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Overcoming the problem of Covid-19 spread, increased severity, and deaths

16 Sep 2021

By Prof. Tissa Vitarana The Covid-19 pandemic is extending worldwide, increasing health, economic, and social problems. The Sri Lankan economy is in a foreign debt crisis as a result of persistent borrowing by successive capitalist governments to bridge the foreign trade deficit (FTD) since 1977, due to the cost of imports often being double the export income. The United National Party (UNP) policy of importing, led by market forces, which the rich and rich countries control, played a major role, while the Sri Lanka Freedom Party (SLFP), influenced by the Lanka Sama Samaja Party (LSSP) and the Communist Party, which turned to develop the national economy, played a lesser role. But both faulted by promoting a luxury lifestyle. The bad mismanagement of the internal economy leading to large budget deficits has increased the internal debt of the government and the people who are at the mercy of money lenders and microfinance companies. In this context, Covid-19 has severely disrupted the economy, with enterprises closed or trimmed and many job losses. Schools are closed and examinations postponed. The future of the most poor students looks bleak. The illicit drug industry is flourishing, with an increase in organised crime. The prices of all goods, especially essentials, have soared under the control of a powerful profiteering mafia that has cornered the markets. Hunger has become a bigger problem than Covid-19, and the Government has been compelled to declare an emergency to gain control of the situation and ensure that essentials can be made available to the poor and lower middle-class under a rationing system. Many people have only one meal a day. The public service has deteriorated and there is widespread corruption. Future prospects are dim. The very fabric of society is breaking down. The prospect of an economic depression has become a real threat. The question being asked is whether we will be able to control the situation at all. When will it end or will we have to learn to live with Covid-19 as a permanent feature. The increase in the number of cases and their severity has in many countries like Sri Lanka (the official figure for confirmed cases has sharply risen to 474,780 by 8 September 2021) led to the overcrowding of hospitals, filling beds, both on and under them, and intensive care units (ICUs). The health personnel are heavily overworked and the service may break down. There has been a steep rise in deaths, and the official figure of deaths had reached 10,689 by 8 September 2021, while the real figure is probably above this. The outcome has created a sense of fear among the people, and the question being asked is whether Covid-19 can ever be brought under control. Though the Government is conducting an intensive vaccination programme, first targeting the vulnerable groups (the over 60 years age group and those with serious co-illnesses like heart disease). The avoidance of taking the vaccine by a significant number has posed a problem. It has been stated that 85% of deaths are in the vulnerable group and this group must all be vaccinated. Further infection is no longer confined to urban areas, especially in the Western Province. It is now prevalent in all districts, including rural areas. I suggested a way out to former Health Minister and incumbent Transport Minister Pavithra Wanniarachchi about eight months ago at the one and only occasion I met her, at the Health Advisory Committee meeting in Parliament. I said that the cluster presentation is being superseded by community spread and that a community-based strategy was necessary. This should be a national effort and it would help if a Covid-19 Committee of party leaders was formed to interact with her. The Muslim burial issue, for instance, could have been solved without it becoming an unpleasant issue. But she refused to accept my assessment and said that the leaders could come to the Health Committee in Parliament. But she held no meeting thereafter. If my suggestion had been put into effect at that time, the magnitude of the problem would probably be much less today. Sri Lanka should aim at minimising the number of those getting the more severe Covid-19 illness and preventing all deaths. At the same time, if everyone can live a near normal life and do his/her job and live comfortably, that would be ideal. The best result is to get rid of the virus altogether, which is very difficult but not impossible. The Covid-19 virus is a fairly large virus (180 nanometres) with radiating spikes that enable it to attach to living cells that have appropriate receptors, like the mucus lining cells of the human respiratory tract. Viruses, unlike bacteria, cannot grow and multiply on their own. If left in the open at our temperatures and humidity, they die out in a matter of about four to five hours (maximum about 24 hours). Thus, the best way to avoid getting infected is to wear a face mask covering the nose and mouth, and spectacles to protect the eyes if possible. The virus is usually transmitted from infected mucosal discharge as droplets when sneezing or coughing, or loud talking by an infected person. By social distancing, one metre or better two metres, the spread can be avoided. Hands also can transfer the virus from any surface while the virus is alive, so frequent hand washing with plenty of soap and water can kill the virus. Avoid crowds. If everyone practises this theoretically, transmission ends and Sri Lanka can be free of the virus. But we Sri Lankans are a friendly, sociable, and ill-disciplined people who automatically rally around when they hear the word “machan” (mate). Ill-enforced shutdowns are also failures. The Government has chosen to resort to vaccines. There are many available, and much money and effort has gone into procuring them amidst heavy competition. Despite the heavy cost, the target is 100%. As the protection is relatively short-lived, less than one year, an annual booster for all will be very costly. Maybe a more targeted approach may give better results. The vulnerable group as a whole should be fully immunised. Those under 60 years of age should be selectively immunised, e.g. frontline health workers, factory workers. The choice of vaccine should be based on proper data. The manufacturing company and supplying country should give the results of their studies and mass use. Other countries using those vaccines should also provide data. Where information is lacking, we may need to do our studies. Since 80% of those infected get no or mild symptoms, especially in those under 60 years, and acquire natural immunity, is it necessary to vaccinate them? This is a subject for further study. Unless more severe variants appear, then newer vaccines may be necessary. Let us watch what Covid-19 is up to. Since at present the case fatality rate is relatively low (1.8%) and the rate of severe cases is also about 5%, there is no need for panic. So let us decide after careful study. (The writer is a virologist, government parliamentarian, the Committee on Public Accounts Chairman, and the LSSP General Secretary)


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