Sri Lanka’s Covid time bomb has started to explode. There has been an exponential rise indaily infections which are currently averaging at around 3000 cases and the number of daily deaths have risen. On the 13th of August, a total of 155 deaths were reported island wide. However medical experts have warned about the discrepancies in figures which are underreported by at least 30 -40 percent. Aftertheir 5th meeting on the 10th of August the Independent Expert Group, a collective of immunologists, community and public health and other specialists which assesses the country’s Covid situation, said Sri Lanka is facing an unprecedented health crisis. They called for critical measures to be taken to heighten current mobility restrictions to what they were earlier in May and June, for four weeks. This is not a big sacrifice. According to the Independent Expert Group it will avert the deaths of 18, 000 people. If not, Sri Lanka’s cumulative death toll by January 2020 will be 30, 000. They also predict that daily infections will rise to 6000 up to mid- September and that daily deaths will keep rising to peak at 220 by early October. The number of daily ICU admissions will peak at around 275 by early October to overwhelm an already burgeoning health care system. The Independent Expert Group bases its warnings on projections carried out by the University of Monash in Australia in collaboration with the WHO Regional Office for South-East Asia and its country office in Sri Lanka. The data on cases and deaths which they used was that of the Epidemiology Unit of the Ministry of Health. Although the choice would have been a stark one for many, it does not appear to be so for the government. It’slukewarm response on Friday evening was to revive the inter provincial travel ban. In the first place, it is yet unclear if the inter provincial travel ban which was introduced in May was completely lifted. Essential service providers in the health sector, the tri forces and workers in the garment and agriculture sector are exempt from the latest travel restrictions. Like the legend of Nero fiddling while Rome burnt, thescenario being enacted is once again a familiar one as the government carries on oblivious to the warnings of medical experts and the thousands who are succumbing to the virus. The fixation on the economy is coming at a cost and nor is the ongoing vaccination program sufficient justification not to have a lockdown. Whether it is a case of save lives and save the economy or save the economy and save lives, either way the man on the street is damned.
There has been a lot of collective crying over spilled milk but the lessons are yet to be learnt.
Samagi Jana Balawegaya MP Mujibur Rahman told parliament at the end of this week how the government failed to shut down the Bandaranaike International Airport (BIA), the only entry point to the country, when the pandemic was taking hold of the world last year. Coupled with some beefing up of the navy patrols to stop Indian fishermen from making incursions into Sri Lanka, it would have gone a long way to stop the pandemic from ravagingthe country as it is now. Early this year when news spread of the havoc the delta variant was causing in India, the government was complacent. There were no measures taken proactively to prevent the strain from entering the country. Instead, the BIA was kept open and tourists, including those from India, were being welcomed with Sri Lanka marketed as a destination for quarantine tourism. When the BIA was eventually shut down at the end of April, the country was in the throes of the alphavariant, the result of the excess of the New Year celebrations. The public had been allowed a free for all so that businesses could benefit and fill their coffers. It ended with hordes of shoppers thronging public spaces and before long the New Year cluster was born. The opportunity cost proved to be high. It was only after repeated pressure by medical experts and health unions that a recalcitrant government announced travel restrictions, which have now become aneuphemism for a lockdown, in May. This period was used to bring in unpopular reform like the overnight ban on the import of synthetic fertilizer to transition to organic farming. The government also put the onus on the people for its poor enforcement of travel restrictions and kept extending the lockdown to keep the farmer protests at bay. Nevertheless, the travel restrictions paid off somewhat. Among the contents of a statement issued by the Association of Medical Specialists on 2 June was the line that they were convinced of the benefits of the lockdown even though it was too early to see a visible impact on the healthcare system. By mid- June the travel restrictions were partially lifted leaving in place only the inter provincial travel restrictions although these too were loosely enforced. The relaxation could not have come at a worse time. It was almost immediately after the detection of the delta variant in the community. The country was also grappling with the third surge which wasdominated by the alpha variant. Speaking to the Hindu at the time Dr Chandima Jeewandara, the Director of the Allergy Immunity and Cell Immunology Unit at the Sri Jayewardenepura university where genome sequencing is done,said the timing of the discovery of delta was the worst that could have been imagined. By 2ndAugust, when delta was raising its head, the government recalled state sector employees back to work. It prompted the Association of Medical Specialists to issue another statement one day later about an impending disaster and the ill– timed relaxation of the travel restrictions. Against the backdrop of an ‘exponential rise in the number of oxygen dependent cases because of the delta variant being commonly detected,the relaxation of Covid restrictions is adding fuel to the fire’ their statement said. While acknowledging the challenges with livelihoods, it went on to add that the relaxation should have taken place four to eight weeks from then (the3rd of August) and urged the government to ‘revisit the Covid restriction protocols in the wake of surging numbers.’ They concluded their statement with what they called a famous medical quote that its better to have a ‘living problem than a dead certainty’.
Responsibility is reciprocal and in this case the government has failed abysmally to give leadership in the country’s crisis. With the medical experts holding its hand it takes one step forward but shakes it off and takes two steps back. The repeated revocations of gazettes notices, regulations and reversal of decisions and the mismanagement of the Covid response including the release of inaccurate data, has made it lose its credibility and created a trust deficit between it and the people. The chasm keeps widening with every reset because it’s one too many.
Even though it’s the proverbial case of shutting the stable door after the horse has bolted, health experts recommend handing back leadership of the presidential task force on Covid response to the health sector. One senior medical expert who is recommends the setting up of a multi- disciplinary team of medical and non -medical experts including social scientists, psychologists and communication specialists to deal with the crisis from now on. This team can be reinforced with economic experts to assess the socio –economic implications of Covid control measures. The appeal to all political parties is to hand over the reins of the Covid response to these specialists for at least one year.
Another recommendation is to have a devolved model down to the MOH level which is the basic primary health care unit in the country. There are 307 MOH units throughout the island. Together with civil society organisations and local NGO’s, these MOH units can lead the way in the early detection of Covid cases, quarantining and testing and raising community awareness about the virus.
What will also be critical is to have a social safety net at the level of the individual household when there is a local lockdown. This can include measures such as involving neighbours in the care of the needy and providing relief, such as dry rations, to the vulnerable. It will also require a fresh approach towards the socio economic recovery of especially the small and medium sized enterprises including linking them up with banking services for advice and emergency grants.
