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Preventing Sri Lanka from becoming another India 

30 Apr 2021

The unfortunate reality is that no one knows as to when the Covid-19 pandemic is going to end, and many attempts to return to ‘normalcy’, which is far different from the actual normalcy that existed in the pre-Covid-19 era, have not borne fruit. The only and most sensible option appears to be limiting movement and interactions as much as possible.  Initially, controlling the number of Covid-19 cases and deaths caused by Covid-19 induced complications were the priority of all nations. But, countries are now forced to deal with new variants of Covid-19, which, according to researchers, are more aggressive and contagious and severe than the previously identified variants. Sri Lanka’s Covid-19 situation too has faced the same fate, and the country has officially declared the prevalence of a variant new to Sri Lanka, known as the ‘United Kingdom (UK) variant’.    New variants in Sri Lanka  Researchers from the University of Sri Jayewardenepura, on 28 April, confirmed that the UK variant has been detected in Sri Lanka. The University’s Allergy, Immunology and Cell Biology Unit Director, Dr. Chandima Jeewandara told The Morning that the UK variant found in Sri Lanka is known as the B.1.1.7 variant.  Speaking to the media on 28 April, he said that the University, after conducting genetic sequencing on several samples received from various parts of the country, has ascertained it.  “This variant is exactly similar to the one found in the UK, and we have found them in the samples collected from several areas including Colombo, Boralesgamuwa and Kurunegala. This new variant has a 55% mortality rate and 50% high transmissibility rate, compared to the previously known variants of the virus. The first case of the UK variant was detected in the Boralesgamuwa area on 8 April,” Dr. Jeewandara added.  He said that thus far, it has not been possible to ascertain as to how the UK variant entered the country. He also said that these findings, which suggest that there is a high possibility of serious public health issues arising in the future, have already been conveyed to the Ministry of Health as well as all the relevant authorities.  Dr. Jeewandara noted: “Until recently, the majority of Covid-19 cases reported in Sri Lanka had been caused by the Sri Lankan variant of the virus, known as B1411, and foreign variants were detected only in those who came to Sri Lanka from abroad, especially from quarantine centres. But, based on the symptoms, we can assume that many cases reported from within the community have the UK variant. We have received a large number of samples from around the country, and we are conducting further experiments to ascertain as to what variant of Covid-19 is prevalent in all districts. We expect to announce our findings in the next seven days. We are also trying to find out whether there are other variants of the virus in Sri Lanka.”  He expressed confidence that the Oxford AstraZeneca Covishield vaccine from the Serum Institute of India, that is currently used in Sri Lanka, responds to the UK variant. He cautioned that the coming few months are extremely crucial, and that preventing the spread of the virus is extremely crucial.  He added that most Covid-19 cases reported in India are in fact caused by the said UK variant of the virus more than by the variant identified as the Indian variant. He noted that according to some reports, over 50% of Covid-19 cases reported from Punjab and New Delhi in India are a result of the UK variant.  According to Dr. Jeewandara, several researchers have claimed that the UK variant can transmit through the air, a process known as ‘airborne transmission’. He added that whether the UK variant is airborne or not is somewhat immaterial, as it does not change the fact that the public needs to be more careful.  He added that Sri Lanka is yet to find out how the UK variant entered the community, which was earlier reported only from quarantine centres.  Earlier, Dr. Jeewandara had said that the South African variant was found from quarantine centres. In addition, it was also reported that three individuals had been infected with another strain, known as B.1.428, which belongs to Denmark/Iraqi lineage. These three cases had been identified from the community in Colombo.    What is the UK variant?  According to the United States’ (US) National Institute of Health (NIH) Director, Dr. Francis Collins, since the genome sequence of SARS-CoV-2, the virus responsible for Covid-19, was first reported in January 2020, thousands of variants have been reported, and at least three variants – including the UK variant identified by scientists as the B.1.1.7. variant – carrying mutations that potentially make them more dangerous have been detected.  The UK variant is considerably more contagious than the original Covid-19, and it has spread rapidly around the globe and likely accounts for at least one third of all the cases in the US, Dr. Collins added. He noted that evidence indicates that infection with the UK variant also comes with an increased risk of severe illness and death.  According to the findings of a study, conducted by Nicholas Davies, Karla Diaz-Ordaz and Ruth Keogh of the London School of Hygiene and Tropical Medicine, the UK variant is 43-90% more transmissible than other existing variants that had been circulating in England. Researchers have also concluded that the risk of death associated with the UK variant was associated with 55% greater mortality compared to other SARS-CoV-2 variants.  The study also says that for a 55 to 69-year-old male, this risk translates to a 0.9% absolute, or personal, risk of death, up from 0.6% for the older variants. That means that nine in every 1,000 persons in this age group who test positive with the UK variant would be expected to die from Covid-19 a month later, and for those infected with the original virus, that number would be six.  Another study by the researchers at the University of Exeter and the University of Bristol had found that the UK variant was associated with a 64% greater chance of dying compared to earlier variants. This conclusion was reached based on an analysis of data from more than 100,000 Covid-19 patients in the UK from 1 October 2020 to 28 January 2021.    Public responsibility  The State Minister of Primary Health Care, Epidemics and Covid-19 Disease Control, Dr. Sudarshini Fernandopulle, said that while the health authorities are taking every measure to curb the spread of Covid-19 and provide the necessary services to the public, it is the public who has a bigger role in preventing the spread of the virus.  She also said that in a context where the UK variant, which is more aggressive than the previously identified variants of the Virus, has been reported in Sri Lanka, the coming few weeks will be extremely decisive.  Speaking of the UK variant, she told The Morning: “It spreads around 50% faster than the variants identified in Sri Lanka before, and also its mortality rate is higher. Even the young groups should be careful as they too are prone to contracting this new variant and experiencing severe complications.”  When queried as to whether more funds or human resources have been allocated to deal with the status quo, she added that the health authorities have to manage the available human resource, and that the public, therefore, have a huge responsibility to take extra precautionary measures in their day-to-day lives.  She noted: “We request the public to stay at home for at least four weeks. If they can exercise self-discipline in this connection, that would tremendously help to manage the situation. If the public can act responsibly, the health authorities would not have to worry about the available resources such as the capacities of the Intensive Care Units (ICUs) and high dependency units and oxygen stocks. In the coming four weeks, the public should strictly refrain from travelling unless it is extremely necessary. If it is necessary to go out, the public should limit such activities to just one or two persons of the household. When it comes to activities such as going to work, even though those types of activities are inevitable, the public should try to spend as little time as possible outside, and return immediately to their homes. Also, when going out, wearing face masks and avoiding crowded places as much as possible should receive the public’s priority.”  She added: “If a person is experiencing typical symptoms such as body ache and breathing difficulties, for example, if it is difficult to hold one’s breath and count to 10 before exhaling, we advise that people seek medical assistance from the nearest hospital. Hospital staff have been readied to provide the necessary medical assistance to those seeking assistance promptly, as the new variant has been identified to cause severe complications.”  “The strategy adopted to manage the country’s Covid-19 situation is the same one employed to deal with it earlier,” she said, noting that the health authorities however, are putting extra efforts into preparing to face the new variant. These efforts include, according to the State Minister, identifying Covid-19 infected persons as early as possible, especially before experiencing severe complications.  “The public taking necessary steps to refrain from contacting the Virus is the key,” the State Minister emphasised, adding that since admitting a Covid-19 patient to the ICU is the last resort and it might be too late, the Government and the health authorities are prepared to take necessary precautions including detecting infections early.  When queried about her opinion regarding the fears among the public that Sri Lanka may be on the verge of facing a scarcity of resources to deal with Covid-19 as has happened in India where the Covid-19 pandemic keeps worsening drastically, she responded: “The health authorities have the resources to handle the prevailing situation. But, if a large number of cases are reported at once, a situation that is difficult to manage, may arise, A shortage of resources may arise only if the public continues to travel freely in the coming four weeks. If the public adheres to guidelines stipulated by the health authorities, there is no need to fear such a shortage.”  Whether we like it or not, Sri Lanka now has to deal with foreign variants of the virus, which, according to researchers, are more contagious and deadly, and due to the nature of the virus, even though Sri Lanka is in possession of adequate resources for the time being, a shortage may arise if the number of cases exceeds the country’s health sector capacity. Also, it is important to understand that the vaccine can only do so much, and does not guarantee that one cannot contract Covid-19.  In this context, now, more than before, the public understanding and fulfilling their responsibilities for themselves and their loved ones, is of great importance. There is no limit to what one can do to protect one’s life, and steps such as maintaining two metre social distancing, wearing the face mask and limiting interactions with others are exceedingly simple and not at all impossible. 


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