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1. Now that the debate over whether or not lockdowns make sense in a context like Pakistan's (with good arguments on both sides) has been rendered moot by the government's decision to ease restrictions, it is important to consider exactly what the plan is going forward.
2. It has been two months since the first cases of Covid-19 were detected in Pakistan and in that time, the number of infections and deaths has continued to increase. How has the government's response evolved since the virus began to spread?
3. Even though lockdowns are arguably the best way to slow the spread of Covid-19, critics are right to point out how the economic costs of shutting a country like Pakistan down will disproportionately affect the poor. Yet, could these costs have been mitigated?
4. Related to this, what of the costs that are likely to be incurred if a relatively uncontrolled spread of Covid-19 crashes an already ramshackle health infrastructure and incapacitates a significant section of the population, most of whom are likely to be poor?
5. On the first issue - offsetting the costs of a lockdown - the government has had the right idea. Expanding the BISP/Ehsaas programme was the right thing to do and the government seems to have done the best it could to deliver on this given its constraints and circumstances.
6. On the second issue - offsetting the long-term costs of infection - there is less reason for optimism. It is true that the capacity to deal with a pandemic like Covid-19 cannot emerge overnight, but it is difficult to see what the governments - national and provincial - are...
7. Doing. Put differently, how much difference is there between Pakistan's level of preparedness today and what it was when the first cases were detected? In key areas, such as the number of hospital beds, ventilators, and so on, it is clear that the country remains unprepared.
8. These things take time to change, but is there much evidence to show that plans have been put in place to improve on the existing situation? Similarly, while there has obviously been an increase in testing since the first cases were detected, is Pakistan on course...
9. To achieve the level of testing that is arguably required to accompany a strategy that avoids complete lockdowns. For example, on 10 Feb South Korea was conducting 0.01 daily tests/1000 people. By 31 March this number had risen to 0.30/1000. From 10 March - 7 May, New Zealand
10. Went from 0.02/1000 to 1.62/1000. In contrast, Pakistan has gone from <0.01/1000 on 18 March to 0.06/1000 on 8 May. This is an improvement, but is it sufficient? It could be argued that South Korea and New Zealand are unfair comparisons, but how about Uganda, which has gone
11. From <0.01/1000 on 10 April to 0.08/1000 on 8 May, or Vietnam, which went from <0.01/1000 on 10 March to a peak of 0.13/1000 by 10 April. If a lockdown is not possible, evidence from around the world shows that the next best thing is social distancing with targeted...
12. Quarantines and limited lockdowns. This is also the basis of the 'smart' strategy currently being deployed by the government but again, it is not clear that testing capacity is being increased as much and as quickly as needed to do this properly. This observation is...
13. Independent of the broader questions that could be raised about the government's capacity to properly implement the proposed 'smart' strategy; the capacity constraints that hamper policy implementation elsewhere apply to the Covid-19 response as well, and saying you will...
14. Pursue a 'smart' strategy - which is not a bad idea at all - does not automatically mean it will happen. The other major issue that is evident is the government's lack of clear direction when it comes to emphasizing the need for social distancing. While there has been much...
15. Talk of SoPs and guidelines for mosques, markets, and so on, it is clearly obvious that these are not being enforced in any meaningful way. It could be argued that enforcement was always going to be difficult, but this is precisely where clearer messaging from the government
16. Would have been helpful. What we have had, instead, is repeated attempts to downplay the threat of the virus (comparing it to the flu, as one governor did yesterday), and petty partisan point-scoring by different parties and leaders. At a time when better coordination and...
17. Direction could have ensured a better collective response - and there are institutional mechanisms that could have facilitated this - what we have instead is a fragmented, dysfunctional, and often confusing national effort to prevent the spread of Covid-19.
18. Where lockdowns have been avoided or limited, high levels of trust in the government and clear direction were crucial to ensuring social distancing. Is that the case in Pakistan? If lockdown restrictions are being eased have efforts really been made to implement alternatives?
19. Critics of lockdowns in Pakistan have spent a lot of time emphasizing the costs that will be borne by the poor. This is a valid concern that cannot be taken lightly. Yet, less energy has been expended on asking what the government is actually planning to do as an alternative.
20. There are good options here - 'smart' testing, increasing hospital capacity, social distancing, continuing cash payments etc - and while the government may be able to deliver on some of them, it is not at all clear that enough work is being done to make this strategy work.
21. The debate needs to move beyond the costs or benefits of lockdowns. That ship has sailed and, crucially, the point of a lockdown was always not to 'cure' Covid-19 but to buy time to mitigate its effects. That is what the focus should be on. How is the government expanding...
22. It's capacity to deal with Covid-19? How is it coordinating a national response? What decisions is it making regarding the allocation of resources for healthcare and welfare? Are resources being diverted from less pressing concerns? Are plans being made for a more robust...
23. Economic response to the anticipated shocks that will come from greater Covid-19 spread and subsequent waves later in the year? Is testing capacity being increased fast enough? Will the government do more to emphasize the need for social distancing and enforce quarantines?
24. The government must do more than simply say it is ending the lockdown to help the poor. It must show more leadership and clarity of purpose than it has so far, and do more to mitigate the inevitable long-terms costs of Covid-19. There needs to be less talk and more action.
