By 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.