key: cord-0690945-gcaj3p0f
authors: Shah, Pir Tariq; Xing, Li
title: Increasing and declining of COVID-19 cases puzzling the health experts in Pakistan
date: 2020-10-17
journal: New Microbes New Infect
DOI: 10.1016/j.nmni.2020.100791
sha: 857090c707a69b9d300a101313a686a59a14984a
doc_id: 690945
cord_uid: gcaj3p0f

Although the comprehensive social measures had been engaged, COVID-19 cases remained increasing until mid-July in Pakistan, which was followed by unexplained declining. Therefore, those countermeasures need to be re-examined to find out the loopholes or defects in implementing policies in order to eventually win the war against COVID-19.

Bangladesh (1.3%) were observed to be lower than that in other regional countries including China (5.2%), Iran (5.7%), and Afghanistan (3.6%), and major developed countries including the United

States of America (USA, 3.1%), the United Kingdom (UK, 13%), France (14.9%), Germany (4.1%),

Italy (13.9%) and Spain (8.3%) ( Figure 3A ). The lower case-fatality rate in Pakistan can also be seen in individual regions including Azad Kashmir, Balochistan, Gilgit-Baltistan, Islamabad, Khyber Pakhtunkhwa, Punjab, and Sindh ( Figure 3B ). The reasons for the lower case-fatality rate have yet to be investigated. One of the possible reasons may be the age demographics of Pakistan. Pakistan's population is over 220 million with an estimated 64% under the age of 30 years old (10) . Globally, individuals with older age have proven to be more susceptible to COVID-19 (11).

In conclusion, while the comprehensive social measures had been taken even at the early stage of COVID-19 pandemic in Pakistan, the data shown in this letter suggest that the engagement of countermeasures needs to be re-examined to find out the loopholes or defects in implementing policies in order to eventually win the war against COVID-19.

The data and information used in this report are available from public sources, including the databases of the World Health Organisation (WHO) (https://www.who.int/emergencies/diseases/novelcoronavirus-2019).

PTS and LX conceived the study, analyzed the data, and wrote the manuscript. All authors read and approved the final manuscript. 

A pneumonia outbreak associated with a new coronavirus of probable bat origin

WHO. Coronavirus disease (COVID-2019) situation reports 2020

COVID-19 outbreak: current scenario of Pakistan

Is Pakistan prepared to tackle the coronavirus epidemic?

Countrywide lockdown stretched till May 9

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Unexplained decline in COVID-19 cases' in Pakistan puzzles health experts and policymakers. The News International

Early Successes in the Epidemiological Battle

Unleashing the potential of a young Pakistan

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The authors thank all the persons who contributed to the production and the collection of the data in WHO database.

Authors' contributions