The Express Tribune Editorial 16 June 2020

On a rampage

The Covid-19 coronavirus is now proliferating in Pakistan at a frightening rate. On May 22, the number of confirmed Covid cases in the country totalled 50,694. This figure nearly doubled to 98,943 on June 7 — i.e. an addition of nearly 50,000 cases in a period of 16 days. The tally swelled by another 50,000 cases or so, but in half the number of days (eight), standing at 146,254 as of June 15 (yesterday). This shows a little less than 200% increase in 24 days in the rate at which the deadly virus is mushrooming in Pakistan, taking it to the sixth rank among countries with highest number of new cases.

No wonder Asad Umar — the Chairman of the National Command and Operation Centre that is supervising the affairs related to Covid-19 — sees the number of cases of the infection exceeding one million by the end of next month. During a press conference on Sunday, Umar, who is also the Federal Minister for Planning, Development and Reforms, claimed that wearing masks is a verified way of curbing the spread of Covid-19 by up to 50%, alongside warning the public that the government would start taking administrative action against those not wearing masks or maintaining social distancing.

Umar’s estimate looks miniscule when compared with Imperial College London’s predictions about the spread of the virus in Pakistan in case lockdowns are not imposed to contain it. However, since Pakistan’s economic situation does not allow a full-fledged lockdown — which has otherwise proven to be an effective way of breaking the transmission chain of the virus, thus containing its spread — the country is mainly relying on the general public as well as the business class to exercise social distancing and adhere to the SOPs to keep the lethal virus at bay and help the infection curve to start plateauing.
Unfortunately, people are not as responsive as the situation warrants. What is even more worrisome is the fact that a big percentage of people are not even ready to accept the presence of a deadly pandemic in their midst. While the government has adopted a selective lockdown strategy to seal areas with serious virus infestation, it must also go tough on violation of SOPs.

Sacrificial animal markets

Perhaps, never before was uncertainty so intense as it is now in the wake of the coronavirus pandemic. One is sure of only one thing and it is about Covid-19, though the curve is yet to flatten in Pakistan. Confusion surrounds the setting up of markets of sacrificial animals for Eidul Azha. The festival is only a month and a half away and uncertainty prevails whether the sacrificial cattle markets will be established in Karachi and other parts of Sindh. Officials are adding to the confusion by issuing conflicting statements. They are not much to blame because they themselves are unsure whether the pandemic could subside or intensify by the time of the festival. In order to remove the confusion, they should announce that things depended on the intensity of the coronavirus pandemic, instead of keep people and cattle traders bussing.

The local government secretary says the official notification banning cattle markets in Sindh’s capital applies only to regular markets. Earlier on June 2, a notification issued by the home department has said all cattle markets in Karachi would stay closed ahead of Eidul Azha. The secretary says the ambiguity in the language of this notification has led many to believe that even the markets for sacrificial animals would not be set up this year.

A spokesman for the Eidul Azha market(s) says, “Last week a notification announced that sacrificial animal market(s) would be allowed to be set up if SOPs were properly adhered to. Now another notification says all cattle markets have been canceled.” He said that at sacrificial animal markets, around 600,000 cattle were sold. However, in the absence of cattle markets, prices of animals would shoot up making them go beyond the reach of many. He said that they planned to open the cattle markets for the public from June 21.
The prevailing confusion about cattle markets will likely affect both traders and intending buyers.

Drug shortage

The government’s Covid-19 response has gone from ‘no problem’ to ‘no medicine to treat the problem’. After reports of surging prices, hoarding, and shortages of several medicines being used to treat Covid-infected people, the government says it has taken notice of these issues and will take action against profiteers. But as we know all too well, the best-case scenario will be fines totalling a few hundred thousand on profiteers who have already made millions.

The fact is that the approved prices of some of these medicines are so high. The approved maximum retail price for Actemra 80mg injection is Rs11,952 per vial, whereas Rs29,882 for Actemra 200mg injection vial and Rs59,764 for Actemra 400mg vial. Actemra is among the drugs being sold at higher than the approved cost, according to reports on the supply situation.

The government also took credit for restoring the supply of Tocilizumab, but worryingly, also said the National Task Force on Eradication of Spurious and Sub-standard drugs would be investigating. We must make the worrying supposition that the increased availability may be due to substandard drugs entering the market. Remdesivir also remains an issue. The drug has shown some evidence of shortening the duration of Covid-19 in people, but there is little local output, and restrictions on its import were only recently lifted.
But it doesn’t stop here. Chemists have said that people are even hoarding multivitamins, allergy medicine, and cough and cold medication and becoming belligerent when salesmen try to get them to buy less. It has gotten to the point where even medical store owners are asking the government to issue orders to ration these items.

Unfortunately, ours is a country where people continually question the opinions of medical experts. When they get sick and it is too late, the same people do exactly what the experts had said, but at home, and overmedicate to compensate for lost time, because they ‘know’ it will work. After all, why would an expert know more than a random web page or an aspiring quack relative?