Faithful attend Friday prayers at the Red Mosque in Islamabad during a government-imposed nationwide lockdown. AFP

A group of senior doctors in Pakistan and abroad have written a letter pleading with the country’s religious clerics and the prime minister to reverse a decision to leave mosques open during the Holy Month of Ramadan warning it could result in an explosion of COVID-19 cases saying numbers are already on the rise at an increased rate throughout the country.

Large gatherings will only worsen the numbers and overwhelm the health care system that has less than 3,000 acute care beds for a population of 220 million people, says Dr Qaiser Sajjad, secretary general of the Pakistan Medical Association and one of the authors of the letter.

The numbers are escalating at roughly 500 a day, he said, and the large gatherings at mosques during Ramadan is certain to overcome doctors and paramedics, he warned in an interview.

People offer Friday prayers at a mosque in Islamabad. AFP

They urged the government 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 by Indus Hospital CEO Dr Abdul Bari Khan, was also addressed to the ulema (clerics) 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.

The other day President Dr Arif Alvi 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.

The letter written warned that with mosques across Pakistan 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 Ramadan approaching, we would understandably expect higher number of 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 worshippers, 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.