Pakistan is a developing economy with limited resources to deal with a disease out- break or pandemic. As the number of cases continued to increase, to prevent disaster in terms of burden on the healthcare system and massive loss of life, the government slowly started imposing restrictions in dif- ferent provinces on March 15, 2020. Ini- tially, educational institutions were closed and then restrictions on unnecessary move- ments across cities were imposed (Sarwar et al., 2020). Forced lockdown was imposed on March 24, 2020, and work-from-home was implemented, educational institutions went to online learning, and shopping malls and markets were closed except for essential gro- cery stores and pharmacies. Lockdown decisions are a trade-off between people’s health and the economic prosperity of a country. In Pakistan, 24% of the country’s population lives below the poverty line and according to the Multidi- mensional Poverty Index, 39% of the popula- tion is poor. During 2015–2017, 21% of the country’s population was undernourished (Mamun & Ullah, 2020). To help these pop- ulations, especially “daily wagers,” and to keep the economy from collapsing, the gov- ernment slowly began easing the lockdown around May 9, 2020 (Rasheed et al., 2021). After this time, partial or smart lockdown was in place, which meant that educational institutions and the majority of offices were closed, and markets were allowed to open only during a specific time window in the daytime (Sarwar et al., 2020). All restric- tions related to COVID-19 were lifted by the government in March 2022 following the vaccination of a majority of the population and a decline in active cases. Pakistan is the most urbanized among all countries in the South Asian region and its ambient air quality is worsening. Air pollu- tion has been reported to cause 11 million premature deaths in the Pakistan (Ullah et al., 2021). The country ranks third in the most number of deaths due to air pollution, after China and India (Iftikhar et al., 2018). Particulate matter is a major atmospheric pollutant responsible for adverse effects on human health, climate, and visibility. It is produced through various processes such as industrial emissions, fuel burning, and bio- mass burning. With a vehicular growth rate of 11% per year, the number of vehicles on
Map of Pakistan Identifying the Selected Cities FIGURE 1
FIGURE 2
Comparison of the Monthly Average of PM 2.5 for the Selected Cities in Pakistan
January 2020 February 2020 March 2020
April 2020
May 2020
Month
Karachi
Lahore
Islamabad
Peshawar
17
January/February 2023 • Journal of Environmental Health
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