WHEN the jury is out, can a verdict be in?
A lot does not make sense as we survey the coronavirus afflicted landscape across major urban centres. After wreaking havoc in June, the virus appears to be on the retreat. It may return with a vengeance, it may find new towns and villages to infect, but till that happens — or if that happens — there is time to draw some lessons from the experience thus far to prepare for the second wave. If it comes. When it comes.
Today countries like the United States, Brazil and India are struggling with rising cases and mounting deaths. But there are others like Vietnam. With a population of 100 million, this East Asian nation has reported only 300 cases and no deaths. Pakistan finds itself in the middle category of countries that may have peaked and are now on the mend. Clearly there is something at play that defies wisdom. Is it possible to distil lessons out of this perplexing situation?
The logic of policy in the initial months of Covid-19 across most countries was fairly clear: lockdown, create distance between people, break the chain of virus and buy time for a vaccine and immunity. Most countries followed these protocols along a wide spectrum of toughness and laxity. Yet in a few months it became fairly clear that things were more complicated than originally thought.
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It is easier to distil these conclusions now that we have traversed the difficult path.
For instance, among the countries that opted for lockdowns, some got encouraging results while others like the United States and Brazil did not. Experts then extrapolated that it wasn’t just locking down that was important, it also depended on when you locked down, how you locked down and how frequently you locked down. Even then, there appeared no hard and fast formula for success.
Sweden opted for a policy closest to herd immunity. It focused on protecting its elderly and young population and let others lead a normal life. For a while, this appeared to work. Today, however, it is clear that Sweden has suffered more than countries like Norway both in terms of mortality and economic devastation. There were lessons, but they were really hard to pin down with certainty. The learning curve, it seemed, was as steep as the corona curve.
In Pakistan, the proliferation of cases climbed steadily from March onwards but never really exploded exponentially till near the peak in June. At the National Command and Operations Centre (NCOC), officials monitoring the numbers kept saying the actual cases stayed behind all projections. This was despite the fact that the federal government’s policy was plagued by confusion and dithering. The politically divisive debate over lockdowns consumed precious time and policy oxygen. In fits and starts, the centre and provinces lurched from option to option, basing decision-making on factors that were a combination of gut feel, partisan politicking and prevailing trends. This hotchpotch policy led to hotchpotch results.
Today, we are one day short of completing five months since the first Covid-19 patient was diagnosed in Pakistan on Feb 26. In these five months, there are many dates that help map policy trends tried and tested by federal and provincial authorities. This timeline paints an interesting picture.
Feb 26: first case reported
Mar 23: Decision made for a lockdown
Apr 18: Ramazan strategy announced
Apr 24: Tracking Tracing and Quarantine (TTQ) strategy starts
May 9: Lockdown eased
May 30: Wearing masks outdoors made mandatory
June 5: Strict enforcement of SOPs ordered
June 15-20: Virus peaks
Based on various policy prescriptions over the last five months, we can draw some preliminary conclusions.
1) Lockdown worked. Yes there was a debate over the cost to the economy of the lockdown and its sustainability, but the fact remains that when the lockdown was lifted on May 9 and then bazaars were flung open on judicial instructions prior to Eidul Fitr, infection rates soared leading to a frightening increase in the death rate. Once smart lockdowns were instituted, the situation started to improve. The basic logic of the lockdown has therefore worked for Pakistan: keep people away from each other and contain cases in the localities of origin.
2) Lack of policy clarity and national cohesion of action in the initial months resulted in precious time lost. If March, April and May had seen the clarity and focus witnessed in June and July, the virus may have been controlled much earlier.
3) Targeted and aggressive communication should have started in March so that the prevailing ambivalence about the virus among the citizenry could have been addressed and behavioural change may have taken off earlier rather than in late June. Time lost can be measured in lives lost. Data available now suggests that messaging could have been targeted for identifiable audiences. For instance, we know now that the median age of those infected in Pakistan is 60 years; 71 per cent of patients are males; 75pc of all Pakistanis infected are over the age of 50 etc.
Hindsight is always 20/20 and it is easier to distil these conclusions now that we have traversed the difficult path for five months. We can today accept what we did wrong and where we were right. But all of this still does not fully explain the dramatic reduction in cases and deaths. Recent reports in The New York Times and the Economist magazine discuss these unanswered questions in the case of Thailand and Vietnam. Did a culture of wearing masks help in these countries? Or do their populations have stronger immunity because of exposure to earlier strains of the coronavirus? In Pakistan too, something unknown is aiding us. We should be grateful.
We should also be ready for the next wave. If it comes. When it comes.
The writer is Dawn’s resident editor in Islamabad.
Published in Dawn, July 25th, 2020