George Orwell wrote in his bestseller Animal Farm, “All animals are equal, but some animals are more equal than others.”

The current pandemic is thought to affect everyone and spare no one. Whether this is true or not is still too early to say. As humans, will we learn from this pandemic or will we return to our normal selves as if nothing has happened? One thing is for sure, that the economic repercussions of this will adversely affect the lower- and middle-income classes. The current recession may also have benefited a few chosen ones right now and will benefit a few more in the long-run but, will damage many for a long time to come.

The Pareto Principle (also known as the 80/20 rule, the law of the vital few, or the principle of factor sparsity) states that, for many events, roughly 80 percent of the effects come from 20 percent of the causes.

Today, when we look at the COVID-19 situation, 5 percent of the countries are contributing to more than 80 percent of the reported cases and only 8 countries (4 percent) are contributing to 85 percent of the mortality. An interesting fact to note here is that all these countries are the ones which contribute more than 8 percent of their GDP on healthcare. Leading the list is no other than USA which spends more than 17 percent of its GDP on healthcare.

The beauty about science is that it is not linear as put forward by Thomas Kuhn. History has shown that science takes various paradigm shifts: For a long time, it was believed that the earth was the centre of the earth and it was only when Galileo proved that Sun is the centre that people, after the darkness of centuries, realised that they were wrong. Kuhn claimed that development in any scientific field happens via a series of phases from normal science to the revolutionary process. The essence of his work was perhaps explaining “paradigm” as an intellectual framework that makes research possible.

The coronavirus is a crisis that will cause a paradigm shift and will surely change the whole world. A new world order will be defined, and the social fabric of many societies may grossly change. Our decisions today will dictate our future and our future generation(s) will have a different perspective towards life. Good or bad, the time will tell. Today, everyone is an expert on COVID-19 and has something to add; from conspiracy theories to actual treatment of the disease. Many theories are circulating as to why and how this virus came. Allegations are being levelled at both the global and national levels. Finding out whether this virus is manmade or the progression was due to a lab error will definitely help us to prevent future catastrophe by being more prepared but the situation at hand is to be dealt differently and more wisely. The earlier we accept the fact that COVID-19 is just another disease and not the only disease the sooner we may be able to get out of this.

The data available to us is scarce. A rush towards finding the diagnostic system to the cure in form of a vaccine has created a chaos situation. Studies done on as few as 5 patients are not only being published but also being advertised in a manner that is not acceptable. The current data has a lot of ‘publication bias’ or ‘negative outcome bias’. Authors are not submitting negative outcome studies and editors may not be accepting these. Even the studies with positive outcomes do not have the patient number or the duration to show a definite outcome. On top of it, there is cherry-picking in the data to bring a positive outcome that is also leading to the confusion and chaos. The phenomenon of “I broke the news first” is prevalent currently in the healthcare community as most “researchers” want to be in the spotlight on the screen.

Dr Zafar Mirza, under the leadership of Prime Minister Imran Khan, has done a good job and they should keep it up. The concept of a smart lockdown is the requirement of the day. We must understand the need for a customised policy that suits our country rather than following other systems. The role of opposition is not to oppose just because they are called opposition. They need to understand that they carry the mandate of the people and are in the house representing a large population base. They are as much a part of this system as the government is and only a collective effort will take us out of the crisis. Economic and health perspectives have a very delicate balance and policymakers at the national level have rightly created a balanced approach till now. This is a time to come together as a nation. The target should be to protect the common man, the healthcare worker and at the same time, not to derail the already struggling fragile economy.

Healthcare professionals need to break out of their tunnel vision. Their responsibility is of paramount importance in this pandemic and they are also at the highest risk. Pakistan has a healthcare system that has very weak foundations and if healthcare professionals lose their focus, the system may collapse. COVID-19 is not the only disease, it is just another one and we can’t put all our resources to fight it alone. Yes, they should take the utmost precautions but at the same time should remain panic free. We need to strengthen the government and the system by making the best of the limited resources that we have and give our best to the health system. Don’t let COVID-19 mask all other ailments.

The views in this article are personal and cannot be ascribed to any organisation.

Dr Kamran Qureshi and Dr Khawar Abbas

Dr Kamran Qureshi is a health economist and policy expert and Dr Khawar Abbas is a consultant pulmonologist. They can be reached at and