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.

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.