The Government’s C word

On 24 January, Sri Lanka saw the highest number of Covid-19 cases within a 24-hour period in the Colombo district. Prior to this, the Health Promotion Bureau reported 887 cases on 21 January – the highest number detected within 24 hours in the country. Yet, as we have reported today on our front page, the Government is still not ready to say the words: Community. Spread.

Covid-19 spreads in four stages. Stage 1 is the first appearance of the disease through people with a travel history. Here everyone is contained and their sources are traced, and there is no local spread from those affected. The number of those infected would be quite low at this stage.

Stage 2 is local transmission, when those who have been infected and have a travel history spread the virus to close contacts, friends or family. At this stage, every person who came in contact with the infected should be traced and isolated.

Stage 3 is community transmission, when infections happen in public and a source for the virus cannot be traced. At this stage, large geographical lockdowns become important as random members of the community start developing the disease.

Stage 4 is when the disease actually becomes an epidemic in a country with large numbers of infections and a growing number of deaths with no end in sight. It is then considered to be endemic, or now prevalent in the region.

To any casual observer, it would appear that Sri Lanka is in Stage 3. But not to the Government. They would not say community transmission because that would cause panic. They reckon it’s better to maintain a perception of control, regardless of whether they actually have this pandemic under control or not. Perception is everything. Another reason they point to is the fact that their entire strategy would have to be altered in the event the country moves into the community spread stage.

According to the World Health Organisation (WHO), community spread or community transmission is evidenced by the inability to relate confirmed cases through chains of transmission for a large number of cases, or by increasing positive tests through sentinel samples (routine systematic testing of respiratory samples from established laboratories).

By this definition, it is hard to see how the Government could argue that there is no community spread in Sri Lanka. It is even harder to see any medical reasons for the lack of admission of such community transmission. The reasons appear to be far more political than medical.

The government had a halo around its head during the middle of 2020 for its handling of the pandemic. Even its critics acknowledged that the deployment of the military and a safety-first approach helped us stay protected while far more developed and well equipped nations were seeing mounting death tolls and overflowing hospitals.

While that halo has long since disappeared, particularly after the second wave in early October, many Sri Lankans still feel safer than a lot of people in other countries, due to the still acceptable number of cases and deaths we have seen.

Some argue that any debate or investigation about whether we are in the community transmission stage is moot and a waste of time, because the more important thing is that people follow health guidelines. However, it is highly likely that an official declaration that Sri Lanka has reached community transmission, would make people more vigilant and cautious while going on with their day to day lives. This could even help contain the spread of the virus.

There are enough and more people who still have no qualms about shaking hands or hugging, and those at the receiving end of these greetings may feel awkward or insensitive rejecting the handshakes and the hugs, even while knowing that it is far from a good idea. There are those who still frequent crowded coffee shops, pubs or clubs, where the furthest thing from inebriated patrons is social distancing or health guidelines.

Would these people not take the virus a bit more seriously if there was official confirmation that Sri Lanka has entered the community spread stage? Would they not wear the mask and try to maintain distance if there was real fear of contracting a virus that has already caused the deaths of over 2 million people around the world?

As of yesterday (25), Sri Lanka had around 59,000 confirmed cases and over 280 deaths. It’s time for the Government to abandon its fear of the C word, and call a spade a spade. It may scare people, but would that be such a bad thing?