The Sri Lankan Ministry of Health removed the mandatory regulation of wearing masks on 9.6.2022 . However, the World Health Organization South East Asian Regional Office (SEARO) working with 11 countries including Sri Lanka had renewed its campaign stating that the “COVID pandemic is not over” on 25. 6.2022 calling to “do it all” in all the member states with 7 prevention strategies including the advice to wear the mask properly . The objective of this article is to assess the risk of the next COVID wave with the available epidemiological evidence and to provide timely technical advice to Sri Lankans.
While the economical crisis hits the headlines in local news and the effects of Russia-Ukraine war get reported in the international news, COVID statistics is no more a priority to the Sri Lankan media. The COVID statistics released by the Epidemiological Unit, Ministry of Health, Sri Lanka reported 5 new cases on 25.6.2022  though it is spreading at a very low level as depicted in the graph below (figure 1).
Figure 1 New COVID-19 cases reported in Sri Lanka from March 2020 to 24th June 2022 
However, the situation in our closest neighboring country India has been quite alarming in the last few days and India appears to be in the early stages of a new wave. On 24th June 2002 India reported an alarming increase in COVID with 17,336 new cases in the last 24 hours  and the highest number of new cases in the last 4 months . An increasing trend in COVID cases during June 2022 is obvious in the table below 
On 18th June 2022, Economic Times reported for the first time in 113 days that India has recorded over 13,000 cases . This increase in cases is getting reported despite the high-level vaccine coverage India had achieved with fully vaccinated (2 doses) of 83.38 % of the eligible population and partly vaccinated (1 dose) of 93.39 % of the eligible population . India had already experienced three waves of COVID-19 with the first wave peak in September 2020, second wave peak in May 2021 and third wave peak in January 2022 (vide Figure 2).
Figure 2 COVID 19 Daily New Cases in India 2020 to 2022
The worst part of the Indian COVID-19 picture is that the geographical regions in close proximity to Sri Lanka, Tamil Nadu and South India are more affected than the rest of India (vide Figure 3) .
Figure 3 COVID-19 map as reported on 24th June 2022
This situation is more alarming for Sri Lanka as Sri Lanka is planning to resume cheap flights between Trichy in Tamil Nādu and Jaffna in Sri Lanka in July 2022 . An escalation in the cases of India will pose an increased risk for Sri Lanka in the coming days. Sri Lanka will face a total disaster if another wave of COVID strikes as the country is in a profound economic crisis and definitely imposing a lockdown will cause a further setback to the economy of the country. On the other hand, with the shortage of medicines, limited facilities in the hospitals and distracted staff due to fuel shortages, all these factors will lead to an increase in case fatality during the next COVID wave. As the economically dilapidated Government will not be able to give adequate protection to the citizens from an imminent COVID wave, the only step available to Sri Lankans seems to be resuming the self-protection measures: “do it all” as advised by the regional WHO office. The recommended seven steps are as follows:
1. Mask up well covering the nose, mouth and chin
2. Wash/ clean hands regularly
3. Cough/sneeze into the elbow
4. Avoid crowded places
5. Ensure safe distance from others
6. Ensure good ventilation when indoors
7. Get COVID-19 vaccines as per recommended schedule.
*Disclaimer: Author Dr. Murali Vallipuranathan is a Consultant Community Physician at the Ministry of Health and a visiting lecturer at the Universities of Jaffna and Colombo. He was trained at the Section of Epidemiology at the King’s College, London in 2006/7. Though he was involved in managing the COVID 19 Crisis at the Northern Province he claims the technical opinion expressed in this article to improve the public awareness is his private opinion and in no way reflects the official position of the Ministry of Health in this issue.