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India vs Pakistan: Why Are India’s COVID-19 Cases Inflating While Pakistan Has Almost Overcome The Pandemic?

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While India has literally been brought to its knees by the COVID-19 pandemic with almost 100,000 cases reported daily, the number of coronavirus cases and deaths in Pakistan are shockingly low. 

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With a large population density and poor healthcare services, both the South Asian nations were predicted to suffer severely from the pandemic. India is seeing the largest number of cases in the continent and second-highest in the world with cases crossing 53 lakh mark with over 85,000 deaths, trailing only after the US which has a total of at least 66 lakh positive cases. 

On the other hand, India’s neighbor, Pakistan has recorded only 3 lakh cases with over 6000 fatalities. Surprisingly, while India is seeing a rapid increase in COVID-19 cases, Pakistan and even Bangladesh are seeing a downfall.

With similar socio-economic conditions in both the countries, how did Pakistan manage to flatten the curve?

According to a report in The Diplomat, National Command and Operations Center (NCOC) chief Asad Umar explained Pakistan’s strategy – “Media played an important role in creating awareness, which was backed by our testing, contact tracing, and quarantine program.

We managed to increase testing capacity in a very short period and applied a sophisticated tracking system that ran through the ground to apex level.”

The lockdown imposed in both countries had a stark difference. While India went into a complete lockdown, Pakistan was laxer. Prime Minister Imran Khan in his address to the nation said that the country cannot afford to go on full lockdown.

“If we were like Italy, France, America, or England, I would have locked Pakistan down completely,” Khan said in an address to the nation on March 22. “But our problem is that 25% of Pakistanis are below the poverty line. They can’t even afford two square meals a day. If working-class Pakistanis are locked up for two weeks, how will they feed their families?”.

The approach also prevented economic hardship that came after the lockdown.

In contrast, India’s total lockdown trapped workers in the big cities that was followed by massive migration. Experts have argued that while the movement of labour from cities to villages was low in Pakistan, the virus that came to cities through international travellers, stayed in the cities only.

On the other hand, due to massive migration in India, the virus was pushed all over the country including the small towns and villages.

Another important factor is the demographics of the population. While India’s median age is 28.7, Pakistan’s is 22. The mortality rate is higher in countries with an older population. Most of the western countries saw the virus spread in old age homes which led to higher fatalities. In contrast, the culture and social norms in South Asia veto elderly members placed in old age homes. 

A seroprevalence study conducted in July in collaboration with the World Health Organisation (WHO) revealed that that 11 percent of Pakistanis have developed COVID-19 antibodies while 89 percent remain at risk.

According to a report in Deutsche Wells, a government official in Punjab Province of Pakistan said that he had direct orders from his superior to omit numbers by almost half. This month he reported 34 new cases, instead of 63. 

This is indicative of willful misreporting at the district level and raises concerns regarding the accuracy of the official figures. Misreporting, coupled with a decrease in testing, greatly skews the recorded prevalence of cases in the country, said the report quoting experts.

Epidemiologist Dr. Rana Jawad Asghar talking to The Diplomat acknowledged that while India’s testing capacity is way ahead of Pakistan, social stigma around the virus and the fear of government intervention had prevented many families from getting tested.

“Pakistan may have fewer cases but its mortality rate (2.13 percent) is higher than India’s (1.8 percent).”

study conducted from May to July at the National Institute of Blood Diseases (NIBD) Karachi and published in the Oxford University Press’s Journal of Public Health, suggests that the chances of a second wave in the country are slim. This further strengthens the Pakistani government policy of re-opening businesses.

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