COVID-19 Outbreak in Pakistan; a Situational Analysis

The corona virus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Corona Virus-2(SARS-COV-2), that emerged in China, Wuhan, in December 2019, has upended the world, with spread to 216 countries to-date, infecting 5,931,963 people and killing more than 365,051 persons and 2,496,857 recoveries in almost five months. Pakistan reported its first two confirmed cases among religious pilgrims on 26th February 2020 having the travel history of Iran. Methods: It was a descriptive retrospective study using the publicly available data on cumulative confirmed COVID-19 cases, active cases, deaths, and recoveries from 26th February to 29th May 2020. The objective was to analyze the overall outbreak situation across Pakistan. The literature search strategy was through keywords on Pub-med and Google databases. Data analysis was done as descriptive statistics as percentages and frequencies using Epi info version 7 and Microsoft Excel 10 statistical components. Results: The number of confirmed cases nationwide stands at 66,457 on 29th May 2020 with 26,113 cases in Sindh, 4,104 in Punjab, 9,067 in Khyber Pakhtunkhwa (KPK), 4087 in Baluchistan, 2192 in Islamabad Capital Territory (ICT), 660 in Gilgit Baltistan (GB), and 234 in Azad Jammu &Kashmir (AJK). The current CFR is 2.1%. The highest number of deaths was reported from Khyber Pakhtunkhwa (445) with a crude fatality rate of 4.9%. Currently, case and death doubling time was 15 days, a total of 1945 healthcare workers (3%) are affected with 21 fatalities. To date 74 % of confirmed COVID cases are males and 25.9% are females. The highest number (22.5 %) of confirmed cases from the age group of 20-29, highest deaths (29.8%) is in the age group of 60-69 years. Local community transmission is reported to be 92%. Conclusion: Large scale outbreak has exposed the gaps in the underlying healthcare system. A very high population density, lack of public awareness, weak healthcare system, the resistance created by community dynamics, local and religious beliefs are making the containment of virus a tough challenge in Pakistan. COVID-19 will have long-lasting health and economic effects beyond morbidity and mortality caused directly by the virus itself.