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The fourth wave is well and truly here. And it could well just be the beginning.The country already has more active cases than it had at the peak of second wave. The national positivity rate at 6 percent is starting to look alarming but is not even close to the previous peak. But national positivity is not necessarily the way you should look at the threat of the spread, as it can often lead to a false sense of complacency.

Karachi leading to Eid-ul-Adha looked all sorts of normal. At 3 percent national positivity, you would tend to think people are somewhat justified to lower the guard. Only that Karachi’s positivity had already touched 11 percent two weeks leading to Eid, and 16 percent one week leading to Eid. And because national positivity rate is all that makes most headlines, complacency set in, and Karachi’s positivity is now hovering around 25%.

Now that is a terrifying reading. But alarm bells have not rung as such as positivity for the rest of the country still sits at what they call a “manageable” 3.8 percent. Some sort of restrictions have been reimposed in Karachi, but they are nowhere close to what a positivity as high as 25 percent would demand. But full lockdown has long been out of equation, so one will have to live with whatever weaker forms of restrictions there are.

Remember that it is the Delta variant that has now proven to be on the spread in the country. Research shows it spreads faster than other variants. And there is evidence in Karachi, as how fast it went from 10 percent to 24 percent. Thankfully vaccination rollout is going on smoothly, but Pakistan is far from any semblance of safety in, given only a fraction over 5 million are fully vaccinated.

The active cases to hospitalization ratio has improved, from every 120th Covid positive needing a ventilator in the previous waves, the number is around 190-200 in this one so far. But it is early days and may take longer before it can be called a trend. Vaccination would surely have played a role in lowering that number. But bear in mind, the capacity of the healthcare system is not infinite. Even a city like Karachi, has more than 70 percent oxygen beds in use. If the curve does not flatten from here, it could be a disaster for the metropolitan city, seen not so long ago in the neighboring countries. Time for people to mask up and vaccinate.

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