Say it's premature to assume the virus has been defeated
Doctors agree that the number of coronavirus cases in Pakistan is going down. In Sindh, the government is shutting down the Field Isolation Centre that was set up at Karachi’s Expo Centre to isolate mild and asymptomatic COVID-19 patients, as well as decreasing the number of beds in isolation wards of hospitals. But the experts still advise caution.
“Cases have been declining,” a spokesperson of the Sindh health department told SAMAA Digital Tuesday. “Keeping this and the high costs of maintenance in mind, it has been decided to shut down the field isolation centre.”
Beds and medical equipment from the Expo Centre will be moved to existing hospitals in the city. The Sindh government in collaboration with the Aga Khan University Hospital had set up the 1,200-bed isolation centre, which was inaugurated on April 3.
Most of the equipment will be moved to the government’s infectious diseases hospital built at NIPA. As for the items donated by the Provincial Disaster Management Authority, they will be returned to the authority which will decide what to do with them, according to the health department.
Contrary to the rumours, the Jinnah Postgraduate Medical Centre in Karachi is not shutting down its COVID-19 ward. The 90-bed facility is functional and currently has seven patients admitted, JPMC Executive Director Dr Seemin Jamali told SAMAA Digital. She urged people to continue following precautions to avoid a surge in infections.
AKUH, one of Karachi’s main private hospitals, isn’t downsizing its COVID-19 wards either.
“We are not yet done with the pandemic,” says Dr Faisal Mahmood, associate professor of infectious diseases at AKU, who has also been working closely with the government on the country’s COVID-19 response.
“It’s premature to assume coronavirus has been defeated. Precautions need to be continued.” The infectious disease specialist laments that people have become complacent about the precautionary measures.
He elaborated on activities and actions that carried a high risk of virus transmission. These include being in poorly ventilated small rooms in close proximity with other people, not wearing a mask and pulling down the mask while talking.
The virus spreads from the mouth, Dr Mahmood notes. Masks that either don’t entirely cover the nose and mouth or hang from people’s necks are useless.
The degree of contact between two individuals is important, according to Dr Mahmood. Transmission risk increases if the duration of contact exceeds 15 minutes.
He said he had recently been seeing more recovered coronavirus patients with long-term COVID-19 symptoms and post-COVID syndromes, also known the world over as “COVID long-haulers”.
These are patients who continue to experience COVID-19 symptoms such as fever, cough, diarrhoea and fatigue for more than two weeks and sometimes up to three or four months. In addition to these, the patients also report psychiatric issues such as depression, anxiety, mental fog and short-term memory loss.
At his clinic, Dr Mahmood saw patients who had recovered from coronavirus infection presenting with complaints of fatigue, tiredness and depression.
We have seen the whole spectrum of COVID-19 symptoms ranging from asymptomatic cases to those with severe disease and difficulty breathing, said the infectious disease specialist.
A recent study by AKU has revealed that the proportion of asymptomatic cases in Pakistan is much higher than other countries. Seroprevalence surveys, blood tests that detect virus antibodies, were carried out on over 2,000 people in Karachi. The metropolis has had the highest number of cases compared to other cities of Pakistan: 84,538.
The researchers found that 95% of those who tested positive for COVID-19 reported feeling no symptoms of the illness such as a cough, fever or sore throat. This led them to conclude that asymptomatic people likely made up Pakistan’s major chunk of infections. Since those without symptoms do not seek hospital treatment it would explain why hospitals here have not been under the same strain as in Spain and the UK, the authors said.
“Antibody testing or seroprevalence provides a true picture of the burden of COVID-19 as they capture asymptomatic cases who represent silent carriers of the disease,” said Dr Fyezah Jehan, an associate professor at AKU and co-author.
Another interesting finding of the study was confirmation of a surge in COVID-19 cases between April and June. Areas with low levels of community transmission such as Ibrahim Hyderi saw a spike from 0.2% to 8.7%, while high-transmission neighbourhoods like Safoora Goth, Faisal Cantonment, Pehlwan Goth and Dalmia witnessed a rise from 0.4% to 15.1%.
Currently, the occupancy of ICU and HDU beds in Karachi has also seen a downward trend as doctors say hospitals are no longer overburdened. A Sindh health department report shows that out of 409 ICU beds with ventilators in different hospitals, 343 lie vacant and 1,261 HDU beds are unoccupied among the 1,350 available as of September 8.
Only 34 patients are now using the isolation beds set up in various facilities, while 4,016 lie empty.On Tuesday, 136 new infections took the number of confirmed cases in the province to 130,807. The death toll in Sindh is 2,425.