Authorities have reimposed restrictions in high-risk areas of Pakistan as of Oct. 29, citing a 'second wave' of coronavirus disease (COVID-19) infections. Restrictions are mainly in place in multiple urban centers such as Gilgit-Baltistan, Hyderabad, Islamabad, Karachi, Lahore, Mirpur, Muzzafarabad, Multan, Peshawar, Quetta, and Rawalpindi. Officials have closed some nonessential businesses in such areas; while Islamabad authorities are restricting public gatherings of more than five people through December, other localities may see movement and transport restrictions. Authorities could limit entry and exit into high-risk areas. Measures are typically imposed for two weeks but may be extended. Local governments are allowed to ban nonessential activity and movement in identified high-risk areas.

Outside of high-risk areas, officials continue to tighten restrictions across the country. As of Oct. 29, authorities have intensified enforcement of social distancing measures and the wearing of face coverings in public; violators may be subject to fines and arrests. Entertainment venues must close by 1800, while shopping malls, markets, and wedding halls may operate until 2200. Only essential shops may function after 2200. Although educational institutions are permitted to reopen with social distancing measures, many schools and universities have closed in the past weeks due to COVID-19 cases. Large gatherings are mostly banned and subject to official approval; wedding events must only last for two hours, end by 2200, and consist of up to 300 guests for indoor venues or 500 guests for outdoor venues.

Public and private transport services have resumed nationwide, though seating restrictions continue at the provincial and local levels in some areas. Domestic and international flights from all airports are allowed, though flight availability remains restricted due to decreased demand and restrictions on travel from Pakistan imposed by foreign countries. Regional variations in rules are likely to continue; reports indicate generally poor adherence to and enforcement of guidelines across the nation.

Travel Restrictions
Authorities have permitted the resumption of international passenger flight operations at all international airports in the country as of Oct. 29. However, flights are severely restricted in number and routes due to low demand and travel restrictions imposed by foreign governments on Pakistani citizens and air carriers. Cargo, charter, and repatriation flights are also operational. All incoming travelers to the country, including Pakistani nationals, must self-isolate for two weeks if they have no COVID-19 symptoms. Symptomatic passengers are mandated to undergo testing and a 14-day quarantine at home, paid accommodation, or a medical facility, based on health assessments.

Land border crossings with Iran and Afghanistan are open for trade - mainly of essential goods - and exchange of stranded citizens. However, cargo transit continues facing intermittent disruptions, mainly along the Afghan border due to protests over the permitted number of vehicles and passage of people. The Attari-Wagah border with India remains closed, except for repatriation and transit trade with Afghanistan. Suspension of bus and train services between India and Pakistan will continue until further notice.

Authorities could reimpose, extend, further ease, or otherwise amend any restrictions with little-to-no notice depending on disease activity over the coming weeks.

Background and Analysis
The measures adopted by the government are similar to actions taken by other regional governments in recent days in response to the spread of COVID-19. COVID-19 is a viral respiratory disease caused by infection with the SARS-CoV-2 virus (previously known as 2019-nCoV). Symptoms occur 1-14 days following exposure (average of 3-7 days). These symptoms include fever, fatigue, cough, difficulty breathing, sometimes worsening to pneumonia and kidney failure - especially in those with underlying medical conditions. On March 11, the WHO declared the ongoing COVID-19 outbreak a pandemic.

Confirm travel arrangements. Follow all official instructions. Abide by national health and safety measures. Reconfirm all business appointments, deliveries, and travel arrangements. Liaise with trusted contacts for further updates and guidance. Maintain contact with your diplomatic representation. Ensure contingency plans account for further disruptive measures or extensions of current restrictions. Reconsider and reconfirm nonemergency health appointments. Ensure access to essential items. Avoid all large gatherings; heed security and traffic advisories.

Emphasize basic health precautions, especially frequent handwashing with soap and water, or an alcohol-based hand sanitizer if soap and water are unavailable. Practice good coughing/sneezing etiquette (i.e., covering coughs and sneezes with a disposable tissue, maintaining distance from others, and washing hands). There is no evidence that the influenza vaccine, antibiotics, or antiviral medications will prevent this disease, highlighting the importance of diligent basic health precautions.


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