In the early hours of June 12, Daud Shah decided it was time for his uncle, Haji Muhammad Bakhtiar, to go to a hospital. His condition had rapidly deteriorated after testing positive for coronavirus earlier in the week.
Shah drove his 60-year-old uncle from their village of Bar Nawagai in the Mohmand district to Peshawar, the capital of northwest Khyber Pakhtunkhwa province.
After a nearly 150-kilometer drive, every major hospital refused to admit Bakhtiar, who was breathing with great difficulty.
“We first went to Lady Reading Hospital but were told there were no beds. We then checked with Khyber Teaching Hospital and the Hayatabad Medical Complex,” he said of the three major public hospitals in the city. After checking with the private hospitals in Peshawar, they decided to try in the capital, Islamabad, some 200 kilometers away.
“Both the Pakistan Institute of Medical Sciences and Shifa Hospital said they had no free beds,” he said of the city’s leading public and private hospitals. After a series of frantic telephone calls, a private hospital admitted him late in the afternoon of June 12.
But three days later, Bakhtiar died while on a ventilator. Shah told Radio Mashaal that his father, also hospitalized, died on June 17. Their elder brother had died earlier in the month. Bakhtiar and his two brothers were among the more than 3,200 Pakistanis killed by the virus, which has infected at least 165,000 people in the country of 220 million people.
Shah’s experience is now increasingly common across Pakistan. As the infection rates and death toll mount because of a growing coronavirus outbreak, the country’s healthcare system is facing an unprecedented crisis amid a lack of beds, oxygen, and medicine, as well as attacks on medical staff. Even the number of deaths and infections is seen as being underreported due to limited testing and patients hiding their infection status because of government restrictions.
In a sign of a looming healthcare disaster, senior officials are preparing people for difficult days ahead as they impose selective lockdowns, project much higher infection numbers, and even blame the masses for the virus’s spread by not following the government’s so-called standard operating procedures.
Faridullah Khan, a physician in Peshawar, says he and his father are now isolating at home after the three major hospitals in the city told them that they have no more beds for coronavirus patients. “We were also told to arrange oxygen cylinders for ourselves,” he told Radio Mashaal.
Pakistan followed its neighbors and countries around the world to impose a lockdown in late March nearly a month after the first cases of the highly contagious virus were recorded in late February. But it practically ended last month after the government loosened some restrictions and a top court ordered malls and businesses to reopen. Pakistan is now witnessing one of the fastest-growing infection rates in the world, but authorities are reluctant to reimpose a lockdown, citing the economic costs.
The high infection rates are now rattling Pakistan’s anemic healthcare infrastructure.
“Beds aren’t available anywhere,” Rizwan Kundi, head of the Young Doctors Association in Khyber Pakhtunkhwa, told Radio Mashaal. He added that all the wards and intensive care units assigned to or built for treating COVID-19 patients in Peshawar are packed to capacity. “We can clearly see that some patients need hospitalization, but we cannot admit them.”
In Quetta, the capital of southwestern province of Balochistan, the 150 beds authorities assigned for coronavirus cases are now falling far short. “We have a waiting list, but many patients are not getting any beds,” Yasir Khostai, local physician, told Radio Mashaal.
In the larger and more populous provinces of Sindh and Punjab, the situation is equally dire. In Karachi, the country’s largest city, many hospitals now prominently display banners on their gates stating that they cannot take any more COVID-19 patients.
Frustrated patients and their relatives are now increasingly attacking doctors and medical staff over inadequate treatment, deaths, and widely held misconceptions about the coronavirus. On June 18, police in Karachi arrested a member of the counterterrorism force after he allegedly shot a doctor inside a hospital. The two reportedly engaged in an altercation after the doctor asked the policeman to wear a facemask.
A video circulating online shows relatives of a coronavirus victim forcefully removing his body from Karachi’s Civil Hospital in late May. They harassed medical staff and broke doors and windows in their wake.
Sanaullah Khilji, a young doctor in Peshawar, says he was attacked and beaten on June 2 following an argument with relatives of a coronavirus patient.
“I was attacked. They removed my protective equipment and broke my nose,” he said of the late-night attack. “I wanted to still protect myself from contracting an infection after they tore away my PPE [personal protection equipment].”
In Islamabad, Fazl-e Rabi, a physician said that a lack of beds is contributing to the number of serious patients.
“In the early days of the outbreak, we used to get patients who had mild symptoms, but we are now getting patients who need urgent intensive care,” he told Radio Mashaal. “But we don’t have any free beds, which enrages their relatives. This is why we are seeing increasing attacks on doctors.”
In the initial days of the outbreak, doctors across Pakistan protested the lack of protective equipment. But they are now seeking protection from angry mobs.
“This is very unfortunate, and we have zero tolerance for such violence because the doctors are our front-line workers,” Taimur Khan Jhaghra, Khyber Pakhtunkhwa’s health minister, told Radio Mashaal. “We are working on soon adopting a law to end such incidents.”
But Jhaghra’s ruling Pakistan Tehreek-e Insaf [PTI] political party has faced severe criticism of its handling of the coronavirus pandemic. Since March, party leader and Prime Minister Imran Khan opposed a lockdown. He argued it would devastate millions of Pakistan’s poorest.
Asad Umar, a key Khan confidant and planning and development minister this week indicated that the country was bracing for more than 1 million confirmed cases and a much higher death toll by the end of July. “There is much we are still learning about Covid spread and mortality,” he tweeted.
Yasmin Rashid, the health minister of eastern Punjab Province, the most populous region, apologized after calling her constituents in the provincial capital, Lahore, “ignorant” for not following government rules.
In the absence of a successful containment or mitigation strategy, Islamabad seems to be relying on the hope of developing collective immunity. Also called herd immunity, the concept denotes collective protection against an infectious disease if a majority of the population contracts a virus or is vaccinated against it.
“The disease is here, and it will continue to spread,” Khan’s healthcare adviser Zafar Mirza told Dawn News, an independent TV station, in early May. “We are not aiming for zero transmission of this disease,” he added. “Actually, it is better for the future if it spreads to a certain level because it will provide immunity to the people.”
But no one knows how the country’s crumbling healthcare system will cope with the pandemic until tens of millions of Pakistanis contract the virus.
Local media reported that the prices of oxygen cylinders were already up by 500 percent earlier this week. Injections of Tocilizumab, an immune suppressant medicine, were in short supply across the country after it demanded increased for use in critical COVID-19 patients. Authorities have begun to monitor the supply of dexamethasone, a steroid tipped to be effective in some serious coronavirus cases, aimed concerns over hoarding and profiteering off the commonly available medicine.