The Influx of COVID-19 in Sindh, Pakistan
Sindh’s influx of the first COVID-19 case originated from Iran, and presented to Aga Khan University Hospital (AKUH), Karachi. It was thereby labeled as a pandemic by the World Health Organization. The common symptoms of the virus are flu-like and include cough, chest discomfort, fever, and malaise. The virus multiplies in the lungs for 7-14 days before its symptoms become apparent. The lengthy incubation period makes the isolation of suspected cases difficult. To date, no vaccine or treatment against it has been developed. One of the primary methods to ensure maximal protection from contracting this virus is adopting social distancing methods. Therefore, counter-measures like school shutdown, exit screenings, and dissolution of mass gatherings are necessary. Pakistan is slowly becoming one of the hardest-hit countries by this virus in the world with over 40,000 cases reported so far and the number still increasing.
With its first case confirmed on April 26, 2020, Sindh distinguishes itself as the hardest struck province of Pakistan with this virus. The latest data from the government of Sindh as on May 17 confirms 15,590 patients contracting the virus with 268 people losing their lives to this pandemic. Sindh unlike other provinces responded promptly to the situation and forced its lockdown very early in the course. The situation urged the need for strict measures to be taken to keep the health of public safety. All the public places, shopping malls, and hotels were closed May 24, 2020, with the educational institutes already closed on May 1, 2020.
The State of COVID-19 Cases in Sindh So Far
Among those affected by this virus in Sindh, 3800 patients have recovered so far. The recovery rate of COVID-19 patients is 24.40%, which is obtained by dividing the number of patients recovered with the total cases reported so far. Punjab on the other hand despite sheltering the largest population of Pakistan has a far better recovery rate of 33.48%. The majority of patients dying from this virus were those who already have some co-morbid diseases like heart disease, asthma, lung problems, and diabetes. A total of 606 patients defeated the virus in Sindh and were sent home after recovery on May 13, 2020, which is the largest number of recovered patients in a single day for any province. However, it contributed very little to affect the overall recovery rate of Sindh when compared with the rest of the provinces.
By May 18, 2020, about 60% of the total cases diagnosed in Pakistan were the pilgrims returning from Iran, a country with the highest number of deaths in Asia. After the completion of their screening process, patients who were diagnosed positive for the Coronavirus were shifted to Sukkur Quarantine. With limited resources and testing capacity at that time, Sindh ensured the proper isolation of those patients, which helped to keep the local transmission from the patients to zero. All those patients who were quarantined together were recovered and were sent to their homes after being tested negative for the virus.
The local transmission rate in Sindh measures 92% which is higher than in Punjab (85%) and KPK (84%), the other two largely affected provinces. The local transmission averaged around 49% during the early days but ever since the restrictions of lockdown have been lifted, the interaction of community has almost doubled the rate of local transmission. This has placed a burden on the hospitals which is already an acute shortage of health equipment.
Following the WHO advice on Covid-19 “Test, test and test”, the provincial government has managed to raise its testing capacity of the province, which now approaches 4,400 tests being conducted daily. Pooled sampling has also commenced in the region that may help in promoting quick analysis of patients. The slow recovery rate is also due to the need to test the diagnosed patient twice until he can be given the clearance. This requires greater testing compared to the number of patients being recovered. Increasing the testing rate confirms the proportionate increase in the number of illnesses, which can only be controlled by practicing social distancing.
The Impact on Workers in The Region
First, more than 90 Doctors and many health care workers have been affected in Sindh by this virus. Eleven health care professionals so far have lost their lives. The increase has left officials worried about the treatment of virus patients at tertiary-care hospitals and the care of serious or critical cases related to the virus at facilities across the country. All these doctors have put themselves into Quarantine, which too has destabilized the health care system and affected the treatment of patients.
Second, the financial crisis has forced the laborers and the poor to come out of their homes and on to the roads in search of the work. This is a big problem for the Sindh government which has to ensure social distancing and at the same time look after the health care system. Steps taken to provide the public with the necessities of life in their homes will help the Government avoid public gatherings and the possible spread of the virus. Moreover, the Sindh Government has purchased more than 200 ventilators during this period for the treatment of patients. This has resulted in strengthening the health system in its fight against the coronavirus.
The Ongoing Efforts Against the Coronavirus in Sindh
The constantly increasing tally of cases demands the improvement of health facilities by the addition of more health care equipment and consequently will lead to an improved recovery rate. It is therefore imperative that community and medical staff be equipped with empirically precise knowledge and tools to effectively address and cope with the impact of COVID-19. The effective alleviation of COVID-19 requires strengthening personal beliefs regarding the threats of the disease, effective preventive measures, the need to modify lifestyle habits and the improvements in health and management systems to save precious lives. A strict lock-down is key to decrease the rapid up-rise of COVID-cases.

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Post by: Sarmad Janjua
Sarmad is doing his M.B.B.S from King Edward Medical University, Lahore. Pakistan. He has been a keen and diligent student and has a passion for surgery. His current focus is quality research in medical sciences for which he is involved in certain research projects.
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