By Ravini Perera
In the wake of the global Covid-19 pandemic in March 2020, the country's health authorities implemented intense measures to control the spread of the virus. The Ministry of Health played a prominent role in enforcing guidelines to be followed at the time. Some guidelines were homegrown, while most others were developed according to international standards and regulations.
While local authorities have been successful in issuing guidelines in the past to suit the situation in question, steps are being taken to amend these guidelines to adapt to the changing conditions. Thus, the objective is to make them simpler to ensure higher acceptance rates by the public and easy implementation mechanisms.
The cause for change
Secretary to the State Ministry of Primary Health Services, Pandemics, and Covid-19 Prevention Dr. Amal Harsha de Silva shared his views on the subject with The Sunday Morning.
Dr. de Silva stressed that these amendments are brought about mainly with the intention of encouraging people and businesses to operate better than they have till now, and to also support the Government’s efforts in containing the virus.
The criteria are expected to be changed and modified as per new information, focusing on the risks the country is willing to take. Initially, a zero-transmission concept was followed by the officials, where person-to-person transmission of the virus was not possible.
However, there were difficulties in achieving successful results with this concept, as it would require country borders to remain closed, and also cause the economy to come to a standstill. Though the concept of zero transmission may be ideal, authorities are currently holding discussions on enforcing short-term solutions while managing the economy.
“There must be a balance between running the country and medical views expressed. For instance, the decision to lockdown a country is of a political nature, but the medical authorities will influence such a decision based on recommendations on the risks and benefits for the country,” said Dr. de Silva.
Similarly, the advantages and disadvantages will be studied thoroughly by a panel of experts when amending the guidelines, and the concurrence of the top-tier officials will be required before the amendments take effect.
[caption id="attachment_111814" align="alignright" width="507"]
People going about their daily work, following health guidelines[/caption]
Implementing a practical approach
Utilising a practical approach in resolving the issues related to the pandemic within Sri Lanka is essential. Thus, regardless of the quantity of guidelines issued, if the general public was to refrain from adhering to such guidelines, they would be deemed unproductive.
Hence, guidelines should be accepted and comfortably followed by the people including internal customers (medical practitioners), and external customers (people receiving medical services). If the guidelines are too elaborate, people will face difficulties in complying with them.
With the development of new studies, and based on the current research, the world community is relatively well-informed about the virus. Thus, guidelines can be adapted accordingly. Initially, sufficient information was not available to be referred to by decision makers, leading many countries on the path to a complete lockdown. Though such practices would benefit the country in terms of maintaining a low death rate and limiting communicability of the virus, it creates irreparable damage to the economy and society.
Referring to the reality of the situation, Dr. de Silva explained that although health officials have urged the general public to maintain social distancing, this may not always be possible. Therefore, one must be mindful of the practical issues such restrictions may entail. “Restrictions must be realistic in curbing the spread of the virus – this is the main goal of the amendments,” he added.
Expert committee advice
A committee has been appointed to pioneer the amendments, comprising a variety of professionals such as public health specialists, epidemiologists, and medical specialists. This committee will study the guidelines followed by foreign countries, along with its consequences prior to changing the current guidelines enforced in Sri Lanka.
Several factors are considered in the face of a public health emergency prior to taking decisions for the betterment of the country. Hospitalisation rates, death rates, disability rates, communicability, treatability, economic impact, public concern, and the cost of treatment are some of the factors.
Speaking further, Dr. de Silva explained that the number of days that travellers are mandated to be quarantined upon entering a territory, the number of guests allowed to attend a function, conducting tuition classes, reopening of schools, and operations involving economic centres and fish markets are among the areas being considered for change.
“We need to strike a balance between the health requirements in place, and allowing operations to continue,” he said.
The panel of experts selected for this task includes Galle Faculty of Medicine Prof. Sarath Lekamwasam, University of Kelaniya Faculty of Medicine Prof. Arjuna de Silva, Postgraduate Institute of Medicine Director and Senior Prof. Janaka de Silva, National Research Council Chairman and gynaecologist Dr. Hemantha Dodampahala, Paediatrician Dr. Lakkumar Fernando, Sri Lanka Medical Association President Prof. Indika Karunathilake, Paediatric Neurologist Dr. Anuruddha Padeniya, General Surgeon Dr. Lalith Perera, and Neurophysician Prof. Ranjani Gamage.
The need to view problems through the eyes of professionals such as the aforementioned group is vital when handling issues related to public affairs. “It is important to take into consideration all aspects of healthcare, and not just prioritise a specific segment,” Dr. de Silva explained.
He also stated that the updated guidelines will be made available on all social media platforms in the days to come.
Healthcare norms in Sri Lanka
The primary concern of medical care is to not only improve the people’s health, but to also keep social tensions low, create employment, focus on medical and other industrial complexes, focus on the economy of the country, consider the feasibility of carrying out the recommendations, and reserve foreign exchange, among others.
Elaborating on the topic, the doctor stated: “Not allowing tourists to enter the country has had an immense impact on the economy. Therefore, recommendations of health officials in reopening of airports were crucial. Health diseases are social diseases. It reflects on our daily lives.”
Furthermore, the appointment of suitable individuals to fulfil roles at times such as these is of utmost importance, and must be considered strictly.
While the guidelines are being amended, authorities and the Government are also focusing on improving the healthcare system of the country by promoting access to medical care for all members of the society. Approximately 1,200 primary healthcare institutions are to be developed in the coming months to yield results of satisfactory standards to the users of healthcare.
Development of databases and digitalisation of all medical records of patients for easy accessibility, tailor-made medical advice, and consultation of doctors through the use of technology are some of the aspects of development. This is regarded to be a great step towards avoiding the inconvenience faced by people from overcrowding at hospitals, especially at times such as these. “Communicating rather than commuting,” he emphasised.
Adherence to the new guidelines issued by the authorities will yield benefits for the public, the country, and the individual in question. Furthermore, it was noted that non-compliance could entail punishment.
Photo The Sunday Morning
People going about their daily work, following health guidelines[/caption]
Implementing a practical approach
Utilising a practical approach in resolving the issues related to the pandemic within Sri Lanka is essential. Thus, regardless of the quantity of guidelines issued, if the general public was to refrain from adhering to such guidelines, they would be deemed unproductive.
Hence, guidelines should be accepted and comfortably followed by the people including internal customers (medical practitioners), and external customers (people receiving medical services). If the guidelines are too elaborate, people will face difficulties in complying with them.
With the development of new studies, and based on the current research, the world community is relatively well-informed about the virus. Thus, guidelines can be adapted accordingly. Initially, sufficient information was not available to be referred to by decision makers, leading many countries on the path to a complete lockdown. Though such practices would benefit the country in terms of maintaining a low death rate and limiting communicability of the virus, it creates irreparable damage to the economy and society.
Referring to the reality of the situation, Dr. de Silva explained that although health officials have urged the general public to maintain social distancing, this may not always be possible. Therefore, one must be mindful of the practical issues such restrictions may entail. “Restrictions must be realistic in curbing the spread of the virus – this is the main goal of the amendments,” he added.
Expert committee advice
A committee has been appointed to pioneer the amendments, comprising a variety of professionals such as public health specialists, epidemiologists, and medical specialists. This committee will study the guidelines followed by foreign countries, along with its consequences prior to changing the current guidelines enforced in Sri Lanka.
Several factors are considered in the face of a public health emergency prior to taking decisions for the betterment of the country. Hospitalisation rates, death rates, disability rates, communicability, treatability, economic impact, public concern, and the cost of treatment are some of the factors.
Speaking further, Dr. de Silva explained that the number of days that travellers are mandated to be quarantined upon entering a territory, the number of guests allowed to attend a function, conducting tuition classes, reopening of schools, and operations involving economic centres and fish markets are among the areas being considered for change.
“We need to strike a balance between the health requirements in place, and allowing operations to continue,” he said.
The panel of experts selected for this task includes Galle Faculty of Medicine Prof. Sarath Lekamwasam, University of Kelaniya Faculty of Medicine Prof. Arjuna de Silva, Postgraduate Institute of Medicine Director and Senior Prof. Janaka de Silva, National Research Council Chairman and gynaecologist Dr. Hemantha Dodampahala, Paediatrician Dr. Lakkumar Fernando, Sri Lanka Medical Association President Prof. Indika Karunathilake, Paediatric Neurologist Dr. Anuruddha Padeniya, General Surgeon Dr. Lalith Perera, and Neurophysician Prof. Ranjani Gamage.
The need to view problems through the eyes of professionals such as the aforementioned group is vital when handling issues related to public affairs. “It is important to take into consideration all aspects of healthcare, and not just prioritise a specific segment,” Dr. de Silva explained.
He also stated that the updated guidelines will be made available on all social media platforms in the days to come.
Healthcare norms in Sri Lanka
The primary concern of medical care is to not only improve the people’s health, but to also keep social tensions low, create employment, focus on medical and other industrial complexes, focus on the economy of the country, consider the feasibility of carrying out the recommendations, and reserve foreign exchange, among others.
Elaborating on the topic, the doctor stated: “Not allowing tourists to enter the country has had an immense impact on the economy. Therefore, recommendations of health officials in reopening of airports were crucial. Health diseases are social diseases. It reflects on our daily lives.”
Furthermore, the appointment of suitable individuals to fulfil roles at times such as these is of utmost importance, and must be considered strictly.
While the guidelines are being amended, authorities and the Government are also focusing on improving the healthcare system of the country by promoting access to medical care for all members of the society. Approximately 1,200 primary healthcare institutions are to be developed in the coming months to yield results of satisfactory standards to the users of healthcare.
Development of databases and digitalisation of all medical records of patients for easy accessibility, tailor-made medical advice, and consultation of doctors through the use of technology are some of the aspects of development. This is regarded to be a great step towards avoiding the inconvenience faced by people from overcrowding at hospitals, especially at times such as these. “Communicating rather than commuting,” he emphasised.
Adherence to the new guidelines issued by the authorities will yield benefits for the public, the country, and the individual in question. Furthermore, it was noted that non-compliance could entail punishment.
Photo The Sunday Morning