Lessons for Pakistan from India’s COVID-19 catastrophe
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The apocalyptic COVID-19 upsurge in India has been as shocking in its severity as in its suddenness for a population that was lulled into complacency by a combination of factors, not least of which was triumphalism among its leadership.
With the number of daily infections close to 400,000, experts estimate that if the current rate of growth continues, it could peak at almost one million daily new cases within a few weeks. With an official count of almost 4,000 deaths every day, it is feared that many more thousands remain uncounted. Burial grounds have run out of space and funeral pyres burn nonstop. With more than one out of every five coronavirus tests returning positive, it would not be unfair to assume that the number of tests being carried out is insufficient, and that COVID-19 is more widespread than officially stated.
The unfolding tragedy should provide pause for introspection for policy makers not only in India, but Pakistan too. The misplaced notion of South Asian exceptionalism, which promoted folklore such as that of the population being imbued with a genetic advantage or having protection through childhood immunization, have proven to be dangerous fallacies. There was always little supporting scientific evidence for such ideas and these must now be firmly rejected.
The sharp decline in case numbers in India between October 2020 and February 2021 also promoted the belief that Indians have attained herd immunity, a view that an Indian government-commissioned study appeared to affirm. This encouraged the leadership to claim victory against the pandemic and relax public-health precautions. Overconfidence among government officials that a ‘second wave’ would not strike India framed their public messaging. Consequently, not only was there a decline in mask-wearing and social distancing measures, but massive political rallies were organized for state elections. To cap it all, the government gave permission for religious festivals that brought together hundreds of thousands of people. All this while little was done to prepare for a possible resurgence in cases that scientific voices were warning of.
The misplaced notion of South Asian exceptionalism, which promoted folklore such as that of the population being imbued with a genetic advantage or having protection through childhood immunization, have proven to be dangerous fallacies.
Javed Hassan
The lack of preparedness proved to be costly. As the case numbers surged, hospitals ran out of life-saving oxygen and were found to have grossly insufficient numbers of beds. As reported by Fitch, “lack of medical funding and health care infrastructure inform our view for the potential epidemic to be worse in India if it is not adequately contained. With 8.5 hospital beds per 10,000 population and eight physicians per 10,000, the country’s health care sector is not equipped for such a crisis.”
Across South Asia, years of underinvestment have resulted in woefully inadequate capacity to meet basic health care requirements, let alone cater for an epidemic. Although Pakistan has so far managed to avoid experiencing a surge in COVID-19 cases comparable in severity to India, the creaking health system is stressed.
If sufficient caution and social distancing measures do not prevail in stunting case numbers, the Dantesque nightmare witnessed in India could well be repeated in Pakistan.
The total number of critical care patients on oxygen in the current wave in Pakistan is almost 60 percent greater than the number during the previous COVID-19 peak in June last year. The National Command and Operation Center (NCOC) that has organized the national response to the pandemic has so far ensured that the health system is managing to cope with the recent surge in COVID-19 cases. In its handling of the crisis its centralized approach has been the most distinguishing feature between India and Pakistan.
While there have been some lapses in ensuring adequate compliance of social distancing and mask wearing, which could have contributed to the recent surge, the NCOC has nevertheless proactively worked at warning the public of the dangers of the third wave of COVID-19. At the same time, it has also mobilized resources to build up oxygen production capacity in Pakistan, which has been bolstered from 487 tons/day to presently 798 tons/day. It has also imported 19,200 oxygen cylinders last year to ensure its availability to designated COVID-19 hospital beds. The NCOC can be credited for trying to keep political considerations out of decision making and instead allowing data and science to drive policy. Thus far, it appears to have prevented an exponential surge in COVID-19 cases.
Nevertheless, the challenge is far from over and case numbers have still not started to decline to the point at which it can be established that a crisis has been averted. Hospital capacities to cater for new cases remain stretched and any premature celebration of success can prove to be deadly. The need for an abundance of caution and further preparedness of the health system must go hand in hand with efforts to ensure that the majority of the population is vaccinated as soon as is practicably possible. Failure to do so opens up the country to the possibility of suffering a catastrophe that may be comparable to India’s.
– Javed Hassan has worked in senior executive positions both in the profit and non-profit sector in Pakistan and internationally. He’s an investment banker by training.
Twitter: @javedhassan