Background: The 2019 novel coronavirus disease (COVID-19) has spread to more than 213 countries and as of 17 April 2020, 1,995,983 confirmed cases and 131,037 deaths have been reported globally. Pakistan sharing border with China and Iran, having a high frequency of travel and trade , has been at risk of viral transmission. Methods: We examined the current state of the COVID-19 epidemic and Pakistan's preparedness, using publicly available data and documents on the COVID-19 government dashboard.

BACKGROUND The 2019 novel coronavirus (SARS-COV-2) originated in the central Chinese city, Wuhan by end of December 2019.Pakistan reported its first 2 confirmed cases,on26th February 2020 linked to travel history of Iran. OBJECTIVE The study was conducted to see the trend of covid infection growth and doubling time in Pakistan from an early containment state to much belated exponential rise pattern . METHODS This study is based on analysis of the publicly available data on COVID-19 from Ministry of National Health Services Regulations and Coordination covid-19 dashboard and National Institute Health Islamabad(NIH) situation reports from 26th Feb to 30th March2020. RESULTS A total of 1875 COVID-19 patients has been reported with 25 deaths,11 critically ill and 58 recoveries. Punjab has highest number of confirmed cases (593)Sindh(508),Khyber Pakhtun Khawa (195) Baluchistan(144)Gilgit Baltistan(128),Islamabad Capital territory (51) Azad Jammu Kashmir (6). Majority of effected patients are male(64%).Iran Zairian are making 49% of positive patents Local transmission cases stands at 29%.Daily cases surge is 12.3% increase per day. 30th March 2020 witnessing highest reported cases so far (240 new Cases). Pakistan reached its first 100 confirmed cases on 16th March,2020,20 days after first reported case. The case doubling time was 3 days initially after first cases then it was reported as three days and then five days till 30th March 2020 CONCLUSIONS Grave mishandling, lack of quarantine facility and limited testing capacity at Taftan border crossing resulted in importation of virus in country.Cumulative confirmed case count in Pakistan is still in sub-exponential growth pattern. Stringent risk mitigation measures by provinces and Federal being implemented have resulted in slow rate of infection growth with reduced infection doubling rate in days. Pakistan with limited testing capacity of 2000-3000 tests per day needs Extremely comprehensive testing regime is required to halt the community transmission leading to exponential increase in cases.

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