Is COVID-19 like Polio for Pakistan?

Author: Dr Omer Nasim

On the 11th of March 2020, novel Coronavirus became a highly contagious outbreak that evolved into a pandemic, according to the World Health Organisation (WHO). As many countries prepared themselves for a jolt of nature so did Pakistan. Being a Muslim-majority multiethnic nation with numerous sects and the political agendas constantly fluctuating tides, it became evident that it was going to be one of the many nations that were going to struggle with this force of evolutionary nature. In such a peculiar setting, where different beliefs and cultures develop rapidly with misinformation circulating through masses, disaster was only inevitable.

As of 24th of June, the country has reached 188,926 cases in total with the limited testing abilities and a total of 3892 new cases of COVID-19 were reported in the last 24 hours (ref http://covid.gov.pk/stats/pakistan). As we ponder upon how our nation is failing in restricting the spread of the virus, we can draw a synonymous image with a similar pattern emerging to that of the eradication of poliovirus. It is similar, with its rapid spread, and it shows a lack of symptoms in the beginning until it has infected others, and how the people of this country have often downplayed it.

As Mark Twain is said to have said, “history does not repeat itself, but it often rhymes,” and it seems that the endemic nature of polio and COVID -19 has something similar in what it entails for Pakistan. The coronavirus crisis led Pakistani authorities to stop a nationwide immunisation drive scheduled for April that was intended to vaccinate some 40 million children. This campaign was deemed crucial after Pakistan recorded 147 polio cases in 2019, a sharp rise from a record low figure of 22 cases in 2017. So far this year, authorities have recorded 41 cases Many of the public-health studies in Pakistan have shown that maternal illiteracy and low parental knowledge about vaccines — together with poverty and rural residency — are one of the many factors that most commonly influence whether parents vaccinate their children against the poliovirus. In the wake of the pandemic, coronavirus is only the latest obstacle keeping Pakistan from eliminating polio.

Persuading many in Pakistan’s most underdeveloped regions to support polio eradication is an uphill battle

Khyber Pakhtunkhwa is a poor and (mostly) religiously conservative region, which lies along the porous border with Afghanistan. Therein, many residents have been suspicious of the polio vaccine, with conservative Islamic clerics and militants claiming it to be a Western conspiracy to harm or sterilise children.

In a 21st century world, the public tends to drift towards superstitious beliefs, as the world progresses at lightning speed with technology, our people often regress with poverty, lack of education and thus it builds upon only apprehensions. A basic problem that overlaps in all studies is the lack of awareness and proper counselling regarding why it is necessary to get the vaccinations and as the world comes together to build another vaccine- now for the COVID-19, it seems unlikely that our people will be so forthcoming to give it to their families.

The government has not made its job any easier since it has yet to give its populace a clear directive with an appropriate strategy to properly educate and safeguard the population. At times it is seen the elected Govt officials are not in unison about the severity of the disease and mostly squabble over popularity and win points for the opposition. As a result of this, many people now refuse to acknowledge the existence of the COVID-19, with blatant disregard for the laid out standard operating procedures (SOPs), and guidance from the doctor’s community.

Many people in Pakistan do not properly comprehend the severity of the situation and disregard public messages about proper hygiene and social distancing. Along with this, there comes an added burden of policymakers often met with heavy resistance from leaders of religious institutions and Muslim fundamentalists. The disease has been stigmatised in society resulting in nonadherence to testing and isolation. The same lack of appreciation of the importance of the polio vaccine is also palpable within the masses.

The Global Polio Eradication Initiative (GPEI) recommended on March 24 that all vaccination programs be paused until the second half of the year. “We did not want to have the program be responsible for worsening the situation with COVID-19,” said Michel Zaffran, director of the World Health Organisation-led group.

Persuading many in Pakistan’s most underdeveloped regions to support polio eradication is an uphill battle. “During our campaigns, some people asked us to make basic health units, to provide free treatment for diarrhoea and even give them medicine for headaches, and then come with polio vaccines.

To those saying proper disease control is impossible in our poverty-stricken region, we need only to look to our neighbour. In 2014, they were officially declared Polio free, proving that eradication can be achieved with appropriate resource management and clear governance. An organisation at all levels is mainly what differentiates India’s and Pakistan’s response to the cause of eradication of Polio and maybe curtailment of the spread of the current Corona Virus.

A major concern is the number of funds allocated to the healthcare system with only two per cent of the GDP being set aside as compared to a global average of 10 per cent. Many feel this is because of a higher focus on disease treatments rather than prevention. The lack of coordination between the federal and provincial governments is another key factor in the inefficient response to the crisis.

As for the technical capabilities go the percentage of errors in collecting samples is very high.

One of the largest testing facilities for coronavirus in Pakistan “received a batch of 800 samples from Bahawalpur in Punjab, of which only 261 could be processed. The labels were wrong, the samples had leaked, the tags had rubbed off. This affects our testing capacity and accuracy,” said a doctor working in the facility.

Keeping view of all the hurdles that surround our country – Pakistan has got a long way to go in respecting the severity of the disease. A proper government response is required with all cultural and religious leaders taken on board. SOPs must be enforced in all places of worship and business. Information about COVID-19 should be encouraged in any Friday sermons and the availability of sanitizers should be made ensured. The use of masks, and its free provision, will alone decrease infection rate by a significant amount. There must be stern action taken against those who have disregard for public safety and any sort of callous approach be punishable by incarceration. The discipline of the people and a political will is what can get us closer to a new postmodern virus-free dawn. Until that happens, the fear of prevalence will remain as that of the poliovirus.

The writer works at Shaukat Khanum Memorial Hospital & Research Centre, Peshawar, KP

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