Based on a year-long study involving interviews and surveys among low-income households in Karachi and Lahore, this article describes how participants articulated their experience of the pandemic through ideas of ‘chronicity’ which consisted of poor material conditions, longstanding health problems, and the risks of COVID-19 infections. I consider the bundling of the three elements in relation to the Pakistani state’s imposition of social distancing regulations through its security infrastructure which resulted in reinscribing social differences based on class and religion. Through ethnographic research, I consider how the centrifugal forces at play in the cities at large were negotiated in kinship as members came together during times of illness and emergencies, and conversely, when care to intimate kin was neglected as social distancing practices were taken up selectively in a way that overlapped with deep seated hostilities within families, resulting in further impacting the health of the vulnerable in the absence of adequate health services.