KARACHI, Pakistan — Doctors are refusing to show up for work. Clerics are refusing to close their mosques. And despite orders to stay at home, children continue to pack streets across Pakistan to play cricket, their parents unwilling to quarantine them in crowded homes.

Pakistan is facing its biggest challenge ever: how to mobilize its broken state as the number of coronavirus cases rapidly spreads in the world’s fifth most populous country.

More than ever, the epidemic is showcasing weaknesses in the government, and the tensions between it and the country’s powerful military. Many within the country’s clerical establishment have refused to help, rejecting calls to limit mosque gatherings and bringing together at least 150,000 clerics from around the world this month in a religious gathering that helped spread the virus.

By Thursday afternoon, Pakistan’s cases had risen to 1,098, up from some 250 a week ago. Eight deaths have been reported. But many fear that the real numbers are much higher because of a lack of testing and, in some cases, suppressed information.

Already, Pakistan was struggling to provide electricity, water and adequate health care to its 220 million people. Diseases that have been controlled elsewhere, like rabies and polio, still persist here.

In recent weeks, as the coronavirus’s march across the globe was intensifying, Prime Minister Imran Khan played down its dangers. Pakistani officials bragged that the country was virus-free, but little was being done to set up testing anywhere.

Mr. Khan rejected calls from health care workers and provincial officials to enforce a lockdown, saying it would ruin the economy. Instead he urged citizens to practice social distancing and ordered everyone back to work, many returning to the sweltering, cramped factories that are the backbone of the economy.