As Covid-19 cases slowly begin to rise across Sri Lanka, a familiar debate is re-emerging: should the public be wearing masks again?
The Ministry of Health says no – unless you are sick. But others, including the Government Medical Officers’ Association (GMOA) and leading medical specialists, say yes – as a precaution.
This division is fuelling confusion on the ground, especially as public PCR testing has become limited and case tracking less visible, and as people begin to question whether the country’s health system is ready for another unexpected spike.
Waiting too long to act?
In early June, the Deputy Chief Secretary (Administration) of the Western Province issued a circular instructing all Government employees to wear face masks in office settings and in crowded public areas, citing an observable uptick in respiratory infections, including Covid-19.
The move seemed like a return to basic pandemic-era precautions, but the response from the Government was swift – and dismissive.
Health Ministry Secretary Dr. Anil Jasinghe wrote to the Western Province Chief Secretary urging the circular to be withdrawn, arguing that such blanket advice was unnecessary, could cause fear, and risked disrupting routine administrative functioning.
Dr. Jasinghe’s rationale rested on the official line: Covid-19 is now endemic, much like influenza, and while it may rise seasonally, it no longer warrants special treatment or mandates.
According to the Health Ministry, the country should rely on routine communicable disease management protocols. Face masks, it argues, should be a personal choice or a recommendation only for symptomatic individuals, not a general precaution for everyone.
However, this position is not universally shared. The GMOA has voiced concern over the ministry’s messaging.
In a public statement, the GMOA said masks remained a scientifically proven, low-cost barrier against respiratory infections and should be encouraged in all crowded and enclosed settings, particularly now, when early signs of viral resurgence are evident but widespread surveillance and testing are not.
“We shouldn’t wait until hospitals fill up to act,” one GMOA spokesperson warned, urging the public to exercise personal caution regardless of what official circulars dictated.
Pandemics vs. endemics
Dr. Asoka Gunaratne, a Senior Consultant with the Association of Medical Specialists (AMS), said that Covid-19 was now an endemic virus and unlikely to cause another pandemic on the scale experienced in 2020. “Coronavirus will never disappear from the world,” Dr. Gunaratne asserted.
“It will continue to be present, but without the severe impact we saw a few years ago,” he said, noting that while positive cases would still be detected through testing, the virus’s current form was less likely to trigger widespread disaster. Dr. Gunaratne highlighted the importance of understanding the difference between a pandemic and an endemic.
Unlike a pandemic, an endemic virus circulates in the population at lower levels without causing major disruptions. He compared this to influenza viruses, which periodically infect large numbers but rarely lead to serious complications or death.
“People have always died from influenza, but it was never widely discussed,” he said, recalling that even during his medical training, deaths due to influenza were noted but did not prompt alarm.
On the topic of mask usage, Dr. Gunaratne pointed out a notable decline in respiratory infections during the pandemic, especially among children. “Wearing masks in crowded places such as public transport remains a good protective measure, not just against Covid-19 but other respiratory infections as well,” he advised, although masks are not necessary when exercising outdoors.
Regarding ongoing testing, he questioned the value of random PCR tests now that the pandemic phase has passed. “The virus has not been eliminated, so positive PCR results are expected,” he said. The key indicator to watch, according to Dr. Gunaratne, is whether death rates increase significantly.
He also touched on the virus’s natural progression, likening it to the Spanish flu, which caused a deadly pandemic in the early 1900s but eventually became endemic. “The pandemic phase typically lasts three to four years before the virus settles into endemic circulation.”
Finally, Dr. Gunaratne stressed the importance of surveillance for new variants that could potentially cause future pandemics. “The Ministry of Health’s Epidemiology Unit is actively monitoring for any such developments, and so far, no evidence points to a new variant capable of triggering a pandemic.”
Need for a cautious approach
What has changed, however, is Sri Lanka’s surveillance infrastructure. During the pandemic, testing was widespread, with PCR sites operating around the clock and data updated daily. Today, PCR testing is limited and largely restricted to hospital admissions or suspected severe cases.
The public no longer sees real-time dashboards or weekly infection trends. With testing down and mild cases often going unreported or misclassified as general flu, the true picture of the current spread remains murky.
As a result, health professionals worry that the virus may be spreading silently – just as it did in early 2020 – without triggering the institutional alarm bells until it is too late. Compounding this uncertainty is the mixed messaging coming from within the Government itself.
While the Ministry of Health is urging calm and reassuring the public that there is no current risk of a pandemic-level outbreak, other arms of the health system appear more cautious.
However, recent data suggest that a cautious approach remains wise. Globally, the World Health Organization (WHO) reported an 11% Covid-19 test positivity rate as of 11 May, matching the peak seen in July 2024 and marking a significant rise from just 2% in mid-February. This surge is primarily driven by increased transmission in Southeast Asia, Western Asia, and Eastern Asia.
Between 19 and 25 May, out of 54,603 samples tested worldwide, 4.7% were confirmed positive. The WHO also flagged a shift in the dominant variants, with Omicron subvariants LP.8.1 and NB.1.8.1 now leading globally. Notably, NB.1.8.1 has jumped from 9% to 21% of sequenced cases within just one month.
A rising trend in Covid-19 cases
In Sri Lanka, the picture reflects a similar but controlled trend. According to the Health Promotion Bureau (HPB), between 9% and 13% of patients presenting with respiratory symptoms are testing positive for Covid-19. While two recent Covid-related deaths have been reported – both involving individuals in high-risk categories – health authorities maintain that overall severity remains low.
The HPB has acknowledged a rising trend in Covid-19 and influenza-like illnesses.
Two individuals had died in Sri Lanka after contracting the currently circulating Covid-19 variant, Wayamba University Faculty of Medicine Chair Professor of Medicine Dushantha Madegedara said during a recent press conference held at the HPB on Wednesday (11).
Citing data from the Department of Virology, Prof. Madegedara noted that between 9% and 13% of patients presenting with respiratory symptoms had tested positive for this latest strain.
“This Covid-19 infection is of very low severity and its harmful effects are minimal,” he assured. However, he stressed the need for caution among vulnerable populations. “The two fatalities reported were patients with existing health complications. Those over 65 and individuals with weakened immune systems remain at higher risk,” he said.
While the general public need not panic, Prof. Madegedara advised that high-risk groups should continue to take protective measures.
The Health Ministry, for its part, says the country is prepared. Officials claim that surveillance is ongoing through the Epidemiology Unit and that any serious spike in deaths or hospital admissions would be detected early.
But without visible data or community testing, this assurance rings hollow for many. There is no national dashboard showing daily Covid-19 trends and no recent public campaigns urging high-risk groups to get booster vaccines or avoid large gatherings.
Hospitals, while better equipped now than in 2020, are still operating under normal staffing and stockpiles. If a sudden surge occurs, particularly one affecting the elderly or those with chronic illnesses, it is unclear how fast the system could pivot back into pandemic mode. This ambiguity places much of the burden back on individuals.
One Colombo resident noted: “I don’t mind wearing a mask. But I just want to know the truth about what’s happening.”
If the last five years have taught us anything, it is that viruses don’t wait for consensus. They spread – silently, swiftly, and sometimes catastrophically. Whether Sri Lanka avoids another crisis will depend not just on how fast the virus moves, but on how fast the system responds as well. Right now, that response is cautious. The question is, is it cautious enough?