Covid: Bracing for the peak

The Prime Minister was briefed that the number of positive coronavirus cases in Pakistan by April 14 (day 49) were 30 percent of what was earlier predicted. He seems to have taken heart from the number, which probably made it easier to allow certain industries to start opening.

There is another way of looking at the number, and that revolved around inadequate testing. The model may well have assumed four times the number of tests, than what actually could be conducted. The testing angle was discussed in this space yesterday, pointing at the issue of kits availability versus lab capacity.

Pakistan’s cases per million population are no comparison to what the likes of USA, UK, Italy and Spain are observing. Pakistan’s cases per million population at 30 are a tenth of the global number at 300. But the number looks three times bigger, when compulsively compared with the neighboring India, which is 27 days deeper in the pandemic than Pakistan.

It would make more sense to compare the numbers at similar number of days since the first case (See table). Till Day 49, Pakistan has fared multiple times better than the likes of USA, Japan and India, in terms of testing. The total tests per million are one-third of UK’s, with only slightly lower number for positive cases per million.

There is one positive case in Pakistan for every 11.7 tests. There is not much one could look at the number, as it changes as the number of test goes higher. In some cases it has come down as the tests are ramped up by hundreds of times. In others, it has also gone up, despite a massive increase in testing. Pakistan’s 11.7 is surely reflective of selective symptomatic testing, which should go higher if cluster and aggressive testing ever happens.

Should Pakistan increase the daily testing capacity by four times from the current 5000 a day, which will still be half the testing ability promised by the NDMA, in the next 40 days, it will have tests per million increased by 12 times, and closer to the likes of the United Kingdom. What could that mean in terms of cases? Even if the ratio improves as a result of moving from selective to aggressive testing, say by a third – Pakistan could be looking at 60,000 plus positive cases in the next 40 days.

Those looking at possibility of the curve having peaked and about to flatten should look again. Barring China and South Korea, both of whom went for ultra-aggressive testing and strictly enforced lockdowns well in time, all major countries, saw the curve only starting to rise around the stage where Pakistan currently is. Pakistan’s healthcare system seems up for a nerve-wrecking challenge in a month’s time.