Public Cooperation Key to Curbing Pandemic
The Government’s battle against the Coronavirus pandemic continued this week with a short break in travel restrictions, allowing the general public to obtain food and other essential items but the war against the disease is far from over, with daily deaths and the number of infections still causing concern.
The travel restrictions, which were lifted at 4 a.m. on Monday June 21 were re-imposed at 10.00 p.m. yesterday (Wednesday). Thereafter, they are due to continue at least until 4 a.m. on Friday but these decisions will be subject to an ongoing review.
On public transport, passengers were limited to seating capacity. It was mandatory for every person to wear a face mask. Public meetings, gatherings, ceremonies, trips and pilgrimages were not permitted.
Further restrictions were imposed only in the Western province. The country’s most populous province is also the province with the most number of infections. There, public transport was restricted to those employed in essential services and those employed in any non-essential services were allowed to report to work for only two days per week.
The response of the general public to the lifting of restrictions was being monitored closely. Army Commander General Shavendra Silva who also heads the Presidential Task Force on Covid-19 urged the public to conduct themselves in a responsible manner.
“We are still continuing to report a high number of patients, so the public is urged to behave responsibly. We urge people to leave home only if necessary, as the lifting of restrictions should not lead to an increased spread,” General Silva said. “If this does not work out as planned we will have to take alternate decisions again,” he cautioned.
The lifting of restrictions was accompanied by a set of guidelines issues by the Director General of Health Services Dr. Asela Gunawardena. These guidelines spell out in detail the number of persons that are allowed in different institutions such as grocery shops, bakeries, banks, supermarkets, restaurants and courts and also in private and hire vehicles.
Challenging task
The imposing of restrictions and then lifting them even temporarily has been a difficult and challenging decision for the Government which needs to strike a balance between sustaining the country’s economy at a functional level while at the same time ensuring that the health needs of the country are met in the face of a rampaging pandemic.
The statistics from the health sector have not provided any reason to be complacent. The average number of daily infections appears to have reached between 2,000 and 3,000 per day while about 50 daily deaths on average have been attributed to the Coronavirus over the past few weeks.
This is despite the imposition of strict restrictions which had significantly hampered output from the services and manufacturing sectors. Employees in these sectors continue to receive wages but their employers will not be able to sustain them indefinitely without sufficient productivity.
Herd immunity
On the other hand, the health needs are so dire that completely ‘opening up’ the country raises the prospect of mass scale infections and invariably, more deaths. Countries such as the United States and Britain which initially adopted this model had to revert to a ‘health before economy’ policy which can be reviewed only after a significant percentage of the population has been vaccinated to achieve some sort of herd immunity.
This is why the country’s premier medical body, the Sri Lanka Medical Association (SLMA) urged caution in ‘reopening’ the country after the prolonged period of travel restrictions. “The country is still experiencing more than 2,000 new cases and around 50 deaths every day. To complicate this situation further, there is also evidence of the Delta variant (Indian origin) of the COVID-19 virus being prevalent in the community. This variant is fifty per cent more transmissible than the currently dominant variant,” the SLMA pointed out, in a letter addressed to President Gotabaya Rajapaksa.
“Accordingly, a release of the current lockdown even for a few days will lead to the uncontrolled free movement of the people and would thereby lead to an alarming increase in transmission, with the rapid spread of the new variant. The pandemic will thereby escalate to an unprecedented level, causing increasing numbers of cases and unacceptable mortality on a scale that could completely overwhelm the health system,” the SLMA said.
In the interim, the brief easing of restriction on June 21 was aimed at providing some respite to the public to obtain food, medicines and other essential items and services. The Government was hopeful that the short window period allowed to the public would be utilised responsibly, so as not to aggravate the current health crisis.
The battle against the pandemic was also not without controversy last week. This was because discrepancies were observed between figures released by the Epidemiology Unit of the Ministry of Health and the parent Ministry itself. This inconsistency was noted and brought to the attention of President Gotabaya Rajapaksa who recently presided over a meeting of the Presidential Task Force on Covid-19.
The differences led the President of the Government Medical Officers’ Association (GMOA), Dr. Anuruddha Padeniya to claim that this was because of a ‘conspiracy’. The Director General of Health Services Dr. Asela Gunawardena acknowledged there were discrepancies in some statistics but said there was no evidence to suggest a ‘conspiracy’ as such.
Subsequent to these developments however, the Head of the Epidemiology Unit, Dr. Sudath Samaraweera has been re-designated as the Head of the Dengue Control Unit of the Ministry.
COVID-19 vaccination
Meanwhile the Government is also focusing on accelerating the COVID-19 vaccination drive which is now in progress in various parts of the country. The districts of Colombo, Gampaha, Kalutara, Kurunegala, Puttalam, Batticaloa, Anuradhapura, Kandy, Badulla and Kegalle have been accorded priority and vaccination is progressing in 51 centres in these 10 districts. The venues have been notified in the media and the public is urged to attend and obtain their vaccinations.
In a boost to this campaign, leading vaccine manufacturer Pfizer will dispatch 25,000 doses of its vaccines to Sri Lanka before July 10 to initiate mass inoculation, State Minister of Production, Supply and Regulation of Pharmaceuticals Prof. Channa Jayasumana said. Pfizer is expected to deliver 300,000 doses altogether next month. The initial doses will be a ‘trial’ as this vaccine has a different cold chain requirement of -70 Celsius, Minister Jayasumana said.
Sri Lanka will also receive a slice of the 16 million vaccines being distributed by the United States to the Asian region, alongside other nations such as India, Nepal, Bangladesh, Pakistan, Afghanistan, Maldives, Bhutan, Philippines, Vietnam, Indonesia, Thailand, Malaysia, Laos, PNG, Taiwan, Cambodia, and the Pacific Islands. The exact number of vaccines designated for Sri Lanka is not known at this time.
The need for vaccination was highlighted by health experts who note with concern that the more infectious Delta variant of the Coronavirus may now be circulating in Sri Lanka. Deputy Director of Health Services Dr. Hemantha Herath said that the health authorities are still not clear on how the Delta variant entered Sri Lanka. The variant was first detected in Dematagoda and there is now a suspicion it may have spread to other areas as well due to its high transmissibility.
Increased PCR and Rapid Antigen Testing (RAT) as well as genome sequencing of samples are being carried out in areas that are deemed ‘high risk’, officials said. There were also reports, as yet unconfirmed, that another case of the variant was detected in the Madiwela area. This patient is now undergoing further testing.
However, experts were also urging the public not to panic but follow simple public health precautions. Prof. Neelika Malavige of the Department of Immunology and Molecular Medicine at the University of Sri Jayewardenepura, while noting that the Delta variant is considered to be the most dangerous variant among the Coronaviruses, requested the public to follow health advice diligently.
“It is vital to strictly follow health guidelines such as wearing a mask properly, maintaining social distancing and washing hands regularly,” Prof. Malavige said. “Observing these measures and receiving two doses of any vaccine can protect people from any variant,” she advised.
In the weeks to come, the Government is likely to work out a strategy that will encompass safe health practices and limited economic activity while at the same time minimising the further spread of the pandemic. How this is done will depend on the success - or failure - of the limited release of restrictions within the past few days as well as the progress of the vaccine rollout in the country.
The vaccine rollout is at present limited by a lack of adequate supplies but this situation is likely to improve over the next few months. Until then, much will depend on how the public will comply with the requests that are made from them to follow safe health practices. As Sri Lanka is considered a health literate and educated society, the country could look forward to more easing of restrictions and relative normality towards the latter part of this year - but only if the public act with a sense of utmost responsibility.
The vaccination drive in progress. Picture by Sulochana Gamage
source http://www.dailynews.lk/2021/06/24/features/252309/public-cooperation-key-curbing-pandemic
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