By M.M. Janapriya –
Corona Virus disease 2019 is a dreadful killer disease which devastated counties like Italy, Spain, France, the US and England at the beginning, has been having a field day in India over the last couple of months and is starting to create havoc amongst the corruption ridden poverty stricken and brow-beaten Sri Lankan population. This is a virus that enters the body through the facial orifices mainly the nose and the mouth and that predominantly affects the lungs. The fact that wearing an effective face mask, maintaining a one meter distance from nearby people and keeping hands clean by frequent hand washing with soap and water or sanitising them with alcohol gel would keep the virus away is not rocket science. Whatever the variant virus (England, India, Brazil or South Africa) is, the preventive steps that should be taken are exactly the same. Hence no country or indeed a task force appointed to quell the pandemic within any such country should adduce lack of foreknowledge of a new mutant/variant emerging as an admissible mitigating reason why they should not be reported to the international criminal court for mass murder of their own nation by inaction deliberate or otherwise or indeed malefaction. Even England under Boris Johnson’s leadership is guilty of this malfeasance. Different countries made different choices in the way they managed the pandemic and were either rewarded or made to pay heavily. Sri Lanka being a small island her nation was eminently protectable from the virus that left the shores of China due to inadvertent and inconsiderate action of the local rulers and their colluding partners WHO which I have rebranded the Worst Health Organization in the world. I have written about this before so I am not going to elaborate on the matter any further. For our rulers, only some lives seemed to matter and as such our destiny was written on the wall right from the beginning of the pandemic.
Some countries decided on elimination of the offending virus than mitigation of its carnage from the very outset and were duly rewarded independent of their per capita income. These include, Vietnam, Laos, Thailand, Taiwan, New Zealand and Australia. Others decided to religiously Test Trace and Isolate with partial or total lockdowns when needed. They tested large numbers, detected most needed to be detected and isolated them and their multiple layers of contacts with all their might. They were rewarded too. Merkel’s Germany, Hong Kong, South Korea and Singapore are some of the countries that adopted this method and reaped its benefits. Others like the UK and US which were headed by people who seemed slightly off the centre adopted insane methods and paid heavily as a result. Unfortunately it is not the idiotic rulers who paid the price but the unsuspecting elders, frontline healthcare workers especially of Black (A)and Minority Ethnic (BAME) origin and economically challenged individuals of the general public who did. Both Bojo and his US counterpart Trump wanted to save their respective economies while managing the pandemic and had sacrificial animals in the form of impoverished people, the senior citizens in elders’ homes and frontline health workers who were commandeered to work without proper Personal Protective Equipment (PPE) acting as cannon fodder. Adopting appropriate measures could have reduced the death toll to a minimum but they regarded pounds and dollars to be worthier than human lives. One chap has already paid with his political future and the other definitely will when the time comes. India made a mockery of the pandemic trying to jump the `developed country band wagon’ having a per capita GDP of only USD 2099. Meagre first innings score, insane declaration and dropped catches brought them an innings defeat. Watched on TV a few days ago how Indian public was asking for Narendra Modi’s scalp. He too will pay a heavy price which might well be his entire political and may even be his personal future. Sri Lanka’s performance is as enigmatic as her political culture. Whether our rulers sleep walked us to the cliff edge through just ignorance or greed or indeed they had the bayonet of a force to which we are indebted for some reason or another on their backs just enough to cause a twinge, one would never know but what is as clear as daylight is the management of the period around the Sinhala & Tamil New year was an ignominious failure of insane proportions which makes me wonder if this too was another `experiment’ like the bubble gum experiment of the expat Bacillus Medius Kingside terribly gone wrong or indeed a manmade disaster smoke screen behind which to carry on pushing bitter pills down people’s throats. Who talks about Government’s responsibility towards bringing perpetrators of Easter Sunday carnage to justice anymore? Sri Lankans closed the country down on the 22nd March 2020 when the total number of cases was less than 150 and total deaths were under 5. Yesterday’s new cases recorded were close to 3500 and deaths 38. Why are the authorities hesitant to close the country down? Is it because there is no major election round the corner?
Sri Lankan Covid Madness sans Method
How did Sri Lankans fare in the Covid arena? We did not seem to belong to any of the above categories. Our approach seemed blunderbuss from the beginning with the message that SARS COV 2 could literally be frightened away by the army Generals. Sometimes masked and at other times not. Social distancing would be adhered to if remembered to do so. At shop fronts some had hand washing facilities and others did not. I would call the Sri Lankan method the Yo Yo method.
1. When Covid-19 hit Sri Lanka in late 2019 in the form of a ‘bad flu’ during which period there were many hospital admissions with what they called atypical pneumonia, the treating physicians failed in their duty to notify these and in turn their slumbering Public Health counterparts rolled to the other side and went in to deeper sleep. (do a retrospective data search)
2. First case of Covid-19 in Sri Lanka was a 44 year old Chinese tourist detected on the 27th Jan 2019 who was treated at the IDH and after a fortnight or so was released from hospital amidst usual pomp and pageantry.
Look at the ‘virus proof’ DGHS and the fool hardy minister in kissing distance from the patient and the rest of the crowd. No masks and no distancing. Sending the outrageously insane message to the greater public.
3. First SL indigenous sufferer was detected in the second week of march 2019
Give the credit where it is due. The waiting period between identifying the Chinese tourist and getting our own first case was used fruitfully by the task force to get prepared to face the enemy. By 23rd March the SL Army had built 45 quarantine centres. Thermal detectors at the air and sea ports etc. By the 25th there were 3500 in quarantine and 14,000 contacts in isolation. Sri Lanka was branded the 16th Most Covid-19 prone country but ranked 9th best country as per its control at that time.
4. With the advent of SL expatriates from Europe Covid-19 started spreading fast and country’s test trace isolate led by the military worked somewhat.
5. By the 3rd week of March arrivals to all needed to go to quarantine and a few days later airports were closed altogether except for flights that were used to repatriate SL expats.
6. All island curfew was imposed on the 22nd March 2020. By this day the total infected was around 150 and total dead were under 5 and after a month this was lifted but continued in several high risk districts. Restrictions on gathering like weddings, funerals and birthday parties remained for many months.
7. Navy Camp Nidus
Navy camp was a rapidly growing cluster from late March 2020. A navy sailor holidaying at home in Polonnaruwa tested positive for Corona on the 23rd April 2020 had gone home from the Welisara camp crossing district borders. It was alleged that those who got the disease were the ones who wrestled with the uncooperative drug addicts from Suduwella in Ja-Ela on the 10th of April or so. The fact that this incident gave rise to a cluster of several hundred inside the camp is no secret. Therefore it seems that the sailors were released on leave before they finished their quarantine period. Who released them and on what grounds?
8. Situation improved slightly. Then came MP Thondaman’s funeral saga in which no health guidelines were followed. Crowd restrictions were flouted with the greatest impunity. Look at the picture below. Is there even a one inch distance here? This happened on the 31st May 2020.
Thondaman died at the Thalangama base hospital on the 28th May 2020. His body was airlifted to Gampola the morning of the 29th and was taken to the Ceylon Workers Congress headquarters in Kotagala 30th.The remains were also placed at his residence at Wawanthan Estate, Ramboda, Kotmale.The funeral of the late CWC leader took place at Thondaman Stadium in Norwood, Hatton on the 31st. All this `round the country funeral procession’ took place very soon after the lockdown was lifted and while stringent crowd restrictions were supposed to be in place.
9. Kandakadu Cluster
In early July last year the rehabilitation centre at Kandakadu got inundated with Covid patients. In a jiffy numbers rose to 252 and the Head of the Corona Control Task force told us ‘bed time stories’ as to how the inmates could have got infected. This link will lead you to an article if you want to read more about it. Clearly this incident was a nasty ‘own goal’.
Despite Welisara cluster and Kandakadu debacle Covid transmission in the island was getting under control slowly. People relaxed on health guidelines thanks to wrong messages sent on electronic and print media by the politicians and health officials.
10. General Elections on the 5th August 2020
Picture shows ‘disinfection’ facilities that were made available at polling booths. Where is the distancing? Corona was barely under control and the conditions were far removed from ideal or even good enough for elections to go on. Holding elections did go on as scheduled apparently with the approval and blessings of the Health Authorities who themselves have shown in no small measure their scant knowledge and their backbone made of jelly. Macko tried to conduct the elections under health guidelines and he may well have got it right for the most part but a project of this magnitude cannot guarantee a 100% transmission proof environment and as such may have contributed to the surge in infections seen in October 2020.
11. Brandix was allowed to import infected labour from India and the second wave got on to a flying start. Before we could say Jack Robinson Covid had spread far and wide. Subservient stooges lied to the public again. They maintained a ‘no community spread’ stance when indeed quite a few patients who had no connection to a known cluster were abound. It was only the PHI union boss, Upul Rohana I think is his name, who had the backbone to say that there was community spread as they were seeing cases with no connection to an established cluster. I take my hays off to him. Long may you keep telling the truth. This will take you to an article about the above incident if you are interested in reading more about it.
12. With difficulty numbers were coming down albeit slowly. Foolishly the authorities lowered the daily PCR numbers too. Naturally the numbers detected would go down. This pushed them in to a state of complacency and then to a state induced slumber. Emboldened by these inaccurate figures the authorities ventured out to `import’ Ukrainian tourists in what they called a bio-bubble to keep the `economic embers glowing’ little realising or indeed being consciously oblivious to the fact that in early February 2021 the figures were showing an upward trend. Some of the tourists were found to be infected on arrival. I guess in an economically challenged country like Sri Lanka this kind of `experiment’ to see if her biggest foreign exchange earner’ tourism can be kept on some inexpensive life support such as the bio-bubble scheme is pardonable provided her bureaucrats and the businesses responsible were law abiding or at least god fearing. They showed themselves to be neither and hence this so called ‘experiment’ is not an experiment at all but a desperate attempt at keeping the economy going. This is a link to the bio-bubble tourism of Sri Lanka.
13. The Great Indian Tragedy Next Door
Indians initially showed a degree resilience in battling the infection and some resistance to the transmission of the virus. Modi did act sensibly at first and slowly but surely began to lose his grip. When `sun was shining’ on India she was generous enough to donate large amounts of vaccine to the rest of the world. Alas! Indian resistance was only as strong as their poor state of literacy and their high degree of ignorance. The present epidemic took off like a heap of cotton catching fire the moment England variant of high transmissibility reached India. Even though India has an intense population density and almost negligible literacy the spread of Covid could have been controlled better if not for the pig-headedness of Modi. I am not getting in to politics of India ruining the chances of survival of her people but if you want to read more here is a good link. There is a lot of similarities with Sri Lanka.
Please don’t get carried away by Indian politics. I just wanted to show how our task force snoozed on when the next door was on fire.
It is a carnage of unimaginable proportions with patients being found in hundreds of thousands overwhelming hospital capacity thousands of whom dying defeating mortuary and cremation facilities, people dying on the roads and dead bodies being cremated by the roadside, open spaces and esplanades.
With such a virulent virus next door creating pandemonium Sri Lankan authorities failed to act quickly enough to close her borders to India. This is a gross violation of duty by the Sri Lankan rulers. Restrictions on travellers from India were only imposed only a few days ago. Trying to close the stable door when indeed the steed has already fled.
14. Sinhalese & Tamil New Year
It is true people have been eagerly waiting to celebrate the above New Year. Last Christmas was celebrated by the British in a muted way and there was no discord amongst them around the decision as the country was in a partial lockdown. Sri Lankan situation was not that much dissimilar. Our numbers had shown a rising trend despite lowered testing figures. If this is not enough of a red flag what could be? However a conscious decision was made not to impose strictures for the New Year and when the Head of the Task Force announced this over tele it appeared as if this was what they were going to do come what may. Advise to the public was scrappy too little and not forceful enough indicating the Governments complacency on the matter. History has shown us that Sri Lankans have been oblivious to health guidelines and lockdowns had to be imposed from time to time. So the question arises as to why this decision that lacked subtlety and precision was indeed made and by whom? Post New Year numbers sky rocketed. ICUU were overwhelmed. Few days down all hospital designated Covid-19 beds were full.
15. Current Situation.
Into the valley of death
Is riding the 23 million
Covid to the left of us
Covid to the right of us
Covid in front of us and
Covid behind us. Volley’d and Thunder’d. (Apologies Lord Tennyson)
Will there be any solace? We have to create our own `Faraday Cage’ guys. It is not difficult.
1. Just stay at home.
2. If you ever have to go out stay masked and
Don’t ever touch it till you return home.
3. Wash your hands when and where
You can with soap and water or sanitize them frequently with 80% alcohol gel/liquid
4. Keep a 2 metre distance from everyone around
And you would be home and dry
Corona virus disease 2019 is a respiratory illness mode of transmission of which is now very well established. The intricacies of molecular and sub-molecular virology is not useful to the common man. The simple truth is that the virus can be kept at bay by observing what I have listed above. Whatever the viral mutant is, no matter how virulent or how transmissible the virus is, what is required of the public is what I have listed in green and what is required of the government is, to Test adequate numbers, detect patients, Trace multiple layers of contacts and Isolate them. It is the bounden duty of all governments both in rich and poor countries to accord their citizenry security not just from macroscopic enemies like suicide bombers but also from Nano-enemies like viruses causing pandemics.
Countries that succeeded in getting on top of the pandemic had leaders who put the country first, thought clearly and acted decisively and were of the strong and unwavering belief that spending time needed to stop transmission was time well spent and economy that may have shuddered a bit would soon recover. Dithering leadership is a recipe for disaster just like in a real time conventional war. Unlike in a conventional war a viral pandemic poses an `unseen enemy’ which the military is ill equipped to handle. Hence steadfast preventive medical personnel should have taken the lead and the tri-forces with police should have helped in achieving physical success in testing tracing and isolating. Not to be. When the virus was a milder one as was the case with the initial phase military was effective but with the more infective Peliyagoda cluster that spread far and wide within days and with the present wave with the England strain military was caught out like how the ‘broken bone’ weda ralas get caught out with supra-condylar fractures of limbs (in which arterial complications leading to limb loss can occur even with allopathic treatment). Unassertiveness of the ring of health specialists that surround the President, with their hazy knowledge of the subject in their own chosen fields seems to have led to erosion of President’s confidence in their ability to handle the pandemic. Eventually the resultant combination seems to be like the lame and the blind. No wonder slightly more than an ordinary epidemic proved just too much for them.
Authentic Information & Public Confidence
In managing a deadly pandemic of the present sort public confidence is paramount. Scrappy, incoherent, inconsistent, inaccurate, incongruent and scant information deeply undermines public confidence and leads to disobedience as evinced by masks worn across foreheads or around the chin and people getting into `scrums’ at public transport facilities, any public utility or indeed shops. When there is no concrete information coming from official government sources any Tom Dick or Harry becomes a source of `official information’ like the GMOA, the union of Medical Laboratory Technologists etcetera. Representatives of these organizations who address the public do not have the necessary knowledge to comprehend the intricacies of epidemics let alone being experts in infectious diseases. This leads to a state of confusion of the public which rulers of primitive countries like Sri Lanka would seize to get behind in order to cover their sins. It is of note that German Chancellor Angela Merkel herself who of course is a learned woman being a qualified scientist, personally came on German TV regularly and briefed the public candidly on the daily situation of Covid-19. Why can’t Sri Lankan leaders do that?
I have pointed out several instances in which Health Departmental spokespeople appeared to be blatantly lying to the public. One such instance is when the former DGHS came on TV and said the 3 cases from the NHSL, Rajagiriya and Kolonnawa who tested positive for Covid the previous day have been rendered negative on retesting. He was so predictable. I knew he had to do this in order to maintain `no community spread’ status. Lo and behold he did. Naturally people become cynical about all government communiques. Just look at these figures. Highest number of Covid patients so far detected per day has been yesterday. It was something to the tune of 3500 or so with 38 deaths. This number of positives has been detected by testing only around 25,000 people. If simple arithmetic is used to calculate how many it would have been if the testing has been close to recommended numbers viz. 20,000/1 Million population the real number detected would have been 64,400. [(460,000 ÷ 25,000) x 3500] This seems about right to me but as I have not used an appropriate statistical method I cannot vouch for its accuracy. Nevertheless even if the corrected figure is half of my score which would still be 32,200 a figure close to 10 times the government declared figure. A specialist doctor in the Health Department reiterating on TV a few nights ago that there was no community spread is hilarious. On that count the president of one of the nurses’ unions openly challenged the authorities to link the 5 names he was going to forward to any or more established clusters. Also, criteria for inclusion for someone to be listed as a Covid death was changed recently as per announcement by the chief Epidemiologist on electronic media a few days ago. If a heart patient dies of Covid-19 that would not be counted as a Covid death unless he had evidence of Covid pneumonia. This is clearly a vain attempt at keeping the number of Covid deaths recorded to a bare minimum. As senior doctors we know (or for that matter every doctor should know) that SARS COV-2 virus infection adversely affects the whole body in seriously ill people. So much so many researchers have compared it with Systemic Inflammatory Response Syndrome (SIRS) which not infrequently happens with sepsis (serious infection with pus forming bacteria). This literally means the whole body is inflamed. When patients die of it they do so mostly because of multi-organ failure and in quite a few of them there may not be any evidence of lung involvement on plain X-ray. Also as it appears that quite a few now die at home there is no way to know if they ever suffered a pulmonary insult during the course of their illness. As such the new classification of Corona deaths is a last ditch attempt by the authorities to try and keep the number dead low.
Applying the same calculation as above the real number dead yesterday would have been around 699! [(460,000 ÷ 25,000) x 38] Lying to the public is a dangerous game that can come around to bite them on the back.
This is counterintuitive because;
* Firstly the Department of Health Services loses its credibility and being the Health arm of the Government, the latter itself falls in to disrepute.
* Secondly the health officials have lost a golden opportunity to educate the public as to how the virus spreads and how human beings keep on disseminating it by their irresponsible behaviour towards a deadly illness. VIRUS DOES NOT MOVE. WE MOVE IT AROUND BY IRRESPONSIBLE BEHAVIOUR.
* Thirdly because of the fact that the mere knowledge of community spread would put mortal fear in to people’s minds so that they would try their best to follow health guidelines, authenticity should have been the flagship principle behind dissemination of Covid information at this point in time. Not to be.
Take home message. Corona though a rapidly mutating manmade virus is not invincible. Viruses need the internal milieu of living beings for their survival. If we do not offer ourselves as a freely available lodging the viral transmission would invariably slow down and eventually die away slowly and if we completely `insulate’ ourselves from the virus the latter lurking around in droplets etc. would die away quickly. New Zealand did this well. Hence we can do it too. Only political appetite and will would be needed. Numbers given by Sri Lankan authorities do not seem accurate enough. The real numbers seem a big multiple of them. There is Corona everywhere. Anecdotally people are dying like butterflies at their homes in many places. As such closure of villages or closure of districts or indeed prohibition of interprovincial movement is tinkering around the edges. I am surprised Public Health Specialists haven’t told the law makers of Sri Lanka such. What I am not surprised at though is, if their opinion has been steamrolled by the `know it all’ politicians. Come on Mr. President, be real, put your foot down and lockdown the whole country for a month not just two weeks contrary to the belief of some public health experts who wrote to you recently one of whom being a global expert and a 1967 batch-mate of mine.
After reading this exhaustive essay you deserve a good breather. Here is one.
Please substitute Corona for Religion in the lyrics and it will mean a lot too.