SOON after the vaccination drive was opened for elderly citizens, I asked a few colleagues if they were planning to take their parents for a shot anytime soon. Except for one notable exception, whose parents didn’t fall in the right age category, the rest said that their parents (and a grandparent or two) were not willing. I was taken aback to say the least — after all, most of these colleagues had spent the past year working in or around a news studio where they had heard constant and incessant discussion about the pandemic, as we interviewed doctors and health experts in Pakistan and around the world. They were all aware of the virus and the risks it brought and yet some in their families thought otherwise. None of them expressed any discomfort with the idea of vaccination but the parents were reluctant — and they didn’t know how to convince them otherwise. If this is a situation in a news channel’s office, one can only imagine what the rest are thinking.

No wonder that the vaccination drive is the biggest challenge at the moment, especially as the new variant — or is it variants? — sweeps across Pakistan. Indeed, it’s not just Pakistan but the entire region, which had escaped the kind of havoc witnessed in, for example, Europe, or the US since the beginning of the pandemic. But this time around, South Asia hasn’t been lucky. Consider the figures provided by World in Data, on April 7; the positivity ratio in Bangladesh, Iran, Pakistan and India is 22.6 per cent, 19.4pc, 9.6pc and 9.1pc respectively.

For perspective, consider the positivity rate in the earlier wave. Bangladesh didn’t see similar numbers till August 2020. And India till July. And by then, Pakistan was already on its way down after having experienced the highest rate in the region (its upsurge as well as the decline was the steepest of the four countries). But this time around, the upswing in the rate for Bangladesh, India and Pakistan seems to be roughly similar — beginning towards the end of February. However, the rate is far higher in Bangladesh and Iran while India and Pakistan are behind.

The rapid rise this time around is being attributed to the new, more infectious variant as well as fatigue which is making it hard for people to continue using precautionary measures. Government officials acknowledge this during interviews as well as at media briefings organised by the NCOC. In addition, local administrations are also facing similar fatigue cracking down on citizens.

Along with the challenges of the vaccination drive, there is another one looming large.

This has been a constant across the world — as infections rose in the third wave, governments found it hard to convince people to adhere to social distancing. In Pakistan for example, much has been said about the absence of masks in public places and the big gatherings for weddings which have played a role in the spread.

India has been covered more extensively in the international press in the current wave. A story in the Financial Times says, “...it took just six weeks for the daily new infections to surge by a magnitude that took three months last year”. Like Pakistan, big weddings have played a role and so has electioneering, say news reports.

The vaccination efforts, so far, have not been enough to affect the spread — even though vaccination numbers in India and Bangladesh are higher than Pakistan’s, this has had no impact, it seems, on the spike.

However, unlike India, Pakistan’s decision-making through a single platform of NCOC does help; in the former, the state governments and the federal sometimes appear to be at odds. According to the NYT, federal officials have blamed state governments for mismanagement. But another lockdown like the one last year has been ruled out.

Pakistan too seems averse to a national-level lockdown; in an NCOC briefing last week, it was said that the restrictions (non-pharmaceutical interventions, as they are called in the NCOC) are having an effect. However, better results in terms of hospitalisations and deaths will not be evident for a couple of weeks. Hospitalisations, according to NCOC numbers, are higher than the first wave but there are fewer stories in the press and anecdotally of patients not being able to find beds. This is partly due to the capacity of the health system, which, says the government, increased throughout 2020. But the numbers are nonetheless putting pressure on the health system in the more affected parts of Khyber Pakhtunkhwa. And even at the time of writing, there were reports that a lockdown in Lahore was being considered.

But alongside the limited restrictions, the government is counting on the expansion of the vaccination drive to provide the real break in the spread of the virus. However, here the problem is twofold — the first challenge is the reluctance of the people and the second is the availability of the vaccine. With most of the Western supplies tied up by wealthier governments, there is a limited supply of vaccine, mostly Chinese and Russian, which can be bought. According to NCOC chairman Asad Umar, the issue is not the payment but the availability. A major setback in this regard has been the delay in the stocks promised by Covax, a global initiative aimed at equitable access to the vaccine, to be provided in March. The Indian government stopped export of the vaccine as its own cases went up. It is now expected around May but what if the numbers in India continue to rise? Would the export of the vaccine be stopped again?

Along with the challenges of the vaccination drive, there is another one looming large. Ramazan is about to begin and it will be followed by Eid. Last year, the shopping frenzy in the last days of Ramazan led to the spate of infections we term the first peak. The positivity rate then was the highest Pakistan has witnessed so far — how will the government deal with it this year? Perhaps, the precautions we take and the restrictions the government imposes over the coming weeks will determine what the days leading up to Eid will look like.

The writer is a journalist.

Published in Dawn, April 13th, 2021