28th March 2021

Staff report

The highest number of daily COVID-19 infections since the turn of 2021 were recorded on Friday, March 26. With 4,468 fresh cases and barely 20 days into the third wave, the ongoing surge in infections has already surpassed the peak of the second wave.

As the government scrambles to impose smart lockdowns in hotspots in Punjab, Khyber Pakhtunkhwa and the Islamabad Capital Territory (regions which have reported the most worrying number of cases in the third wave), and close down educational institutions merely weeks after they were reopened, it remains to be seen whether these measures will rein in the spread of the novel coronavirus disease quickly enough.

Breaking down the onset of the pandemic in Pakistan

The first wave is generally considered to have started when the pandemic first broke out in the country in late March 2020. However the Government of Pakistan began compiling statistics and data on April 1. Pakistan’s biggest daily case count was recorded on June 13 – 74 days into the outbreak of the virus – at 6,825 with the positivity ratio hitting a peak of approximately 20 percent.

The period was marked with a strict country-wide lockdown that saw the suspension of intercity and interprovincial travel; the complete closure of all businesses save pharmacies, grocery stores and delivery services for restaurants; and the invocation of Section 144 of the Criminal Procedure Code (CrPC) which banned all gatherings of more than five people in public spaces. The Federal and Provincial governments urged the populace to remain indoors and adhere to health guidelines to prevent further spread of the virus.

Like many countries where such strict measures were rolled out to contain the pandemic, Pakistan’s economy took a hard hit and thousands suddenly found themselves below the poverty line. In an effort to prevent a complete economic meltdown, the Federal government introduced its trademark ‘smart lockdown’ policy in early June 2020, through which restrictions were only imposed in areas where virus clusters were detected.

Despite opposition from doctors’ associations and health experts, the policy seemed to have paid off: the first wave petered out by July 31, lasting a total of 122 days, and cases stabilised to less than a thousand a day.

Legacy daily COVID-19 cases in Pakistan
Legacy daily COVID-19 cases in Pakistan

The second wave hit its peak faster than the first wave

Pakistan recorded its lowest number of daily infections on August 30, 2020, at 213 cases. This period of relative stability lasted just three months, near the end of which the Federal and Provincial governments pulled educational institutions and wedding halls out of limbo. Infections were on the ascent once again, and the National Command and Operations Center (NCOC) as well as the Special Assistant to the Prime Minister (SAPM) on Health Dr. Faisal Sultan officially declared the onset of the second COVID-19 wave on October 28, 2020.

The second wave appeared to have lasted about as long as the first wave, just shy of eleven days, however it reached its peak in half the time it took in the first wave. Forty days into the official announcement by the NCOC and Dr. Sultan, daily infections hit a high on December 6, 2020 at 3,795 cases. The positivity ratio for that period hovered between five to eight percent, dropping to around three percent as the second began waning well into late January, 2021.

Although no severe restrictions were imposed this time around as smart lockdowns were the preferred policy, the Federal and Provincial governments and health authorities struggled with a public that had thrown both caution and standard operating procedures (SOPs) to the wind.

Unlike the initial wave, there was no stable period following the second surge. The lowest case count for 2021 was reported on February 15 at 958, after which cases once again began to steadily climb as schools, which had been ordered closed, once again reopened and celebratory functions such as weddings carried on as usual.

But what contributed to the rapid onset of the third wave was the spread of a new, mutated version of the coronavirus discovered in November of 2020 in the United Kingdom.

The third wave is unlike the first two

There is no clear beginning to the third wave as there was no period of stability preceding it. But this new boom in cases is attributed to the introduction of the B.1.1.7, also known as the UK strain of the novel coronavirus disease. It is a mutated version of the original COVID-19 virus, in that it binds to an enzyme attached to the membranes of cells located in the lungs, arteries, heart, kidney, and intestines.

The UK variant is more transmissible than the original virus strain, and is widely attributed to the sudden and rapid increase in new cases being reported in Punjab, Khyber Pakhtunkhwa and the Islamabad Capital Territory.

These regions in particular were visited by many Pakistanis from the UK in the months following the discovery of the mutated strain. Coupled with the arrival of China’s Sinopharm vaccine in early February which caused the public to become even more complacent with SOP, it was a recipe for disaster.

Within two weeks since the first major spike in cases was reported on March 10, with 2,258 infections, the daily case count surpassed the second wave’s peak of 3,795 on March 24, with 3,946 fresh cases. The following day, daily cases crossed the 4,000 mark threshold after nearly eight months when 4,087 new cases were reported on July 3, 2020.

Tried and tested methods may not work this time

The Pakistan Medical Association (PMA) has urged the Federal Government to step in and impose a country-wide lockdown for a few weeks until the situation normalises, a move which the authorities cannot entertain while the economy is still far from stable.

However, the authorities have moved to introduce slightly more restrictions than were present during the second wave – workplaces must now operate at a 50 percent attendance policy, railways can only fill up seats up to 70 percent capacity, and restaurant dining is only allowed so long as it is outdoors. Moreover, all businesses should remain closed after 8 PM.

Regrettably, there is little evidence to suggest that these measures have been effective in putting a dent in the rate of infections, a fact which has prompted head of the NCOC and Federal Minister for Planning, Development, Reforms and Special Initiatives Asad Umar to issue warnings of a severe lockdown if health guidelines continue to be flouted.

While it is apparent that the third wave has yet to reach its zenith, the presence of a new, far more contagious variant has thrown off earlier predictions that the third surge will be over quicker than the one preceding. Until then, we can only rely on the data.