Coronavirus and how to fight it. What to do and what not to do.

[BHarwana]

Disclaimer.

I am no health expert or any kind of Guru or pandit. What I will state in this thread is purely observations from the pandemic and its relief efforts around the globe. The info I provide can be wrong or misleading as this is a totally new virus and not fully understood yet but I will try my best to keep it as factual and backed by sources.


How to quarantine and control coronavirus in Pakistan.

Every country is at different stage of Coronavirus and Pakistan has its own stage.

There are 4 stages of this virus.

Stage 1. This is a stage when you have only patients coming from over sea.

Stage 2. This is when you have a community spread of Coronavirus. This means when virus spreads in a certain town and domestic cases start appearing in number of more than 200+

Stage 3. This is when there is a provincial wide spread of virus and govt are unable to track source and contacts infected people have made

Stage 4. This is a pandemic stage when govt gives up all tracking efforts for the virus and focus all its resources on fighting the pandemic then preventing it.


Pakistan is at stage 1 of Coronavirus outbreak and at this stage what should be done to control this virus. What is relevant and what is not.

Stage 1 is the initial stage of this virus and it is very controllable at this stage and is not high risk or threat and can be defeated.

What should be done.

How to quarantine.

When patients come from over sea they need to be quarantined for atleast 16 days.

SOP of quarantine.

The quarantine should not be collective as there is a chance of spread of virus during incubation. The quarantine should be individually done. If you quarantine people together to wait for their test results and a single one among them is infected will infect all.

This is an image of a quarantine facility of Pakistan at taftan border.

This quarantine facility is wrong and will spread virus further. In this quarantine facility infected and non infected people can interact with each other. This can result in people getting infected while waiting test results and can go free in society after while getting infected in quarantine and their test results showing them negative.

This type of quarantine can only work if the person is kept in for the entire time of incubation. So govt needs to ditch this style of quarantine and make the facility of individual isolation.

Best practice for this would be to use universities hostels and people are kept in total isolation during quarantine time.

This an image of Israeli quarantine room for coronavirus and this is how stage 1 countries should quarantine.

This is how quarantine should be done in solo confinement.

Moving on the evacuation procedures.

In Pakistan there are 4 province and each province is responsible for it own health and patients. Which is wrong cause extracting people to their respective provinces can place them at risk of being infected.

What Sindh govt did in by extracting it patients from taftan has resulted in more patients in Sindh. Instead of taking patients to sukkur Sindh govt should have quarantined them in Balochistan. Separated in infected from non infected and then transported the infected. This action of extraction and evacuation of Sindh govt resulted in more patients.

This action of Sindh govt was wrong and should not be repeated in future.

https://www.brecorder.com/2020/03/1...centre-to-send-pilgrims-in-taftan-to-karachi/

Will more hospitals help?

Hospitals are a need to treat virus but the number of suspected will be always more than the number of infected so bigger quarantine facilities and with better SOP are more need than hospitals.

Collective wards for coronavirus treatment.

Yes coronavirus patients can be treated in collectively in treatment wards as all patients are infected and the risk of further infecting each other is not there.

..........

How to prevent your self from virus.

There are many suggestions about personal hygiene and prevention.

Hand senitizers. Masks. Gloves. Etc

Hand senitizers.
Yes hand senitizers work as coronavirus stays on infected surfaces for a long time and senitizers are good approach to prevent it but they are not a solution.

Face Masks.
Yes face masks work as the virus has a tendency to stay airborne and can spread through sneezing and cough.

Gloves.
No gloves will not work if you touch your face with an infected glove. So there has to be a combination of gloves and mask.

Goggle.
Coronavirus is an air born virus and can stay in air for hours and can enter your body via eyes so Goggles are help but probability is low for spread through eyes.

https://twitter.com/x/status/1239588615782633472

Best practice for prevention is social distancing. This practice should be maintained 24 days after your country has hit its peak of the virus.


I will add further info to the thread.

@Foxtrot Alpha

 

[LeGenD]

Good effort.

Pakistan is at STAGE 2 now.

 

[-=virus=-]

This is what the American govt is telling it's people, applicable everywhere else on earth too.

Stay safe, if you're young, don't infect the elderly by being callous. All of our grandparents and a lot of our parents are in the high risk group.

 

[Amaa'n]

Disclaimer.

I am no health expert or any kind of Guru or pandit. What I will state in this thread is purely observations from the pandemic and its relief efforts around the globe. The info I provide can be wrong or misleading as this is a totally new virus and not fully understood yet but I will try my best to keep it as factual and backed by sources.


How to quarantine and control coronavirus in Pakistan.

Every country is at different stage of Coronavirus and Pakistan has its own stage.

There are 4 stages of this virus.

Stage 1. This is a stage when you have only patients coming from over sea.

Stage 2. This is when you have a community spread of Coronavirus. This means when virus spreads in a certain town and domestic cases start appearing in number of more than 200+

Stage 3. This is when there is a provincial wide spread of virus and govt are unable to track source and contacts infected people have made

Stage 4. This is a pandemic stage when govt gives up all tracking efforts for the virus and focus all its resources on fighting the pandemic then preventing it.


Pakistan is at stage 1 of Coronavirus outbreak and at this stage what should be done to control this virus. What is relevant and what is not.

Stage 1 is the initial stage of this virus and it is very controllable at this stage and is not high risk or threat and can be defeated.

What should be done.

How to quarantine.

When patients come from over sea they need to be quarantined for atleast 16 days.

SOP of quarantine.

The quarantine should not be collective as there is a chance of spread of virus during incubation. The quarantine should be individually done. If you quarantine people together to wait for their test results and a single one among them is infected will infect all.

This is an image of a quarantine facility of Pakistan at taftan border.
View attachment 614996

This quarantine facility is wrong and will spread virus further. In this quarantine facility infected and non infected people can interact with each other. This can result in people getting infected while waiting test results and can go free in society after while getting infected in quarantine and their test results showing them negative.

This type of quarantine can only work if the person is kept in for the entire time of incubation. So govt needs to ditch this style of quarantine and make the facility of individual isolation.

Best practice for this would be to use universities hostels and people are kept in total isolation during quarantine time.

This an image of Israeli quarantine room for coronavirus and this is how stage 1 countries should quarantine.

View attachment 615002
This is how quarantine should be done in solo confinement.

Moving on the evacuation procedures.

In Pakistan there are 4 province and each province is responsible for it own health and patients. Which is wrong cause extracting people to their respective provinces can place them at risk of being infected.

What Sindh govt did in by extracting it patients from taftan has resulted in more patients in Sindh. Instead of taking patients to sukkur Sindh govt should have quarantined them in Balochistan. Separated in infected from non infected and then transported the infected. This action of extraction and evacuation of Sindh govt resulted in more patients.

This action of Sindh govt was wrong and should not be repeated in future.

https://www.brecorder.com/2020/03/1...centre-to-send-pilgrims-in-taftan-to-karachi/

Will more hospitals help?

Hospitals are a need to treat virus but the number of suspected will be always more than the number of infected so bigger quarantine facilities and with better SOP are more need than hospitals.

Collective wards for coronavirus treatment.

Yes coronavirus patients can be treated in collectively in treatment wards as all patients are infected and the risk of further infecting each other is not there.

View attachment 615017

..........

How to prevent your self from virus.

There are many suggestions about personal hygiene and prevention.

Hand senitizers. Masks. Gloves. Etc

Hand senitizers.
Yes hand senitizers work as coronavirus stays on infected surfaces for a long time and senitizers are good approach to prevent it but they are not a solution.

Face Masks.
Yes face masks work as the virus has a tendency to stay airborne and can spread through sneezing and cough.

Gloves.
No gloves will not work if you touch your face with an infected glove. So there has to be a combination of gloves and mask.

Goggle.
Coronavirus is an air born virus and can stay in air for hours and can enter your body via eyes so Goggles are help but probability is low for spread through eyes.

https://twitter.com/x/status/1239588615782633472

Best practice for prevention is social distancing. This practice should be maintained 24 days after your country has hit its peak of the virus.


I will add further info to the thread.

@Foxtrot Alpha

Now you got it right about the Mask and Gloves, earlier you had it wrong. PPE helps you protect against the virus the key is use of PPE needs to be smart. I can be the carrier and not show symptoms and infect others during social interaction hence important to don a Mask.
Isolation and Quarantine will serve a purpose be it collective or Single. look at the countries who are bringing in people and asking them to Self Isolate at homes, this is coming for rich and developed states not third world countries.
Venezuela has also set up 6 x Collective Quarantine camps across the country.....

 

[BHarwana]

Now you got it right about the Mask and Gloves, earlier you had it wrong. PPE helps you protect against the virus the key is use of PPE needs to be smart. I can be the carrier and not show symptoms and infect others during social interaction hence important to don a Mask.
Isolation and Quarantine will serve a purpose be it collective or Single. look at the countries who are bringing in people and asking them to Self Isolate at homes, this is coming for rich and developed states not third world countries.
Venezuela has also set up 6 x Collective Quarantine camps across the country.....

Nope quarantine is possible as solo quarantine. It was incompetence of PTI govt first not to totally seal border and then quarantine collectively.

They have sealed the border now after there were calls for their incompetence and they are now setting up a solo quarantine facility next to multan.

The PPPP Sindh govt also is not that clean and responsible for cases increase in Sindh. They evacuated from taftan collectively. Although the sukkur facility is solo quarantine but collectively transportation was what made cases rise in Sindh.

Still they have not learned and extraction from taftan in on table which will increase the risk.

The best practice is to contain situation at stage one by facilitating at taftan and engaging it there. The place is remote and current number can be handled there.

Good administration is more important than more hospitals to fight this virus.

@Foxtrot Alpha I know they could have done this before they showed incompetence.

https://twitter.com/x/status/1240184088524357632

This is a solo quarantine and they have many facilities like this.

 

[Amaa'n]

Nope quarantine is possible as solo quarantine. It was incompetence of PTI govt first not to totally seal border and then quarantine collectively.

They have sealed the border now after there were calls for their incompetence and they are now setting up a solo quarantine facility next to multan.

The PPPP Sindh govt also is not that clean and responsible for cases increase in Sindh. They evacuated from taftan collectively. Although the sukkur facility is solo quarantine but collectively transportation was what made cases rise in Sindh.

Still they have not learned and extraction from taftan in on table which will increase the risk.

The best practice is to contain situation at stage one by facilitating at taftan and engaging it there. The place is remote and current number can be handled there.

Good administration is more important than more hospitals to fight this virus.

@Foxtrot Alpha I know they could have done this before they showed incompetence.

https://twitter.com/x/status/1240184088524357632

This is a solo quarantine and they have many facilities like this.

so you are saying that Taftan camp is the only place where there is a risk of contracting the virus to the masses? the carrier could have spread the virus on way to the border. So it does not matter.....bottom line is and a harsh reality that it is the cost effective way of filtering out the infected lot

 

[BHarwana]

so you are saying that Taftan camp is the only place where there is a risk of contracting the virus to the masses? the carrier could have spread the virus on way to the border. So it does not matter.....bottom line is and a harsh reality that it is the cost effective way of filtering out the infected lot

The cost effective way is quarantine till incubation but that has to solo quarantine not collective cause will produce more patients and increase load on hospitals and thus will increase cost.

First priority should have been sealed borders and quarantine in Iran.
They failed there.
Second priority should have been solo quarantine at taftan.
They failed there.
Third priority should have been solo evacuation from taftan.
They failed there as well.
These all are SOP of stage 1 quarantine that should have been followed.
Now their plan is on track of solo quarantine but with risk of transition into stage 2.
Hope they get successful here.

 

[Verve]

Pakistan is at stage 3 already, considering the low levels of testing.

But people will not adhere to social distancing. The whole point of schools etc shutdowns was for people to Isolate at home but they are not doing so.

It will only sink in when deaths increase rapidly. We as a nation like tough lessons only.

 

[BHarwana]

Pakistan is at stage 3 already, considering the low levels of testing.

But people will not adhere to social distancing. The whole point of schools etc shutdowns was for people to Isolate at home but they are not doing so.

It will only sink in when deaths increase rapidly. We as a nation like tough lessons only.

Yes social distancing is the best solution but most of us are not taking this pandemic seriously.

 

[Verve]

Yes social distancing is the best solution but most of us are not taking this pandemic seriously.

The more I think about it, I'm forming the opinion that Pakistan should stop this whole shutdown business. If we start recording every single normal flu infection and deaths, we'll end up shutting the country too.

Prolonged shutdown is going to kill a lot of businesses and livelihoods increasing poverty.

Tell people to take the advised precautions and only serious cases be brought to hospitals. Tell people to self isolate to avoid infecting elders and those with serious health problems - no different than what we should be doing for flu as well. Distance from those with weak immune systems and get on with life.

Death is in Allah's command. There's no point causing mass poverty and hunger due to shutdowns and whatnot.

Start production of suitable masks and alcohol sanitizers as an emergency and distribute to everyone at very low prices to wear and carry all the time when out of house. Which will protect people from breathing in other pollution related toxins as well - improving health of people in longer run too!

My precautionary measures in UK are P3 level masks, disposable nitrile gloves and alcohol santizer. Moving around with these and washing up immediately upon arrival at home. That's it. Gloves are not really necessary but an added precaution at present.

Shutting down the country is not the solution to this problem.

 

[RescueRanger]

Disclaimer.

I am no health expert or any kind of Guru or pandit. What I will state in this thread is purely observations from the pandemic and its relief efforts around the globe. The info I provide can be wrong or misleading as this is a totally new virus and not fully understood yet but I will try my best to keep it as factual and backed by sources.


How to quarantine and control coronavirus in Pakistan.

Every country is at different stage of Coronavirus and Pakistan has its own stage.

There are 4 stages of this virus.

Stage 1. This is a stage when you have only patients coming from over sea.

Stage 2. This is when you have a community spread of Coronavirus. This means when virus spreads in a certain town and domestic cases start appearing in number of more than 200+

Stage 3. This is when there is a provincial wide spread of virus and govt are unable to track source and contacts infected people have made

Stage 4. This is a pandemic stage when govt gives up all tracking efforts for the virus and focus all its resources on fighting the pandemic then preventing it.


Pakistan is at stage 1 of Coronavirus outbreak and at this stage what should be done to control this virus. What is relevant and what is not.

Stage 1 is the initial stage of this virus and it is very controllable at this stage and is not high risk or threat and can be defeated.

What should be done.

How to quarantine.

When patients come from over sea they need to be quarantined for atleast 16 days.

SOP of quarantine.

The quarantine should not be collective as there is a chance of spread of virus during incubation. The quarantine should be individually done. If you quarantine people together to wait for their test results and a single one among them is infected will infect all.

This is an image of a quarantine facility of Pakistan at taftan border.
View attachment 614996

This quarantine facility is wrong and will spread virus further. In this quarantine facility infected and non infected people can interact with each other. This can result in people getting infected while waiting test results and can go free in society after while getting infected in quarantine and their test results showing them negative.

This type of quarantine can only work if the person is kept in for the entire time of incubation. So govt needs to ditch this style of quarantine and make the facility of individual isolation.

Best practice for this would be to use universities hostels and people are kept in total isolation during quarantine time.

This an image of Israeli quarantine room for coronavirus and this is how stage 1 countries should quarantine.

View attachment 615002
This is how quarantine should be done in solo confinement.

Moving on the evacuation procedures.

In Pakistan there are 4 province and each province is responsible for it own health and patients. Which is wrong cause extracting people to their respective provinces can place them at risk of being infected.

What Sindh govt did in by extracting it patients from taftan has resulted in more patients in Sindh. Instead of taking patients to sukkur Sindh govt should have quarantined them in Balochistan. Separated in infected from non infected and then transported the infected. This action of extraction and evacuation of Sindh govt resulted in more patients.

This action of Sindh govt was wrong and should not be repeated in future.

https://www.brecorder.com/2020/03/1...centre-to-send-pilgrims-in-taftan-to-karachi/

Will more hospitals help?

Hospitals are a need to treat virus but the number of suspected will be always more than the number of infected so bigger quarantine facilities and with better SOP are more need than hospitals.

Collective wards for coronavirus treatment.

Yes coronavirus patients can be treated in collectively in treatment wards as all patients are infected and the risk of further infecting each other is not there.

View attachment 615017

..........

How to prevent your self from virus.

There are many suggestions about personal hygiene and prevention.

Hand senitizers. Masks. Gloves. Etc

Hand senitizers.
Yes hand senitizers work as coronavirus stays on infected surfaces for a long time and senitizers are good approach to prevent it but they are not a solution.

Face Masks.
Yes face masks work as the virus has a tendency to stay airborne and can spread through sneezing and cough.

Gloves.
No gloves will not work if you touch your face with an infected glove. So there has to be a combination of gloves and mask.

Goggle.
Coronavirus is an air born virus and can stay in air for hours and can enter your body via eyes so Goggles are help but probability is low for spread through eyes.

https://twitter.com/x/status/1239588615782633472

Best practice for prevention is social distancing. This practice should be maintained 24 days after your country has hit its peak of the virus.


I will add further info to the thread.

@Foxtrot Alpha

Very good effort, just want to point out that we SHOULD be on stage 3: Suppression, Pakistan doesn't have the resources to play the mitigation game and here is why:

Reading the Imperial College London report on Covid19, if we used the modelling by the college for a US and British scenario and apply that to Pak, 80% of Pakistan's population would get the virus and using this model 0.9% of them would die that's 1773000 people.

7.3 million Pakistanis are over the age of 60, conservative estimates of 4% of the elderly would die that's 280,000 people. The model showed that people with underlying health conditions and severe Covid19 would need to be put on ventilators, 50% of those of ventilators would die.

Pakistan has an approx 1460 ventilators available in public and private, the demand would outstrip supply and the model shows 100% of those without mechanical infection would die. conservative estimates within the model of 4% fatalities would mean 2053000 would die.

How many people is that? that's roughly 28 times the number of people that died during the Pakistan earthquake in 2005. Pakistan unlike Western countries is not in a position to mitigate the infection and will need to look at strategies to move to suppression of the infection.

If we learn anything from Italy is that our government cannot afford or allow the infection to spread to the levels seen in Iran and Italy as our health care systems will just not be able to cope. Suppression as a strategy should be the priority.

As mentioned in the report, if the suppression measures which may be needed to remain in place for an extended period of time (5+ months) the infection could return in the community and start infecting and killing all over again.

With a vaccine 18 months or more away, developing nations like Pakistan must look at innovative ways to deal with the greatest crisis that has faced the world since world war 2

 

[BHarwana]

The more I think about it, I'm forming the opinion that Pakistan should stop this whole shutdown business. If we start recording every single normal flu infection and deaths, we'll end up shutting the country too.

Prolonged shutdown is going to kill a lot of businesses and livelihoods increasing poverty.

Tell people to take the advised precautions and only serious cases be brought to hospitals. Tell people to self isolate to avoid infecting elders and those with serious health problems - no different than what we should be doing for flu as well. Distance from those with weak immune systems and get on with life.

Death is in Allah's command. There's no point causing mass poverty and hunger due to shutdowns and whatnot.

Start production of suitable masks and alcohol sanitizers as an emergency and distribute to everyone at very low prices to wear and carry all the time when out of house. Which will protect people from breathing in other pollution related toxins as well - improving health of people in longer run too!

My precautionary measures in UK are P3 level masks, disposable nitrile gloves and alcohol santizer. Moving around with these and washing up immediately upon arrival at home. That's it. Gloves are not really necessary but an added precaution at present.

Shutting down the country is not the solution to this problem.

Actually we are not at the stage of high risk and this crisis can be handled but for that we need a very strict administration. If you think that stick and carrot policy or deterance policy no those will not work we need real time administration for this crisis. Someone who could well manage the quarantine and track patients. Plus strict border regime and entry criteria into the country. We can defeat this virus with in 25 days. It is not a big deal just lacks political will and engagement.

Very good effort, just want to point out that we SHOULD be on stage 3: Suppression, Pakistan doesn't have the resources to play the mitigation game and here is why:
View attachment 615256
Reading the Imperial College London report on Covid19, if we used the modelling by the college for a US and British scenario and apply that to Pak, 80% of Pakistan's population would get the virus and using this model 0.9% of them would die that's 1773000 people.

View attachment 615253
7.3 million Pakistanis are over the age of 60, conservative estimates of 4% of the elderly would die that's 280,000 people. The model showed that people with underlying health conditions and severe Covid19 would need to be put on ventilators, 50% of those of ventilators would die.
View attachment 615257
Pakistan has an approx 1460 ventilators available in public and private, the demand would outstrip supply and the model shows 100% of those without mechanical infection would die. conservative estimates within the model of 4% fatalities would mean 2053000 would die.

How many people is that? that's roughly 28 times the number of people that died during the Pakistan earthquake in 2005. Pakistan unlike Western countries is not in a position to mitigate the infection and will need to look at strategies to move to suppression of the infection.

View attachment 615255
If we learn anything from Italy is that our government cannot afford or allow the infection to spread to the levels seen in Iran and Italy as our health care systems will just not be able to cope. Suppression as a strategy should be the priority.

As mentioned in the report, if the suppression measures which may be needed to remain in place for an extended period of time (5+ months) the infection could return in the community and start infecting and killing all over again.

With a vaccine 18 months or more away, developing nations like Pakistan must look at innovative ways to deal with the greatest crisis that has faced the world since world war 2

View attachment 615258

Great post.

Do you have the study of how China approached this out break. Cause currently the USA approach is yet to be implemented but Chinese model has already shown results.

We have currently 260 cases and I expect the number to double in few day. Observing the movement they made of pilgrims to their provinces the total is going to rise. Once pilgrims are in quarantine then we will have a way forward on what to do.

In my understanding what China did is that they devided their country in internal borders Wuhan was made stage 4 and kashghar was made stage one in this way they were able to contain the virus in certain areas and then bring in relief accordingly. Dividing the country in different stages of virus helps you to better manage then considering the whole country at a higher stage. Pakistan has a good river system and crossing points are bridges on those rivers which could be used to divide the country as well but that is far fetched idea cause we are not on that stage yet. Just mentions it as an option

 

[LeGenD]

Actually we are not at the stage of high risk and this crisis can be handled but for that we need a very strict administration. If you think that stick and carrot policy or deterance policy no those will not work we need real time administration for this crisis. Someone who could well manage the quarantine and track patients. Plus strict border regime and entry criteria into the country. We can defeat this virus with in 25 days. It is not a big deal just lacks political will and engagement.



Great post.

Do you have the study of how China approached this out break. Cause currently the USA approach is yet to be implemented but Chinese model has already shown results.

We have currently 260 cases and I expect the number to double in few day. Observing the movement they made of pilgrims to their provinces the total is going to rise. Once pilgrims are in quarantine then we will have a way forward on what to do.

In my understanding what China did is that they devided their country in internal borders Wuhan was made stage 4 and kashghar was made stage one in this way they were able to contain the virus in certain areas and then bring in relief accordingly. Dividing the country in different stages of virus helps you to better manage then considering the whole country at a higher stage. Pakistan has a good river system and crossing points are bridges on those rivers which could be used to divide the country as well but that is far fetched idea cause we are not on that stage yet. Just mentions it as an option

Here: https://www.weforum.org/agenda/2020/03/coronavirus-covid-19-hangzhou-zhejiang-government-response/

China is/was far more scientific and capable in dealing with BIO-HAZARD crisis in comparison to numerous countries.

 

[BHarwana]

This is the latest update just posting it here to keep this in mind as well.

https://twitter.com/x/status/1240425250854178816

 

[313ghazi]

The UK response has been poor. Pakistan is also making mistakes.

1.As a people we must self isolate. Do not go out if you can live without it.

2. Regularly wash your hands with soap and water.

3. Clean surfaces in your house, especially handles etc with disinfectant daily.

4. Separate your indoor and outdoor clothes.

5. Wipe down your phones with disinfectant and tissue.

If you do go out, wear a mask, keep a distance from people, don't touch anyone where possible.

People in service sector should be supplied with masks and disposal gloves. We need to keep hospitals, pharmacies, doctors, hospitals, petrol pumps, public transport and food shops open and running. Industries supporting them should also keep running.

Office based work should switch to von and working from home.

Anyone with symptoms should be tested. Armed forces should be deployed to assist them and to make sure people follow rules at medical facilities.

Only the severally Ill should be treated all hospitals.

For the next 3 months all routine medical surgery and appointments should be cancelled to ensure medical capacity to deal with the issue at hand and to reduce risk of contamination.

Masjids should be shut, all public gathering banned.