Can we relax social distancing? | Daily News


 

Can we relax social distancing?

A critique based on COVID19 data in Sri Lanka

Perhaps Sri Lanka has now reached the phase-5 of the COVID-19 outbreak in which the number of cases are expected to decline. This is quite evident from the fact that we do not get newly infected cases from the community other than from NAVY pocket and the imported cases (the infected people who return from overseas).  Therefore, we do not want to fear that the COVID-19 will recur and could generate a situation like in other countries such as USA, UK, Brazil, or India because we have maintained extreme precautions to prevent the disease in the community.

In fact, I predicted that COVID19 curve in Sri Lanka will be flattering by middle of May.  I also pointed out that based on estimated the rate of spreading COVID-19 by a single infected person, the chance of spreading COVID19 at community level in SL is almost zero. In fact, it was proven correctly (08th May and 11th May Daily News).

Therefore, it is my strong belief, that we must practice data driven decision making (DDDM) as far as we can, in order to achieve the best possible outcomes in both socio-economic and health terms. Of course, we need to understand that all decision may not be perfect, but it is our responsibility to make judgements based on scientific evidence. 

Over the last 3 weeks we hardly observed a new COVID-19 case apart from the Navy group and the infected people coming to SL from different parts of the world.

This fact has provided enough evidence to assume that the transmission of the disease has been under control, even when we have released lockdowns partially.   Nevertheless, the health system of Sri Lanka is deemed to have handled the disease outbreak well in a local context although it may not be sufficiently resourced for a huge surge of patients at a given point of time. 

Thus, I am very confident that we do not get a large spread of COVID19 under the prevailing conditions in Sri Lanka.

COVID19 is a new disease and therefore limited information is available with regards to its risk factors and the severity. Based on currently available information and clinical expertise, elders and people with serious underlying medical conditions are at higher risk for of a severe form of illness from COVID-19.  In fact, the case specific morality rate in Sri Lanka has been among the lowest compared to other countries.

We have decided to go for the general elections, though it is late. That is good.

So why should we fear? Neither the health authorities nor the statisticians can assure that there will be no COVID-19 person for sure (100%) in the foreseeable future. The main advises given by the health authorities to reduce the spread of COVID19 are:  social (physical) distancing, wearing face masks and washing hands.

Social Distancing

To practice social or physical distancing one should stay at least 3 feet (about 2 arms’ length) from another as shown below.

The flattening curve of COVID-19 in Sri Lanka is similar to that of New Zealand by middle of May.   Inclusion of positive cases reported from Navy pocket and people who are returning from other parts of the world is not correct as they do not reflect the detection from the general public. If we exclude those from our database, the COVID-19 curve in Sri Lanka, is far better than the New Zealand.   New Zealand has now ignored social distancing and has opened the country for normal functions. In fact, they have even started rugby matches from 14 June 2020.

lIf you go to banks, supermarkets, government offices, pharmacies, shops etc.  you will find how difficult to maintain social distancing. Only thing you could do is to stay in a queue with a physical distance from another.

lWhen it is allowed two persons in a motorcycle, 3 persons in a three wheeler, 4 persons in a car, 7 persons in a jeep (deepening on the seats), and more people in a van (depending on the number of seats) no social distancing is practiced.  In public transport such as buses and trains, one could hardly maintain social distancing.

lWhen group discussions and interviews are being held, when foods are distributed by various agencies, in press conferences, and in many events in TV we do not see social distancing much.

lIf we visit a doctor no social distance is maintained there too.

lWe had lock downs, we maintained social distancing, we wore and wear face masks, and we wash our hands as routine habits.

lMoreover, social distancing is difficult to maintain in many parts of the country as the distance between many houses of poor people are less than one meter. Two or three people sleep together in a small single room in some houses. All of them go to work in different places and come back home in the evening.

lWhen you go to fish market, vegetable market, no social distancing is maintained.

lThough some people stayed at home during initial lockdown, majority of them did not maintain the distance among people within the house or between houses.  Of course, it is quite natural to occur as people have complex social behaviors.

lPeople living together in close quarters, or share a small apartment, when people live in the same household with large or extended families it is quite impossible to maintain social distancing.

Face Masks

lWearing face mask was not practiced properly. However, wearing face mask may have many problems. There are various views from the medical professions in reference of wearing face masks in different parts of the world.  Situation is same in Sri Lanka too. In practice, it may not possible to wear a face mask for a long period when someone is working.

lDoctors have also advised not to wear face mask in certain events such as jogging, exercising etc. as long as you keep the distance. Even when driving in an air-conditioned vehicles it is not possible to wear face masks if the driver use spectacles. Further, even for a normal person it is not possible to wear it for a long period.

Washing Hands

lWashing hands is not practiced often, because most people have no access for water and soap when they are away from their home or workplace (e.g. traveling in a bus). 

lPeople in many parts of the country have no water even to drink.

lAs an alternative, if the hand sanitizers are used, how can a poor person afford them continuously. Even, in most of pharmacies, shops this is not practiced.

Therefore, I wish to make following suggestions to expedite the social and economic recovery of the country while sustaining the prevailing control situation of COVID-19 outbreak.  

lNo, need to spend large amount of money for rehearsals of election polling and also during elections, apart from normal activities as we used to practice. Generally, even in a normal election day, people used to walk in a queue slowly without disturbing to each other.

lEating food from hotels and restaurant can be allowed as we practiced past.

lIf in house, people work in different places and come back home in the afternoon and stay together, may be 4 or 5 in a small room. So why can’t 2-3 university students can stay in a hostel depending on the size?

lTuition classes can be started.

lPost graduate courses in the both public and private universities can easily be started.

lMost of other activities such as barber shops, beauty parlors, etc. can be allowed to start as normal.

lMost of private sector can be allowed to start their actives as they practiced.

lGathering people in form of public rallies can be controlled.


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