A group of senior doctors in Pakistan and abroad on Tuesday wrote a letter to the government, urging it to review its decision to allow congregational prayers to be held in mosques and limit the prayers to 3-5 persons as it had done previously in view of the coronavirus outbreak.

The letter, the veracity of which was confirmed to Dawn.com by Indus Hospital CEO Dr Abdul Bari Khan, was also addressed to the ulema and business community. While thanking the government and ulema for developing a consensus over the issue, the letter listed the medical community's "strong reservations" over the decision to allow prayer congregations.

On Saturday, President Dr Arif Alvi had announced that neither the state machinery nor clerics would stop citizens from visiting mosques as the government accepted almost all demands of the clerics related to the holding of Friday, Tara­weeh and daily congregational prayers with the condition of social distancing and other precautionary measures.

Editorial: Efforts to curb congregational prayers should not be seen as an affront to religion

But the letter written by the doctors warned that with mosques across the country being filled predominantly by people over the age of 50, the risk of the virus spreading is high. It said videos that surfaced in the past 48 hours had shown that more than 80 per cent of the people attending prayers in mosques were mostly in their 60s and 70s.

"Clearly this has resulted in the violation of the first and foremost principle of preventing the spread of the virus in the most vulnerable group" of elderly people, stated the letter, which has been endorsed by the Pakistan Islamic Medical Association (PIMA).

"With Ramazan approaching, we would understandably expect higher number of namazis (worshippers) attending the prayers. Moreover, long Taraweeh prayers and waiting times will lead to prolonged gatherings. It is all but certain that this will cause significant mayhem, as the mosques practising social distancing will only be able to accommodate 20-25pc of the regular namazis, which will further worsen the situation," it added.

According to the letter, the mismanagement could also result in conflicts between worshipers, mosque administrations and law enforcement agencies, as observed in some areas of Karachi recently.

Hospitals in Karachi have started experiencing a "significant influx of corona positive patients", the communique revealed, adding: "We anticipate these numbers and resultant mortality to expand exponentially in the next few days."

"This will undeniably result in significant pressure on our already compromised health system."

The doctors explained that increased exposure to the virus increases the likelihood of getting infected and, as a consequence, of complications and death. "We fear that allowing congregational prayers in larger number in our mosques may contribute to such fatal outcomes," the letter stated.

It expressed the fear that all of the above issues will have the combined effect of jeopardising the "reputation of Islam and that of our ulema" and will lead to "unwanted loss of lives".

Noting that Pakistan is considered as a "fort of Islam", the letter said that the existence of the Muslim ummah is closely linked to the strength and progress of Pakistan.

"In these circumstances, if Covid-19 disease becomes an epidemic in Pakistan and the government loses control of its management in the country, it will not just be a failure of Pakistan as a country but it may have substantial unwanted and unforeseen effects on the whole Muslim ummah," the letter said.

It also cautioned that while doctors are ready to put their lives at risk, if healthcare professionals in Pakistan die as per the trend seen in other countries, "there won’t be many resources [left] including manpower to look after our patients".

'Indiscipline' of Pakistani society

The medics also clarified that Pakistanis "are no more immune to this virus than the rest of the world" , saying data released by the UK's National Health Service had shown that a vast majority of healthcare staff who died there due to Covid-19 comprised Asians including many Muslims.

They observed that the "social fiber" of the Pakistani society is one where "mismanagement, indiscipline and not following or obeying the rules is predominantly common [and] where [even] educated people do not follow the day-to-day traffic rules (for example) and miscommitment in our dealings is a norm".

With such habits and behavioural patterns, it is "almost impossible" for ulema, mosque managements and the administration to make people abide by the conditions mentioned in the consensus document of the government and the ulema, especially in densely populated areas of the country "where people are generally not educated and unable to comprehend the consequences of such violations", their letter stated.

It added that while the comparison between the opening of mosques with the opening of businesses and shops is "not valid", the doctors also requested the government and business community to "practice patience" and continue to keep markets and non-essential shops closed and only allow home deliveries from restaurants.

In the same vein, "any other worldly matters leading to public gatherings and interactions should also be curtailed in exactly the same fashion", the letter suggested, reminding that the novel coronavirus does not distinguish between people based on the nature of their activities but the strength, quantity and duration of their gatherings.

The letter was signed by the following doctors: