25 September, 2020

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Corona Management – Are We Diving Into The Deep End, And Knowingly?

By Thangamuthu Jayasingam

Dr. Thangamuthu Jayasingam

An outbreak of pneumonia of unknown reason was first reported on 31 December 2019 from Wuhan city in Hubei Province of China. On 7th January 2020, it was diagnosed as “Novel Corona Virus”. On 30th January, WHO declared it as a Public Health Emergency of International concern (PHEIC). On 11 February WHO renamed the disease as COVID-19 and on 11 March 2020 declared as pandemic. The incubation period is reported as 2-14 days.Situation report-26-4-2020, Epidemiology Unit, M/H&IM

The Government planned to open the country from lock down on 27th April 2020 which was  then delayed for a week trying to bring back ‘normalcy’. But Corona has accelerated during this  period and reached the 500 mark on 26th April just two days after reaching the 400 mark. The graphs below indicate that we are in the ‘exponential growth’ of the infection. Opening of this country at this time would  be an unwise decision that could cost a serious setback to the reduction of the Corona Virus.

Fig. 1 is  from the Ministry of Health, Epidemiology unit (26-4-20) and the cumulative figures calculated from the same and produced Fig 3. Fig 2 was the reported information by the same office on 18th March 20220. It is difficult to understand how the planners missed these indicators over time. One does not have to be an expert on Corona virus or its infection to be competent enough to study trends and analyze them and relate to Existing knowledge. The situation report for the 18th march is given below again from the same source.

Fig 1: Corona summary ( Epidemeology unit, Ministry of Health, 26-4-2020) The number at 10 am on 26th had been 460 which is 588 on 28th 10 am.

There is a trend line of increase of the cases that led to the closure of the schools on 12th March and the Universities on 16th March 2020. But though some areas such as Puttalam was locked down the rest of the country was open until 20th March 2020. Whether this was to accommodate the nominations for general election that closed on March 19 is commented upon, but earlier closure would have helped the country. The Airports were declared closed for arrivals on 19th March 2020.

Fig 2: trend of Corona patients from march 11 to 18 march 2020

The trend line shows a slow down in terms of patients recognized each day and then starts to climb again after 12th April 2020 (Fig1). Whether this was due to the relaxing of the curfew in most of the country except for the selected hotspot districts, needs investigation. However there had been  reports of  crowding during this period. However since then, the graph shows an acceleration that takes place, much faster than before. It needs to be reminded that during this period following the 16th April, intercity transport had been allowed and buses have been plying between cities including areas of earlier ‘restriction’. Whether this was  also a cause for the rise is to be checked. It is hard to believe that the authorities were unaware of this trend as this is taken from the Ministry web and if so, it is a matter of utmost concern how were the plans made for opening the country on 27th of April for  almost ‘business as usual’.

Fig 3 and 4 were computed on the same information of Fig 1 but on a cumulative basis for better representation. 

Fig 3 shows that we were almost zero for the first 50+ days and it was around 11 March 2020, the numbers showed increase, which is detailed in fig.4.

Trends 

It had taken us around 57 days for first 100 patients , 18 days for the second and 8 days for the third, 4 days for the 4th and two days for the 5th(  it had reached 588 on 28th Morning at 10 am). It is vividly clear from the graphs that we are on the exponential growth trend and trying to ignore it and behave as ‘business as usual’ will not result in reduction in the spread but most likely the reverse.

I also had a chance to look at the article by Dr S. Ratnajeevan H. Hoole (Are we and Independent Commission?, Colombo Telegraph, 27-4-2020) where he discusses the  postponement of the date for General Election which was to be on the 25th April by the declaration of the President on 2nd April 2020  and the associated scenarios. In the context of the possible catastrophe that the country faces, it is foolhardy that the Election Commission had not looked at these data but fixed the date based on an imagined end of the Corona saga on  May 2nd, 2020. This questions the rationale and expertise of these eminent persons to decide beyond their realm. I think under the circumstances that we need to concentrate on coming out of the Corona spread as we are on the threshold of a major increase as shown in the graph and time will be a crucial factor.

Fig 5: Moderately increasing Sri Lanka had changed pace after 12 April, 2020 and is rising and perhaps faster than other countries in the region. (Graphs were taken from SanjeewaDayaratne@dayaS on Twitter.)

Fig 5 shows the comparison of trends in many countries and Sri Lanka does not show a leveling impact but an increased trend of escalation after 12th April to  24.4.2020  even before the 500 mark was reached. It just concurs that we have little time and need to act fast.

Concentrate on Corona 

At a time when global economic giants are facing crisis on control we should not let the spread of the disease to levels where we would be in a disaster situation, where control goes beyond us. It is also a duty and a responsibility on those who are handling the Corona control to ensure that the data are used in the decision  making process. The failure to utilize available information was the allegation over the Easter carnage on 21 April 2019. The fact that the information made available was not utilized by those in positions of authority and thus failed to avoid the disaster, led to senior officers being charged for that negligence as a crime. 

It is known that the election commissioner had requested or planned to request for curfew passes for the 7000+ candidates who  are the nominees for the election, who in turn may call for meetings small or big. If they call for meeting with 100 person each we are talking of 700,000 people to attend the meetings which would be a feast for the Corona. Even otherwise if the candidates wish to visit homes then it would be 7000 homes per day at a minimum which would also be a disaster. It would not be wise to deal with election and Corona at the same time as they demand opposite strategies, where social isolation and distances are useful for Corona control while social gathering and crowds attract the election platforms. 

There is also a questionable edge to the COVID assistance being provided by the government which may be also seen as a part of a campaign, while the present government is only a caretaker government to cover up duties and not for making policies. There would be and could that sections of the people are favored or seen to be favored which is also unhealthy. The best is to forget about the election at present until the Corona is settled to limits where its presence may be of acceptable levels. After all People should be the first priority and not the politics. At the same time it would be useful to engage the previous members of parliament as they are representatives of the  people and have a mandate until August 2020, for inclusive planning against the Corona disaster.

It is great to be a country that handled Corona better than most with all its differences and defects rather than be a country which had its election amidst the Corona and failed to save the people.

Recommendations

The following are submitted for consideration by the authorities and related agencies. The recommendations are basic and suggestions are rational for consideration.

a) Continue the lockdown of the entire country for the next several days as necessary

b) Advocate the  use of NIC for travel as suggested in future to reduce crowding

c) Study the Corona spread data by districts and provinces as necessary

d) Relax the curfew for limited hours each day, FOR ESSENTIALS, ONLY, in areas where the spread has  not been seen. The others need to be analyzed and acted accordingly.

e) Improve the distribution of food, medicine and essentials through effective and safe modes

f) All  inter city /district transport to be curtailed and essentials be allowed only under quarantine conditions.  Limited buses may operate on quarantine conditions from point to point but those who move from one to the other district,  especially from the Corona zone to free zone will need to be quarantined for a limited period in centers or homes as appropriate.

g) Offices/Officers to operate form home and permission may be granted to those who wish to be in offices. The transport and the ‘best practices’ will be their responsibility.

h) Essential services may operate as at present but with care.

i) The testing of the communities for Corona  as suggested by GMOA  much earlier,  begins as early as possible.

I am aware that I am no authority on the subject of the Coronavirus per se but  am only interpreting the data that is readily available from the state.  But as an educated citizen  I consider it my duty to make  my case,  with evidence.

*Dr T Jayasingam, Professor of Botany, Eastern University

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Latest comments

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    PART ONE

    Thanks, Professor Thangamuthu Jayasingam, for a wonderful article – although you’ve made some mistakes with the dates that you have put on the graphs. In quite a few places, actually, but they will be obvious enough to an attentive reader. “18th March 20220” should be 18th April 2020, for example.
    .
    Never mind, the insights are brilliant. In relation to the mess up with election dates, for instance, you’ve said, “This questions the rationale and expertise of these eminent persons to decide beyond their realm.” Writing the sort of article that you have, it is praiseworthy that you didn’t get mired in the politics of the decision – which is all too obvious to people with even half of Jayasingam’s intelligence.
    .
    You have recognised how sensible it is to prescribe the last digit of the NIC number for taking turns to venture out. We’re fortunate to have in DIG Ajith Rohana a man who seems to be decent and kindly – I heard him say that this NIC business should be used as a guide by “responsible citizens.” When guidelines become orders, most of us are likely to look for loopholes.
    .
    tbc

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    PART TWO
    .
    The last graphs show us that the greatest mess is in Spain.
    I googled for information on the political mess in the country, and came across this balanced article.
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    https://www.ft.com/content/819e8bf2-60fc-11e9-a27a-fdd51850994c
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    Being a Sinhalese villager (I’ve never been outside Asia) I think that I’m in better position than the “educated citizen” author to warn that we will definitely pay the price for our divisive and racist politics.
    .
    Having hopefully indicated that this entire article is one that should be studied carefully (paying heed to those mistakes which are only typos).
    .
    What is above this I had typed out yesterday, but was waiting for other comments. None have come! However, many other articles concur with what you’ve said. Nobody has probably looked at what you wrote. Let me provide some links in comments elsewhere, because I’m sure that what you’ve said is valuable.
    .
    http://www.dailynews.lk/2020/04/29/local/217544/president-outlines-steps-taken-battle-covid-19-whilst-revitalising-essential
    .
    About to submit, I found that, and the count 649 now at 1.00 am on the 30th. This is crazy!
    .
    Panini Edirisinhe (NIC 48 3111 444V) aka “Sinhala_Man”

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