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By Asra Haque

On April 7, Special Assistant to the Prime Minister on Health Dr. Zafar Mirza tweeted that Pakistan’s daily testing capacity will be raised to 20,000 “in the coming days”. Fast forward to May 16 and Pakistan has conducted only 14,878 tests in a day across the four provinces as well as Gilgit Baltistan and Azad Jammu and Kashmir! The infections have surged to a national tally of more than 39,700 cases in a few weeks, but at best there have not been more than 14,878 tests conducted in a day.

In fact, late April to early May, Pakistan has conducted less than half the proposed 20,000 daily tests, up until May 4 when it finally crossed the 10,000 daily test threshold and has managed to make steady gains till now. On May 9, the World Health Organization (WHO) announced that Pakistan was equipped with the capacity to conduct 16,000 daily tests – for a population of over 212 million, these numbers already seem scant, a problem which is compounded by the fact that Pakistan struggles to maintain its average of 13,000 daily tests since May 9.

Moreover, the trends these numbers follow reveal a ridiculously delayed response to a pandemic that was detected in the country as early as March 20 and was treated as a minor inconvenience, despite countless real-time examples of countries struggling to rein in a contagion that has, till date, infected 4.56 million and killed 308,000. Prior to May 9, all four provinces apart from Sindh conducted a fraction of their daily capacity, a strategy that may have jeopardized the health and possibly lives of thousands of coronavirus-positive patients.

What Was Said And What Was Done

On April 21, Punjab’s Minister for Primary and Secondary Healthcare Dr. Yasmin Rashid announced that the province’s testing capacity was to be increased to 5,000 daily tests within a week. However, in the following week, the Punjab government had reduced daily tests from an average of around 2,400 from April 14 to April 21, to just above an average of 2,030 tests from April 22 to April 29.

A little over a week later, on April 29, Dr. Rashid stated during the inauguration of a level 3 bio-safety laboratory at the Institute of Public Health that the health department was yet still in the midst of upgrading Punjab’s testing capacity. However, testing would remain at around 60% of the province’s proposed 5,000 daily tests as the infection rate began to gain a frightening momentum after April 27.

On May 4, Punjab made a leap from just 3,272 tests a day prior to 6,005 and maintained an average of over 5,000 daily tests so far. As more and more infections were being detected, the province had little recourse than to utilize its utmost capacity to detect as many COVID-19 patients as soon as possible – a strategy that should have been implemented in the early stages of the spread of the contagion but was inexplicably held back at the last moment.

Punjab daily testing and detection

Sindh Triumphs Over Punjab With Testing 

In the meanwhile, the province had introduced a “smart lockdown” which would see businesses and other sectors resume daily operations under a set of SOPs on May 10. Two days later, on May 12th, Punjab saw its highest spike in confirmed cases with 1,356 new patients.

Sindh, on the other hand, provided slightly more realistic estimates. Sindh Chief Minister Syed Murad Ali Shah, during his daily COVID-19 report, stated on April 23 that the province would raise its daily testing capacity to 2,400 in the next three weeks. In days that followed, Sindh conducted nearly twice the number of daily tests carried out in Punjab despite possessing half the population.

Daily testing late April

It was not until May 10 when Punjab would overtake Sindh in terms of the number of tests conducted daily. Interestingly enough, despite a denser population and an increased number of tests being carried out, Punjab still has a smaller number of confirmed cases against a higher number of testing, while the opposite is true for Sindh. Punjab so far has tested 141,391 individuals out of whom 14,201 were diagnosed positive; a 10% detection rate. In comparison, Sindh tested 113,396 of whom 14,916 were diagnosed positive; a 13% detection rate.

Daily testing May 10

Politicizing An Epidemic

Why did Sindh have a higher infection percentage than Punjab, a province with twice the population and around 30,000 more total tests, Referring to the period of reduced testing in Punjab, the Sindh government (constituted by the Pakistan Peoples Party) alleged that the Punjab government (constituted by the ruling Pakistan Tehreek-i-Insaaf) attempted to artificially “flatten the curve”, that is deliberately distorted statistics so that they reflect an improving situation in the province, to gain a favorable image and tout the “smart lockdown” as a success.

On the other hand, the PTI has accused the Sindh government of failing to rein in the spread of the contagion, made apparent by the higher case count, despite the Sindh government’s hard lockdown and refusal to ease restrictions. PTI asserts that Sindh has utterly failed to manage its hospitals, ensure provisions to its healthcare professionals and cater to the medical needs of COVID-19 patients. Meanwhile, Sindh has repeatedly blamed the center for refusing to disburse aid in the province and attempting to undermine the 18th Amendment through a takeover of Sindh’s hospitals.

Too Soon To Say?

COVID cases in Pakistan - trend

Current trends indicate that the virus situation in Pakistan is far from over. However, the rate at which new cases may be reported may indicate the extent to which the pandemic may last in the country. Increased testing capacities and a greater number of daily testing can ensure that cases are detected, quarantined, and treated as soon as possible. The more people that are missed out due to a limited testing quota can spell disaster for the country’s health, economy, and future. But will Pakistan’s testing capacity be raised, and are the numbers that are being reported reflect the actual number of cases are questions that need be approached with due caution.