Pakistan Covid: Peak or plateau?

Pakistanis shopped for Eid alright. They seem to have paid for it too. There was one positive case reported for every sixth test conducted in the week ending May 28, 2020. Right after the Eid holidays, the ratio worsened to a case for every fourth test. There is more than one way to look at the number. Some will see this as part of strategy, others will see this as a fallout of a failed strategy that led to early lifting of the lockdown.

That debate could be left for the experts, as compelling arguments could be presented from both sides. Some would refer to Brazil, others would point at India. Both had contrasting degrees of stringency, but the cases are rising alright. That is where, it helps to look beyond testing and cases. Deaths from the virus are still on the lower side in Pakistan, and only a handful of countries have bettered Pakistan’s case-fatality rate with as many deaths or as many days into the pandemic.

All eyes are on the oft-discussed peak. The answer to that may not be as straightforward, as there may not be a peak, or there may well be many smaller ones. The point to note is that the pace of deaths in Pakistan never really caught up with the rest of the world, or even the region. When you are going very slow at 30kph, you would hardly notice a dip to 25kph. The curve may not bend as it did for many others in Europe and USA, but it may well be a long period of flattening. Pakistan’s is likely to be more of a plateau than a peak.

For the first time since the first instance of five daily deaths, Pakistan’s week-on-week deaths have entered negative growth. This sure offers hope, unless the flattening of the death curve takes an ugly turn, like that of Brazil. No country other than Brazil has doubled the daily deaths 40 days (since 5 daily deaths) deep in the outbreak.

The likes of India and Russia, where the curve still seems to be on the rise, have grown at a rate of 1.4x in the last ten days. There is no one pattern. It is different for different countries, but the sample is large and old enough to infer insights with some degree of confidence. Pakistan’s doubling of deaths to 1200 at 19 days is bettered by only three of the 25 countries having reached that level.

Even if Pakistan’s daily deaths unexpectedly decide to double from hereon, on the line of Brazil, doubling the deaths from the low current base to 65-70 daily deaths, though unfortunate, will be manageable without overwhelming the system’s capacity. The number of Covid patients on ventilators has stayed stable over the past ten days, representing 15 percent occupancy of available ventilators. The dedicated bed space utilization is 20 percent only. It has s far been so good. Hope is not a strategy, and if it is not, then one hopes, Pakistan manages the low and slow plateau without burdening the healthcare system.