COVID-19: Why is Punjab not reporting accurately?

Lahore, 12th November: Why is the COVID-19 number not accurately reported in Pakistan’s Punjab province?

A doctor-journalist from the Express Tribune showed concern on why Punjab was not telling the truth about its COVID-19 cases. Doctor Rana Javed Asghar wrote, “it’s not uncommon in Pakistan that official records may be very different from the actual situation.”

He revealed that during major measles outbreak their teams went to villages in remote areas. There was zero vaccination while official records showed 100% vaccination coverage.

“Polio was no different and we were surprised many years back when we identified key gaps in the Lahore district when everyone was presenting a rosy picture. But finding inconsistencies in official numbers is not received well,” he said.

Dr Rana Javed Asghar wrote that even though he was a US-CDC resident adviser of Government of Pakistan’s Field Epidemiology and Laboratory Training Program, invitations for independent assessments were often cancelled at the last moment when government officials became worried about the truth surfacing.

Truthfully told by him that reality is something we don’t want to face. It’s natural to avoid knowing about something which may be bad. He reveals when administrative officers and political leaders start making public health decisions they don’t want big numbers. Optics and narratives are more important than controlling an outbreak.

Punjab is the largest province with more than 50% of Pakistan’s population, while in Islamabad with two million residents, the number reported was an average of 80% of Punjab’s numbers.

Some could say that Islamabad is having an outbreak but no city in Punjab, thanks to good public health measures in the province.

However, an alarming sign came a few weeks back when Punjab deaths started rising but its case numbers were not increasing. Death is a late indicator and only rises nearly 3-4 weeks after the increase in cases.

Dr Rana said that we better not single out just Punjab: how good is our national data? The purpose of any disease surveillance system is to understand the real spread of disease. Only then we could make reasonable estimates and effective decision-making.

He informed that the daily dumping of laboratory data is not the health intelligence required. To ensure a good quality surveillance system we need to stop being afraid of numbers and let epidemiologists do their job.

In the US, where the pandemic has wreaked havoc, the President-elect has promised a new strategy starting with the following science and letting public health officials make decisions and communicate to the public.

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