Covid-19: emergency response – Dr Akmal Hussain


Pakistan has begun to enter the steeply rising phase of the incidence of the Covid-19 infection. Less than a month ago on February 26, there were two cases infected by the virus and by March 16 there were 53 reported cases. Still a number that appeared manageable. But within the last one week alone, the number of infected cases has jumped exponentially across all four provinces of the country.

The alarm bells should start ringing. This is a pattern that is typical of every one of the 184 countries affected by the virus: initially the cases are very few but within a relatively short period of time, the number of infected people shoots up. If effective containment measures are not undertaken early on, the sheer number of cases requiring hospital treatment becomes so high at some point, that the medical facilities of any country are liable to be overwhelmed.

There are three features of the Covid-19 virus that explain this graph of disease incidence: first, there is no immunity against the virus in most cases, since it is newly mutated. Second, this particular virus is far more infectious than any other in the Corona class of viruses. Third, in many cases symptoms don’t appear for a week during which period the infected person can pass on the illness to those he meets and they in turn become carriers to others.

So, even if the initial number is small the illness can spread at an exponential rate. That is why, as international experience shows, restricting people to their homes, early on is of crucial importance. That timing is critical for containment, is illustrated by the contrasting examples of China and Italy. Very soon after the outbreak in Wuhan, the Chinese authorities undertook a complete lockdown. It is testimony to the quality of their leadership, the commitment of their nation and the planning and implementation capacity of governance, that the virus was overcome within an amazingly short period.

By contrast, the Italian authorities delayed the lockdown and so the disease spread quickly, overwhelming their medical system, which is among the most robust in the world. The disease is now out of control and thousands of patients are dying as overstretched medical staff, short of equipment, is desperately trying to save those they can; the number of dead bodies in hospital morgues has become so large that the army has been called in to carry the coffins. It is a nightmare. It is perhaps worse in Iran which not only delayed the lockdown but has a much weaker health infrastructure than Italy. The disease has spread so rapidly with possibly a higher lethality index that people, even young ones, are falling on roadsides and dying untended.

Four urgent administrative decisions await the government in Pakistan as we enter the accelerating phase of the infection: First, lockdown of all non-essential activity, to slow down the spread. Exhortations for staying at home don’t seem to be working. Delay could lead to a human catastrophe.

Second, acquisition of testing kits to conduct testing of a regionally stratified random, representative sample of the population to ascertain the number of infected people. The purpose of this exercise is to identify asymptomatic patients, isolate them early to avoid rapid spread and win time to prepare medical facilities for the onslaught later. At the sametime, the availability of this information will enable big-data computer modelling to predict the pace and geographic location of the spread so that medical facilities can be deployed where they are needed most.

Third, acquire ventilators, oxygen cylinders, specialized protective suits, masks and gloves urgently and also configure the domestic industry with finance and machines to manufacture these products locally. Fourth, keep track of the development of vaccines and human trials on various medicines that are candidates for a cure and order their import early.

What are the actions required on the economic front to build a people-centered economy and also support a just and effective lockdown?

First, if you are asking people to stay at home, their income during the lockdown and after should be secured. The most important action that is now a public demand, is to announce a Universal Guaranteed Basic Income for all citizens. This would give respite to those on the margins of hunger such as daily wage workers, street vendors, rickshaw drivers, during the lockdown period and at least a minimal security against economic shocks thereafter. This would be a major step forward towards building a humane economy. Apart from this, employers should be required and if necessary, helped to secure the salaries of existing employees, whether permanent or on contract, even though they are at home for a month.

The second strategic economic initiative is to give a commitment for the universal provision of quality healthcare and education. This would lay the basis of a new trajectory of sustained growth after the pandemic, based on human development. My work for the UNDP shows that government investment in human development leads to a higher and sustained economic growth.

Those who say we cannot afford this should look at the new evidence which shows that many countries that achieved sustained economic growth through universal provision of health and education had a lower per capita income, at the time of this commitment, than that of Pakistan today. For example, Bismarck’s Germany in the late 19th century, Meiji Japan in the mid-19th century, China in the mid- 20th century. (UNDP, Islamabad, ‘A Framework for Inclusive and Sustainable Development’).

Third, as discussed in my earlier article in this newspaper, the government should restructure the production system to secure and integrate supply chains for food, medicines and necessary articles of daily consumption by the people. At the same time, distribution systems should be established for enabling the poor to acquire these items in their residential localities through cash grants or vouchers via an enlarged Benazir Income Support Programme.

Fourth, it is essential to find adequate fiscal space to face the pandemic and at the same time, set the country on a new path of sustained growth based on the enterprise and creativity of all of the citizens, not just the elite. This requires a people who are healthy, educated and secure. It also requires finance.

More than half the government revenue currently goes into debt servicing. We must be liberated from this bind: the government should seek a debt moratorium for at least two years. During this period the government should privatize loss-making public sector enterprises, and lease out prime state land in urban areas to property developers in the Middle East and China. The proceeds from this capital restructuring should be spent on retiring the hundred-billion-dollar debt that is paralyzing the government financially.

The government needs a bold and comprehensive plan to fight the pandemic. The lives of citizens and the future of the nation depend on it.

[Note: This article was written on March 23]

The writer is a dean at theInformation TechnologyUniversity Lahore.

Email: akmal.hussain@itu.