Health officials are putting in place measures to deal with the surge in the number of Covid– 19 positive cases following the fresh wave which has hit the country. Predictions are that the number of cases willrise in the coming weeks.
Preparations are underway to have 5000 more hospital beds and about 100-150 more ICU beds, which will affect its availability for patients with other illnesses.
Dubbed the New Year cluster, the fresh wave comes on the heels of the traditional Sinhala and Hindu New Year celebrations and holidays. The number of positive cases which were being reported daily soon after exceeded the 1000 mark for the first time. It currently averages at around 1500 and is expected to increasewhich will stretch the resources of the health services if their capacity is not upped.
‘Right now, the situation we are in is not a comfortableone’, said a well -placed health official. ‘If we do nothing about it and act the way we did during the new year period there will be serious consequences.’ People put their guard down and forgot to follow basic public health guidelines as they thronged public spacesand packed into shops and malls in the days before the new year.
The situation has become more worrying after Sri Lanka isolated the B117 variant which was first found in the UK, around the 6th of April this year. It wasdetected in about 150 samples which were sent for testing.
The B117 has a number of different properties. Its transmissibility is 30-40 times more, it affects the elderly and the young mostly and has different symptoms or sometimes could even be symptomless. Because it affects the lungs before symptoms start to show patients will need more oxygen to begin with, the implication being that more hospital beds and oxygen will be needed. Health officials are optimistic about containing the situation by May or June if at a minimum, basic public health measures are followed. What is required will be a multi stakeholder effort involving the government, health ministry, the people and the media on whom there is an onus to pass on correct messages to the public.
Sri Lanka’s Covid vaccination program has been in limbo after the first round of immunization of about 900, 000 front line health works, members of the armed forces, politicians and the vulnerable populationaged over 60. Opposition political parties say the delay to the second round of immunization is because the government mismanaged the vaccination program.
So far, the country has received about 1, 264, 000. 000 of the Oxford Astra Zeneca Covishield vaccine as a donation from India and the WHO’S COVAX facility. Another lot of vaccines which Sri Lanka received was part of an order from India which has to provide a further one million vaccines to complete the order. But with India struggling to contain the Covid cases on her doorstep, sources point out the question is ‘when’ will India be able to deliver the balance vaccines.
Until then, Sri Lanka is negotiating for the vaccine from the COVAX facility and from countries such as USA, Europe and Australia which have reserved but refused to use the Astra Zeneca vaccine. ‘The plan is to get about 300- 400 thousand of the Astra Zeneca vaccine to complete the second round and then start with the new ones’ said the source.
The vaccines which have been greenlighted for use in Sri Lanka by the National Medicines Regulatory Authority (NMRA) is the Astra Zeneca and Gamaleya’s Sputnik V vaccines. NMRA approval for the Sinopharm vaccine is still pending due to it not being provided with data about the vaccine’s phase three trials. Several members of the NMRA were sacked or pushed to resign after they refused to give into attempts by senior health ministry officials who in their haste to get the vaccine approved, tried to circumvent procedures which have to be followed for it to approve a vaccine before it can be used on the public. WHO approval of the vaccine is also still pending but is expected to be cleared for use by May.
The outcome of studies which are currently being carried out on a community in England to look at the compatibility of the Astra Zeneca and Sputnik V vaccines could also be a lifeline for Sri Lanka since this will make it possible for a recipient to be vaccinated with the two different types of vaccine during the first and second rounds. This is because both these types use the same Adenovirus and the reactions to them are also more or less the same. ‘The WHO has not said yes to this for the moment’, said its representative in Sri Lanka Dr Palitha Abeykoon. ‘Its’an interesting theory which is yet to be given the go ahead’.
Meanwhile with adequate supplies of oxygen being key to fighting the new strain of the virus, the President of the College of Medical Laboratory Science Ravi Kumudesh said there is sufficient oxygen in the country for the next two weeks but was scathing about the ministry of health not forecasting and planning to ensure there will be enough for beyond that. ‘We can see that the number of Covid positive cases are risingand the health ministry has to start planning now itself for the coming weeks.’
How the supply chain works is that the Medical Supplies Division of the ministry of health purchases oxygen from two suppliers and it is then distributed to the network of hospitals.
Kumudesh explained that usually, the bottle neck is in the supply chain. ‘It is the responsibility of the directors of the hospital to ensure their station has sufficient supplies. But we don’t see that happening’.
