Corona and clergy - The missing link for effective social distancing in Pakistan: Time for some unpopular decisions.

Religious congregations have resulted in an explosive spread of COVID-19 in many countries. At one stage, more than half of the COVID-19 cases in Malaysia had been infected during a congregation of 16 000 believers from 30 countries (Beech, 2020). For weeks, the clergy in Iran refused to accept a ban on gatherings of pilgrims in holy shrines until the virus had crossed the borders of neighboring countries (Ziabari, 2020). Tableeghi Ijtima (an annual, international Muslim missionary gathering) in Raiwind, Pakistan became a super-spreader of the virus due to the ‘stubbornness of the clergy’, which opposed the closing of the congregation; however, it subsequently agreed to curtail the 6 days event to 3 days. Later, when cases surged in those attending the congregation, Raiwind was sealed off and declared a hotspot. More than half of the cases in Punjab (the most affected province) had emanated from the Raiwind congregation (Table 1 ) (Government of Pakistan, 2020).

Table 1

Number of COVID-19 cases in Pakistan, based on data available on April 20, 2020

Province/Federal	Confirmed COVID-19 cases
	From Tableeghi Ijtima Raiwind	Pilgrims from Iran	Others	Total cases	Total deaths	Total recoveries
Punjab	1531	701	1489	3721	42	702
Sindh	658	280	1599	2537	56	625
Khyber Pakhtunkhwa	–	–	–	1237	67	267
Balochistan	–	148	284	432	5	152
Islamabad	–	–	–	181	3	20
Gilgit-Baltistan	9	22	232	263	3	194
Azad Jammu and Kashmir	–	–	–	49	0	10
Pakistan	2198	1151	3738	8420	176 (2.09%)	1970 (23.39%)

Pakistan's case is of concern due to its fragile healthcare system, poor hygiene practices, limited access to healthcare, and a steep rise in the number of local cases in a population bigger than Italy and Iran combined. Evidence supports the substantial impact of social distancing as a viable practice for containing the spread of the virus (Koo et al., 2020). However, the successful implementation of any social practice requires public support. In Pakistan, the practice of social distancing has remained poor due to a lack of support from the clergy, which influences religious congregations as well as the wishful beliefs of the public. Mosques are auspicious in Muslim societies, where congregations held five times a day. The public and clergy perceive closing of mosques as a bad omen or anti-religious bias, and view the pandemic as a sign of God's rage that can only be appeased by collective prayers. However, when places of worship can aid the spread of COVID-19, the clergy needs to rethink its religious perspective on congregations and convince the public to keep the faith not the germs.

Pakistan's clergy remains opposed to restrictions on mosques, and has pressurized the government on grounds of religion. As a result, Pakistan's lockdown policy involves a ban on public gatherings, but excluding congregations in mosques (Sajid, 2020). This defies the logic of social distancing and will undermine previous efforts to contain local transmission, leading to an indomitable public health risk. The preposterous proposal of the clergy to control and organize the influx of people at each mosque is as vague as the initial idea of voluntary social distancing.

Amid the pandemic, other Muslim countries have taken unconventional, yet exemplary decisions. For instance, across the Middle East, Friday prayers have been cancelled in mosques. For the first time in modern history, Saudi Arabia has closed Mecca, the spiritual center of Muslim world, and cancelled the Umrah pilgrimage. In Kuwait, Adhan (call for prayer) — an element of Islam that has remained unchanged for centuries — has undergone a slight tweak, with the muezzins replacing ‘hayya alas-salah’ (‘come to prayer’) with ‘as-salatu fi buyutikum’ (‘pray in your homes’) (The Economist, 2020).

WHO has warned that ‘the worst is yet ahead [of] us’. Pakistan is now facing the challenge of implementing social distancing in the holy month of Ramadan (April 26), when attendance at mosques increases many-fold for daily prayers and Tarawih (an additional prayer in Ramadan). This will be followed by the month of Hajj (the pilgrimage to Mecca and the largest gathering in the Muslim calendar). During this time of uncertainty, the public needs an unequivocal narrative on social distancing and congregations. This is a critical time for the government, which needs to make some unpopular decisions in order to prevent the situation getting out of control.