With a mix of pandemic denialism and exceptionalism, Pakistan makes a cynical bet on the coronavirus

A man wearing a protective face mask as he gestures while shopping amid the rush of people outside an electronics market, after Pakistan started easing the lockdown restrictions, as the outbreak of the coronavirus disease (COVID-19) continues, in Karachi, Pakistan June 4, 2020. REUTERS/Akhtar Soomro

Pakistan’s coronavirus lockdown was implemented in March, along with much of the rest of the world. The lockdown order actually came from the country’s provincial governments, which have considerable decisionmaking authority, and in spite of objections from Prime Minister Imran Khan (as he himself reminds the country). The lockdown fell apart first in mosques at the beginning of Ramadan in late April, as the government caved to demands of the country’s Muslim scholars (ulema). From there, it unraveled in markets in the last two weeks of Ramadan, where traders had had enough. Then malls, which the country’s Supreme Court ordered to reopen in the days before the Eid festival at the end of May, saying in a remarkable statement that it saw no reason why the coronavirus, “which apparently is not a pandemic in Pakistan, is swallowing so [much] money.” All the while, the official justification for loosening the lockdown was that it hurt the poor; but the loosened restrictions extended to places — mosques and malls — that helped the religious and the rich far more than the poor.

Pakistan’s COVID-19 cases, as of June 5, have risen beyond 91,000, higher than China’s official numbers. Nearly 1,900 people have died, including at least four provincial lawmakers. Pakistan is the fifth most populous country in the world, with dense cities. As COVID-19 began spreading there in March and April, many feared the worst. But cases and deaths did not rise at as rapid a clip as they did in Europe and the U.S., at least partly because of the lockdown the country imposed in March.

The government has since given in to a strange mix of pandemic denialism and exceptionalism, and is hurtling toward a more open, Sweden-like approach to the virus, reopening across sectors. (Sweden never implemented a lockdown, a decision its chief epidemiologist acknowledged this week caused more deaths than necessary.)

The official denialism extends from its Supreme Court to the governor of Sindh, a member of the ruling party — who, it should be noted, had the coronavirus, but said it is like the flu. The denials and sense of exceptionalism seem to stem, at least partly, from Pakistan’s much lower death rates per million from COVID-19 (8 per million as of June 4) relative to the United States (324 deaths per million) and Western Europe (England’s death rate, for example, is 585 per million). The lower death rates per capita are a puzzle not just for Pakistan, but most of South Asia and Africa, which so far have escaped the worst of the virus. In Pakistan, these numbers have led to non-scientific theories about hot weather slowing down the spread of the virus (which Brazil’s experience negates). That Pakistan’s population is relatively young likely plays a role.

Cause for concern

But compared to its South Asian neighbors, which have roughly similar demographics and weather conditions as Pakistan, Pakistan’s position looks less positive. India and Bangladesh’s per capita deaths stand at half those of Pakistan, and looking at the trends over time, Pakistan’s per capita death rate has been increasing at a rapid clip following the Eid holiday, about two weeks after the lockdown was initially lifted.

In addition, Pakistan’s daily cases have never plateaued or started declining, and recent days have seen successive highs in terms of new cases recorded daily (4,000 a day for the past few days). And though the government claims it has excess ventilator capacity as of now, there are reports of hospitals operating at capacity and medical personnel having to treat patients without personal protective equipment. Hundreds of doctors are reported to have contracted the virus, and at least 30 healthcare workers have died because of it.

Still, the sense of exceptionalism pervades the government’s thinking. Leaders want to take advantage of that by reopening widely across sectors (with standard operating procedures, which I’ll come back to). This includes marriage halls and even tourism, though Pakistan’s northern areas, which attract tourists, are pushing back on the federal government. Schools and theaters are among the last spaces to remain closed. The government is making a bet on the coronavirus, choosing to prioritize livelihoods in the hope that it doesn’t mean large loss of life.

Faulty messaging from the top

In a speech on Monday, Pakistan’s prime minister Imran Khan doubled down on his anti-lockdown rhetoric, arguing against lockdowns from every angle — saying they were unaffordable for even a country like America, and that a lockdown never made sense for Pakistan’s poor. He glossed over benefits of a lockdown in slowing the spread of the virus and the resulting deaths, and said “deaths would rise anyway.” He framed a lockdown as something rich people liked, not the poor. The Sindh governor, a member of Khan’s party, said lockdowns have become “fashion symbols” — when in reality, it is the non-poor in Pakistan clamoring for their spaces to be opened: mosque imams, traders, and marriage hall owners.

Khan said Pakistan’s approach is now “living with the virus,” and that the onus is on citizens to follow the standard operating procedures (SOPs). Those SOPs are social distancing guidelines Pakistan first put out for mosques, and now across the sectors it is reopening. But in a 22-minute address, he never directly detailed them. And because he diminished the health benefits of a lockdown, he did not convincingly make the case for why the country needs to follow its SOPs now. So citizens have little understanding as to why such procedures are necessary. In the wake of such weak messaging, violations of the SOPs are widespread. While the government is threatening fines and sealing certain spaces for violations, ensuring complete enforcement is impractical.

On June 5, Khan gave another televised speech, this time addressing his “Tiger Force,” one million young Pakistanis he has recruited in the last two months to help the government’s fight against the coronavirus. He said these “Tigers” needed to help him message the importance of the SOPs, and inform the government of SOP violations – messaging that he should be directly getting across to the nation when he speaks to the public. The “Tigers” are a gimmick harkening back to Khan’s cricketing career, and it is not clear that they will be effective, least of all in outsourced SOP messaging or enforcement.

In addition, the Supreme Court’s role in shaping Pakistan’s pandemic response has been singularly damaging. Pakistani citizens and analysts have sometimes been happy with judicial activism in the past, if it positively affects the country’s dysfunctional governance and politics. But the Supreme Court has often exercised suo motu judgment on areas far beyond its expertise, including now. It had no place to issue the dangerous reopening ruling it did, and it has hurt the cause of fighting the virus in the country. Pakistan’s provincial governments now say that they cannot reimpose lockdowns even if they want to, because of the Supreme Court’s order.

Pakistanis are on their own

Khan has highlighted the acute economic costs of lockdowns for developing countries, and for their poor, since the beginning of Pakistan’s fight against the virus. He’s not wrong, but digging in on that point repeatedly — as is his nature — badly undermines the public health messaging the government needs to convey to citizens. Pakistanis don’t even know what the government’s guidelines are, let alone understand the need to follow them. Masks, for example, have been made compulsory in public spaces, but Khan did not mention that in either of his two speeches this week.

What Pakistanis also don’t understand is that their government has made a cynical and risky calculation about lives and livelihoods in total favor of the latter — an extremely difficult calculation facing governments around the world. In Pakistan, the reasons have to do less with the poor and more with the economy as a whole. The messaging Pakistanis are receiving on the guidelines to follow and the reasons to follow them is woefully inadequate. Pakistan is taking a bet on a Sweden-like approach to the virus, and as its cases and death numbers climb, its citizens are largely on their own.