BALOCHISTAN HIGHLIGHTS

• 76 years old male patient expired due to COVID-19. The overall deaths

are 39 (CFR 1.2).

• In last 24 hours 106 confirmed cases reported from 05 districts of

Balochistan and total has risen to 3074. The active cases are 2311.

• Out of 3074, 94% (2,918) cases are from local community, Quetta (2,505)

followed by Killabdullah (115) Pishin (106), and Killasaifullah (35). (Detail Table

01, Graph 05).

• UN mission with NDMA lead visited Balochsitan province and had meeting with

Chief Minister regarding COVID-19 response and strengthen support to

Balochistan province.

• Secretary Health had meeting with WHO country representative to talk about

COVID-19 response and strengthening of health system particularly Lab,

Surveillance and Logistic support system in province.

• In last 24 hours 88 asymptomatic home isolated COVID-19 Positive persons recovered/released after completion of 28 days isolation with clear guidelines to follow all SOPs. The total recovered are 724 which is 23% of total cases.

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DAILY SITUATION REPORT BALOCHISTAN

PROVINCE

COVID-19 Updates from Operations Cell, Health Department, Govt. of Balochistan Date: 21-05-2020 Updates till: 8:00 PM

Due to increasing local transmission and

less following disease prevention

protocols the mortality (Deaths) are

increasing. The total deaths are 39.

Majority of COVID-19 patients expired

due to ARDS/COPD which shows typical

pattern of disease.

Highest numbers of deaths from Quetta

(31) followed by Pishin (05) , Lasbela (2)

and Sibi (01).

Death Category with positive COVID-19

04 Renal Failure

06 Hypertension/Diabetes

28 ARDS/COPD

01 Carcinoma

49723

19698 1988816814

3074 542 106 724 2311 39 3950

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20000

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60000

Graph 01. COVID-19 cases details till 21 May 2020, Balochsitan

3074

1992416685

71551235 579 148

48800

1045

14155

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Graph 02. Provincial wise positive cases of COVID-19, 21 May 2020

233

310 4 15

408

483

259

26 14 960

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500

600Graph 03. Quarantine population Till 20 May 2020 - Balochsitan

MORTALITY AND RECOVERIES STATUS OF PROVINCE, TILL 19 MAY 2020

• Rising deaths in relation to speedy reported cases is alarming; overseeing the COVID-morbidity in Pakistan, it is revealed that so

far total of 45,898 confirmed cases have been reported across the country out of which 13,101 (28.5%) cases recovered besides

the 985 (3%) deaths till date.

• Distribution of confirmed cases among the provinces reveals (highest to lowest), province Sindh 17947 (39%) followed by Punjab

16685 (36%), KPK 6554 (14%), Balochistan 2885 (6%) and Islamabad 1138 (2%).

• The consolidated number of deaths from all the provinces to the whole of the country’s death toll, reveals highest from KPK 345

(35%), followed by Sindh 299 (30%), Punjab 289 (29%) and Balochistan 38 (4%) till date.

• The current mortality rate of the province over its confirmed cases reveals highest from KPK (5%), Sindh & Punjab (2%) each

followed by Balochistan, Islamabad, AJK, GB (1% each).

• Beside the prevailing mortality rate, a nominal number of confirmed cases have also been recovered from the province Punjab

5076 (30%), followed by KPK 2058 (31%), Sindh 4741 (26%) and Balochistan 608 (21%). The recovery rate of Balochistan in

comparison to other provinces can obviously be seen improving from 16% to 21% within 4 days.

COVID-19 LABORATORY STATUS OF BALOCHISTAN PROVINCE Presently, (04) lab facilities are existing in the whole province at Fatima Jinnah General & Chest Hospital and Sheikh Khalifa Bin Zaid Hospital

while one specific lab arrangements done in BMC Hospital solely for the tests of Doctors and medical related staff. The graph 04 shows the

daily basis lab capacity improvement. The data is only from PHL-Quetta. BMCH and SKBZ not included.

28

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Balochistan Islamabad KPK Punjab Sindh

Confirmed cases Active cases Rec Rate

118

284189

9410688

199128

385

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321

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Daily Lab Test Conducted at Fatima Jinnah Lab from 9 april - 21 May 2020 - Quetta (n=15881)

Table 01. Districts with Local transmission

Districts % Numbers

1 Quetta 85.8 2505

2 Chagai 0.6 18

3 Lorlai 0.3 9

4 Killabdullah 3.9 115

5 Pishin 3.6 106

6 Mastung 0.9 27

7 Sibi 0.4 13

8 Jafarabad 1.2 34

9 Khuzdar 0.2 7

10 Harnai 0.1 2

11 Kharan 0.1 4

12 Ziarat 0.3 8

13 Nushki 0.1 4

14 Panjgoor 0.1 4

15 Lasbela 0.5 14

16 Killasiafullah 1.2 35

17 Zhob 0.1 2

18 Dera Bugti 0.1 3

19 Gwadar 0.1 3

20 Kachu 0.0 1

21 Musakhail 0.1 2

22 Kohlu 0.0 1

23 Washuk 0.0 1

Provincial RRT RRTs screened 1141 persons for COVID-19 and took 304 lab samples of suspected cases. Total 88 Positive cases released

after completion of 28 days home isolation Protocols.P.RRT, TSO FELTP and WHO start working on COVID-19 revised death Protocols.

As of today, following number of cases were reported by PEI staff through ODK (May 20, 2020) 1. ILI = 1080 2. SARI = 19 3. Suspected COVID Cases Reported by PEI Staff = 1188 4. Suspected COVID Cases Investigated by PEI Staff = 997 5. Suspected COVID Cases became Positive = 139

PPHI-B/MERC Progress Awareness sessions (Male & Female) 25. Peoples aware on COVID-19 in Communities (Male & Female) 301. People Scanned 2766 Screening Activities through PPHI-B 23. No. of Suspect cases identified/ referred 18. MERC Collected 62 samples of Corona suspects.

Graph 06: DOUBLING OF CASES TO 500: The graph shows a smooth pattern of reporting of 500 cases within first 42 days evident to the

newly entry of virus and strict lockdown, restricting people inside home, however a clear picture of rise in coronavirus cases can be seen

through first 500 cases reported over completion of early 42 days which turned twice to 1000 cases within a week. This pattern continued

rising to next 500 cases in the next 7 days cumulating 1500 cases within 2 weeks and this pattern clearly explain increasing of cases due to

very fast local transmission. The recent addition of 500 cases after total 2000 cases was seen within 5 days alone taking these number to

ultimate hype. The hype in reporting of the sudden cases was in result of relaxation in the lockdown, letting masses to move out, extrovertly

visiting shopping places and un-necessary outdoor visit most probably.

LOCAL TRANSMISSION OF COVID-19 CASES BY DISTRICT WISE

SURVEILLANCE

LIMITED EPIDEMIOLOGICAL ANALYSIS OF 3074 CASES TILL 21st MAY 2020

85.8

0.6 0.33.9 3.6

0.9 0.4 1.2 0.2 0.1 0.1 0.3 0.1 0.1 0.5 1.2 0.1 0.1 0.10.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

Graph 5. Local transmission %ge district wise - Balochsitan, 21 May 2020

Graph 07. The line shows that the trend isn't as clearly upward in the first few days, when it dips up and down, but becomes obvious in

the days since. The trend line is clearly modified that positive cases are increasing slowly till 12 May. The positive cases decreased in 19

April and then significantly increase in 25 May. The most cases were reported 26 April to 10 March, after which we see a trend line is

fluctuating upward way. So, owing the trend line the people will become effect mostly on increasing way.

Graph 08. The trend line represent data has changed over time. The positive cases are downward in the trend line till 15 weeks. The

duration of 15 weeks the high-level cases was reported 90. The start of 15, positive cases are upward trend smoothly till 20 weeks of May.

So, the week 20 cases were hows trend line fluctuation. In the end the down word line cases is minimum due to week 21 is still continue.

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42 7 7 5 5 7Number of Days

Doubling of casess within days used 500, Balochistan Province till 21 May 2020

0 0 1 0 0 5 1 1 5 0

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208

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1 513

4 104 6 1 18 2 4

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Graph 7. Daily wise COVID-19 Positive cases trend till 21 May 2020

0 0 0 0 0 0 0 0 0 0 6

9046 50 33

191

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459

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459

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Weekly wise COVID-19 Positive cases trend till 21 May 2020

Graph 09. In the trend line, we observed a smooth trend/zero cases in the number of primary positive cases of COVID-19 over Jan to Feb,

after which we see the number of primary positive cases are being increased slowly in March. From March till May the number of positive cases increase every month however the cases increase remained large. The upward extend trend line shown that the high rate of positive reported cases are 1934 in the month of May.

Table 02 & 03: A side-by-side comparison of the descriptive statistics for the four numeric variables of age range of COVID-19 positive

lab test rate. This allows us to quickly make the following observations about the data. The maximum Age observed on the COVID-19

effected people are 94 and the Reading lab tests exceed 100 points, which was supposed to be the maximum possible age limit. The

minimum COVID-19 age limit is 1 month, which we see that a lot of children are being affected and cases are being reported on daily basis.

The average age of COVID-19 positive test score is 34 among 2883 of the first sections, but the median is 33. Because the median is more

resistant to such errors than the mean. Moreover, median ages are typically 30 – 44 and attack rate 37.84, but people can live to 100.

People of such age have 1 to 4 times the influence on the mean than they do on the median compared to very young people. Thus, the

median is a bit more up-to-date statistic concerning a country's age distribution and is a little more independent of mortality rates and life

expectancy than the mean. but if the mean is 34, you can't say as much, because that 33 could be influenced by a large population bulge

at age 94, for example, or perhaps a population gap in some age range due to a pandemic disease (COVID-19).

Table 02. Mean Age 34.52 Years

Median Age 33Years

Min age 1 Months

Max Age 94 Years

Table 03. Age group (Y) Number of Cases Percentage Population of that age

Group Attack rate/100000

population

<1-14 322 10.5 6715115 4.80

15-29 818 26.6 2832969 28.87

30-44 1006 32.7 2462510 40.85

45-59 543 17.7 884338 61.40

60 + 239 7.8 295446 80.89

Unknown 145 4.7

Grand Total 3073 100.0 13190378 216.82

0 0161

979

1934

-500

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2500

January Febuary March April May

Graph 9. Weekly wise COVID-19 Positive cases trend till 21 May 2020

Table 04. The table shows that the highest attack rate district is Quetta which comprise 2399 positive cases and attack rate is 98.65 of

total 100000. Atfte this, the second highest district is Pishin, which reportd cases are 114 and attack rate 14.49. Third district is Killa

Abdullah with attack rate 13.96.

Table 04. District Number of Cases Percentage Population Attack Rate/100000 population

Kohlu 1 0.03% 229041 0.436603054

Killa Saif Ullah 35 1.20% 366309 9.554774794

Lasbela 17 0.58% 613651 2.770304293

Ziarat 7 0.24% 171234 4.087973183

Dera Bughti 3 0.10% 312603 0.959683688

Panjgoor 4 0.14% 338079 1.183155416

Gwadar 3 0.10% 171234 1.751988507

Sibi 17 0.58% 144864 11.73514469

Harnai 2 0.07% 103666 1.929272857

Kachhi 2 0.07% 253275 0.789655513

Kharan 5 0.17% 166854 2.996631786

Khuzdar 7 0.24% 857187 0.81662461

Mastung 32 1.09% 284723 11.23899369

Musakhaiil 3 0.10% 178464 1.681011296

Sohbatpur 1 0.03% 214282 0.466674756

Zhob 4 0.14% 331827 1.205447417

Pishin 114 3.89% 786705 14.4908193

Killa Abdullah 117 4.00% 809499 14.45338413

Chaghi 11 0.38% 241498 4.554903146

Nushki 6 0.20% 191050 3.140539126

Loralai 8 0.27% 424636 1.883966503

Jaffarabad 35 1.20% 549028 6.374902555

Quetta 2494 85.18% 2431666 102.5634277

Grand Total 2928 100.00% 10171375 201.065882

PICTORIAL VIEW:

Secretary Health had meeting with WHO country representative to talk about COVID-19 response and strengthening of health system

NCOC video link meeting to talk about hotspots for smart lockdown to use IDSRS

The Malaria/VBD control program disinfected team sprayed at SoS village, NAB office and few affected villages related to COVID-19

CONTACT:

DR. SALEEM ABRO Director General Health Services Provincial Health Directorate, Quetta – Balochistan

Tel: +92-81-9211356, Email: dghs_balochistan@yahoo.com

Dr. NAQEEBULLAH NIAZI COVID-19 Operational Cell

Tel: +92-300-3869070

Dr. SARMAD KHAN COVID-19 Operational Cell

Tel: +92-321-2729110

Dr. EHSAN LARIK PDSRU – Technical Support Officer

Mob # 0332-7977162

Dr. DAWOOD RIAZ NPO Public Health Surveillance/ World Health Organization

+92 320 7804297 / +92 320 780429 / riazd@who.int / drdawoodriaz@gmail.com

Dr. SAMI TAREEN Rapid Response Team lead, COVID-19 Operational Cell.

+92 081- 2822762

Control Room Health Dept Govt. of Balochistan operational 24/7 for any kind of information &

coordination regarding COVID-19 activities in Balochistan 081-9202080 / 111-400-400.