Is Pakistan prepared to tackle the coronavirus epidemic?

The World Health Organization (WHO) has classified the coronavirus epidemic as a global public health emergency of international concern [1]. On 11 February 2020, the virus was named by the WHO as ‘severe acute respiratory tract coronavirus-2’ (SARS-CoV-2; also referred to as 2019-nCOV), and the disease it causes as ‘COVID-19’ [1]. On 26 February 2020, for the first time, the number of new cases outside China was higher than the number of new cases inside China (427 vs. 411 new cases) [2]. By 11 March 2020, the virus had spread to 113 countries and territories, with the number of registered cases reaching 118,162 and the number of deaths reaching 4290 (mortality rate 3.63%) [3]. The WHO states that the COVID-19 outbreak is now categorized as a pandemic, with the number of cases increasing by 13-fold in 2 weeks [4], and has issued alerts to countries at risk of getting COVID-19 [5]. Also on 26 February 2020, the Pakistan Federal Health Minister confirmed the first two cases of COVID-19 in Karachi and Islamabad [2, 6]. Within 15 days (12 March), the total number of positive COVID-19 tests reached 20, with 14 cases in Sindh Province, 5 in Gilgit Baltistan and 1 in a 12-year-old child in Baluchistan) [7]. All cases had a history of a recent visit to Iran, Syria or London. To 12 March 2020, a total of 471 suspected samples had been tested, 20 (4.25%) of which were found to be positive [7]. Pakistan borders countries infected with COVID-19, including China, an epicenter of the disease that currently has the highest number of deaths attributed to COVID-19 (n = 3162), to the north, and Iran, a country with the third highest number of COVID-19-associated mortalities (n = 291), to the west; Italy has the second highest number of deaths [3]. This geographical location, as well as a continual increase in the number of confirmed cases, demands a high level of preparedness and requires actions to be taken promptly before the situation becomes worse [8]. The WHO states that countries should take steps to prevent and limit further spread of the virus, including active surveillance, early detection, quarantine, clinical management, and tracing of close contacts [5].