Pakistan’s Combat and Comeback Against COVID-19

When the first case of the novel Corona virus, also known as COVID-19, was reported on December 31, 2019 in Wuhan, China, the beginning of the new decade came at a huge cost to the entire global community. With 463 million patients with diabetes mellitus (DM) worldwide and developing countries such as Pakistan still struggling to combat polio, an illness long eradicated in other parts of the world, the emergence of the new COVID-19 pandemic and its associated global lockdown, sent shock waves that rattled the entire world.

However, I have learned from this outbreak that as history has revealed over past centuries, we once again have an example of how unprepared even our modern world is for such a widespread disease, due to a neglected gap that lies between modern medicine and technology, resulting in a failure of its immediate detection and combat. According to statistics of April 15, 2020, there are currently 5988 total COVID-19 cases in Pakistan, of which 4435 are active, resulting in a death toll of 107.¹ Despite commendable efforts by Pakistan’s government and the military, a negligent attitude by the locals has led to an exponential increase in the country’s cases, as reflected in Figure 1, the pandemic curve illustrated above.² It has been discovered that Pakistan faces a serious shortage of testing kits, protective gear equipment, and ventilators that tally to 2000 for critical COVID-19 patients nationwide, due to which China, Pakistan’s neighbor, has sent medical assistance via air along with trained health specialists to guide and facilitate Pakistan’s medical force. A recent international report from Louisiana State Health Department, United States revealed that “Diabetes tops the list of Underlying conditions in people found dead from COVID-19 in Louisiana.”³ Although there may be claims that there is no correlation between DM and the Corona virus, but with diabetes impairing the functioning of the major organ systems of the body, it comes as no surprise that people with diabetes, especially those with Impaired Insulin Production (type-1 DM), are naturally at a greater risk of contracting this dangerous infection. This pandemic further stresses upon the need for COVID-19 patients, especially patients with diabetes, to regularly monitor their glucose and ketone body levels via efficient administration of Diabetes Technology tools, ie, smart insulin pens, so the increased risk of the development of diabetic ketoacidosis in viral infections is therefore eliminated, which may otherwise lead to sepsis, a common finding in patients of COVID-19.

Figure 1.

COVID-19 pandemic curve for Pakistan from March 20 to April 15, 2020.²

In the future, I predict that the scientific community in Pakistan will take the outcomes of this pandemic as a lesson and avail technology to minimize spread and reduce the time taken to gather control of such urgent situations in order to avoid the loss of innocent lives, as seen with COVID-19, a diminutive virus, that questioned modern medicine and brought our highly developed 21st century world to a halt. With collaboration of all different health departments ranging from pulmonology to endocrinology, doctors and scientists around the world including Pakistan will hopefully come together and utilize their tools, including Diabetes Technology, to identify individuals who are more susceptible to the prevailing disease, such as people with diabetes in this scenario, and ensure timely treatment to such endangered patients. A recent display of innovative technology was highly applauded throughout the country, when students of the National University of Science and Technology Islamabad came together at times of crisis to develop indigenously designed diagnostic testing kits for COVID-19 that cost a fraction of internationally purchased kits.⁴ Along with this, we, as medical practitioners, must analyze and develop methods to help us prepare for calamity beforehand, collectively create vaccines and research pharmaceutical products to hamper spread, and discipline the public on how to avoid panic and prevent transmission of illness. It is also predicted that with education playing its role, people in Pakistan in future will be more serious toward the basic measures of hygiene and protocol that should be followed in case of an epidemic, and in unfortunate periods of quarantine, will be well-versed on how to utilize their time efficiently and engage in healthy and productive physical activities that prevent the emergence of other conditions such as obesity which lead to diabetes.

In short, with the lessons learnt in these dark times, man can, should, and surely would find means to confront, combat, and conquer such illnesses so that we may win the war against this invisible, nanoscopic virus without our centuries of hard work and progress in the fields of science, ethics, and medicine, being questioned.