss of INR460 billion, the iconic Roosevelt Hotel in New York has been sold and our profitable international routes were given to competitors," she said.

Rehman blamed the government's incompetence over PIA's losses and said that PIA flights had been banned in Europe and the US because of the Pakistan aviation minister's "callous statement".

https://www.wionews.com/south-asia/bilawal-bhutto-warns-pakistan-approaching-another-flour-crisis-slams-govt-over-wheat-prices-381510

پاکستان پیپلزپارٹی کے چیئرمین بلاول بھٹو زرداری کی سندھ میں پانی کی قلت کے حوالے سے وفاقی حکومت پر کڑی تنقید

 پاکستان پیپلزپارٹی کے چیئرمین بلاول بھٹو زرداری نے سندھ میں پانی کی قلت کے حوالے سے وفاقی حکومت پر کڑی تنقید کرتے ہوئے کہا ہے کہ پی ٹی آئی کی سندھ میں نااہل حکومت نے پانی کا بحران پیدا کردیا، چیئرمین بلاول بھٹو زرداری نے متنازع چشمہ جہلم لنک کینال کو فی الفور بند کرنے کا مطالبہ کرتے ہوئے بتایا کہ پاکستان پیپلزپارٹی نے عوام کا مقدمہ لڑا

تو پی ٹی آئی حکومت نے مجبور ہوکر غیرقانونی تونسہ پنجند لنک کینال کو بند کیا

، میڈیا سیل بلاول ہاؤس سے جاری اپنے ایک بیان میں چیئرمین پی پی پی بلاول بھٹو زرداری کا کہنا تھا کہ ارسا صرف واٹر اکارڈ کے تحت پانی کی تقسیم کی مانیٹرنگ کا ادارہ ہے، پانی کی ترسیل میں ارسا کی من مانیاں نہیں چلیں گی، منگلا ڈیم کو ارسا کے طے شدہ متنازع فارمولے سے زیادہ بھرنے کی وجہ سے سندھ میں پانی کی قلت پیدا ہوئی، انہوں نے کہا کہ نوبت یہاں تک پہنچ گئی کہ سکھر بیراج میں 27 فیصد جبکہ کوٹری بیراج میں پانی کی 44 فیصد تک کمی ہوچکی ہے، وفاقی حکومت کی نااہلی کی وجہ سے سندھ میں پانی کی قلت کا یہ عالم ہے کہ گڈو بیراج سے پانی کی ترسیل بند ہوچکی ہے

، چیئرمین بلاول بھٹو زرداری کے مطابق گزشتہ سال کی برسات میں ڈیموں میں پانی کی وافر مقدار تھی مگر پی ٹی آئی حکومت کی بدانتظامی کی وجہ سے ڈیموں میں پانی کی کمی ہوئی، پی ٹی آئی حکومت سندھ سمیت پورے پاکستان میں پانی کی ترسیل کی منصفانہ تقسیم میں مکمل طور پر ناکام ہوچکی ہے، اس موقع پر عمران خان کی حکومت کر تنقید کرتے ہوئے انہوں نے کہا کہ پی ٹی آئی حکومت نے سندھ کے زیریں علاقوں کو پیاس کا صحرا بنادیا، کراچی، ٹھٹہ، سجاول، بدین اور تھرپارکر کا پانی بند کرکے پی ٹی آئی حکومت نے سفاکیت کی انتہا کردی، یہ کیسی مدینے کی ریاست ہے کہ بدترین گرمی اور رمضان کے مقدس مہینے میں سندھ کا پانی بند کردیا گیا، چیئرمین بلاول بھٹو زرداری نے کہا کہ اگر سندھ کے زیریں علاقوں میں پانی کی قلت کے بحران کو دور نہیں کیا گیا تو قحط جیسی صورت حال پیدا ہوسکتی ہے، سندھ کے حصے کا پانی روک کر پی ٹی آئی حکومت اہلیان کراچی کو سزا دینا بند کرے

، پی پی پی چیئرمین نے وزیراعظم کو مخاطب کرتے ہوئے کہا کہ وزیراعظم صاحب، خریف کی فصل کا سیزن شروع ہورہا ہے، ہوش کے ناخن لیں اور سندھ کو اس کے حصے کا پانی دیں، پی ٹی آئی کی جانب سے پیدا کردہ پانی کے بحران کے بعد سندھ کے کسانوں کے لئے کپاس کی بوائی ممکن نہیں، ملک میں کپاس کی قلت سے پہلے ہی ٹیکسٹائل سیکٹر کو مسائل کا سامنا ہے، پانی بند کرکے عمران خان نئے بحران نہ پیدا کریں، انہوں نے یہ بھی کہا کہ وفاقی حکومت کی بدانتظامی کی وجہ سے کراچی سمیت سندھ کے مختلف علاقوں میں پینے تک کے پانی کا بحران پیدا ہورہا ہے، پہلے بارشوں کی وجہ سےفصلیں تباہ ہوئیں اور اب سندھ کا پانی بند کرکے دیوار سے لگایا جارہا ہے، چیئرمین بلاول بھٹو زرداری نے وفاقی حکومت کو خبردار کرتے ہوئے کہا کہ اگر ہنگامی بنیادوں پر پانی کا بحران حل نہ کیا گیا تو فصلوں کی بوائی نہیں ہوسکے گی اور غذائی بحران کے ساتھ ایک نیا المیہ پیدا ہوجائے گا-

https://www.ppp.org.pk/pr/24750/

 

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Why Biden won’t engage with #Pakistan

By FM SHAKIL

US leader has not contacted his Pakistani counterpart despite Islamabad's crucial role in brokering an Afghan peace settlement.

When Joe Biden assumed the US presidency in January, many in Pakistan hoped for a bilateral reset. Three months on, there is no such rapprochement in sight as the new administration in Washington delivers perceived snubs rather than engaged olive branches to Islamabad.

Officials claim the US has ignored Pakistan’s hopeful outreach, despite the critical role Islamabad has played in persuading the Taliban to negotiate with the US in a peace process that appears to be headed towards a settlement in neighboring Afghanistan.

Despite that crucial initiative, one that aims to end America’s so-called “endless war”, President Biden has not personally spoken to Prime Minister Imran Khan since the former assumed power, according to Pakistani officials familiar with the situation.That, they say, is likely because Washington thinks Islamabad is pushing China and Russia’s agendas at the expense of US interests in Afghanistan. Washington also knows Pakistan is well-placed to manipulate the formation of a future Afghan government by dint of its proximity and connection to the Taliban.

Washington, some in Islamabad believe, is expressing that displeasure through not-so-veiled diplomatic sleights. For instance, Biden’s Special Envoy for Climate Change, John Kerry, visited India and Bangladesh last month but eschewed a stopover in Pakistan.

Similarly, US Secretary of Defense Lloyd Austin visited India and Afghanistan on March but opted not to land in Pakistan. Instead, the US defense chief spoke with Army Chief General Qamar Javed Bajwa over the phone while he was in Kabul.Islamabad has not yet publicly conveyed its reservations about the Biden administration’s perceived snubs, but senior officials admit privately that they feel the gestures have been deliberate and not mere diplomatic oversight.

Pakistani officials quoted in news reports think that the Supreme Court’s acquittal of Ahmed Omar Saeed Sheikh and three associates who allegedly kidnapped and decapitated Wall Street Journal bureau chief Daniel Pearl back in 2002 put relations with Biden on the wrong foot.The court released Sheikh just as Biden was taking his oath of his office in January. Washington has reportedly asked Islamabad to review its legal options after the ruling and has apparently suggested allowing for the US to prosecute the suspects to secure justice for Pearl’s family if for political reasons it is unable to do so in Pakistan. There is also lingering distrust over Osama Bin Laden, the al-Qaeda leader responsible for the 9/11 attacks on the US who resided quietly in a Pakistan hill-station compound situated suspiciously near a military containment area. In May 2011, the US famously sent commandos into Pakistan without Islamabad’s foreknowledge to assassinate the terror leader. In his recent book “A Promised Land”, former US president Barack Obama claimed that he preferred not to involve Pakistan in the raid because it was an “open secret” that elements inside Pakistan’s military, and especially its intelligence services, maintained links to the Taliban and likely by association al-Qaeda.

Pakistan, he wrote, sometimes used them as “strategic assets” against Afghanistan and India.

Fast forward to the present, the new US administration likely wants Islamabad to demonstrate it is not a pliant proxy of China. That’s easier said than done in light of Beijing’s US$60 billion commitment to the China-Pakistan Economic Corridor, a key, strategic spoke of its Belt and Road Initiative (BRI).

Mushahid Hussain Syed, a Pakistani politician, analyst and Pakistan Muslim League-Nawaz (PML-N) Senator, told Asia Times that there was a perceived lack of sensitivity and gratitude on the part of the US for what Pakistan has and is doing to “pull the American chestnuts out of the fire on Afghanistan.”

“While Pakistan is pressing the ‘right buttons’ on FATF, India, Afghanistan and terrorism issues, which the US considers key irritants, they still seem to view Pakistan through the prism of the emerging Cold War. They are aligning with India to contain the Chinese influence in the region, which is going to backfire. The US should have rather built bridges with Islamabad that strived to bail out Washington from its latest defeat in yet another land war in Asia,” Syed said.

Symbolically, Biden did not invite Khan to his government’s first virtual summit on climate change held on April 22-23. The US president invited 40 heads of state and government, including leaders of India, Bangladesh and Bhutan from the South Asian region, but sent a belated invitation to a low-profile functionary who serves as Khan’s special assistant on climate change.

Khan, who is touting his own “billion trees” environmental initiative, perceived the diplomatic snub, Pakistani officials claim.

While China’s economic influence looms large, Pakistan still needs Washington’s support, both to sustain disbursements of its $6 billion bailout package from the International Monetary Fund (IMF) and to be removed from the terror-financing and money-laundering watchdog Financial Action Task Force’s “grey list”, a designation that hinders Islamabad’s participation in global financial markets. If Biden could influence either organization’s decision-making in Pakistan’s favor, he hasn’t done so yet. The IMF has so far released two tranches of $450 million each of an Extended Fund Facility program initiated in 2019, but delayed a second review meeting and the release of a third tranche last month without letting Pakistani officials know in advance.

Similarly, the FATF kept Pakistan on its grey list in February because “Pakistan must improve its investigations and prosecutions of all groups and entities financing terrorists and their associates and show that penalties imposed by courts are effective.” The next FATF plenary review of Pakistan’s status is due in June this year.

Khan’s government thinks the best way to reset with the US is through economics rather than security. In early March, Khan formed “an apex committee” under the chairmanship of Foreign Minister Shah Mahmood Qureshi to develop an all-inclusive agenda for re-engagement with the new US administration.The committee was specifically tasked to work on economic and industrial ventures that could be put forward to Biden’s policy team for possible economic collaboration.The proposals under consideration include so-called “Reconstruction Opportunity Zones” (ROZs), an initiative first broached by the George W Bush administration in 2006 in return for Islamabad’s support for the US “war on terror” in neighboring Afghanistan, where al Qaeda was then known to maintain bases.

The committee has also proposed the formation of a US-Pakistan Economic Zone at Karachi’s port to re-process industrial goods at concessional rates for export to US markets. The apex committee’s work has so far remained confined to working papers in the absence of an opportunity for Khan to engage personally with Biden’s team.

Mushahid opined that the new US administration seems confused about Pakistan’s role in the Afghanistan peace process, a communication breakdown that could fatally hinder ties. “The only clarity seems to be a readiness to scapegoat Pakistan if and when things go wrong in Afghanistan,” said Syed, “while conjuring up the ‘China threat’ to justify their bloated military budgets.”

https://asiatimes.com/2021/05/why-biden-wont-engage-with-pakistan/

Coronavirus doctor's diary: Families stranded in Pakistan, India and Bangladesh

 Some Bradford schools are missing pupils because they travelled abroad with their families, who cannot now get back without paying a hefty bill for hotel quarantine. This is just one of the risks of travel during a global pandemic, says Dr John Wright of Bradford Royal Infirmary, who notes that British travellers may also have contributed to the spread of the virus.

A head teacher tells me that she has a problem with families stuck abroad, in countries on the UK's red list.

British residents who have been in one of these countries have to spend 10 days in quarantine in a hotel when they arrive back, at a cost of £1,750 for a single adult, and much more for families. Those who can't afford it are sometimes staying where they are - perhaps living free of charge with relatives - and this has left noticeable gaps in some classes.

In Bradford, families are mostly stuck in Pakistan, where the majority of the city's Asian population originates, but it's clear that many UK families are also unable to return from India and Bangladesh.

"We didn't know there was any chance of quarantine - we just went," says Inaya Hussain, who flew to Pakistan with her three children, aged between nine and 13, the week before lockdown, because her mother was seriously ill.

But on 9 April Pakistan was put on the UK's red list, because of rising numbers of Covid infections, as was Bangladesh. On 23 April, India was added too.

Lynette Clapham, head teacher at Grove House and Crossley Hall Primary Schools, says she's aware of 11 families who are currently abroad and unable to return, often because of the cost of quarantine.

I suspect that during each of our three waves we exported the virus from Bradford to low-incidence countries

Dr John Wright
Bradford Royal Infirmary

Some travellers, however, have found a way round this: they are travelling from Pakistan to Turkey, spending 10 days in Turkey, and then returning perfectly legally to the UK from there. They are then able to quarantine at home for 10 days, rather than in a hotel.

But now it turns out that cases have been rising in Turkey too. A week ago the country went into a three-week lockdown as a result. Travel agents say travellers from Pakistan are still arriving in Istanbul en route for the UK, and that while Turkish residents are meant to stay at home, tourists are still allowed to go sightseeing.

The surge of cases in India, and to a lesser extent in Pakistan and Turkey, reminds us how connected our world is in the face of this pandemic. It is less a global village and more a global forest, with the Covid fire igniting one section of dry tinder just as it is extinguished somewhere else.

Front-line diary

IMAGE COPYRIGHTPISHDAAD MODARESSI CHAHARDEHI

Prof John Wright, a doctor and epidemiologist, is head of the Bradford Institute for Health Research, and a veteran of cholera, HIV and Ebola epidemics in sub-Saharan Africa. He is writing this diary for BBC News and recording from the hospital wards for BBC Radio.

Last year, during the first lockdown, when the UK had some of the highest rates of infection, I talked to patients and their families who were escaping back to their roots in Eastern Europe or Pakistan, seeking places of greater safety. I'm aware that in the second and third waves too people have been travelling to see their families, perhaps for funerals or weddings, or to look after elderly parents.

According to the Civil Aviation Authority, 32,000 people either took a direct flight from the UK to Pakistan in January, or flew from Pakistan to the UK. The figure was nearly 38,000 in February and 46,000 in March.

However, as we know from the initial spread of the virus from China to Italy and Spain in 2020, travel is a critical, yet highly controllable route of transmission.

I suspect that during each of our three waves we exported the virus from Bradford to low-incidence countries, and this may well have contributed to subsequent outbreaks in Pakistan, India, Eastern Europe or Turkey.

Nobody wants to be a prisoner on our island, but until we have effective global vaccine coverage and control of international transmission then importation of cases, and new variants in particular, remains a clear and present danger.

Red list restrictions for travellers from high risk countries may be disruptive and inconvenient but they are a crucial public health protection measure.

Quarantine

• A state, period, or place of isolation in which people or animals that may have been exposed to infectious disease are placed
• Origin: Late 15th Century (in sense "place where Jesus fasted for forty days")... The modern sense is from Italian quarantina "forty days", from quaranta "forty"

Source: Lexico.com

The good thing about our connected world, however, is that information also travels with ease.

In the hospital in February 2020 we were getting minute-by-minute updates from our medical colleagues in China, Italy and Spain, who were sharing the latest glimmers of evidence about risk factors and treatments via WhatsApp groups and social media. That speed of knowledge mobilisation saved countless lives.

Recently, my Bradford colleague Dr Dinesh Saralaya and his classmates from medical school in India have been helping one another by sharing what they've been able to find out about best practice since the start of the pandemic.

image captionDinesh Saralaya in April 2020

"We are sharing information about what has worked - Dexamethadone, the early use of C-pap [non-invasive ventilation with oxygen] and proning, for example," says Dinesh.

"Some of the drugs they're using there - Remdesivir and plasma treatment, for example - are hardly used here as they haven't proved effective in trials."

In the early 1990s my wife Helen and I were working in a rural hospital in Southern Africa when we noticed a rapid rise of HIV-related infections.

In the age before the internet, knowledge was a precious commodity that moved slower than the tortoises wandering through the Lubombo bush. Our observation of rising rates of HIV-related TB in 1991 required a letter written on an ancient typewriter, posted by aerogram and eventually published months later as a letter in the British Medical Journal.

There is a long-standing frustration from political leaders about how slowly innovation spreads in the NHS; a good idea in Bradford is rarely adopted in Bristol (and vice-versa). There is a whole field of "implementation science", with its own bespoke journals, dedicated to how we can overcome our natural, curmudgeonly instinct to ignore ideas that are not invented here. But the pandemic has demonstrated that in a crisis we are very good at rapid adoption and spread.

https://www.bbc.com/news/health-56873813