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The Covid conundrum 

02 May 2021

A long-standing South Asian joke, often repeated in jest, is that when India sneezes, Sri Lanka ends up catching a cold. A revised version of this morbid joke is that if India were to sneeze now, Sri Lanka would be on its pandemic deathbed. It encapsulates the current situation facing Sri Lanka with its northern neighbour being ravaged beyond all comprehension by a raging pandemic in all its brutality.  Notwithstanding the inherent geopolitical and social connotations of the “sneezing” parable, especially in the current context of big brother’s quest for regional domination, its fortunes in that pursuit seems intrinsically linked to its battle with the pandemic. Interestingly enough, across the Palk Strait, a similar situation seems to be taking shape with Sri Lanka having to face the same battle, if only to simply stay afloat.  If time can tell a story, at the end of April last year, Sri Lanka only had a few hundred cases, but 12 months later, that number has rocketed to over 100,000. The past week has seen records being broken on consecutive days with daily patient numbers averaging above 1,000 for the first time since the pandemic began. It appears that India’s complacency in keeping the virus under control, especially in the last couple of months has rubbed off on its southern neighbour which too, stands guilty of taking the foot off the pedal at a critical time.  India, obviously buoyed by its perceived success over the second wave, never thought twice about holding elections or allowing mass-scale religious events to go ahead. Now, the damage has been done. The fact of the matter is that the situation is bound to get a lot worse before it gets better. According to projections on CNN, a new scientific model had predicted a mind-boggling toll of a million deaths in India by mid-August. To put it in context, the death toll just crossed 200,000 last week amidst apocalyptic scenes of funeral pyres on street corners.  Back in Sri Lanka, the Public Health Inspectors Association (PHI) issued a stark public warning in the run up to the New Year holidays that unrestricted festive activities will result in a third wave by the end of April. And that is exactly what we have on our hands now. The stringent new measures being announced on a daily basis is akin to locking the stable after the horse has bolted. Therefore, the one thing that the health authorities cannot claim is that they were not warned.  It is unfortunate that the Government Medical Officers Association (GMOA), which normally raises its voice on everything under the sun, was conspicuously unsupportive of the PHI’s call for caution during the New Year period, even though the less influential Sri Lanka Medical Association (SLMA) backed the call of the PHIs. Now, after the damage has been done, the GMOA has resurfaced, offering all manner of advice to both the Government as well as the public.  The Head of the Covid Task Force keeps lamenting that the third wave has come about due to the irresponsible conduct of the public and that people are yet to comprehend the gravity of the situation. History has shown us that even if people understand the gravity of a situation, they are more likely to follow their leaders and the example they set – good, bad, and the ugly. This has been the story for 73 long years now. If, as the Covid Task Force Chief says, people should understand what’s good for them, today, Sri Lanka would be a very different country, with a different political culture and a much more disciplined society.  Right now, it is all about damage control. Whatever action that can mitigate further aggravation of the situation must be implemented quickly and efficiently. The blame game is not going to free up hospital beds or reduce the growing number of patients. Tough, decisive action is the need of the hour. The first thing that needs to be done is to halt arrivals from red zone countries with India at the top of the list. Instead, even while most countries have halted arrivals from India, we are encouraging travel from that country. One year and 100,000 patients later, we seem to have learnt nothing.  Italy last Thursday banned travel from Sri Lanka due to the worsening crisis here. It joins the US, UK, and Australia that have cautioned citizens against travel to Sri Lanka following the sharp spike in cases. Many other countries are likely to follow suit which makes the policy of keeping the country’s airport open for incoming traffic look increasingly ridiculous.  The danger in encouraging Indian or any other tourists to travel here is not just limited to the risk of importing new strains of the virus but also the possibility of some of them ending up occupying hospital beds in this country which at this critical hour should be exclusively reserved for its own people. The authorities should not only think of tourism dollars, it must also do the right thing by the people in a situation where health resources have been stretched to the limit.  An unspoken reason for the sudden explosion of cases could be the phobia and stigma that has been created about the people who test positive for the virus even though the great majority of them recover without any hiccups. This has forced people to evade testing until forced to do so. Treating patients as outcasts and criminals, banishing them to far flung, isolated areas when they could easily better isolate themselves in their own homes, putting less stress on state resources, has proven to be counter-productive. In the greater interest of all concerned, this strategy needs urgent review along with that allowing treatment of Covid patients exclusively at government hospitals.  At least at this late hour, the health authorities should take the public into confidence and reveal the true status of the origin of the new variant that is causing all this havoc. According to health authorities, it is the UK variant of the virus first identified on 8 April that is responsible for the current upsurge in cases. However, up until early last week, the majority of the new cases were attributed to the Peliyagoda cluster. It was only at the end of the week that the new cases were attributed to a “New Year Cluster”.  A “cluster” in the Covid context is usually the identified place of origin of a cluster of patients. With the authorities identifying the new cluster as “New Year Cluster”, they are in fact admitting that the origin of the cluster cannot be traced, unless of course New Year is a place in Sri Lanka. With the source unknown, what it means is that the long-denied community spread has now officially begun.  The raging pandemic has also brought to light the worrisome fact that there are only 700-plus intensive care beds across Sri Lanka for a population of 21 million. Basic scrutiny of this data shows that the country’s healthcare infrastructure is ill-equipped for coping with a pandemic of this magnitude. With that being the ground situation comes the news that the Government is preparing to purchase four Russian-made helicopters, spending millions of precious US dollars, that too for “peacekeeping purposes” in other countries. Whatever the merits of that may be, it is obvious that priority should go towards the rapid upliftment of the country’s healthcare infrastructure because Sri Lanka, like India across the seas, is in for the long haul with this pandemic, given that vaccination is nowhere near what it should be.  Today, Sri Lanka finds itself between a rock and a hard place in its vaccination programme with just 4% of the population having received the first dose of the AstraZeneca vaccine. Unfortunately, with the Indian-sourced vaccine supply running dry, only one-third of those that received the vaccine can be administered the required second dose, meaning that two-thirds will be left high and dry until a new supplier is found by which time it would be outside the window for administering the second dose. As a result, 600,000 Sri Lankans may now be guinea pigs of the world’s first vaccine mix and match research project.


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