17 June, 2021

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Are The Numbers Right? Are They Not?

By M.M. Janapriya

Dr. M.M. Janapriya

Man is least himself when he talks in his own person. Give him a mask, and he will tell the truth” ~ Oscar Wilde. Those of you who are not acquainted with who Oscar Wilde was, he was a French Poet and a playwright who lived in the 19th century AD. While respecting the writing and philosophical prowess of the former, I find no great reason to pay much heed to the above quote of his as these are dramatic quotes with mostly poetic overtones. There is no need to go that far. There is a famous age old Sinhalese adage “the two things one should not fear to do is to tell the truth and to sit on the ground”. As such I have not feared to put my real name in all the articles I have written for I have not deviated from or distorted the truth. There is a good chance the writer of Pseudonym Janaka Goonatilake would not have heard of the above adage, Singhalese probably not being his mother tongue. 

The above article purported to have been written by this gentleman is a well composed article in which some of the statistics produced too are accurate enough. For example, the mortality figures table and even the number of tests done per day in Sri Lanka as being 100 which was nearer the truth at that time, even though he got the number of PCR machines available terribly wrong. Additionally, a lot of others are inaccurate too viz. As I have said in my previous articles the basic severity figures of SARS COV-2 infected people are as follows. 81% are mildly or moderately affected (mildly affected have no pneumonia and some may be asymptomatic), 14% severely affected, 5% critical with 2.3% of the critically affected dying no matter what you do. The writer has conveniently increased this mild to moderately affected group to 85% and classed all of them as asymptomatic. This seems to be deliberate and wanton distortion of the truth and is downright disinformation. 

If, as the writer alleges the Ministry of Health has issued strict guidelines to define a ‘test worthy’ patient that ties the hands of Consultant Physicians behind their backs, it is wrong but I have not been able to find credible evidence of this despite contacting two of my colleagues in active government service. In my last article I have suggested we should start testing more and more. In this background if the writer’s allegation is correct I think we are not doing as well as we should be at this point of time. However there is a circular issued by the DGHS dated 7th April 2020 extending the use of laboratory testing for Strengthening Covid-19 Surveillance. This circular definitely gives physicians a free hand as per point No 5 of page one of the said circular which says “Any other patient in whom the treating clinician decides to exclude Covid-19”

Also the writer alleges that a multimillion rupee new laboratory project which is going to take months to build is being talked about and there is much less interest in improving the existing facilities to increase the testing capacity. I am unaware of the first part of the revelation but if it is true this will be a clear case of someone trying to ‘make hay while the sun is shining on them’ (and setting on the country) and as per the second, the Minister of Health, at a recent TV interview reiterated that the testing numbers would increase to 800/day by the end of the week. So the writer seems to be not very generous in coming out with the truth but seems to adopt a liberal approach to converting social media small talk etc. to a kind of gospel.   

Let us concentrate on the following sentence of the writer. “It should be observed where the rapid spread of disease is present, the mortality is high as the testing rate increases. In simple the more you test the more deaths will be diagnosed as Covid-19 deaths”. The writer seems unable to analyze a simple matter such as this. In countries where the spread is rapid the mortality is high, clearly because all or some of the factors below could be in operation. 

* People were more susceptible and had a poor prognosis (as in Lombardy where there was a high percentage of very old people)

* The health care facilities were overwhelmed so that some who could have been saved died because of failure to accord life support

* As the numbers were so high the front line health workers were so demoralized (some committed suicide) that they were unable to accord even simple straight forward medical care 

“In simple the more you test the more deaths will be diagnosed as Covid 19 deaths”. There is some merit in this statement but the writer should be made aware that all suspicious deaths (every normal death is registered and a death certificate issued) are cremated after taking saliva, throat swabs etc. from the dead. This may not be ideal but it is worth remembering that this virus stays alive on many surfaces for a long time. Also in high testing countries, the number of new patients discovered is large and as such the mortality rate as a percentage of total affected, goes down. The gross number of deaths actually might be more than if one tested less, but the former is a bad indicator of how well a country is doing. It is the percentage that is all important. 

Clearly with all his disinformation and lopsided analysis he eventually approaches his goal which is a conspiracy theory of letting the virus run through the country to build herd immunity. 

“The cumulative effect of lack of testing and hence the deaths as well as patients being undetected, is the figures remaining “acceptable” while the disease may be spreading within the community.” This analysis lacks credibility. If we tested more and more so that a large number of asymptomatic or mildly symptomatic people were discovered, then, even if the number dead increases by a few digits the overall death rate comes down. The simple arithmetic being (N/Total infected) x 100= Mortality percentage. Look at US figures. Total cases 468566, total deaths 16691 and hence the percentage is 3.5%. This is clearly because the total infected is a colossus of four hundred and sixty eight thousand five hundred and sixty six.  I am at a loss to understand why the writer failed to see this. As I explained earlier there is a possibility of Corona deaths being slightly under reported here in Sri Lanka but nowhere near what this gentleman is trying to make out. If patients are allowed to go on and infect to the extent he is postulating, Corona R0 being 2-2.5 (R0 being the basic reproductive number pronounced R naught which is the number of people each infected person can infect in turn) the disease would have galloped in Sri Lanka. This did not happen and the writer seems extremely unhappy about it.

There are a few things that emerge from his article as blindingly obvious. The gentleman was expecting Sri Lanka to make a mockery of the Covid-19 situation and when he realized that it was not so and indeed Sri Lanka  has done very well to contain the spread of the disease he was very disappointed. He then set out to do two things to pull the rug from underneath the government’s feet. Firstly he has tried to show that the SL government is doctoring the figures. Secondly he has tried to use this hypothesis to discredit the government as irresponsible enough to let the virus run through the community to achieve ‘herd immunity’. 

What the writer has to understand is that with substantial slowing down of the spread of the virus we are in a great position to look after the symptomatic, inclusive of according life support to the critically ill. This is the exact position we are in, right now. While the country is in lockdown it is entirely possible for the virus to infect the population at a slower rate albeit according the infected, some immunity. However this is nowhere near enough to achieve the level needed for ‘Herd Immunity’. This though is a desirable by product and there is absolutely no reason for someone to be despondent about.

As I have pointed out previously in my second article, we probably had Corona coming our way in Dec 19/Jan 20 without our knowledge blew across the country masquerading as a bad flu taking with it some susceptible lives and conferring immunity to others. I said therein that this could account for the low mortality rate we were experiencing. Recent research from Australia suggests that countries that have embraced the BCG vaccination in to their Expanded  Programme on Immunization (EPI) from the very outset in 1949 such as Sri Lanka which vaccinated all newborns in 1963 have shown a greater resistance to invasion by the Corona virus. Please read this article for more information. Together with these nature’s gifts our government deployed a lockdown in good time and with the help of nice hot weather we seem to be slowly but surely getting out of the woods. Of course we got to be patient for a little longer. So let’s give ourselves a pat on the back and sing Namo Namo Maatha than dive deep to try and find even the flimsiest of reasons to wrong the government. 

I agree testing could have been and by now should be a lot better. In fact I suggested to the health authorities to try and look towards testing around 5000/day in my last article. I also suggested a way of raising money for this. The big advantage in such testing is that we can relax a bit on the lock down as in Singapore and South Korea. This is important for people in the districts of Colombo, Gampaha and Puttalam districts who are clocking in towards a month of lock down in a few days time. We have not complained. I live in the Colombo district with my family and we do face hardship. Our psychological health has taken a bit of a bash as has the physical health. I have been jogging 3 miles twice a week to keep my coronaries patent for over 50 years. As I cannot do it anymore I started jogging inside my premises. 

We must try and adapt ourselves to the situation. There is just no point in writing articles massaging figures at that and castigating the government which is doing its duty of ensuring national safety. We must try our level best to support the government’s efforts in this hour of need. In almost all the countries in the world people have come together forgetting petty differences and have stood up as one to fight the common enemy the, Corona virus whereas here in Sri Lanka some people are perpetually fishing in troubled waters.  We certainly have to keep putting pen to paper to try and get our ideas across to the Health Authorities and the Law Makers but our ideas should be of constructive nature and should encourage the frontline doctors, nurses and others who constantly put their lives on the line to help us. 

Mr Goonatilake’s intentions seem as mysterious as his real name is. If one really works hard one can find shortcomings even in the best thought about and well deployed control mechanisms such as ours. I cannot see any worthwhile reason why anyone should write articles of this nature except to pull the government through mud. Every article we write and those, the newspapers and electronic media publish should convey a strong and an authentic message which is of use to the country. I have often seen as a regular contributor to the Colombo Telegraph, some other regular contributors not so much as writers but as those who critique articles, not infrequently turning the clearest of messages in to a topic with a political hue to have a lash at some members of the governing machinery of the country. I strongly feel that this kind of irresponsible contributions should find it difficult to procure space in responsible journals like yours. 

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Latest comments

  • 2
    0

    When the new cities/villages are being locked down under self quarantine and the numbers in these cities/villages are not added on to the number of cases, I wonder why quarantine a city/village if there are no cases or possibility of having cases in those cities? How many have they tested in these cities which are being quarantined? Why the advice of GMOA is not being followed? These are questions that need to be answered.

    • 2
      0

      Dear Buddhist,
      .
      I’ve not had time to study this carefully, but your comment has this misunderstanding, is what I feel.
      .
      Cities are quarantined when there is a possibility of cases. Until a positive case is unearthed, we should not add that to the “cases”. We’ve got to keep our statistics clear at the very least.
      .
      So far a steady supply of electricity was a blessing. But it has got as crazy as I expected after our first shower of rain in Bandarawela. Apart from communication, it affects our refrigerators.
      .
      By the way, Oscar Wilde was not French. He was Irish and wrote in English. Good to see Dr Janapriya continuing with his stream of articles. I just put one here, before the deadline for expiry:
      .
      https://www.colombotelegraph.com/index.php/covid-19-downright-disinformation-should-be-worse-than-rumour-mongering/
      .
      Please look there for this link:
      .
      https://www.youtube.com/watch?v=qN5zfWpm91k
      .
      I had already pasted it on here as well:
      .
      https://www.colombotelegraph.com/index.php/answering-the-call-of-duty-the-medical-professionals-of-sri-lanka/

    • 1
      1

      Buddhist

      Quarantine & detecting positive covid 19 cases are two different things. All contacts of conform cases are quarantined but they are not considered as patients.

      • 2
        0

        Latha,
        .
        Not all contact persons, but those who are now arriving in BIA are quarantined.
        .
        But at the beginning they were not consistent and that is what the trouble came up – that some of those arrived from Italy, Korea, Germany or any other destinations were for some reasons were not controlled. May well be BROTHER duo were not well informed about the gravity of the contagiousness of the deadly virus.
        :
        Brother DUO until day before yesterday thought, that GMOA morons are the specialists in COMMUNITY diesease related stuff. We could teach goda meeharakas, but as we know we cant teach RAJAPAKSHES. that is known to at least 60 lacks of voter eligible while others not.

        Be it Iran or any other countries where idiots are the politicians were misled at the very beginning but the increasing number of the infected and the deadly effect of the virus, tamed them sofar. So is the case also with the stupid BROTHER duo in Srilanka.

        Experts and island analysts make it very clear today, SRILANKENS should have been doing what they have been doing as of the end of Feb/beginning of March; If done so, this country and govt would have been considered as a model to have contained the virus being spread across the poor and easy targets across the island.
        :
        But today, even last night, local analysts were repeating that the danger before the NATION is very high even if that BED-PAN style mouth piece bearer, APAWITHARA Wanniarachchi is repeating her lies as their two most knowin TV channels continue.

        Buddhist, please stay at home, get your medicine and food items transported you…. you ve been a great commenter… unlike this LATHA an another back licker of Rajakshes for nothing. –
        .
        May all beings be blessed with TRUE teachings of buddha – be strong.. we will make it.

    • 3
      0

      Dear CT Readers,
      Dear Mr Janapriya,
      .
      https://en.wikipedia.org/wiki/Oscar_Wilde

      Dear Mr Janapriya,
      Thank you for coming back with an another article, but this time criticising a writer.

      But beg to differ, to me, you are both no right regarding your information on the subject and aboutt the poet …. just confusing.

      Further to this, if you would plesae correct yourself about your information regarding OSKA WILDE, that would help us all further to rely on yours from now on.
      :
      Since your information sounds tob e somewhat bias to ruling govt, I thought to make my recherche and found myself, that Oska Wilde was not a french but an irish person but had died in Paris, France
      Please get it by clicking on the following link.

      https://en.wikipedia.org/wiki/Oscar_Wilde
      .
      Wilde in 1889
      Born Oscar Fingal O’Flahertie Wills Wilde
      16 October 1854
      Dublin, Ireland

      16 October 1854 30 November 1900 (aged 46)
      Saint-Germain-des-Prés, Paris, France
      Dublin, Ireland Père Lachaise Cemetery

      Author, poet, playwright
      Died English, French, Greek
      Saint-Germain-des-Prés, Paris, France Irish
      Buried Portora Royal School

      • Trinity College, Dublin
      • Magdalen College, Oxford

      Occupation Victorian era

      Language Epigram, drama, short story, criticism, journalism
      Nationality • Aesthetic movement
      • Decadent movement

      Education • The Picture of Dorian Gray
      • The Importance of Being Earnest

      Constance Lloyd
      (m. 1884; died 1898)
      Alma mater • Cyril Holland
      • Vyvyan Holland

      Magdalen College, Oxford • Sir William Wilde (father)
      • Lady Jane Wilde (mother)
      • Willie Wilde (brother)

      • 1
        1

        Dear Mr.Bunjappu,
        My article was not on Oscar Wilde. I agree I got his nationality wrong. Please comment of the substance if you would.
        Many thanks

        • 0
          0

          Dr.J,
          It seems that Germany uses a system where 100 samples from the same area are mixed up and tested as one sample. A negative result means all are clear, whereas a positive result leads to individual testing in the particular area. Much easier on resources and time.

          • 0
            0

            Dear Old Codger,
            .
            PCR testing which is the only GOLD STANDARD method being used to test the COVID-19 patients would not be reliable 100%. As MRI head, and several others believe that we can rely on 70% of the results.
            Meaning 30% we cant feel like that the results are right. That is why repeated testing would be necessary.
            :
            I will add you here below there numbers of tests per 1 mio of following populations as of today:
            .
            USA 7,907
            Spain 7,593
            Italy 15,935
            France 5,114
            Germany 15,730

            UK 4,934
            Iran 2,997
            Turkey 4,036
            Belgium 8,814
            Switzerland 21,954
            Netherlands 5,926

  • 0
    0

    This comment was removed by a moderator because it didn’t abide by our Comment policy.

    For more detail see our Comment policy https://www.colombotelegraph.com/index.php/comments-policy-2

  • 3
    0

    With all due respect,I need to make a correction.
    Oscar Wilde like George Bernard Shaw
    is an Irishman. He was by no means a Frenchman.

    • 3
      0

      Plato,
      This Dr. had been counting his PP money in his active years. I am sure he has no clue about poets in France and Ireland. For him both are the same.

  • 3
    0

    Dr Janapriya clearly disagrees with what Janaka Goonatilake has written.

    However, I was startled to read right at the beginning, that Oscar Wilde, according to Dr Janapriya. . . ‘Those of you who are not acquainted with who Oscar Wilde was, he was a French Poet ‘ . . . .

    Gulp! and to think that for over 70 years I have believed that Oscar Wilde was an Irishman.

    I think the question of ‘numbers’ relating to Covid-19 in Sri Lanka is a proper dogs breakfast, and there is no point in us beating each other over it. Most readers will make up their own minds over the veracity of the information coming out of the various sources.

    On the question of pseudonyms: there could well be a perfectly good reason for using such. It doesn’t really matter – WE the readers will decide, on a balance of probabilities, the quality of what is put before us. Writers write, and WE the readers reserve the right to comment (or not).

    • 3
      0

      Dear Springkoha,
      .
      you are right, … and please read mine above which I have added regarding the TRUTH of Oskar wilde
      .
      THanks for being that accurate.
      :
      If anyone criticises the other, he or she should come with the facts – that is what we learnt but Mr Janapriya has been an another nodding his head to all what is being spread by rulers false propaganda. I think what is being in the air regarding the numbers of the infected and all are just doctored. We know how Rajakshes and their henchmen very well.
      I have a greater respect on that Mr MRI head… he has been telling the truth unlike that bugger/Padadeniya. Not even 200 hundred test have yet been performed by MRI but they have the capacities to increase the tests per day in the days to come. That is what MRI head reiterated last night a SirasaTV program called ” AVADIWENNA”

    • 2
      0

      Spring@

      With all what he has been revealing; we feel he should be over 75 and you should also be over 70 as of today.
      .
      But we respect you MORE Springkoha, because you are even more correct than this Janapriya. May well be some hepatagenarians become demented with the time and does not know what they are talking about.
      :
      Once he argued himself why not he allowed HOME-QUARANTINING while the other who was said to have arrived in BIA had no choice but to go for 2-wk quarantining under the command of SL-triforces.
      :
      I think our SINHALAYA are the easy surrenders to any brutal men – I really dont know why. Nevertheless I respect retired surgeon Mr Janapriya. :: by the way, you guys may not know it yet, so long you have not completed a doctorate you have no right to set the prefix ” Dr” when refering your name. This is very common with my medical professionals I have been dealing with in England. They asked me to use ” Mr” instead.

      But today in SL, they dont care about world standards, they even call some stupid politicians with Dr titles. (best example to call Dr Mervin Silva, Dr Bandula Gunawardhana etc).
      May be latter may have completed it, but many in SL context, dont respect truthful information.

      • 0
        0

        “I think our SINHALAYAS are the easy surrenders to any brutal men.”

        We proved it by fighting with brutal Piripaharan.

    • 2
      1

      Dear All,
      Thanks for views of all of you. I am disappointed at the reasons for them being so diverse. It would be nice, I am sure the writers would appreciate too, if the readers comment on the essence of the article than concentrate on minutia.
      Many thanks,
      MMJ

  • 2
    0

    Let’s check one clinical decision maker’s own hypothesis testing for challenging a hypothesis testing of another hypothesis testing!
    Hypothesis: Singhalese adage: “The two things one should not fear to do is to tell the truth and to sit on the ground”
    Conclusion: “Singhalese probably not being his (Anonymous author) mother tongue. “
    ——
    Hidden hypothesis: If you are afraid to tell a truth then you mother tongue is not Singhalese!
    Hypothesis:
    1-MR & Co didn’t know this adage 10 years ago when they officially claimed that war was won with ZERO civilian casualties.
    2- Mother tongue of MR & Co is not Singhalese.
    Conclusion: MR& Co can’t be trusted!
    ——-
    The Anonymous author cast doubt about the choice of data collection from a source that is still struggling with credibility issues.
    Someone said that statistical test depend on the choice of data and the choice of statistical model.
    Shouldn’t anyone doubt the validity of states regardless of their mother tongue?
    ——
    Hypothesis: Crooks always get a second chance.
    Conclusion: No one can rewrite the history.
    ——-
    C-Virus-19 is a golden opportunity for the MR & Co to earn the trust and boot its credibility in and out of SL.

    • 2
      0

      Dear Karma is boomeranging@

      You are right.
      :
      I dont trust any information coming from SL, I am a srilanken living in Germany.
      :
      We had some trustful information at the begining of GOOD governance govt, but later it turned out to be no more truthful.
      :
      Prior to 2015 it was like in Zimbabwe governed by Mugabe.
      :
      Now it is even worst – TWO channels, that behave like the own orifices of Rajakshe family , feeding the nation with all hearsay-style information from dawn to dusk.
      :
      Shamelessly, EVEN Sirasa is inviting that Padaeniya on and on.. knowing that he is not the specialist neither in COMMUNITY/CONTAINGIOUS diseases nor in alternative.
      :
      His specialization is in PAEDIATRIC NEUROLOGY – I would not go to the carpenter to get my IT problems solved right ? likewise, BROTHER duo should finally MAKE statements, that the UNIVERSITY specialists be invited by the TV channels would be compulsary when holding discussing rounds. Else, this country would be NO better to that of MOST known to Mugabe rule.

  • 0
    0

    I think Janaka Gunathilake picked one point. His argument, as I understand, was something that Mahinda Rajapakse, PM, talked in front of Journalists. That is they are doing at the maximum available capacity at present and that is 750 a day and they expected to double it. So, he thought GOSL or GMOA is lieing.
    I think, that is simply asking questions from the wrong person. I think the PCR machine that Sri lanka has the capacity of running 36 samples a machine. I heard they have about 52 machines, that is only with the universities and in the govt labs.

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