Islamabad, Pakistan - The World Health Organization (WHO) has recommended that Pakistani authorities reimpose a strict, intermittent lockdown targeting localities with high coronavirus spread, as cases in the South Asian country increase exponentially since most restrictions were lifted last month.
In a letter sent to the provincial governments on Sunday, WHO Pakistan chief Palitha Mahipala said the country did not meet any of the organisation's six technical criteria for easing a lockdown.More: The curious case of South Asia's 'low' coronavirus deaths In Pakistan, mosques become coronavirus battleground issue Pakistan coronavirus: Concerns grow over use of low-quality masks
"As of today, Pakistan does not meet any of the pre-requisite conditions for opening the lock down," says the letter, shared with Al Jazeera on Wednesday.
Pakistan's government, led by Prime Minister Imran Khan, had imposed lockdown restrictions of varying strictness in different provinces, but lifted most measures in late May, ahead of the Muslim festival of Eid al-Fitr.
The lifting of restrictions ushered in a skyrocketing of reported coronavirus cases, with daily infections rising from about 1,700 per day before the relaxation to 5,385 new cases on June 9, a single-day record.
So far, five of the nine days in June have posted single-day case increase records.
Pakistan currently has 113,702 cases of the coronavirus, with 2,312 deaths recorded so far, according to government data.
In its letter, the WHO said Pakistan's rate of coronavirus-positive patients was too high (24 percent), indicating that not enough testing was being done.
The global body recommended that Pakistan ramp up daily testing to more than 50,000 per day.
Current testing capacity is about half that number, with 23,799 patients tested for the coronavirus countrywide on Tuesday, according to government data.
The WHO also said the country's surveillance system to identify, test, isolate, medical care and contact tracing was "weak".
"There is limited capacity to provide critical care [only 751 ventilators are allocated for COVID-19] and the population is not ready to adapt to change behaviour," Mahipala wrote.'Lockdowns aren't a solution'
Prime Minister Khan has long resisted reimposing any lockdown measures, ruling out the possibility in remarks made earlier this week.
"Although lockdown restrictions slow down the spread of the virus, we must also realise that Pakistan is a poor country and that we had no choice but to reopen the country," he said in a televised address to the nation on Monday.
"The entire world has understood that lockdowns aren't a solution."
The WHO's letter included modelling of projected cases based on various forms of lockdown. Imposing a two-weeks-on and two-weeks-off cycle of restrictions would bring Pakistan's estimated case peak down to about 400,000 cases.
Continuing on the current path, the model projects, would result in more than 800,000 infections at the peak of the virus' spread.
"These difficult decisions will require the need to balance response directly to COVID-19 which includes intermittent lockdowns of targeted areas ... as a first option and should be dealt on a priority basis, while simultaneously engaging in strategic planning and coordinated action to maintain essential health service delivery, mitigating the risk of system collapse," the letter says.
Doctors at major hospitals in three major Pakistani cities told Al Jazeera they were approaching or had reached their capacity for treating COVID-19 patients in isolation and intensive care wards.
Political opponents have criticised Khan's response to the crisis, with the Pakistan People's Party - which controls Sindh province - in particular calling for stricter restrictions to be imposed.
"WHO letter to Sindh government raises valid concerns and suggestions," said Bilawal Bhutto Zardari, chairman of the PPP, in a tweet.
"Will be discussed by Sindh govt before being taken up at national level. We've long called for national policy to be linked to facts and our own capacity."
Provincial chief ministers will hold a virtual meeting with the Prime Minister's National Coordination Committee on the coronavirus response to discuss the WHO's recommendation on Wednesday.
Asad Hashim is Al Jazeera's digital correspondent in Pakistan. He tweets @AsadHashim