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Why Is the COVID-19 Curve on a Decline in Pakistan?

Published online by Cambridge University Press:  19 November 2020

Muhammad Osama Yaseen*
Affiliation:
Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
Arifa Saif
Affiliation:
Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
*
Corresponding author: Muhammad Osama Yaseen, Email: [email protected].
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Abstract

Type
Letter to the Editor
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - SA
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http://creativecommons.org/licenses/by-nc-sa/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is included and the original work is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use.
Copyright
© Society for Disaster Medicine and Public Health, Inc. 2020

In June 2020, the Imperial College of London predicted 2.2 million coronavirus disease (COVID-19) related deaths in Pakistan. Reference College1 To address this situation, COVID-19 twin peaks were observed on June 9 and 13. 2 The World Health Organization (WHO) informed the Government of Pakistan that it didn’t fulfill the preconditioned criteria of relaxing lockdowns. Reference Hashim3 However, the rise in the number of cases proved short-lived, as the number of new cases fell distinctly even though none of the WHO’s recommendations were effectively implemented. 2 A new debate started in the country about this rapid decline in the number of cases, as some people would argue that lack of testing is linked with the rapid decline. Others argue that the government is intentionally disguising the number of cases to justify its policy of relaxing lockdowns. However, all of these theories proved wrong because the number of patients recovering from disease were increasing and there was a rapid decline in the demand for pressurized oxygen, ventilators, intensive care unit wards, and personal protective equipment. Reference College1 Addressing this issue scientifically, Braun et al. provided the following justifications that can be linked with the COVID-19 decline in Pakistan Reference Braun, Loyal and Frentsch4 :

  1. 1. Over time, it is observed that the infected patients developed S-reactive CD4 + T cells, but these T-cells were also seen in 35% of non-COVID-19 patients. Reference Braun, Loyal and Frentsch4 These non-COVID-19 patients may have developed such cells due to previous encounters with other coronavirus endemics, and these cells may have prevented further infection or severity of disease by the virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Moreover, SARS-CoV-2 mutations, Bacillus Calmette–Guérin vaccines, and the presence of human leukocyte antigen genotype as host genetic variation may also be associated with the severity of infection and fatality rates. Reference Toyoshima, Nemoto and Matsumoto5 These factors may have affected the dynamics of the pandemic in Pakistan.

  2. 2. Climatic reasons could also affect the severity of the pandemic, because almost the whole Asian continent has escaped from the catastrophe of the pandemic. Like Pakistan, Sri Lanka, Thailand, Vietnam, and many others have seen a sharp decline in the number of cases. Reference Hashim3

Although Pakistan has averted the catastrophe somewhat, it is still premature to declare victory in the fight against COVID-19. The most important metric to find success against this pandemic is the number of new cases that are still being reported on a daily basis. Even though the daily number of cases has been down to less than 500, 2 the curves have not yet flattened completely, as compared with the other countries in the region. Pakistan still stands at the top among such countries that are still reporting the number of cases daily, and it couldn’t yet control the local transmission. As long as the number of cases reported due to the local transmission is not controlled, the danger of a second wave of the pandemic is imminent. Strict implementation of standard operating procedures, as observed in New Zealand, will be a prime measure to contain the emergence of new cases. Reference Baker, Wilson and Anglemyer6 Until we find solid answers to why this virus didn’t create as much of a catastrophe as it created in many other countries, and until we have definitely gotten rid of local transmission, it would be a delusion to think that the fight against the novel coronavirus has been won.

Conflict(s) of Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this paper.

References

College, Imperial of London. COVID-19 reports. Updated June 2020. https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/covid-19-reports/. Accessed September 10, 2020.Google Scholar
Worldometer . Coronavirus. Updated September 7 , 2020. https://www.worldometers.info/coronavirus/country/pakistan/. Accessed September 7, 2020.Google Scholar
Hashim, A. WHO says Pakistan should reimpose lockdown to curb coronavirus. Updated June 2020. https://www.aljazeera.com/news/2020/06/pakistan-reimpose-lockdown-curb-coronavirus-200610093521629.html. Accessed September 12, 2020.Google Scholar
Braun, J, Loyal, L, Frentsch, M, et al. SARS-CoV-2-reactive T cells in healthy donors and patients with COVID-19. Nature. 2020;587(7833):270274. doi: 10.1038/s41586-020-2598-9.CrossRefGoogle ScholarPubMed
Toyoshima, Y, Nemoto, K, Matsumoto, S, et al. SARS-CoV-2 genomic variations associated with mortality rate of COVID-19. Am J Hum Genet. 2020;epub, 18. doi: 10.1038/s10038-020-0808-9.Google ScholarPubMed
Baker, MG, Wilson, N, Anglemyer, A. Successful elimination of COVID-19 transmission in New Zealand. N Engl J Med. 2020;383(8):e56.CrossRefGoogle ScholarPubMed