Coronavirus disease (COVID-19) Pandemic and Pakistan; Limitations and Gaps

Abstract

Background: The 2019 novel coronavirus disease (COVID-19) has spread to more than 213 countries and as of 17 April 2020, 1,995,983 confirmed cases and 131,037 deaths have been reported globally. Pakistan sharing border with China and Iran, having a high frequency of travel and trade, has been at risk of viral transmission. Methods: We examined the current state of the COVID-19 epidemic and Pakistan’s preparedness, using publicly available data and documents on the COVID-19 government dashboard. Results: Pakistan reported its first 2 confirmed cases on 26 February 2020, linked to Iran’s travel history. The number of confirmed cases nationwide rose to 7,025 on 17 April 2020 with 135 deaths, and 3276 confirmed cases in Punjab, 2008 cases in Sindh, 993 in Khyber Pakhtunkhwa, 303 in Baluchistan, 237 in Gilgit Baltistan, 154 in ICT and 46 in Azad Jammu Kashmir. To date, 7000 Pakistani pilgrims have returned from Iran and have been placed in quarantine in Taftan. The directing of pilgrims back to their cities without testing at the border resulted in introduction of the virus in country. Pakistan’s weak healthcare system, with 0.6 beds for 1000 people and less than 0.75% of the GDP allocated to health spending, is doubtful to bear the COVID-19 shock if there were to be an exponential increase in cases. Conclusion: Low literacy rates and a general lack of awareness is leading to people not seriously adopting social distancing and hand hygiene. The high population density in major cities of Pakistan can facilitate the spread of virus. The three-pronged approach of trace, test and treat needs to be aggressively implemented to halt the community transmission leading to exponential increases in cases.