Professor of Applied Economics at Johns Hopkins University Steve Hanke has said that COVID-19 cases are likely being "highly underreported" in Pakistan which could be the reason for the recent drop. 

The country has had some respite over the last few weeks with the rate of new infections slowing. But experts say it’s difficult to assess the path of the nation’s epidemic because its testing rate remains one of the lowest in the world.

“The significance of the drop is that cases are likely being highly underreported,” Hanke said in an email to Bloomberg.

The report cited a study by the country's largest pharmaceutical manufacturer Getz Pharma which tested 24,210 people in mostly urban workspaces.

Its study then extrapolated those findings to the urban, adult, working population of Pakistan and found active COVID-19 infections would likely reach 4.11 million, which is almost 15 times higher than the current tally.

"The positivity rate for those tested in the study was 17.5%, higher than government data that shows the rate dropping to below 5% from more than 20% in June."

Risk of second wave

Hanke said that the festival of Eidul Azha will draw millions of people into crowded fairs and religious and family gatherings, risking a second wave of the deadly virus which has so far claimed nearly 661,000 lives throughout the globe. “Masks and social distancing will be abandoned and similar to the Chinese New Year in Wuhan, Eidul Azha could become a cataclysmic event for Pakistan and the region."

Bloomberg report stated that Pakistan will also have to manage Muharram processions in late August. Globally, religious gatherings have sparked several virus clusters.

Despite the low number of cases in the recent days, the government has advised caution to the public. “Any complacency and we will face the same increase we saw earlier,” said Faisal Sultan, the prime minister’s point person for COVID-19 strategy and an infectious disease expert.

"The reason for the recent drop in cases is harder to know but is likely multi-factorial. The biology of the epidemic including interplay of host, pathogen and environment but also interventions have likely helped.”

The pressure on Pakistan’s hospitals has also eased with patients on ventilators and low flow oxygen dropping by more than 50% since June 20, he added.

Pakistan’s medical associations and experts have also long warned that low testing and lack of data means there is an underbelly of virus cases that don’t appear in official figures.

Serology tests, private hospital data and many virus-related deaths are not being reported in the government’s official numbers, said epidemiologist Wajiha Javed, head of public health and research at Getz Pharma.

“The initial peak was two weeks post-Eidul Fitr and we may expect the second peak at two weeks post the second Eid.”

https://tribune.com.pk/story/2257296/pakistan-warned-of-spike-in-COVID-19-cases-as-millions-travel-for-eidul-azha