{"id":222368,"date":"2021-09-08T04:22:05","date_gmt":"2021-09-07T22:52:05","guid":{"rendered":"https:\/\/www.colombotelegraph.com\/?p=222368"},"modified":"2021-09-11T12:11:11","modified_gmt":"2021-09-11T06:41:11","slug":"a-way-forward-on-effective-management-of-covid-19-pandemic-in-sri-lanka","status":"publish","type":"post","link":"https:\/\/www.colombotelegraph.com\/index.php\/a-way-forward-on-effective-management-of-covid-19-pandemic-in-sri-lanka\/","title":{"rendered":"A Way Forward On Effective Management Of Covid-19 Pandemic In Sri Lanka"},"content":{"rendered":"

By Krishan Deheragoda<\/a> –<\/span><\/strong><\/span><\/p>\n

\"\"<\/a>

Prof Krishan Deheragoda<\/p><\/div>\n

The COVID-19 Pandemic Situation is miserably going out of control from the hands of the Government and the Health management system of the country, due to inability of the authorities to take timely and rational informed decisions. Cluster base identification of COVID-19 cases and their associates was the key strategy adopted by Sri Lanka from its inception, while categorically rejecting any possibility for risk of its Community Spread. However, it is evident that the COVID-19 \u00a0 <\/span>pandemic is now widely spread into the Society and the Authorities are no longer talking about any clusters[1].<\/i>\u00a0<\/span><\/p>\n

Had the truth about the Community Spread of pandemic being revealed to the general public without concealing the real facts, they would have volunteered to take self-prevention precautions and believe what health authorities tells. It could have helped to manage the situation more effectively than now. Moreover, many sources including the political partners of the present coalition government alleged that the health authorities and the COVID-19 Control Task Force have systematically distorted the real facts on Number of PCR and Antigen Tests done and their results, reported incidences and deaths, vaccination process, drug shortage etc. This has severely constrained the ability of government to take informed decisions in a timely and relevant manner. As a result, a situation had emerged, where the people and many agencies including a larger segment of medical fraternity to question the authenticity of official figures, statements, and directives of the Government. Because of the fact that the entire COVID-19 management process had turn into a highly politicized operation, the country becoming more and more vulnerable to the pandemic disaster is inevitable. <\/span><\/p>\n

Some salient features of Sri Lanka\u2019s COVID-19 Control\/Management<\/span>:<\/span><\/p>\n

1. The authority of the health sector specialists was undermined in the COVID-19 Pandemic Control\/Management, and their professional advises were unheeded by the Government. <\/span><\/p>\n

2. The whole pandemic control\/management endeavour was politicized on one hand, and the GOSL favoured unscientific methods, over the globally accepted best practices on the other. <\/span><\/p>\n

3. Lack of scientific informed (evidence based) decision making by the GOSL with regard to COVID-19 Control\/Management.<\/span><\/p>\n

4. Large Majority of the deaths could have been prevented, if Sri Lanka had followed the internationally recommended Vaccination Protocol: i.e., give first priority to vaccinate; a) the Health System personnel, b) other Front-Line people involved in COVID-19 Pandemic Control\/Management, 3) the Population over 60 years of age and 4) the persons suffering from noncommunicable diseases. This approach was abandoned, by excluding the 3<\/span>rd<\/sup><\/span> and 4<\/span>th<\/sup><\/span> categories of people, soon after the vaccination process commenced. Accordingly, instead of vaccinating the age 60 & <\/span>+<\/span> people and those who were suffering from noncommunicable diseases, the 30 & <\/span>+<\/span> age group and various others were given priority; on an ad-hoc basis for the reasons best known to those who changed the protocol.<\/span><\/p>\n

5. Due to adherence of archaic data management methods, the ability to analyze, forecast, predict spatial and temporal trends of Community Spread, and assessment of logistical requirements such as: pharmaceuticals, medical and testing equipment, clinical Gas, ICU bed capacities, hospital, and manpower needs, including procurement processes and lockdowns were all throw into disarray and out of control.<\/span><\/p>\n

6. Poor reporting of actual cases; <\/span>either<\/span> due to not collecting or fabricating relevant data, <\/span>or<\/span> not doing testing.<\/span><\/p>\n

7. Poor risk communication by authorities, resulted in forming a huge professional and public mistrust on the COVID-19 information presented by the authorities.\u00a0 \u00a0<\/span><\/span><\/p>\n

Following Outcomes have become apparent due to above situation:<\/span><\/p>\n

1. COVID-19 Virus has already spread into the Community.<\/span><\/p>\n

2. Sri Lanka has very high Deaths per Million individuals.<\/span><\/p>\n

3. We have the highest case fertility rates due to COVID-19.<\/span><\/p>\n

4. We have very high positivity rates and very minimum testing.<\/span><\/p>\n

5. Indicates that the hospital system is overwhelmed: not enough ICUs, Oxygen, Drugs and Trained Staff available to care for patients.<\/span><\/p>\n

6. Public dissatisfaction is rising on the face of unsound and inconsistent GOSL directives and decisions.<\/span><\/p>\n

7. Sri Lanka classified into the \u201cRED LIST COUNTRIES\u201d, with highest COVID-19 risk. <\/span><\/p>\n

In the light of the above following are recommended to the GOSL for its consideration<\/span>: <\/span><\/p>\n

(1) Replace the existing<\/span> <\/span><\/strong>PRESIDENTIAL TASK FORCE ON COVID-19 CONTROL<\/span> with the <\/span>NATIONAL COUNCIL FOR DISASTER MANAGEMENT<\/b>,<\/span> which has the legal teeth to control and manage the present pandemic. As per the section 2 of the Sri Lanka Disaster Management Act. No. 13 of 2005<\/a><\/span>, there shall be a unique body called the NATIONAL COUNCIL FOR DISASTER MANAGEMENT (NCDM).<\/b> According to Section 3.1 of this Act, the NCDM is consist of the President of the Country as its Chairman, and the Prime Minister, the Leader of the Opposition and all relevant ministers, Chief Ministers, including 5 Parliament MPs to represent the Opposition, as its other members. It should be noted that there is no other comparable statute as powerful as the above act in this Country, which has vested with wide range of powers to handle any type of disaster of any origin or magnitude including current COVID-19 Pandemic. Unfortunately, it seems that the Government of Sri Lanka is unaware of this statute, and its provisions. This has been the case thus far with regard to many governments in the recent past.\u00a0 <\/span>Therefore, the NCDM was obsolete since it was mandated, and it was nominally summoned few times since 2005 to date, that was also without its full constituents members. There will be Subject Specific Technical Advisory Committees to assist the National Council for Disaster Management and the Disaster Management Centre[2]. <\/span><\/p>\n

Instead of trying to re-invent a wheel, GOSL should have use the Disaster Management Act to control\/manage the COVID-19 Pandemic.\u00a0 <\/span>It has the mandate to formulate a National Policy and programme on the management of any disaster. Based on such National Policy and Program it is mandatory to prepare a National Disaster Management Plan<\/b> and the National Emergency Operation Plan<\/b>[3]. The first National Disaster Management Plan was prepared in 2014 with a time horizon of 4 years (2014-2017). As per the Disaster Management law it is mandatory to revise the National Plan in every four years. Accordingly, a revised plan was prepared in 2018 as per the Sendai Framework for Disaster Risk Reduction (2015-2030) protocol; that Sri Lanka has ratified, for the next 12 years (2018-2030). Unfortunately, this plan lies unfollowed at the Disaster Management Centre, and today it is functioning without a plan, approved by the Cabinet of Ministers. <\/span><\/p>\n

There shall be a special organization created by the Disaster Management law called Disaster Management Centre (DMC)<\/b> and a Technical Advisory Committee<\/b> to guide it[4]. Sadly, the DMC is idling at present together with its trained staff and mechanisms, and island wide networks including the Village Level DM Committees, which could have effectively used for COVID-19 pandemic control work at the district and community levels. Moreover, it shall be the duty of every Ministry, Government Department and public Corporation to prepare a Disaster Management Plan with respect to such organization to counter any disaster or impending disaster, based on the National Disaster Management Plan and in accordance with such guidelines as may be specified by the Council[5].<\/span><\/p>\n

In an eventuality of a disaster the President may, on President\u2019s own motion or on the advice of the Council, by PROCLAMATION DECLARE THAT A STATE OF DISASTER EXISTS, either in respect of any area or areas specified in such proclamation, or of the whole country. None of these legal provisions have been used by the government at precent instance. Further, provisions are there to maintain an <\/span>emergency fund<\/span> to enable the people under such emergency situation; deviate from the normal public administrative circulars and public procurement procedures and mobilize resources at all levels etc. to bring relief to the affected people. Also, delegation of authority, the professional indemnity for the public officers and procedures to be followed upon the declaration of a State of Disaster are there in this statute and readily available to use at this critical hour of COVID-19 Pandemic. All disasters are well defined and listed in this statute and also it is subject to amend as and when required.<\/span><\/p>\n

(2) ENABLE THE PRESIDENT <\/b><\/span>to make <\/span>EVIDENCE BASED INFORMED<\/span> POLICIES AND DECISIONS<\/span> on COVID-19 Control for Implementation, which is currently lacking. Following actions will be useful in this regard. This can be done through by empowering the <\/span>NATIONAL COUNCIL FOR DISASTER MANAGEMENT (NCDM)<\/b><\/span>.<\/span><\/p>\n

a) Appoint a TECHNICAL ADVISORY COMMITTEE ON HEALTH FOR COVID-19 MANAGEMENT<\/b>, under the Disaster Management Law, comprising of relevant Health Sector experts, sans politicians including the Minister\/s of Health. This could be headed by Director General of Health, to make recommendations to the President and the National Council of Disaster Management to take decisions on: <\/b><\/span><\/p>\n