Government should review its strategy and learn some lessons from the past mistakes

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Selective Smart Lockdown may not achieve the desired objective
Government should review its strategy and
learn some lessons from the past mistakes
Failure to listen to Health Experts as well as WHO to opt for
lock down has led to enormous increase in patients infected
with the virus and loss of precious lives
Thousands of family members of HCPs who have tested
positive are going through difficult times living under
constant stress and psychological disorders

ISLAMABAD: The government decision to impose selective Smart Lockdown in various localities of Sindh, Punjab and Islamabad besides other areas may not achieve the desired objective. Pakistan Medical Association (C) has also rejected the smart lockdown and urged the government to follow the WHO advice of intermittent lockdown, two week on, two weeks off to check the increasing spread of COVID19 infection. With the every passing day the number of those who have tested positive and the number of lives being lost is increasing. Government t’s decision to ignore the advice of Healthcare Professionals as well as the World Health Organization has cost the country very dearly. We have not yet seen the peak of the virus and still there is time that the government should review its strategy, listen to the health experts and take effective measures.

The problem with the government is that it lacks expertize and it is also not prepared to learn from others. In the meantime the ever increasing number of healthcare professionals working under difficult circumstances treating these COVCID19 patients are faced with stress, suffer from burnout syndrome. Health experts have suggested that these HCPs should not be asked to work for more than a four to five hours shift and then they must get enough time to rest otherwise many of them may eventually refuse to work under these stressful situations. The family members of these HCPs are also at a greater risk and they seem to be worried and many have reported to be suffering from psychological disorders.

On the other hand most of the healthcare facilities in public sector are choked, it is difficult to get an ICU bed. The situation is so grave that recently a senior retired faculty member of a medical university had to be kept in Emergency for two days before he could get an ICU bed. Now there are reports of shortage of oxygen as well while any drug which is termed as effective in the treatment of COVCID19 patients immediately disappears from the market. While the authorities claim that there is no shortage of PPEs but last week the healthcare professionals in Gilgit Baltistan were found protesting about the lack of PPEs and other protective measures.

Healthcare professionals working in different units of hospitals are being forced to take care of COVCID19 patients and those who refuse, disciplinary action is being recommended against them. One hopes that the government will learn from its mistakes and try to build a national consensus to face this tragedy. So far there is no definite cure for this disease and all treatment modalities including the use of Chloroquine, plasma therapy and steroids are all experimental and there has been no real breakthrough so far. As regards the role of steroids, the results of a trial of Dexamethasone in UK has just been released which shows some promise but these steroids are already being used to manage critical ill patients in Intensive Care Units in Pakistan as well for the last many years. The government needs to take the well-known health experts on board and issue guidelines. Efforts should also be intensified to check the spread of misinformation on social media. Authorities with the advice of Health Experts should announce guidelines on which patients can be kept in home isolation and for how long, when the patients’ needs to be kept under constant medical care, when they should visit hospitals and get admitted. When one should opt for test and which test in what circumstances and situation. At present there exists lot of confusion and we desperately need national guidelines.

The government must have realized how difficult it is to run and manage healthcare facilities. You cannot force HCPs to work in a risky environment. It should also forget of getting back the control of the three major hospitals at Karachi i.e. JPMC, NICVD and NICH. Let the provincial government manage it with the help of corporate sector. Federal Government which cannot run and manage the two hospitals at Islamabad i.e. PIMS and the Central Government Polyclinic efficiency, how it can run the hospitals at Karachi through remote control. Just look PIA is now being run under the cover of Essential Services Act and so is the case of Utility Stores Corporation. Healthcare professionals cannot be treated as routine labour. They need respect and safe working environment. The sooner the malicious campaign against the healthcare professionals and the healthcare facilities is stopped on the media, better it will be otherwise the victims will be poor patients. Doctors are already reluctant to examine and manage serious patients brought to the hospitals in such a condition that not much can be done and then they have to face the wrath of violent mobs. There have been increasing incidents of violence against doctors and healthcare facilities.

The government will also be well advised to apologize to Prof. Saeed Akhtar the founder of PKLI at Lahore who had been ridiculed, defamed, persecuted and his character assassination went on for the last two three years. Bring him back and let him run and manage the PKLI the way he and his team had planned. It will encourage other Pakistani doctors overseas to come and establish more healthcare facilities. They should also be encouraged, provided incentives like lands and some tax holiday or rebate in import of equipment for these healthcare facilities. Let the government concentrate on more essential services and improve the overall business environment in the country to check the growing threat of increasing unemployment. At present doing any business has become next to impossible.

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