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Can pandemics affect educational attainment? Evidence from the polio epidemic of 1916 | Cliometrica (Berl) | Nature Public Health Emergency Collection | PubMed Central®.

[Open Access] [2020 Jul 27 : 1–35] [Epub ahead of print] [Received 2020 Feb 4; Accepted 2020 Jul 11]


We leverage the largest polio outbreak in US history, the 1916 polio epidemic, to study how epidemic-related school interruptions affect educational attainment. Using polio morbidity as a proxy for epidemic exposure, we find that children aged 10 and under, and school-aged children of legal working age with greater exposure to the epidemic experienced reduced educational attainment compared to their slightly older peers. These reductions in observed educational attainment persist even after accounting for the influenza epidemic of 1918.

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Afghanistan: Weekly Humanitarian Update (24 – 30 August 2020) | ReliefWeb.

[Source: OCHA] [Posted: 2 Sep 2020] [Originally Published: 2 Sep 2020] [Origin: View original]

North-east: 66,290 people displaced by conflict.

Fighting between Afghan National Security Forces (ANSF) and a non-state armed group (NSAG) continued across the north-east. The recent fighting in Kunduz displaced 9,150 families (approximately 64,050 people) in Khan Abad, Imam Sahib and Aqtash districts. In Kunduz, some 20 per cent of displaced families returned to their place of origin, while 28,282 displaced people were identified to be in immediate need of shelter, food and safe drinking water. Also, some 300 families (about 2,100 people) were displaced in Cheshm area of Pul-e-Khumri district in Baghlan province and 20 families (140 people) were reportedly displaced in Raghestan district in Badakhshan province. Humanitarian partners continued to support local authorities to respond to people in need and have deployed 22 interagency assessment teams to affected areas.

Overall, 1,294 families (9,058 people) newly displaced by conflict were identified to receive humanitarian assistance. Among them, 6,517 were assisted in Kunduz, Baghlan, Takhar and Badakhshan provinces with the distribution of assistance ongoing notably in Kunduz. Furthermore, 5,152 vulnerable and food-insecure people affected by COVID-19 were reached with humanitarian assistance in Baghlan and Kunduz provinces.

East: 23,387 people receive humanitarian aid.

The security situation remained volatile across the east mainly in Nangarhar and Kunar provinces. During the reporting period, heavy rainfall led to flash floods in Nuristan, Laghman, Kunar and Nangarhar provinces in the east. Reportedly, 100 houses were destroyed with some causalities reported across the east. Also, two people were reportedly killed and three others injured when a house collapsed due to floods in Hesarak village, Rodat district in Nangarhar province.

Interagency assessment teams identified 4,746 internally displaced persons (IDPs) as being in need of immediate humanitarian assistance. This week, 23,387 people received humanitarian assistance across the east. A total of 7,191 returnees, IDPs and people from host communities were reached with emergency outpatient health services and 408 children were vaccinated for polio and measles.

North: Over 1,400 people displaced by fighting.

The security situation remained volatile in the north with continued armed clashes between ANSF and an NSAG mainly in Balkh, followed by Faryab, Sar-e-Pul, Jawzjan and Samangan provinces. Reportedly, the fighting resulted in the displacement of people from Khwja Sabz Posh, Andkhoy and Qaram Qul districts, to safer places in Faryab province. Also, 200 families (1,400 people) were reportedly displaced in Sozmaqala district, Sar-e-Pul province. During the reporting period, 9,303 vulnerable people including people displaced by conflict, returnees and people affected by COVID-19 received humanitarian assistance in Balkh, Faryab and Samangan provinces. In addition, 651 people were verified as displaced by conflict in Faryab, Sar-e-Pul, Samangan and Jawzjan provinces by interagency assessment teams and will be receiving assistance in the coming days.

South: Fighting resulted in displacement and closure of health facilities.

During the reporting period, the security situation deteriorated across the south mainly in Kandahar, Hilmand and Zabul provinces. Improvised explosive devices(IEDs) planted along main roads reportedly killed 21 civilians and injured three others in Kandahar and Zabul provinces. The armed conflict in Hilmand reportedly displaced 1,400 people. According to initial reports, the ongoing fighting resulted in the closure of three health facilities in Kandahar and Zabul provinces depriving nearly 75,000 people of access to health services. Humanitarians are negotiating with parties at the local level to restore access. During the reporting period, the Government assisted 400 families (2,800 people) who were affected by conflict in Uruzgan province. Also, 193 IDPs in Kandahar province received food, hygiene supplies, and emergency latrines from humanitarian agencies. In addition, 402 IDPs were identified to receive humanitarian aid in the coming days in Lashkargah district, Hilmand province.

West: 7,723 undocumented people returned to Afghanistan from Iran.

During the reporting period, the security situation continued to be tense across the west mainly in Qala-e-Naw, Hirat and Badghis provinces. According to local authorities, around 7,723 undocumented people returned to Afghanistan from Iran from 22 to 28 August of whom 621 received humanitarian assistance at the point of entry and a transit centre in Hirat city. During the reporting period, 525 people displaced by conflict were identified to receive humanitarian assistance in the coming days in Hirat province. Needs assessments of people affected by conflict are ongoing across the west.

Centre: hundreds of people were affected by severe flooding.

The overall security situation in the centre remained volatile and unstable. On 26 August, severe flooding resulted in the deaths and injuries of hundreds of people and damaged thousands of houses in several provinces across central Afghanistan particularly Parwan province. Reportedly, 141 people died and 126 were injured including women and children and 26 people remain missing in Parwan province. Agricultural land and public infrastructure have also been impacted. In Parwan, interagency assessment teams have to date identified 973 families (about 6,811 people) as being in need of immediate humanitarian aid and assessments are ongoing. A total of 4,410 people affected by natural disasters received assistance across the centre. In addition, 973 people displaced by conflict were identified to receive assistance in the coming days in Logar and Khost provinces. Need assessments of people affected by conflict are ongoing in Ghazni and Daykundi provinces.

Funding Update.

US $13 million was allocated for Afghanistan by the Emergency Relief Coordinator through the Central Emergency Response Fund (CERF) underfunded emergencies window. The in-country prioritization process is about to be completed. Simultaneously, the Afghanistan Humanitarian Fund (AHF) completed the cluster prioritization process for an upcoming reserve allocation of some $15 million which is pending approval by the HC following deliberations by the Advisory Board next week. The prioritization for both CERF and AHF are complementary and informed by the recent Humanitarian Funding Gaps analysis (August – October 2020) which outlined the most time-sensitive underfunded gaps. The CERF and AHF allocations together provide 17 per cent of the immediate funding gap of $164 million.

UN Office for the Coordination of Humanitarian Affairs:
To learn more about OCHA's activities, please visit

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Post-COVID-19 precautions based on lessons learned from past pandemics: a review | Z Gesundh Wiss | Nature Public Health Emergency Collection | PubMed Central®.

[2020 Aug 4 : 1–9] [Epub ahead of print] [Received 2020 Jun 4; Accepted 2020 Jul 10]



In view of the spread of the contagious coronavirus disease (COVID-19) globally, the present review focuses on the details of past pandemic diseases, along with comparisons and lessons learned. A general awareness of COVID-19 infection is addressed, and it is compared with the Spanish flu pandemic. Based on the successes, failures and lessons learned in the past, governmental efforts must be undertaken to empower citizens by providing accurate information and implementing post-COVID-19 precautions that need to be taken now to stop the spread and recurrence of the virus locally, and to restore health and economic normalcy.


A detailed literature survey of past pandemics is undertaken in order to extract the successes, failures and lessons learned from previous breakouts. The comparison of past pandemics will enable us to determine post-COVID-19 precautions that should be followed. Separate tables are prepared to highlight the lessons learned and measures to be taken. Both general precautions and preventive measures for pregnant women are compiled.


The literature shows a continuous struggle of humans with disease outbreaks, with the most adverse impact of the Spanish flu killing 20–50 million people. Precautions need to be taken including social distancing, compulsory mask-wearing, avoiding public gatherings and washing hands regularly. The lessons from earlier pandemics show that they were equally devastating, and vaccines were not available at the time of outbreaks. Vaccines developed for polio, H1N1, measles, and other viral diseases have proven to save countless lives. Living with COVID-19 and evolving the work culture of protecting oneself and protecting others also has to be adopted.


COVID-19 has become an everyday topic of discussion throughout the world, indicating the increasing number of COVID-19 cases, deaths and recoveries. The lessons learned from past pandemics such as social distancing, wearing masks, avoiding public gatherings and adherence to guidelines, along with personal hygiene, are the key measures that must be taken in order to live with COVID-19. Precautions for the elderly and pregnant women advised by medical authorities are to be strictly adhered to. These will help in reducing COVID-19 cases and in turn will reduce the pressure on hospitals to serve those in need. India has learned lessons from the past and the present pandemic and will move towards growth through its self-reliance.

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Has Pakistan weathered the Covid-19 storm? | The Express Tribune.

[September 01, 2020]

Passengers wearing facemasks wait next to a vehicle in Islamabad. PHOT: AFP
Passengers wearing facemasks wait next to a vehicle in Islamabad. PHOT: AFP

But the theory that the virus has mutated and somehow become weaker in Pakistan doesn't hold true.

Rina Saeed Khan writes:

During the height of the coronavirus pandemic in Pakistan, particularly in June, when dire predictions were being made about millions of fatalities in the country, many reporters and researchers seemed to have gotten it all wrong. There were accusations of the government covering up infection rates, of un-reported spikes in deaths and shrill demands for a total lockdown. One researcher, however, who was actually working with the government in a public health advisory role, with training in infectious diseases, Dr Adnan Khan, seemed to have gotten it right from the start.

I noticed his updates on social media and week after week he was proven correct. Unlike others who were basing their views on second hand sources and reports coming in from panicked health workers, he had access to the field level data coming in from around 450 hospitals and labs across the country. “You take a look at the data and you get a picture” is how he described his work with Dr Faisal Sultan, who was recently appointed the Special Assistant to the PM on Health. Dr Adnan, who is based in Islamabad, had already been working on other programmes like polio, HIV and family planning so had plenty of experience in working with the government.

Finally, with coronavirus infections dwindling down to 200-300 a day, I decided to interview Dr Adnan to find out what were the “multi-factorial” reasons for the decline of the virus in Pakistan. “The government actually did a good job. It was a data driven operation,” he explained. Data software helped to analyse the data sent in by the field responders. All this was done under the umbrella of the National Command and Control Centre (NCOC), which was set up in March to “synergise” a unified national effort against COVID 19. All the data from the four provinces and territories was sent to the NCOC who would come up with recommendations for the National Coordination Committee headed by the PM who would then make the relevant decisions.

“Around 12 or 13 entities including the Army and National Institute of Health and even the polio progamme worked under this umbrella. All this cooperation made the job easier”. Dr Adnan pointed out that the initial hiccups such as the Punjab government forcibly taking coronavirus positive patients to quarantine centers (which scared people off from testing) and infighting with the Sindh government were eventually overcome. “Sharing data proved to be mutually beneficial. They soon recognised that the NCOC would benefit everyone”.

There were three modeling groups within the NCOC and Dr Adnan said that Tania Aidrus’ Digital Pakistan group made a major contribution. “Tania would sit in on all the data meetings and I think 20-30% of the response was from the digital platform”. Another contributor was Dr Bhutta from Toronto, a former Aga Khan Hospital health official whose team contributed via telephone. The third group was from the Army itself who lent their data analysts. It was also the Army who actually coordinated and helped implement all the lockdowns.

“We would hold meetings on a daily basis and sometimes sit until 10 or 11 pm sharing information and discussing what to do and what to say to the public”. He admitted that the government’s messaging to the public was mis-coordinated and that has received a lot of criticism in the media. “We should have had better central coordination on the messaging of the data,” he said.

At any rate, action counted more than words and today he says the trend is that the virus is in decline with just around 200 cases recorded yesterday across the country. “I hope by September 15 we hit zero cases. If our cases finish off then the second wave, if there is any, will be mild”. His only slight worry at the moment is the opening of schools on September 15th. “Maybe this is good enough. But if there are still 20 or 25 cases recorded by September 10th then perhaps we should postpone the opening of schools by two weeks just to be sure”.

In his view, we may be close to herd immunity in Pakistan. “You don’t need 50-70% of the country to be infected with the virus. It was never a big deal in our rural areas – the problem is in the cities. We found that in the cities one third or 38% got infected after exposure to the virus”. He explained that people meet the same people on a regular basis. This group is their social network. Most acquaintances have similar networks. A typical urban working person’s network has around 30-35 people (it is smaller in Pakistan due limited economic activity and exposures such as subway or bus travel). Once someone is infected, everyone in their network is at risk.

As soon as people’s social networks became saturated meaning that all those in their network have been infected or avoided the infection, the infection finishes in these networks. Because most acquaintances have shared networks, the spread of infection remains limited to a small group of people. As for the rest, the two-third who were not infected but exposed to the virus (and did not get sick), it is unclear if they developed immunity.

“According to the ongoing study by the Pakistan NIH, around 5 to 15% have developed anti-bodies in cities. If you multiply that by 3 (to account for the one third of all exposure that became infected) that means 50% have been exposed to the virus. So we are getting there, to the point of herd immunity”. He said a second wave (triggered by infections coming from travellers) would be unlikely as there would be few left to infect due to the “network effect”. Plus Pakistan is not exactly a tourist destination and our limited economic activity means less investors and visitors, which has proved to be a blessing in disguise.

Pakistan’s cities also have less density than Indian cities. Our biggest city Karachi is a blip compared to Mumbai. There are “areas in Mumbai with density of over one million per square km. Pakistan’s cities cannot boast that,” explained Dr Adnan. The coronavirus spreads quickly in dense urban areas. He said India has at least 5 cities bigger than Karachi.

He pointed out that the theory that the virus has mutated and somehow become weaker in Pakistan doesn’t hold true. “There is no evidence for that”. But what could be true is that we have much greater exposure to viruses as babies growing up in the Subcontinent (which explains the low death rates in the region). “We are exposed to heavy duty infections so we develop immunity. COVID immunity is through a mechanism called T Cells which provide us with non specific immunity and protect us”. However, this is still speculation although we have some studies showing that the BCG vaccine (mandatory for TB in Pakistan) could have played a role in our stronger immunity.

In the end, he said, we can certainly be proud of our coordinated response in controlling the pandemic and the smart lockdowns certainly helped to prevent the virus from spreading. Unfortunately, the NCOC will soon be disbanded according to Dr Adnan. The data analysts will go back to their regular jobs as the pandemic winds down in Pakistan. “You have to give credit where credit is due. The NCOC did a good job in making sense of the data and coordinating different actors”

Could there be a role for a centralised unit like the NCOC run by civilians in the near future? What about the climate challenges such as floods and droughts? “Yes, we do need a unit that uses data to make good decisions. This data unit can certainly be applied to other programmes that are much needed in this country like family planning, HIV, immunisation or even climate change and water conservation”.


Photograph of Rina Saeed Khan

Rina Saeed Khan

The writer is an award-winning environmental journalist based in Pakistan. She holds an MA in Environment and Development from SOAS in London as a Chevening Scholar and received the Earth Journalism Award in Copenhagen in 2009 for her climate change reporting.

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