Unprecedented Opportunity for the Environment and Science

April 22, 2020, marked the 50th Earth Day, half a century since the original Earth Day in 1970 that turned environmentalism into a mainstream global movement. All of us eagerly waited for this occasion, as huge commemorations were planned around the world with as many as one billion people expected to participate. Environmentalists planned to hold massive rallies akin to the ones in 1970 and prepared to launch various programs such as the Great Global Cleanup, a campaign of volunteering for cleaning up litter. In the wake of 2019’s strong climate change activism, Earth Day 2020 was supposed to be one more watershed occasion for our struggle to safeguard the health of our planet.

Then came the coronavirus pandemic. The rapid spread of SARS-CoV-2, a virus new to mankind, is a huge and completely unexpected shock to the world system. It has upended societies and turned the lives of billions upside down. Social interaction has been curbed dramatically, as people are keeping physical distance from others and staying home. Most of the activities we spent years planning for Earth Day 2020 have therefore been cancelled. Earth Day organizers have done their best to adjust by turning Earth Day commemoration into a largely digital affair, with much success.

The real challenge, however, has just started.

Earth Challenge 2020, launched last month, is one of the biggest environmental campaigns scheduled to be held in heel of Earth Day 2020. The largest citizen science program ever, it is working to mobilize millions of people around the world to collect data on environmental conditions, so the data can be analyzed and combined to provide a clearer picture on planet’s overall ecological health. Basically, the Earth Challenge campaign has been formulated with the goal of getting ordinary people to monitor threats to the environment in a coordinated manner.

The coronavirus pandemic throws a curveball in our path. Environmental monitoring is still possible while maintaining social distancing, but the fact remains that it will have to be done under very challenging circumstances.

Additionally, the pandemic and the disruptions to society it has wrought actually diminish the intended usefulness of the Earth Challenge campaign. We are supposed to be making observations about current environmental conditions so we can better understand how human activity is impacting the Earth, but those very conditions have changed momentarily as the virus brings most human activity to a halt. For instance, air pollution, generally one of the biggest environmental problems, is one of the main topics pursued by Earth Challenge but lockdowns around the world have suddenly made the air much cleaner, which is only for a short period. The problem for Earth Challenge is that if we study the environment during the pandemic, we will be presented with a picture that does not entirely reflect how the environment normally is. To put it simply, we cannot monitor threats to Planet Earth when these threats have gone into hiding for the time being. 2020 is therefore the worst time to hold this ambitious environmental science program as we planned for it.

This need not be the case if we reevaluate our goals. We have good reason to, because the spread of COVID-19 presents the world with an incredibly unique opportunity. By dramatically suppressing many human activities, the pandemic has provided Planet Earth with an enormous relief. As a result, our environmental dreams have come true for the time being. The world has struggled with air pollution. Now, much of that has vanished. Animal habitats have been constrained by human trespassers. Now animals are wandering everywhere freely in the relative absence of humans. Human activity has been pumping greenhouse gases into the atmosphere non-stop, while we have yet to find out how to stop ourselves. Now, carbon dioxide emissions all over the world have plummeted.

If we conduct a scientific study of the environment now, we will see something extraordinary – a world that we have been fighting to create for half a century.

It is extremely important to study this world while it lasts. It will inform us of how the environment reacts to the cessation of manmade disturbances, as well as how the strategies to mitigate these disturbances can be implemented. It will provide us with enormous insights into environmental dynamics and how the natural environment and human society interact. As we fight to create a healthier planet, observing how things are now will allow us to better know what our desired planet will be like and how we can create it.

This makes 2020 the most important time for environmental science ever. All those who spent years preparing for Earth Challenge may not have gotten what they were planning for, but instead they have something very, very special. Because of COVID-19, the world’s largest citizen science program will not be able to investigate much how the natural environment generally fares but will be able to discover more about how it works and how certain changes impact it. It is a rare opportunity that has come our way.

Of course, citizen scientists and professional scientists alike face challenges in carrying out their work because of COVID-19, but it is very important that we overcome them in order to avail our great opportunity. Now is the time for scientific endeavor to become more active, not to slow down. That shouldn’t be too difficult for environmental science. Right from the beginning, Earth Challenge 2020 is meant to largely consist of activities happening in the telecommunication sphere and in the great outdoors. Volunteers are supposed to explore and examine the natural environment, such as wildernesses and even just the air around them, which they can easily do while staying away from people. Then they are to upload the data they collect onto digital networks for others to view. Communicating with others remains vital and can be done virtually, which is how all social interactions are being done wherever the fight against the virus is in full gear. The Earth Challenge platform has created a variety of digital resources for use by citizen scientists. We have to rapidly innovate to get our work going, as the impacts on nature of our responses to the pandemic are likely to be short-lived, although, as of late June, the coronavirus pandemic seems to be just starting in the developing world and is seemingly making a comeback in developed countries.

2020 is a year of unprecedented challenges, but there is a lot of benefit we are capable of getting out of it in the field of scientific research. As a result, Earth Challenge 2020 has acquired more significance than we could ever have imagined.

Shahzeb Khan is environment journalist, writer, student of Earth sciences, and director at Pakistan’s People Led Disaster Management (https://pldmsite.wordpress.com/). He tweets at https://twitter.com/justinshahzebkh.

CIVIL UNREST & VIRUS TRANSMISSION

Following is a COVID-19 issue brief from PPLDM.

On 10 March, a choir rehearsal was held by the Skagit Valley Chorale in Washington State, USA, where the coronavirus pandemic was just beginning to take hold. Lasting two and a half hours, it was attended by 56 people who took precautions such as keeping social distance and using hand sanitizer.

Within weeks, 45 of those people were diagnosed with COVID-19. Two of them died of it. There is little doubt that the choir practice is the cause of this huge cluster of cases. But how could the virus have spread so widely in the room given that it is unlikely that more than a few infected people were present?

At the time of the choir practice, the WHO downplayed concerns regarding the virus spreading widely through the air. The Washington disaster forced experts to rethink this. It is believed that, by singing, infected individuals emitted large amounts of viral particles into the air from respiratory tract. As a result, the choir rehearsal became a super-spreading event (an event that transmits the virus to an unusually high extent.).

It shows that we have to be very careful about events which involve people congregating densely in large numbers. A ‘small number of gatherings’ could be responsible for a high number of COVID-19 transmission. Regulating such gatherings could help us go a long way in slowing the pandemic. Restricting any potentially super spreader activity can sometimes be challenging, especially if the activity happens discreetly, or participants are too numerous to handle easily. Otherwise, it is fairly easy to track and suppress large gatherings of people.

There is, however, one kind of mass gathering that is always very difficult to disperse or control – civil unrest. Whether in the form of peaceful demonstrations or rioting, protesting has been a common feature all over the world, especially during last year. People gather in large number to vent their anger and discontent or to voice their demands in a manner that is disruptive because they mean to create an impact. Demonstrations are effective only when people crowd densely at certain vital spots, usually frequented by lots of other people.

Such disturbance happening while the pandemic is in full swing is a recipe for disaster. It will involve very large number of people tightly packed together. They will be chanting and shouting, thus expelling respiratory particles in thick amounts. The protestors will often come into proximity with a lot of other people like bystanders and law enforcement. Protests are therefore a major coronavirus hazard that Pakistan needs to be wary of as it battles the outbreak.

Should the circumstances be ripe for fermenting protest, dealing with the threat will be a huge challenge. By their very nature, protests are difficult for the authorities to block or control without resorting to actions repugnant to human rights values. The alternative is for the authorities to defuse the tensions that cause protests. Also, when people are aware of what is at stake, they themselves might avoid protesting out of concern for the outbreak. The pandemic is a crisis so big that we might expect people to avoid doing anything to further worsen it en masse.

However, the danger that protests and civil disturbances will break out in Pakistan while the coronavirus outbreak is occurring is very high. We have already seen coronavirus protocol being violated a lot by large numbers of people. Angry people are especially likely to disregard rules or concern for the safety of themselves and their fellow human beings. There will be a lot of anger as the pandemic brings massive disruption and misery to Pakistan. This is going to be a very difficult time for Pakistanis, who may resort to demonstrating due to hard circumstances even when nobody is clearly at fault for such circumstances. For example, in recent years, we have seen angry protests in Pakistan over water shortages, with poor people demanding that water be delivered, even if the water supply to a lower riparian state like us falls short during a season. Since rioting in the sun can make one a lot thirstier, it demonstrates that people will eagerly engage in such confrontational behavior even if it worsens the problem they are angry about.

What worsens the risk for us is that the authorities are likely going to be directly responsible for much of the hardship people will experience. This pandemic is driving governments everywhere to impose a slew of restrictions on all aspects of life for an extended period. Such policies are damaging people’s livelihood and are extremely unpopular with many across the world. These policies will bear down especially hard on Pakistan’s poor and lower-income people. They might see what is being done to them as a bigger source of anguish than an invisible virus killing a relatively small number of people. Plus, if drastic measures are successful in keeping the virus under control (therefore keeping the death count small), ordinary people might assume COVID-19 is not a serious threat to begin with and that the restrictions they are made to bear are unnecessary. So the motivation to engage in protests will grow higher as the reason to avoid protest decreases.

Protests have already happened since coronavirus became an emergency in Pakistan. Early on, there were protests by the pilgrims quarantined in Taftan over the conditions they were being held in, but their protest most likely created no risk that they were not already exposed to. On April 6, there was a protest by 150 doctors, who are the people who should know the best about what their behavior entailed, in Quetta over lack of personal protective equipment for those treating COVID-19. This protest also perhaps did not create new danger, except that the police arresting them provided opportunity for virus transmission.

Of much more concern, a major protest movement occurring during the COVID-19 crisis was launched against the detention of Jang Geo’s Mir-Shakil-ur-Rehman, who was arrested by NAB on 12 March over suspicion of corruption (specifically a bribe he was alleged to have taken from then Punjab Chief Minister Nawaz Sharif way back in 1986). The protests, which still continue, have often involved protestors crowding together in the typical manner. This unrest happening seems especially unbelievable as the grievance seemingly has nothing to do with coronavirus and there are much more important things to worry about. But, as it always turns out to be the case with anything happening during this pandemic, Mr. Rehman’s imprisonment is relevant to COVID-19 in important ways. Prisoners are among the people most vulnerable to the pandemic, as prisons are very fertile places for the disease to spread, so arresting him puts him at risk at a time when police around the world are considering letting people off for charges that do not urgently require detention. Also, media’s role in reporting on the coronavirus crisis is immensely important and a large media group like Jang Geo’s services should be particularly valuable now. Its owner’s arrest has hampered smooth functioning of Jang/Geo network and salaries to hundreds of employees have been halted. It is therefore a highly contentious issue, but it is a bad idea for his supporters to contest the matter in the way they have been doing.

These examples may, unfortunately, be the beginning. There is going to be turmoil in Pakistan. Fear and suspicion of authorities will be rife among the people as hugely controversial policies are pursued. Security forces will be overstretched. There appears to be plenty of mishandling of critical matters by the authorities. As the outbreak continues, Pakistan may resort to imposing lockdowns and quarantines even more, creating the perfect conditions for an outbreak of popular discontent that could greatly worsen the situation we are in. Preventing this from happening will be a huge challenge.

The quickest way for authorities is to break up protests by force. In ordinary circumstances, this is usually done only for disruptive or violent riots. But now, government may feel the need to use force for any protest in which people crowd together. A policy of force has big downsides. As people get hurt, public sentiment is inflamed further. Arresting and detaining people considerably worsens the risk of virus transmission.

An alternative is to defuse tensions. Measures vary depending on the reasons people are protesting and what could placate them. The authorities should, of course, always be willing to do little things like release Mir-Shakil-ur-Rehman, or obtain court orders for payment to Jang/Geo employees by seizing his assets. But when there are much bigger factors that are driving people to take to the streets, giving them what they want is usually no easy task. During this pandemic, in particular, Pakistan will have to navigate its way through many dilemmas and quagmires. For example, we have to tread a thin line between suppressing the spread of the virus and allowing the social and economic activity of the nation to continue. It may prove impossible for Pakistan to adopt a course of action that both protects as many lives as possible from the virus and keeps everybody reasonably happy.

In that case, it will have to be up to people themselves to avoid behaving in a manner that endangers them, the people around, and the broader society. It is important to reach out to every Pakistani and make them understand the danger the pandemic poses and the need to fight it tooth and nail, and to help them understand why things are the way they are. For the poor who resorted to angry protests in places like Karachi during recent summers, awareness was something that they were deprived of as much as water. We have to make sure that it is not the same situation during our current crisis. The pandemic is a crisis for the entire population of Pakistan, so properly informing every single Pakistani about what they need to know is necessary.

One thing that Pakistanis could be made aware of is how they can get their demands across while still practicing social, or physical, distancing. Even if every demand cannot be satisfied in desired time, we should make sure every Pakistani feels like they are being heard adequately. Protests happen because people feel it is the only way to get their message across. Let us provide satisfactory alternatives to this course of action.

If we fail to do that, we must find ways for people to engage in protest without providing the virus with opportunity to spread. All that is needed is for people to stay at a distance from each other and to wear personal protection. Protestors will have an incentive to follow this protocol, because their demonstration will be occupying a wider area, (a desirable thing from protestor point of view). Protesting has traditionally focused on being dense, perhaps because it packs a tight punch. But now, the amount of space protests take place in should be the value protestors should seek. It might be just as effective. People stand out in the open, wave placards, and chant loudly, while being far apart from each other, wearing masks and face shields. In the Washington choir practice, the virus might have spread so much because the crowd was indoors. Enclosed spaces allow respiratory particles to circulate in the same area effectively. But outside, which is where protests always take place, this risk is much lower.

Getting people to either find alternatives to protesting, or educating them to protest in a safe manner are two plausible strategies to be adopted if public discontent cannot be defused. Protesting has always been the last resort for people unhappy with what is happening, but as with many things, what is traditionally done has to be given up during this pandemic. We need to find new ways of doing things. This is a time for civil society and political leaders to reflect on the whole phenomenon of protesting, to reevaluate the mechanism of protest. The upheavals of 2019 made protesting the most valued form of activism for the world. But now, in 2020, we have to discover how to fight injustice and advocate for our cause differently during this global upheaval called the COVID-19 pandemic.

Best of all, we should learn how to get along with each other and cooperate, without resorting to confrontation, in order to make it through this time of crisis.

The brief has been authored by Shahzeb Khan, director at PPLDM.

Questions about the Coronavirus Pandemic

COVID-19 is a disease completely new to the world. The virus that causes it, SARS-COV-2, evolved recently and was first detected only a few months ago. The pandemic it is causing so far appears to be only beginning. There is a lot we need to find out concerning the COVID-19 pandemic.

There are therefore many questions that we have to ask that urgently need to be answered. Some of these questions the experts may already know the answer to, so they just have to explain it to the general public. But many questions nobody knows the answer to yet. There remains a lot for us to discover about the virus, the disease it causes, its spread around the world, and what we can do about it. There also seems to be a great deal of confusion in the information being given out. Many questions, of course, are widely asked and researchers are trying their hardest to find answers to. But we should also keep thinking of new questions to ask. Asking questions is the most important thing we can do. It helps to guide the research.

So, to aid in the world’s struggle against COVID-19, presented here is a list of questions about the new coronavirus, most of which are rarely asked and none of which are clearly answered. You can present them to local experts or you can disseminate them broadly.

The first questions we need to ask are about the viral disease itself, of course.

•(1) Is it possible for some people to be exposed to the virus but not get infected? Is there immunity that we don’t know of?

•(2) How clearly is the distinction made between illness, which is people being affected by the virus, and infectiousness, which is people being able to transmit the virus to others? For example, when they say that sick people have recovered from COVID-19, do they mean those people are also safely non-contagious?

•(3) When the virus is detected, whether inside the human body or not, how do we distinguish between finding live viruses and the remains of viruses that once were?

•(4) Can it be indicated how people who have the virus got infected?

•(5) There are indications that some people have died of COVID-19 without them being known to have the virus. If an infected person dies and is buried and significant time passes, is it possible to examine their remains to detect if they had the virus?

•(6) Exactly where in the human body is the virus to be found and how many types of bodily fluids can harbor the virus?

•(7) There are some hints about the virus being able to infiltrate the circulatory system. Some infected people display cardiovascular symptoms and sources say some of these cases are from the virus infecting the heart. Also, the virus attacks cells with the ACE2 receptor, which are found in the lungs but also in the blood vessels. This raises the serious question: can the virus be found in blood?

•(8) Can you get the virus through a cut on your skin?

•(9) Could the virus possibly then be vector-borne, like by mosquitoes or ticks?

•(10) They say the virus cannot be contracted by eating food. Presumably, this is because, while the mouth leads to a respiratory tract, it closes when eating. But after food passes by, doesn’t it leave behind virus particles sticking to the walls of the throat and esophagus which can then go into the respiratory tract?

•(11) Also, aren’t gastrointestinal symptoms of COVID-19 a sign that the virus can infiltrate the digestive system?

•(12) Does the likelihood of contracting the virus increase if there are a lot of dust particles in the air and they carry the virus?

•(13) They say that sneezing is not a common symptom of COVID-19, but can people infected with COVID-19 also have another condition at the same time that makes them sneeze, like another infection or an allergy attack, and can this sneezing transmit the virus?

•(14) Does being exposed to any other virus in the past give people a level of immunity to SARS-CoV-2, like how contracting cowpox used to protect people from smallpox? The virus that caused SARS back in 2003 is similar to the virus causing the current pandemic. Are people who were infected with SARS back then less affected by COVID-19 now?

•(15) Can people be immunized against COVID-19 by being exposed to such a low infectious load of the virus that it does not progress to any significant illness but results in antibodies being created?

•(16) We hear that people with underlying health conditions are especially vulnerable to contracting the virus. What happens when people are infected with COVID-19 and with other infectious diseases (of the kind caused by viruses, bacteria, etc.) at the same time? Do other diseases have the same effect they normally do?

•(17) Does COVID-19 leave healthy people with new morbidities, which is to say that they have lingering health damage they did not have before?

•(18) How does childhood stunting affect a person’s vulnerability to COVID-19?

•(19) The old and those in poor health are who usually succumb to Covid-19. Is there any indication that most of the people who died from COVID-19 were already going to die shortly of old age or health complications?

•(20) We understand why the virus goes hard on the old, but not why it spares the very young. The immune systems of young children are yet to fully develop, rendering them vulnerable to many diseases. Why isn’t COVID-19 one of them?

•(21) Are there any conditions which allow the virus to survive for a long period of time outside the human body?

•(22) Can the virus be transmitted through water, rendering COVID-19 a waterborne disease?

•(23) What is the longest length of time a person has been infected or ill with COVID-19?

In a similar vein are the questions about the pandemic, the way the infection is spreading through the world and its impact.

•(24) What is it exactly that makes the pandemic such a severe crisis for people? Is it the mortality from the pandemic that people are mostly concerned about or is it also the debilitating or damaging effects of so many people falling ill (similar to how the recent Australian bushfires and the 2010 Pakistan floods are considered huge disasters despite their very low death tolls)?

•(25) If infections from the virus are undetected, can we find evidence of them by noticing a rise in the general rate of illness?

•(26) How is the COVID-19 pandemic, and our response to it, impacting the treatment of other diseases?

•(27) Are the measures being taken against the pandemic, including lockdowns and keeping people home, resulting in smaller numbers of people falling victim to other illnesses and injuries like car accidents, workplace accidents, violence, and respiratory ailments from pollution, thus compensating for the burden the pandemic is placing on healthcare systems?

•(28) Does the coinciding of the COVID-19 pandemic with flu season and allergy season in many parts of the world worsen the spread of the virus by resulting in many virus-infected people also having flu or allergic reactions and therefore sneezing/coughing the virus out?

•(29) If the virus can be found in human feces, does it have potential to become another one of those diseases spread through the fecal-oral route i.e coming out through feces, contaminating water, therefore food that is ingested?

•(30) What are the implications of the two disasters co-coinciding – the desert locust outbreaks in Africa and Asia and the COVID-19 pandemic?

Then, of course, we need to know all about the actions being taken against the spread of the virus. The ways we are responding to it have to be thoroughly scrutinized and suggestions need to be given as to what can be done.

•(31) Why is it going to take a very long time to develop a vaccine for the virus? Simply exposing the virus to soap causes it to burst open, rendering it inactive but leaving its individual components, like the RNA and spike proteins, intact. These are all that are needed to provoke the needed immune response in the body. Why not collect enough of the virus particles, split them open, and inject the remains into people?

•(32) In the bat species that harbors the ancestral virus, do the bats have antibodies or anything that could be used to help humans?

•(33) They say that flattening the curve could result in the same number of people being infected in the end anyway. The goal is just to make sure too many are not infected at the same time. But in China, the epidemic (at least its first wave) seems to have petered out after two months. How it is that they have so far shortened the curve in addition to flattening it and could this work for other places?

•(34) We have two ways to respond to the pandemic. One is to slow the spread of the virus, flattening the curve, and the other is to do nothing. It is generally believed that the former option will result in the outbreak lasting a longer time while the latter option will result in the outbreak quickly running its course, as was demonstrated by St. Louis and Philadelphia during the 1918 Spanish Flu. But there seem to be indications that blocking the spread results in the epidemic quickly coming to an end, including the fact that it seemingly happened in China, and that letting the virus spread unabated may result in the epidemic lasting a very long time. So which is it? Will flattening the curve prolong or shorten the duration of the outbreak?

•(35) Since COVID-19 patients are being concentrated in hospitals, do those hospitals become highly hazardous places where anybody present is at risk of contracting the virus, including patients hospitalized for other conditions? For that reason, shouldn’t separate facilities and clinics be set aside for COVID-19 patients?

•(36) The severity of the pandemic means that people with limited qualifications are being called upon to help treat the virus, including medical students being allowed to graduate early. But providing the wrong care can be much worse than providing less care. How do we safeguard against these sorts of dangers?

•(37) In hard-hit places, medical practitioners of every specialty are being recruited for the fight against COVID-19. But how qualified are they for the job and how does each medical field provide the ability to deal with COVID-19?

•(38) Given the enormity of the disaster, is there any possibility of resorting to using human experimentation to make inroads into treating the disease?

•(39) We are told that making the immune system healthier can improve our chances of fighting off COVID-19, can immunity boosting for that purpose be done quickly enough through injections of nutrients to keep people safe in this current pandemic?

•(40) Can we coat surfaces everywhere with copper if it is an effective anti-microbial agent against the virus?

•(41) Can dogs or other animals sniff out coronavirus infections?

•(42) Why can’t static electricity be used to filter out tiny particles, like the virus we are all concerned about? Electrostatic forces act on small objects but not on air. So if a facemask has a net static charge, which can easily be created, couldn’t it either make virus particles stick to the fiber or keep virus particles away from the mask while allowing air to flow through?

Lastly, we need to broaden our scope and delve into the more general subject matter that surrounds this current pandemic.

•(43) Why is it that viral infections are such a widespread phenomenon anyway? Viruses do not force their way into cells. What goes on is basically the cell sensing virus proteins, letting the virus in, coming into contact with the virus genome, and deciding to follow its instructions. It appears that cells allow themselves to be victimized by viruses. If nature did not do it, can humans simply design cells to keep viruses out?

•(44) The perfect recipe for a pathogen with high potential to go pandemic includes a long incubation period, high virulence, and hosts with no immunity. But if a pathogen has a very long incubation period, during which time it is present in the human body while causing no harm, doesn’t that give time for the immune system to develop antibodies against it, therefore compromising the pathogen’s ability to progress to causing serious illness? (Might this explain SARS-CoV-2’s low virulence?)

These questions will hopefully serve as useful guidance for both researchers and ordinary folks trying to understand Covid-19. There will be many more we will be asking as we proceed on the voyage of discovery alongside this pandemic.

Pakistan’s Coronavirus Crisis and Response Strategy

The COVID-19 pandemic is severe and the only way it seems that nations can curb it is by either subjecting the general population to strict lockdown or to extensive testing, monitoring, and treatment, neither of which is easy for Pakistan.

Lockdown is the more feasible option here and many provincial and local governments have implemented it, Sindh being early at it. But Pakistan does not have any total lockdown policy yet. Prime Minister Imran Khan has rejected the idea. In late March, he said that imposing it on the entire nation will cause economic hardship that the nation cannot afford. With 25 percent of the population below the poverty line (before the virus struck), it could result in more people suffering and dying than from the virus itself. Enforcing total lockdown is also something the authorities might not be very capable of. Imran Khan has therefore suggested self-imposed lock down by people deciding when to go out for the most essential reasons. Working class people continue spending time outside their homes interacting with other people regularly in order to put food on their tables, but otherwise, everybody is advised to take strict precautions.

This is, in theory, a good policy. When a contagion spreads through the population, how each individual responds to it depends a lot upon that individual’s situation, which can be difficult for police enforcing lock down to take into account. Some countries battling the pandemic created a policy of requiring people to submit in documented form their reasons for going out, but this is unreasonable as circumstances may require people to instantly leave home in an emergency.  Leave it to the people themselves to handle the situation, and as long as they have their hearts and minds set on protecting themselves and everybody else, they will mount an effective response to the outbreak tailored to their own personal circumstances.

Try translating this idea into practice, though, and you come up against the cold, messy reality. You cannot ever expect everybody to fully cooperate in the right manner. Sure, they might start doing so when the outbreak becomes severe and everybody becomes afraid, but the point is to prevent or forestall just such a situation by taking measures before the virus spreads widely. Getting people involved in that is notoriously difficult as people often don’t have the urge to take action against a threat before it arrives.

Social distancing and other measures to avoid spreading the virus require a lot of discipline. Our is a nation of more than 200 million people. Most of them live in poverty and endure hard circumstances. Millions are not very much in touch with current affairs. Media itself is not well versed in current affairs. A lot are prone to believing and spreading misinformation. Getting them fully onboard the national response to the pandemic is a tremendous challenge.

In the same speech in which he announced no lockdown, Imran Khan had a go at it by imploring his citizens to keep themselves in isolation when they can. But a lot more is needed. Coronavirus is rapidly turning out to be an unprecedented crisis. Our capacity to cope is limited and what we can do may be very costly. To solve this conundrum and find the best strategy to respond to the emergency, let us take a look at just what this pandemic is all about.

Diseases that infect human beings abound in the world, but their prevalence is limited by many people having strong immunity, as well as by modern medical innovations. COVID-19 is a disease that has just come into existence. This means that nobody in the world at the start of 2020 had complete immunity and there was no specific treatment that could effectively counteract it. As a result, the virus is spreading everywhere very rapidly. Anybody exposed to the virus gets infected and becomes a carrier likely to infect lots of other people. The virus’s explosive spread means that you have lots of people who are infected at the same time and this means that anybody runs a good chance of contracting the virus.

As for people who do, in known cases, which is mostly symptomatic cases, the majority of people come down with only mild illness which may require just bed rest. But in around 20 percent of cases, the infected people have to go to the hospital and receive care. Around 5 percent of infected people end up needing intensive care and there are indications that many of them end up with long-term or lifelong complications. The number of infected people who die from COVID-19 varies regionally from 1 to 4 percent. Chances of survival depend mostly on the level of medical care received. Altogether, this is not a very serious disease as far as diseases go. But the speed of its spread and the huge number of fatalities is a catastrophe in the making for the world.

For Imran Khan, and for every leader of a country where poverty is widespread, a big concern is the economic devastation that could result from taking action to arrest the spread of the virus. So it is important to understand what the consequences of not doing so are and just what the impact of the pandemic will be.

Currently, we don’t have any experience to draw upon. The countries where the outbreak has so far been in full swing, and where it has apparently reached its peak, are all rich and developed. The pandemic seems to be only beginning in the Third World. Two Asian countries with different systems that were affected early, China and South Korea, seem to have taken successful measures to stop the outbreak, but it is impossible for Pakistan to replicate their achievements.

We do know fairly well the impact the pandemic can have on people. If a lot of people end up getting infected with the coronavirus, and if they do so in a short period of time so that healthcare systems are overwhelmed, there will be a lot of deaths. Obviously no one wants that.  If 4 percent is the highest death rate (case fatality rate, technically speaking) that this pandemic can wreak here, almost everybody in Pakistan getting infected means that close to ten million people may die before this contagion runs its course. That would be a super-devastating calamity, comparable to calamities suffered by some of the countries worst-affected by World War 2. This scenario is extremely unlikely, but if a good-sized chunk of our population gets infected, which could very well happen, fatalities will run into hundreds of thousands or a few million. No disaster in Pakistan’s 73 years of existence comes close to matching this death toll.

One thing perhaps worth mentioning is that most of these deaths will be of people who are elderly or living with severe health complications, which limits the economic impact of their demise.

Disaster management is not just about saving people from deaths, of course. One issue to keep sight of is people ending up with long-lasting or permanent damage. I wouldn’t use the word “disability” here at all, but doctors have observed that some recovered COVID-19 patients have ended up with what will likely be permanent health complications, including damage to the respiratory system. We could conceivably end up with millions of people in this state. The economic cost of paying their medical bills throughout their lives is there.

We might think that it is okay to be infected with COVID-19, be ill for some time, and then get back to normal. However, the sheer scale of the coronavirus outbreak means that you have lots and lots of people who are ill at the same time, which means that they will not be working and they will be receiving costly medical care. The statistics tell us that 20 percent of people infected and symptomatic will be severely ill.  Laborers who skirt isolation to do essential work will be among the worst affected. The economic consequences of this alone could be devastating.

Not taking measures against the spread of the virus could wreck Pakistan’s economy more than drastic lockdown measures will. Combine that with the human tragedy of scores of people being dead and disabled, the reasons for taking the most stringent emergency measures to arrest the spread of COVID-19 in Pakistan are compelling.

But so are the reasons that counter it. The economic circumstances of millions of Pakistanis are dire and with this pandemic, matters have only gotten worse, with rising food prices and a persistent locust outbreak decimating crops. This will make our response to the coronavirus much, much harder. Pakistan is truly trapped in a dilemma right now.

To find a way out, we first need to understand the basic nature of the pandemic. This coronavirus outbreak is a disaster that relies upon speed. Firstly, the chance of survival for people infected with COVID-19 is reasonably high if they receive adequate medical care, but so many people are getting infected at once that healthcare systems are unable to cope, forcing doctors in many countries to choose who gets to live and who dies.

Secondly, the faster the infection spreads, the more widely the infection can spread. When a lot of people are infected at the same time, it is more likely that they will spread it far and wide. If the virus spread slowly, some people would get infected and then recover and likely acquire immunity, and become non-contagious. The number of infected people at any given time would be low and there would be many immune people. But what is happening all over the world, unfortunately, is that the coronavirus contagion is pouring in much faster than it is draining out and, as a result, the bucket that is the human population is filling up.

Lastly, the enormous and pervasive disruption brought on by the pandemic is something that governments and societies need a lot of time to prepare for. It is best if they have time to prepare before the virus arrives on their doorstep, but once it does, the quicker the virus spreads, the faster the scope of crisis grows, and the less governments and people are able to respond effectively, such as by boosting medical facilities.

That is why governments are so eager to make it as hard as possible for the virus to spread. The whole point of “flattening the curve” is to slow the spread. And as we have just learned, slowing the spread also means containment of spread.

To better understand how this happens, say you are a person who is afraid of contracting the virus. If 30 percent of the people around you are infected and all of the remaining 70 percent are capable of contracting the virus at any moment (are susceptible, in other words), you are in great danger. If only 10 percent of the people around you are infected and another 20 percent are immune because they already had the virus before, you can breathe easier. Even if this goes on for a long time, the more infected people there are, the more immune people there are, and the harder it is for the number of infected people to increase, while the number of immune people continues to increase. This will work out perfectly provided everybody who recovered from the virus has total immunity and can never pass the virus to others again, though, unfortunately, there are doubts about this. Still, if we can manage to reduce the breakneck speed with which SARS-CoV-2 is spreading through human populations, the benefits will be numerous and immense.

Everyone agrees we cannot let this virus freely sweep through our country. But with our current options, the more we are to slow the spread of the virus, the more we have to slow the economic activity that provides people with their livelihoods. We have to try to find the perfect balance in-between flattening the curve and keeping the supply chains running. Imran Khan has said that the agricultural sector is open and he also wants to keep the construction business open so livelihoods can be sustained. That might be a bad idea, because the best strategy during this pandemic should be to only keep those sectors open which are needed for responding to the crisis. It has worked perfectly well in South Korea, where they put manufacturers into overdrive instead of society into lockdown. Constructing buildings is too long-term an endeavor. But agriculture is vital because people need to eat during the pandemic. Also, farming is a type of work which does not require lots of people to be near each other. Manufacturing sector is required for making medical and related equipment.

Pakistan is a nation with limited means, where poverty is widespread. We have nowhere near the ability that America, China, and Italy have for shutting down. The developed nations, where the outbreaks have emerged first, have plenty of resources to get through a period of reduced production. But if we don’t keep producing, not only will most of our 200 million people suffer very badly, but our ability to manage the pandemic will be compromised.

There is one strategy to protect both human well-being and the economy in the face of the pandemic which is well within our means. Not everyone is equally vulnerable to the coronavirus. Only a minority are at high risk of dying or becoming critically ill if infected. They are the elderly and those with underlying health conditions. We need to carefully examine all the statistics for known COVID-19 infections in the world to get a clear picture of just what kind of people are at high risk, what makes people vulnerable. Then, instead of the “keep everybody isolated” idea that many countries are trying, we can only keep those people isolated who are very vulnerable. The infection is likely to spread very widely among the sea of young, healthy people if we are to go with Imran Khan’s “keep society running” idea, but it will lead to Pakistan gaining herd immunity that will safeguard against future spread of the virus while casualties will be minimal.

This strategy will serve the goal of maintaining economic productivity so that Pakistanis don’t sink into destitution. It is the young, healthy adults who are the backbone of the economy and elderly people, as a rule, contribute little muscle power to productivity (their power is confined to intellectual mostly). Also, like most developing countries, Pakistan’s population is skewed towards youth. That means there are a lot of young people who can continue working, and only a small number of old people who will have to stay home. But what about the category of people with underlying conditions? People suffering chronic ailments are usually the minority in any society, so keeping them indoors is also manageable. However, poor health conditions are widespread in Pakistan, which could make this task harder.

Yet, this is going to have to be our strategy, if Pakistan is to make it through the worst pandemic in a hundred years. It has enormous potential. Those who are in the prime of their life and in fit condition should minimize the risk of coronavirus exposure by equipping themselves with personal protection (dressing up differently) as they keep the lifelines of the nation running, while the most vulnerable should be locked down and receive utmost protection. Manufacturing sector will have to be regulated towards manufacturing goods required during pandemic life style.

The practice of dropping supplies at door steps should be implemented with the elderly and the chronically sick.  They should be isolated and locked down, and government should help create infrastructure for their protection.

We can not have any hope of containing the epidemic in just a few months, like China seems to have done, so the outbreak in the nation will probably last a long time, possibly even two years, unless medical breakthrough comes first. That is a long time for any human being to be confined, but in that period, we can develop ways to enable the isolated segment of our nation to live fuller lives while still staying safe. Even  the elderly and those suffering ailments who live life locked in their homes can contribute during health emergency by making masks at home for distribution to the nation.  The know-how and equipment can be supplied to them.

Ultimately, defeating the coronavirus threat will require the will of the people. It can’t just be done by the authorities controlling everything. The masses of Pakistan will respond to Imran Khan’s call to do what they can to keep the virus and the disease at bay, if their options are properly explained to them. It will require methodical social management and effective public communication to inspire cooperation and enable efficient collective action.  For this to happen, the authorities must follow a singular scientific approach, based on the advice of professionals and experts.

To conclude, our advice is: isolate and lock-down the vulnerable and gainfully provide for them. Equip the young and sturdy with personal protection against virus and let them continue with their work. Carefully nurture sectors of economy needed during pandemic outbreak. Manufacturing and agriculture sector, not construction, should be encouraged to be of use during pandemic economy. When we have managed to successfully get our nation through the pandemic by keeping everyone safe, we will be better able to recover and build back Pakistan better than it was before.

An Age of Storms: COVID-19 Pandemic and the Weather

It’s been raining a lot in Pakistan these days. For the last several days, it has been constantly raining hard in Islamabad. It is often raining in the morning and then again in the night. There has also been heavy rainfall in other parts of the country through the month of March. Unfortunately, these rains have caused a number of deaths and serious injuries. They have even been so severe as to make houses collapse. Reportedly, 7 people in Khyber-Pakhtunkwha have recently died because of the storms. In early March, up to 24 people were reportedly killed across Pakistan.

A lot of damage has also been caused because of these rains and various other forms of severe weather occurring across the nation. Pakistanis in many areas have had to contend with heavy snowfall, freezing temperatures, hail, landslides, and minor floods. As a result, they have suffered significant agricultural losses. Wheat harvests in Bahawalpur appear to have been completely devastated. In addition, roads have been blocked, structures have been damaged, and people have suffered major disruptions of gas and electricity supply (Source: https://tribune.com.pk/story/2171627/1-24-killed-heavy-rain-wreaks-havoc-pakistan/).

Of course, such spells of bad weather are right now seemingly the least of our concerns as Pakistan battles the COVID-19 pandemic. Though it has not yet affected us severely, fear of how bad it could ultimately get is goading the nation towards extreme measures like imposing lockdowns on the population. The consequences of this contagion could be devastating for the entire country. But in this difficult time, in which everything is changing in ways we could never have imagined, experiencing the familiar sight of spring rainstorms got me thinking about what it can mean for us in our present situation.

For starters, people everywhere are supposed to stay home and limit how much they go out, including in Islamabad. The rain and cold makes it a little bit easier. People always stay indoors during rainy days. Perhaps, then, rain could be a boon for us during this pandemic. Whenever bad weather is happening somewhere, the spread of the virus probably slows down there. The rain, the cold, and the snow are keeping many Pakistanis indoors and preventing them from traveling. Landslides have also blocked a few transportation routes, which could limit the spread of the disease. We cannot rely on this weather to be any kind of saving grace, but the authorities might utilize it and formulate their coronavirus strategy in conjunction with the spells of severe weather happening across the country.

For example, they can relax their virus response in areas suffering bad weather, diverting resources and personnel from there to other places, trusting nature to keep people quarantined for the time being. Or they can send workers to weather-stricken areas to fix things up for the virus response, expecting that other people won’t go outside and potentially infect them. But it may not be all that good. The pandemic is already severely straining the country and the occurrence of any extreme event like severe weather in such a time can be disastrous.

When I took one of my rare excursions outside my home in Islamabad during one of the recent rainy days, I saw that water was flowing across the streets. I wonder if this gives us a sort of beneficial cleansing for these times. As infected people move around outside, the coronavirus they shed may end up contaminating the streets by the landing of respiratory droplets, people spitting, and the littering of objects people were touching. People who go out can get the virus on their shoes and then bring it into their homes. So if rain comes and gives the streets a cleansing, what sort of effect does this have on possible coronavirus contamination? Does the rain wash the virus away and make the ground safer? Does it also, on the other hand, spread coronavirus contamination? Does the water get to be contaminated and be therefore a COVID-19 hazard? I have no idea but I think the ecology of the virus outside the human body is more complex than we realize and we really should study it more and seek to fully understand how SARS-COV-2 moves through the environment.

In this time of unprecedented crisis, when it seems that any feasible solution is out of our grasp right now, we will need to think outside the box and get really creative. Some unusual solutions could help us in the fight the pandemic and one we should look into is welcoming the landslides. It is a regular occurrence in Pakistan’s mountainous areas. A landslide occurs, blocks travel, and then we rush with bulldozers to clear it out. But if the virus spreads through people traveling, then maybe the blocking of roads due to landslides, avalanches, rock falls, and floods could be a lifesaver. The virus outbreak is severe in Gilgit-Baltistan. If we give nature free rein to block roads there and even help it to do so, then we may have fewer of these spreaders introducing the virus to new communities while our efforts remain devoted to the handling of the pandemic.

This tactic, however, has potentially huge downsides. When people do get infected, medical care needs to be delivered to them and bad weather getting in the way of delivery is a recipe for disaster. The spread of the virus may be less but the danger it poses may be more. Also, aid workers need to be sent around to help communities safeguard against the outbreak. Lastly, keeping people supplied with the necessities of life is one of the biggest issues in this epidemic. As travel is restricted and national production slows down, bad weather closing the roads can further add to the deprivation that people already face due to COVID-19.

So if we have landslides or storms or snow blocking traffic in Pakistan, what is its net impact on society during this pandemic? Does the good it causes outweigh the bad or does the bad it causes outweigh the good? We need to conduct comprehensive situation analysis to find out and then let it inform our decisions. We are treading on a thin line in almost everything when it comes to COVID-19. It has just been announced that the authorities are sealing off one part of Pakistan, the mountainous area of Chitral, where no cases of COVID-19 are known yet (Source: https://www.aa.com.tr/en/asia-pacific/pakistan-seals-northern-region-with-no-covid-19-case/1788194). This is a sensible measure for any place where the virus has not gained a foothold. But where the virus has already reached and is spreading, there has to be a flow of some people there to bring aid. It wouldn’t really matter if any of them carry the virus because the virus is already there.

Sealing off travel can be quickly implemented and quickly reversed by the authorities at will. But if some untoward phenomenon like the weather gets involved in this, we can only observe what will happen. I wonder what would be the consequences of an event like the 2010 Attabad landslide happening right now (https://earthobservatory.nasa.gov/images/43175/landslide-lake-in-northwest-pakistan). The impounding of the Karakorum Highway and the trapping of entire communities behind a dammed lake could be a saving grace for the region, containing the virus or at least hampering its spread. But on the other hand, the people suffering this incident while the pandemic is already coming upon them could have devastating consequences.

Weather forecasting may potentially be of great use to us during the pandemic. Weather likely plays a big role in how COVID-19 spreads and how we can react to it. So if we know what the weather will be like in the days ahead, we may be able to make predictions about the course of the pandemic and what measures we should prepare. The weather may slow the spread of the virus by itself and make it easier for us to do so or it may worsen the spread of the virus and the illness of those infected by it and hamper our response to the pandemic. Whatever the case, we got to watch out for whatever weather is coming and figure out how it may interact with the virus outbreak.

It is very important. Pakistan is a country very prone to natural hazards. We might be used to it, but as stated before, an extreme event occurring during this pandemic can result in calamity. We just won’t be able to handle so much. Right now is a pretty dangerous time. Severe weather often occurs in Pakistan in the spring, including cyclones. But in this part of the world, the season for hazardous weather does not kick off until the arrival of the summer monsoon.

Widespread flooding frequently happens in Pakistan during the summer monsoon. It can often be very severe, such as in the years 2010-2014. When such a thing happens, people’s lives can be turned upside down and their homes can be destroyed and they can be displaced. In such circumstances, Pakistanis would not stand a chance against the COVID-19 pandemic. In a mild flood scenario, people may be stranded at home and prevented from moving about, acting to hamper the spread of the virus. But in severe flooding, social distancing, sanitation, medical care, and everything needed to fight the virus can become impossible. If large numbers of people are displaced, they can travel long distances and congregate together. Whether in a refugee camp or a small piece of land remaining above the water, people can crowd and live together very densely in filthy conditions with no ability to wash their hands or wear protective gear. People who are sick may not be able to be quarantined in any way. Their access to medical treatment may be impossible. Floods are very good at blocking access to supplies. Plus, the floods themselves can create a large number of people needing medical treatment in addition to COVID-19 patients, overburdening the healthcare system.

The healthcare system being overburdened is a huge concern, and so, unfortunate to say, disease outbreaks are very common in Pakistan during the summer monsoon, especially during floods. The mosquito-borne disease dengue is a particularly big concern. A dengue outbreak in 2011 strained the nation’s healthcare system, requiring military help and the construction of field hospitals (Sources: https://dailytimes.com.pk/477797/dengue-and-how-it-was-controlled-in-2011/, https://tribune.com.pk/story/250366/emergency-measures-army-joins-dengue-fight-on-sharifs-request/). If a major epidemic of dengue or cholera occurs while we are coping with the COVID-19 pandemic, the consequences could be very bad.

The summer monsoon always plays Russian roulette with the livelihood of millions of Pakistanis. It sometimes brings less rain than usual, resulting in water shortages that farmers can’t handle. Sometimes, full-scale droughts occur. If devastating floods occur, that can also cause immense damage to the agricultural sector, as well as all kinds of other damage. Transportation can be blocked and infrastructure can be destroyed. Life can grind to a halt for millions. It is not a good idea for any of this to happen when Pakistan is in the throes of this coronavirus. Treatment for coronavirus and measures to stop its spread can be hampered, for one thing. Also, deprivation will be pushed on Pakistanis by many people falling sick and by measures being taken to stop the disease spreading. Deprivation caused by floods will be added to this.

Our biggest famine threat right now comes from the locust swarms currently ravaging Africa and Asia (Source: https://www.csis.org/analysis/africa-and-asia-have-several-hundred-billion-more-problems-besides-covid-19). Generated by heavy rainfall in East Africa, it has been going on for a long time and seems to only be getting worse, as locusts are breeding within and around Pakistan (Source: https://www.iol.co.za/business-report/international/our-children-will-starve-say-pakistan-farmers-as-locusts-breed-45118469). The summer monsoon is a good time for locusts to breed because they abound when heavy rainfall causes vegetation to bloom. Flooding could therefore bring us further locust plagues and with some crops smothered by water and other crops devoured by the insects, there could be severe food shortages. People will then have to go out and interact with each other as they work harder to get food, social distancing will be impossible, and the virus will spread. Also, locust outbreaks can often be controlled with modern techniques, but it will be hard to apply them when there is also a severe pandemic to fight.

Even if the monsoon rainfall up ahead is not severe enough to cause flooding, it could worsen the locust outbreak, along with causing outbreaks of dangerous mosquitoes. People can’t stay home. They have to go out to struggle to get food, contracting COVID-19 or a mosquito-borne disease along the way and too many people fall sick for hospitals to handle. Not a very good situation all around. There is just so much that can go wrong in the months ahead.

Right now is the beginning of April. The monsoon rains usually arrive at the end of June. That is only three months away. Some experts predict that, without strict containment measures, 20 million people in Pakistan could be infected by June of this year. (Source: Coronapocalypse! https://www.dawn.com/news/1542651.) This would truly be a catastrophic situation. Then the summer monsoon will begin shortly afterwards and if it gives us any trouble, we simply won’t be able to cope. Plus, the outbreak could expand even more and millions more could end up infected. Assuming we do adopt strict containment measures and keep the virus under control, if we have to continue doing so during the monsoon season, severe monsoon weather could make it much, much more difficult. We might be forced to yield and then cases of infection will explode.

Every single South Asian monsoon season is unpredictable. We never know what it will bring us and that is why we should be really concerned right now. The worst monsoon flooding ever to happen in Pakistan was in 2010, when a fifth of the country was flooded and 20 million people were affected. If 20 million really do fall sick from COVID-19, then a comparably severe disaster will ensue after the passage of ten years. But let us imagine that both of these disasters occurred at the exact same time. Imagine that 20 million Pakistanis are infected by June and then the 2020 summer monsoon brings the same sort of rainfall to Pakistan that the 2010 summer monsoon did. I imagine the result would be apocalyptic for our nation.

This is very unlikely to happen though. The monsoon was recently behaving in an unusual manner. We had these unprecedented floods in 2010 and then more flooding every monsoon up to 2015. But after that, the summer monsoon has been relatively calm every year. But judging by its historical patterns, the probability is very good that Pakistan will be struck with severe flooding in the months ahead.

We cannot prevent this if it were to happen. But is there any chance or any way that we can avoid the COVID-19 outbreak happening during that time so that Pakistan doesn’t have to fight a two-front war? In China, the epidemic raged for three months, starting in the beginning of January. Now, it is dying down, new local infections are rare, and life in China is starting to come back to normal. If the same thing happens here in Pakistan, then the epidemic, which began at the beginning of March, will go away in time for the arrival of the monsoon. But China successfully contained the virus by enforcing strict lockdown measures and it is a very prosperous country. Pakistan has very little capacity to do any of the things China did. PM Imran Khan has said that locking down Pakistan will cause more harm through impoverishment than the virus will, especially with the economic problems and rising food prices happening right now. So it is expected that the virus outbreak will progress to a very high level in Pakistan. That means that it should go on for a long time.

Now, hold on a minute, the epidemic going on for a lengthy period of time is also what everyone is clamoring for. This is the whole “flatten the curve” protocol. With proper medical treatment, people have a high chance of recovering from being ill with COVID-19. But the pandemic is wreaking so much havoc because it is causing so many people to be infected so rapidly that healthcare systems around the world cannot cope. So if we slow the spread of the virus, the burden on the medical sector is kept low, even if it persists for a long time until the virus runs out of fresh people to target or a medical breakthrough that can fight it is achieved. Therefore, if Pakistan successfully flattens the curve, the coronavirus outbreak will be kept under low intensity, but it may continue going on and on for a long time, most likely well into the monsoon season. If that season brings severe flooding or some other disturbance, everything could break down and Pakistan will have a convergence of calamities on its own.

(Note: Reading the two paragraphs above might be confusing, as the first one says lack of containment measures will prolong the epidemic and the next one says that it is containment measures that will prolong the epidemic. But there is an explanation of the confusion several paragraphs down. Also, by the end of this article, you will hopefully understand the perplexing nature of the subject.)

We may therefore be standing on the cusp of a profound quandary. If we let the virus run rampant, it will infect huge numbers of Pakistanis in a short period of time. Medical services will be overwhelmed and many, many people will die. But the virus will have probably run its course by the end of June.

If we put roadblocks in front of the virus, then the number of people who fall ill every day is very low, so hospitals can take in the steady stream of patients and save many lives. But this goes on for months on end and then the monsoon season begins. If it brings widespread flooding to Pakistan, then “flattening of the curve” will come to an end as we cannot fight the pandemic and the floods at the same time. This will cause the spread of the virus to skyrocket, leading to a flood of infections at the same time the country is dealing with a flood of water. Locusts may be swarming everywhere and we cannot fight them effectively because we are fighting coronavirus at the same time. Mosquitoes may be biting everyone, clogging the hospitals even harder. We cannot deliver essential supplies and lifesaving medicine to people across the floodwaters while flood-stricken people who desperately wade through these waters will spread COVID-19. Pakistan is smothered under the combined burden of all these events and, in the end, many, many more people could end up dead and the survivors will be left to struggle in a devastated nation.

So do we flatten the curve or do we let it grow? The idea of foregoing “flattening the curve” has already been considered elsewhere during this pandemic. The alternative is achieving “herd immunity”. It involves letting the infection spread unhindered and Britain originally planned to do this. The idea is that only a small minority of people will die if infected by the virus, but they all run a big chance of contracting the virus because everyone around them is being infected and is passing on the virus. The virus is spreading through the general population because they lack immunity, but they will gain immunity to it after recovering from the illness. So the epidemic, if unhindered, will run out of steam after a short period of time. During that short period of time, people who are especially vulnerable if they get infected can be kept well-protected. Afterwards, they will be protected by the herd immunity of their country.

Sounds like a plan crazy enough to work, but by now, it has been generally rejected as too risky. But in Pakistan, where we have to deal with the contingency of a very erratic rainy season from June to September, is it possible that “flattening the curve” is actually the riskier option? Perhaps if we go with seeking to achieve herd immunity, we can make the coronavirus outbreak as brief as possible. Then, when the summer monsoon arrives, we can concentrate on preparing for whatever trouble it brings us without having also to deal with the coronavirus. If done right, we can successfully minimize the number of people who die or are seriously harmed.

Flattening the curve could be considered as being for rich countries, while a country like Pakistan may conceivably have to go with the tougher option of herd immunity. Imran Khan’s rationale is that the country has to keep working. Now, the people who are most vulnerable to coronavirus are the elderly and those with health problems. Such people usually do not work anyway and are a minority in Pakistan where there are so many young people. Our strategy may to identify everybody who is at high risk and have them isolated from the rest of society. All the young, healthy people can continue working and will be trusted to come down with only mild symptoms. Once enough of them have been infected and recovered to achieve herd immunity, the partial lockdown can be ended. Hopefully, this can all be finished before the possibility of floods.

But not containing the spread of the virus is still a drastic course of action. Perhaps we should only resort to trying to make the epidemic end by July if there are indications that the upcoming monsoon season will be hazardous. And just when you thought this year 2020 couldn’t be getting any worse, there are. Floods in Pakistan often occur when there is a La Nina weather condition in the Pacific Ocean. Many meteorologists predict that a La Nina system could develop by late summer or fall. One meteorologist, Dr. Michael Ventrice (http://www.atmos.albany.edu/student/ventrice/documents/Resume.pdf), suggests that it could be the strongest La Nina since the one of 2010-2012 (which caused those severe floods in Pakistan).

(Source: https://www.nbc12.com/2020/03/31/la-nia-may-develop-by-fall-could-mean-active-intense-hurricane-season-ahead/)

Clearly, there are some very dangerous times right now for us. And the worst part is our inability to determine what will happen. There is a lot of uncertainty about the outcomes of whatever option we take. We should expect that containing the virus means the outbreak will last a very long time and letting it spread means the outbreak will last a short amount of time. But in China, where they were containing it, they were able to relax after just two months and the outbreak, so far, seems to have died out. Meanwhile, it is Pakistan not being able to suppress the spread of the virus that is supposed to lead to 20 million infections three months from now if. The fact is that the same phenomenon may lead to different outcomes depending on the situation. Also, in the “20 million by June” scenario, the epidemic might just end there. So there are no more new cases of the coronavirus during the monsoon but the nation will have to take care of a lot of sick people. Also, monsoon floods might add in extra input that leads to even more people being infected. But this is a really big question that we need to resolve. Does containing the spread prolong or shorten the epidemic, or more to the point, where does it do what?

If Pakistan does what China does and achieves the same outcome China did, it would be the best scenario. As few people as possible would be infected and the monsoon season will hopefully be coronavirus-free. But it seems that Pakistan can’t do it. It is impossible. What we could try is deliberately getting most of the population infected very quickly. Maybe we can go and inject the virus into millions of Pakistanis (who are carefully chosen). But, really, it is just very drastic.

If Pakistan does not have hopes of making the epidemic come to an end before the monsoon season is in full swing, then at least we can prepare for a combined coronavirus-monsoon crisis starting right now. A long period of preparation appears to be key. If countries around the world started a full-scale response to the coronavirus as soon as news of its outbreak in China came in late January, then they probably would not be suffering so much right now. Pakistan did not do anything during the whole month of February. Let us not make the same mistake right now. We need to be concerned about any eventuality and we need to build-up our capacity to respond to them. Then, we might be able to respond effectively to disasters possibly coming in the months ahead. We must not be complacent and decide to respond to problems only when they come. At the very least, thinking of solutions to the problems described in this article is a really hard task in itself, so the longer we have the time to do it, the better it is, so we better start thinking now.

Our best strategy, as always, is to hope for the best and expect the worst. Let us hope that nature remains friendly for the duration of the epidemic and doesn’t give us further concerns to worry about, that the rains come in the right manner to allow our agricultural harvests to bloom, and that any bad weather that does happen only has the effect of confining people to their homes and to their local areas so as to restrict the spread of the virus. Let us expect that weather-related disasters could come along and strain our country’s emergency response capacity to the limit, that the locust infestations will get worse as time goes on and produce a severe food crisis, that disasters will turn people into refugees that act as the ideal conduit for the virus and prevent us from delivering the means to fight it, and that the projected La Nina will bring back the monsoon catastrophes of 2010-2012 at a time when our nation is already fighting some of the worst kinds of crises possible.

In the meantime, let us remain calm. We got to think rationally about our situation and our outlook and all of Pakistan has to be united in getting things under control. We are already struggling a lot but much worse is likely to come, both with the current trajectory of the virus and with other circumstances coinciding with it. We must not regard this pandemic as existing in a vacuum, as being an issue separate from all our other issues. When you have a crisis of a nature and a magnitude like the COVID-19 pandemic, a lot of different events and circumstances, including other disasters, are going to interact with it and could create a sort of multi-faceted crisis that Pakistan needs to mount an integrated response to.

We may think that because the coronavirus is such a big menace, it should be our
foremost concern and everything else can take a backseat, but actually, this is a time that we especially have to be on the guard against other menaces. We are going through a time of crises. We need to think of a broad strategy to handle what we are faced with. Speed is of the essence, above all else.

These are stormy days. Sitting and listening to the rainfall and thunderstorms outside can give one either a calming sensation or a sense of gloomy foreboding. Our prospects are very uncertain. Maybe we don’t realize that enough. We don’t know if anything that happens makes things better or makes things worse, but we do know that we have to act. As we brace ourselves for the massive storm that is the pandemic, experiencing these real storms should be a reminder for us of how just about anything can happen and we have to get ready for anything. We might have many things coming together to create a perfect storm. If we are to keep our people safe in these dangerous times, if Pakistan is to weather whatever storm comes our way, let us make sure that we are one step ahead.

About the Author:
Shahzeb Khan is a journalist, environment activist, and co-director at PPLDM.