Remarkably, the national Covid discourse, or whatever is left of it, continues to steer clear of “testing”. Any epidemiologist worth their salt will testify to the fact that there is no way around testing a large number of people to contain the virus. All the analysis of fresh cases and fatalities is futile if the testing is not being done adequately. It’s like putting the cart before the horse.
Promises on scaling up the tests have turned out to be just that. Goalposts have been moved a few times. The end of May has come and gone but the corona czar’s target of 30,000 daily tests didn’t materialize. The actual output remains stuck below 15,000 tests per day. Strangely, the officials feel good about this number, which belies their own claim that 30,000 daily tests would be sufficient for Pakistan.
The demand-side has also been missing in action or compromised amid a pandemic that quickly turned partisan. The public at large has shown eagerness to return to normal life. The leading opposition parties have been unable to keep the government in check. The healthcare community doesn’t have much audience in the power corridors. All we have is aggregate testing data that doesn’t tell much.
The abrupt lifting of lockdown in the second week of May and the limited crisis communications from public officials since then has given rise to a cynical impression that the government has resigned to fate and that it is simply bracing for impact. But it doesn’t have to be this way. There is a need for a national testing strategy that takes care of financial, administrative and human resource issues related to testing.
A testing strategy needs to go beyond testing suspected patients (inactive approach) or tracing and testing close contacts of confirmed patients (reactive approach). Since nobody knows when the peak(s) will strike, “random testing” (proactive approach) still has value in rapidly isolating the virus hotspots and preventing new ones from forming.
New approaches like pre-test sample pooling can be deployed to cost-effectively scale testing and identify the spread among communities. Wastewater testing, favorable evidence of which is emerging can also be used to trace the virus in hard-to-reach communities and dense urban areas. Then there are serology-based testing techniques that can act as early-warning signals to treat potential Covid patients.
Administratively, the federal government needs to play the lead role in preparing the public sector, the provincial healthcare bodies and the private sector to ramp up their testing capacity. Testing a large number of people will cost money, but it will likely be a fraction of the Rs1.2 trillion relief packages. Follow the science, listen to experts, work with the provinces, and protect the country from avoidable miseries and fatalities.
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