11 July, 2020

Blog

We Have At Least Got Corona By The Tail   

By M.M. Janapriya

Dr. M.M. Janapriya

I have already written on the subject of Coronavirus infection urging the government to lock down Sri Lanka for 3 weeks. Since the return of Sri Lankans from highly infected parts of the world like South Korea and Italy, the government of Sri Lanka has deployed a military style control programme which is commendable. 

These include thermal detectors at BIA, quarantine of people returning from the said countries and those suspected of being in close contact with infected ones, quickly expanding the quarantine facilities available, expeditiously making facilities available in 16 major hospitals to house and treat Corona patients, making IDH the key institution to and from where patients and medical information could be exchanged, getting the police involved early to track down people likely to have been exposed and those who are uncooperative, travel ban from infected countries, stopping all flights to BIA, locking down high risk areas in the Negombo and Puttalam districts, declaring holidays and then enforcing island wide curfew, keeping up-to date with the numbers of proven and suspected cases, almost daily health education clips on TV etc.

The above is not an exhaustive list by any means and for a country squeezed of resources we have done extremely well so far. The total number of proven cases remains at 72 as of today and suspected cases over two hundred. These are not bad figures for a country in which the majority are poor and illiterate, fool hardy, know it all and good for nothing idiots. This is specially so as there is no mortality recorded at all. There are a couple of things I have been grappling with for days on end to find answers for, all the same.

1. The WHO accepted Corona mortality is around 3 percent. So Sri Lanka being not the best equipped country in the world to treat SARS Cov-2 infected patients, one would have expected at least one or two deaths by now. Luckily we have been able to keep our slate clean. The slate as clean as it may be, worries me significantly. It puts more questions in to my mind than answers. 

* Are we missing Corona deaths that may be masquerading as due to flu etc.?

* Are we deliberately keeping mortality figures away to prevent people getting frightened?

* Are we sort of a partially immune nation who, with the military style preventive measures are getting on top of the Corona menace?

I only hope that the last bullet point is the truth and this may well be the case for the following reasons. The first case of Corona was found in mid or early November in China even though the country officially declared the emergence of a new virus killing people in late December 2019. With an enormous expatriate Chinese community here in the island, we should have taken stringent measures at that time but for the lack of coffers or because of a sense of allegiance to the monitory superpower or simply because the health authorities were asleep at the steering wheel, this did not happen. This turned out to be a situation where one might say everything happens for the better. Lo and behold Corona probably did come to Sri Lanka in December 19/Jan 20 disguising itself as a bad flu foxed a gullible set of people and a somnolent set of authorities. 

This blew across the country and large numbers were afflicted by this bad `flu’. There were reported cases like the Physiotherapist at the Nawaloka Hospitals (I think he returned from China) who died of an atypical pneumonia following a febrile illness, the Cardiologist at Sri Jayawardenepura General Hospital Kotte (SJGH) who allegedly returned from China after seeing her daughter studying there and dying of a pneumonic complication of `flu’ and about seven or eight cases that apparently died of an atypical pneumonia after a febrile illness at the Teaching Hospital Karapitiya a few months ago. One of my old aunts too died of `flu’ pneumonia at SJGH in mid December 2019. Many other old and frail may have succumbed to this so called `Flu.’ If this was indeed Corona it infected a large number of people killed some, immunized those who survived and most who did not even show symptoms and blew away from Sri Lanka till those returnees did an `Italian Job’ in March. The immunity so rendered is called herd immunity. This is naturally acquired active immunity and is almost ‘god given’ for countries like us. Fortunately for the survivors and unfortunately for those who couldn’t we are a herd and there were enough medically lame and physically frail who unwittingly sacrificed themselves for the sake of the country.

In Sri Lanka we seem to have been taken unawares. While the Health Authorities were slumbering and the politicos were spending their usual extravagant and care free life, nature took control of the destiny of our country. Thank you nature, for according us herd immunity. Boris Johnson the British Prime Minister wanted to let this happen in the UK. Which meant letting the virus run through the entire population so that enough of the community would acquire immunity to make it difficult for the virus to spread. Microbiologists concluded that for this to happen more than 60% of the population would have had to get infected which would have left tens of thousands dead. Bojo was made to backtrack on his irrational idea as there weren’t any in the British herd that could be spared as cannon fodder.

If one does a retrospective study of all cases, at, say at the NHSL Colombo that have died of pulmonary complications of influenza in December 2019 through to February 2020 one would almost certainly see an exponential rise from the previous year. This would strengthen my suspicion. If a random sample of about 1000 normal people who have not had any symptoms of the disease can be found, their blood tested for SARS Cov-2 antibodies and around 50% of them showed good antibody levels, this would be the icing on my cake of suspicion.

Physicians are not the most pro-active people when it comes to radical action which is needed in this sort of situation. They simply do their job in the hospital, grace (or graze) the private sector at 4.00 pm and go home very late hardly able to get up in the morning. There was a Dengue epidemic rampaging across the country in 2004 and I was in active service as a Consultant Surgeon at the NHSL then. To me it was obvious that the so called Flu was indeed Dengue masquerading as influenza. The Department of Health Services had so far not declared this a Dengue epidemic. I interviewed 5 out of 7 physicians of NHSL Colombo as to how they excluded Dengue fever. They simply had not. I begged of them to try and exclude Dengue by taking a proper history and doing the necessary dengue blood tests. Few days later they told me they were seeing more than 50 Dengue cases per day.

I wrote to the newspapers and here is the link. Please read through the linked article too, fully, which would enlighten you as to how health authorities and politicians used to respond to natural disasters of this nature. The epidemic was soon declared a dengue epidemic officially by the government and I became the first ever and the last SURGEON in the whole world to be appointed to a Dengue control programme. Being a Surgeon I didn’t fancy the idea but accepted the challenge. I had to leave the country in a few months and hence could not contribute enough to the efforts of my preventive health colleagues. 

Because of the foregoing I would not be surprised if we have already had the first wave of Corona which took with it some of the susceptible lives while immunizing a large number of others. This may explain why there are no deaths so far.

In the same breath, may I plead with the readership not to relax the measures they have been following so far because sometimes the third wave can kill millions like the 1918 influenza pandemic. So carry on with the good work. Adopt even more stringent measures.

2. The daily suspected cases of two hundred or more, I would have expected, to have been further broken down along the following lines. “We got the blood results for 60 or so and they were negative and hence we sent them home. Even so another 50 suspected cases have been found and added on to the list. Out of the blood tests done yesterday 6 were positive and that is why the total number of sufferers has gone up by that figure”

This kind of transparency would win the confidence of the masses and make them cooperate more. 

*This article is dedicated to those noble people including my aunt who almost acted as the frontline defence against Corona invasion and eventually died while letting others live and acquire herd immunity to protect the vulnerable.

Print Friendly, PDF & Email

Latest comments

  • 3
    1

    Agreed – we have got Corona by the tail – not. Although the military was deployed at the BIA it is surprising to not that many arrivals from Italy and Korea got away without a proper scanning process or providing declaration of their travel and other details. This is a failure on the part of the armed forces assigned to man the entry points. Hence the reported figures of news cases is questionable .

    • 2
      5

      The government was too busy with the elections. They forgot the welfare of the people. Now they are reacting. Bit too late. Eran Wickremasinghe MP says we must unite. All crap he was busy disuniting the party . Now he has nothing more to say. He is now asking people to unite to fight the virus. Go home Eran.

      • 2
        0

        Dr. J,
        That’s an interesting hypothesis, that Covid-19 fatalities in Sri Lanka have been assumed to be something else. It is also possible that the govt. knows something that we don’t. That might explain the strong-arm tactics being employed.

  • 2
    2

    Our Inhabitants are poor illiterate good for nothing Idiots ,according to this Doctor.

    To me , that is the biggest community in Lankawe surpassing all Minority Communities in combination .
    And in fact contributing to make up that 70% of the inhabitant population,whom our well heeled UNP and Yahapalana supporters have labelled as Sinhala Buddhist Racists.

    Out inhabitants the great majority are curious in their nature.
    They probably want to see Corona Vd in action , the same way they went to the Beach to watch the Tsunami.

    When the new Italians and the South Koreans and the Iranians came back , they went to visit them hoping to get some goodies as Sinhala New Year presents.

    One UNP Heavy Artillery piece in my old home town, Mr Abeygoone I head even donated the Respiratory Protection he was wearing to a UNP supporter in th crowd ,who came to cheer him at the Jana hamuwa ,

    That sort of kind gestures in this hour of fear and need make our inhabitants feel good .
    And go about and practicing their curiosity..

    This Dr says our administrators should have checked the Chinese for Corona VD last year.

    I know Prez Nanadasean last year was fighting like hell to keep the CID Abey and the MIG hunters away ,
    He wouldn’t have had time to even eat Chicken Chow Min.. at the Flower Drum , let alone check the Chinese at Port City.,’

    Anyway I am glad the Dr is happy about the Curfew and want more of it.

    But my worry is whether our great majority whom Dr addressed in his preamble have enough Dhall , Rice and Mackerel in their Pantry Cupboards to feed the Kidies and the Hubbies?.

    BTW Prez Nandasena says he has acquired a big stock of anti Corona VD Drugs ,enough to save our Inhabitants,’

    Could it be those old Stocks of Malaria Tablets which Dr Rajtha and and his Osuhala buddy bought for our inhabitants ?.

    Will it work Doc?.

  • 5
    9

    It will not be surprising to hear that Sri Lanka is putting down the actual death toll figures, because this had been the practice before. In 1983 when over 3000 Tamils were killed, they said that only 800 were killed. In 2009 when about 40,000 Tamils were killed they said that only 7000 were killed.

    • 4
      0

      Alas! Dr Sankaralingam has touched a sore point.

      The Government of Sri Lanka has for one reason or another (take your pick from the options) always opted to massage the statistics to suit their particular stance. A reliable source told me of a meeting where the minister announced what he thought the figure should be for a certain key statistic – and lo and behold the Department of Census and Statistics arrived at about the same figure. No government wants to be caught with its trousers down!

  • 2
    0

    Dear Dr. M.M. Janapriya,
    .
    It looks to me as though there are many good articles on display here on “the Corona”. I see that there’s one by Prof. Kumar David that I haven’t yet come to grips with.
    .
    I was getting ready to deal with some of the issues raised in the comments on the article that you wrote just five days ago:
    .
    https://www.colombotelegraph.com/index.php/what-are-we-waiting-for-lock-down-sri-lanka-for-3-weeks-reappraise-the-situation/
    .
    I think that there are a few passing comments that I could make in response to the comments there because parts of our problems are caused by lots of bees in our bonnet.
    .
    I think that there is a good deal more that we have to hear from you as a medical man. Clearly, it is those with such knowledge who should be directing us. You (or shall we say younger counterparts of yours in active service) ought to be making the major decisions. The armed forces can implement, but you must determine wht has to be done.
    .
    This may turn out to be a rather untidy comment, but I hope that you get my message – one of gratitude to you for your exertions.

  • 3
    0

    The Covid-19 Task Force appointed by the President has done a good job in restricting the number of new infections to 5 on Saturday 21 March. This is likely to be further reduced during the next few days. 48 out of 77 Covid patients are those who arrived from visits abroad.

    The publication of the concept paper by Professor Kamini Mendis on the spectacular results achieved in controlling Covid-19 infections with Hydroxchloroquine and Azithromycin is another feather in the cap for Sri Lanka.

  • 1
    2

    It is very strange if those medical people who came from China would have had COVID 19 disease without any transmission to the treating team of physicians like that transmitted to one physician recently. Especislly thattime no rreating team would have employed PPE. We may be in our societynot having too close contacts like foreign guyes doing all sort of huging, night clubs etc. Our culture of having clean procedure like leaving the kitchen utincils in the Sun. Having meals from home. Using natural spices that may boost immunity. As you said all have to brainstorm and analyse our country situation.

    Dr. N. Jeyakumaran

  • 1
    0

    Thank you Dr. Janapriya for your article. I agree 100% with what you say. Perhaps we too had our share last December via Singapore. Luckily no damage. Nobody we knew of got it except perhaps one guy from my age group. I always thought it had been here and given that herd immunity to a good chunk of our population. We have to now lookout for the signs of the third wave. GOSL is handling it the right way I believe.
    The Chinese TV channel was explaining how the two medicines they found act on the virus: one preventing the handshake with the human cell and the other attacking the RNA which is responsible for the multiplication.
    The medicine mentioned above is very bitter; same as the anti-Malaria medicine quinine base product. If taken in excess that can cause nausia and dehydration. When I was in Nigeria I nearly had it. The owner of the hospital himself had come running when alerted and poured saline to my mouth instead of giving to the hand as there wasn’t enough time. We had a good Jaffna crowd in that town and we mockingly call Malaria medicine to Campari. May be it would help to prevent anxiety at least in this case.
    Thank you once again doctor.

  • 1
    0

    There were about a hundred Italians who were the contractors for a road project where I was the Resident Engineer. Italians were known as the road builders to Nigeria and Sri Lankans had reputation as Dam Builders. The first dam in Northern Nigeria (from where the current president come from) was designed and built by a Sri Lankan. So these Italians were very nice people.
    I feel very sad that they have been affected this way.

  • 1
    0

    The argument is interesting.
    That we have had COVID 19 having a free run since Nov 2019 doesn’t sound right. Considering how infectious this whole thing is, and without any isolation in place our population would would have been swamped with a viral respiratory infection along with a noticeable demand for ventilation support among medical patients. There was none of that.

    Now If we actually had Covid 19 without being aware of it in the last 4 months , it has behaved in a very benign fashion I.e. low infectivity and low severity.
    We Must do antibody levels to check if this true

  • 3
    1

    Where are the Yellow Robes? why cannot these Mahanayakas hold any pirith ceremony to chase this Korona Devil which is destroying our country.
    the President and the Prime Minister always meet the Mahanayakas to get advise to solve the Minority problems of releasing the lands forcibly occupied by the Sri Lankan Army and releasing the innocent Tamils taken into custody and living in the Jails for over 15 years without producing them to the courts. Tourism came to 0 level. Over 60 factories closed five star hotels became 0 star hotels. all the Ministers gone underground in fear of the Korona. Minister Rambukwella told that he will destroy the Corona in 24 Hrs. and he went into hiding. where are the Ranavirus and Korona Virus? but Korona is spreading widely all over the country. Karma comes round and round.

    • 1
      0

      Abdul Sabry, If Karma comes round and round, Bible Isa. 53 says that Jesus paid full price on the cross receiving it all in his sinless body so that all human beings can be free. Why not invite him and give it a try if other things are not working. I found freedom from karma.

  • 1
    0

    Serological testing will help to veryfy.

  • 1
    0

    Dr Janapriya, I always read your contributions with close interest. However, you have a habit of knocking me sideways occasionally with some of your less thought through comments. For example:
    ‘With an enormous expatriate Chinese community here in the island, we should have taken stringent measures at that time . . . .’
    Really! Our Chinese population in Lanka is hardly ‘enormous’; the normally resident population is less than 4,000 (not enough to fill the pavilion stand at the SSC) and even counting the itinerants ie the temporary workers, they will not fill half the stadium. By no measure can that be enormous.

Leave A Comment

Comments should not exceed 200 words. Embedding external links and writing in capital letters are discouraged. Commenting is automatically disabled after 7 days and approval may take up to 24 hours. Please read our Comments Policy for further details. Your email address will not be published.