Students wear masks as they go to school amid heavy smog conditions in Lahore on November 14, 2019. (Photo by Arif ALI / AFP)

Three headlines in the space of three days:

According to the latest data provided by the National Command & Operation Centre (NCOC) on Friday, 2304 people tested positive for COVID-19 while 37 people lost their lives in the last 24 hours – the daily infection rate now reaching the heights it had in July, at the peak of the first wave.

By Thursday, in Lahore’s poorer areas, the Air Quality Index had risen to 750 — about 12 times the recommended level – blanketing the city in thick haze of pollutants.

On Wednesday, Primary & Secondary Healthcare Department (P&SHD) confirmed that six new and 592 suspected cases of dengue virus were reported in the province during the last 24 hours – five in the provincial capital of Lahore, one in Multan.

Any one of the three calamities would have been serious challenge for any province – Punjab faces all three at once.

More than the sum of its parts

What makes this problem all the more complicated is that it is not simply a matter of dealing with each health hazard separately, the resources and infrastructure required to tackle these problems are shared, and as a result are spread too thin.

Earlier it was reported that Pakistan’s polio vaccination campaign had suffered greatly since the lockdown had halted it, and staff was pulled away to bolster health officials battling coronavirus in other parts of the country afterwards.

Even more concerning is he fact that each hazard negatively interacts with the other.

Smog damages and weakens the respiratory system that the coronavirus targets. Anza Farid, an environmental expert warned that “coughing, throat infection and irritation in the eyes are common,” adding that as more people burn garbage and stubble burning continues across the farmlands, the situation will worsen. Smog induced coughs and headaches run the risk of being mistaken for COVID-19 symptoms as well; which would lead to an exponential growth in people seeking to get themselves tested, ultimately increasing the burden on the testing capacity.  

Dengue fever’s symptoms are almost analogous to COVID-19 and run a higher risk of being confused for each other; dengue also causes fever, rashes, headaches, and muscular aches, etc. Misdiagnosis has been one of the major causes for dengue fever patients dying, and with the second wave of coronavirus in full flow, the chances of mistakes will increase.

Furthermore, and the medical facilities required to treat each disease overlap; which will bring medical facilities to breaking point even faster.

A new dangerous trend has also emerged. Due to similarity in clinical symptoms, co-infection of dengue and coronavirus has started to appear in Singapore and Thailand: the two other dengue endemic countries apart from Pakistan. The consequences of this new development are still being explored.

Pakistan’s overburdened health system is under pressure even during normal times, during abnormal ones it may come close to bucking under it.

The task at hand

Pakistani authorities have to be proactive to deal with these problems. Coronavirus may dominate the news cycle and the time of government departments, but dengue and smog need attention as well.

In encouraging news, the Punjab Health Minister Dr Yasmeen Rashid recently said that the provincial government was taking all-out measures to cope with the menace of dengue fever. “The ratio of dengue cases has substantially reduced due to the efforts made by the district authorities and other concerned departments,” she said.

On smog, the government has been unable to curb crop stubble burning year after year – there are no-quick solutions here. All it can do now make sure the messaging to the public is effective. Ensuring they wear face masks for protection, both from pollution and the coronavirus, and try to stay at home where possible.


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