Pakistan wins rare, fragile success against novel coronavirus

Walking through the Karachi Company bazaar in the Pakistani capital Islamabad, the coronavirus pandemic seems a world away.

Groups of shoppers gather at the small stalls that line the alleys of the market, selling everything from plastic stools to jewellery and colourful garments. Hardly anyone wears a mask, as they haggle over prices and stall owners shout to try and get the attention of potential customers.

“The danger is much less now,” says Sheikh Usman, 32, who runs a small garment stall and has not worn a protective face mask for months. “The restrictions should be finished, because the virus is over now.”

With a population of 220 million, a ramshackle health and hygiene infrastructure and densely packed urban neighbourhoods, Pakistan was considered by many to be a prime candidate to see the worst of the coronavirus pandemic.

Six months after registering its first case, however, active cases in Pakistan are continuing to steadily decline, with the number of deaths recorded in a day often down to single digits.

The country has seen 293,261 confirmed cases of the novel coronavirus, with 6,341 related deaths, according to official data. Save for single-day blips, active cases have been steadily declining since hitting a peak in June, currently standing at 10,091, their lowest level since late April.

Epidemiologists, however, warn that far from having weathered the storm, the country may be on the cusp of a second wave, primed to potentially hit as large religious gatherings are held this week, and wedding halls and schools are to be reopened by next month.

Underestimation of cases

Critics say testing in the South Asian country has been low, resulting in an underestimation of cases. On Sunday, Pakistan conducted 23,655 tests, with 496 of them returning positive. The government says it has the capacity to conduct up to 67,340 tests a day, but people are simply not seeking them.

“Before, the kind of lines we saw for COVID-19 testing, we used to have to turn people away to come back the next day,” says Seemin Jamali, executive director of the Jinnah Postgraduate Medical Centre (JPMC), the largest government hospital in Karachi, Pakistan’s most populous city.

At present, the hospital’s 90-bed COVID-19 ward only has 14 patients – a far cry from June, when patients’ families in Karachi and other cities told Al Jazeera they were having difficulty finding hospital beds for their dying relatives.

“The decrease in numbers is real, there is no doubt there,” says Dr Faisal Mahmood, head of infectious diseases at Karachi’s Aga Khan University Hospital, the country’s largest research hospital.

“We are seeing less positivity in the lab. We were doing pre-op testing ahead of surgeries, and the rates of those have come down as well.”

Pakistan’s positive test rate – a key indicator as to whether there is adequate testing – was 2.09 percent on Sunday, well within the World Health Organization’s 5 percent threshold for indicating that a country’s outbreak is presently under control.

“The tougher question is why, and the answer to this is the million-dollar question. We are not seeing that huge explosion that we had anticipated,” says Dr Mahmood.

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