The data of the first four waves was targeted and data ranges from 1st April 2020 to 25th August 2021. The data was taken from the website of NCOC. The analysis of the data was done by the use of SPSS software.

Three important factors were turned up after the analysis. The first factor is the testing capacity, it is important to consider the actual number of reported cases by the country. If fewer tests are performed, we are unable to detect the actual number of cases. The fig. 3 shows that the testing capacity of the country. In the fourth wave duration the maximum tests were performed as shown in figure in 3 (d) and the highest mean value is 48558.85. Testing capacity was improved with the passage of the time. The next part of the data deals with confirmed cases that was reported during the pandemic. The confirmed cases are pivotal to understand, so that the infectious person can be traced within the community. The highest number of positive cases was reported in the third wave and the mean value is 3713.47 cases. It is shown in figure 4.

The death rate is critical to understand because it is the percent of people that lost their precious lives from this virus. The mutated virus strain is dangerous as it increases the death rate of the community [10]. As time passes, there is a significant increase in the mutation as well as in death rate of the citizens. The highest death rate is observed during third wave of COVID-19 in Pakistan.

The average death rate during 3^rd wave is 86 deaths per day as shown in Fig 5 (a and b). The extreme values of death rate were noted during the first wave period. By the data analysis, there is a correlation between the number of cases and time. As time passes the new wave has more impact than the previous ones. The second wave is more dangerous than the first. The third one is more than the second; likewise, the fourth wave has a high impact of spreading infection.

Figures & Tables

Discussion

There are many factors affecting the rate of spread of the infection and some of them are discussed here [10]. The government and citizens are responsible for controlling the rate of the infection. The government imposes a lockdown to control the spread rate. The smart lockdown was imposed in May 2020 in Pakistan [11]. A similar study reported in India that lockdown decreases the case of infection [14]. This case shows the lockdown is effective [13]. Social interaction plays a crucial role in the spread rate. Social interaction is of two types one is interaction within different countries and second is interaction of people among same country. A study reported that Sudan has more interaction during  trading of basic commodities, hence there is huge number of cases. A similar case was reported in Pakistan at the funeral ceremony of, Khadim Hussain Rizvi died where two hundred thousand people gathered [12]. This increases the rate of infection [13].

The spread rate of the country is independent of the temperature as reported in Brazil [14]. The low temperature is also independent in several cases [15]. The mutation rate is very high in this virus naturally. The RNA-based genome viruses are less efficient so there are high chances of mutation. The RNA-dependent RNA polymerase incorporates more error in the genome. This causes high mutation in the genome of the virus. The mutation in the genome arises various number of strains, some can be more dangerous as they are resistant to previous treatment [7]. Delta strain in the world is more infectious as compared to beta strain. The new strain of coronavirus that is the beta strain spread in the UK rapidly [16]. This strain was also observed in different parts of the world. This strain is highly contagious and spreads swiftly in the world [9]. The UK has started the lockdown in the country to overcome the rate of spread from this strain. The virus has mutations in the amino acid sequence that are necessary for the spike protein of the virus. This is 56% more contagious than the previous strain and can be more dangerous as shown in fig 6. There is the highest number of deaths recorded in the country, that is one hundred and eleven deaths. Pakistan restricted travel from the UK to protect us from viruses. This shows the more mutated virus can be more lethal for humans. The death rate in Pakistan is lower than in other countries because the Asian countries have already experienced SARS-CoV-2 viruses. People living in this region have already immunity against this virus.

Pakistan has a limited diagnostic test for the country. The biggest reason for the lower number of cases in-country is less testing of people. India is conducting 18831 test people per million while in the US 202106 test is conducted per million. Pakistan is conducting 9878 tests per million which is very low as compared to other countries [11].

Test reporting is a way that helps to know about the cases in the country. The vaccination rate is important to be considered these days. The most effective way of prevention is vaccination. The report gives results show that in the US, Asia, Europe, Africa, South America, and the World will reach 139 million, 109 million, 127 million, 8 million, 38 million, and 441 million people will be fully vaccinated on 1 June 2021, respectively [17]. By 21^st February 2023 there are 132,485,851 people fully vaccinated in Pakistan. 139,735,015 people are partially vaccinated. The total number of vaccines administrated in Pakistan is 303,864,046. 50,114,329 encounter the booster doses. The data is taken from the NCOC website [8]. In Israel, after having a booster dose of vaccination, author reported decrease of immunity from 90% to 40%, this could be due to delta variant [22]. The vaccinated people become asymptomatic especially who are above 60 years old. The vaccinated people have a smaller number of infections than unvaccinated people [23]. The vaccination also decreases the severity of disease as reported in Israel [24]. The similar study was reported in China that fully vaccinated people have less chance of getting infection as the antibody is created. In China the use of the herbal medicines is helpful in treating the patients that are Lianhua Qingwen and Arbidol Hydrochloride. This study reports 98% recovery, so the treatment of affected individuals is required with care of vaccination [25].

The strategy for controlling the positive cases is education about the infection and transmission of disease in the general population. The proper use of masks and sanitizer with PPE can protect the transmission of disease from paramedical staff [2,25]. The major spread is due to a lack of tracing of patients and more social interaction of the patient with community[18]. The isolation of the patient and tracking the patient’s interaction is one of the keys that control the spread rate in months [2,19]. The patients that do not develop symptoms are more dangerous as it is stated earlier that females are more asymptomatic than males [20]. Social distancing is one of the key elements to cut off the transmission route of virus [21]. The vaccination of COVID-19 is necessary to control this disease. The booster doses of vaccines are also available in Pakistan. The people who are vaccinated by Sinovac or Sinopharm can take the booster dose of Pfizer to overcome the infection.

All factors play an important role in the spread of disease and there is need to overcome this spread by following the safety measures. Safety measures like vaccination and social distancing can prevent from this disease. The analysis of data shows the correlation between the factor of time and number of cases. Based on the above data the new waves appear early and have a drastic effect on the country. Concerning the current situation, the country has faced a huge loss faced. The mutation rate is high so the virus would be dangerous in the next waves. Vaccination should be promoted to overcome these cases. Vaccination can prevent the severity of the disease as the immunity was already generated against virus.              

Conflict of Interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

Funding

This research was funded by ORIC-FCCU with grant number IRIF-17

Acknowledgement

Authors duly acknowledge Director ORIC, FCCU Prof Dr. Kauser Abdulla Malik for funding the project and  Ex-Chairperson of KAM-SLS, Prof Dr. Samina Mehnaz, to facilitate in using bioinformatics lab.

Author Contributions

Muhammad Zubair Yousaf conceptualized and supervised the study, Rabia Zia & Zilwa Mumtaz, both collected data, performed experiments, did data analysis and reviewing manuscript, Zubia Rashid helped in computational analysis and Ashaq Ali was involved in proofreading the manuscript.

References