The battles waged by the Government and its health authorities against the third wave of the Coronavirus pandemic continues unabated with the Government once again extending travel restrictions, as the number of infections and the number of deaths from the disease continued to rise.
The travel restrictions were due to have been lifted on Monday June 14 but have now been extended until the following Monday, June 21. It is however not confirmed that they will be relaxed on this date as that would depend on the state of the pandemic at that time- and current trends are not promising.
Health experts have also continued to express similarly cautious views regarding the easing of travel restrictions. President of the Sri Lanka Medical Association, Dr. Padma Guneratne said that although travel restrictions were seemingly enforced, there was much public movement that was visible.
“If the existing restrictions are not properly enforced, they may have to be extended further,” Dr. Guneratne said noting that, with over 2,000 new infections being reported daily, it cannot be said that the country is ‘out of danger’. A sudden lifting of restrictions could see a further rise, she warned.
The Deputy Director General of Health Services, Dr. Hemantha Herath expressed similar sentiments. Dr. Herath observed that while the number of new infections may have declined slightly on some days recently, it was not sufficient to indicate that the pandemic was definitely showing signs of slowing.
Travel restrictions
“The travel restrictions have helped to reduce the number of daily infections from over 3,000 to the 2,000 range. It may be necessary to continue these restrictions for longer or tighten them further to gain better control of the number of infections before relaxing the restrictions,” Dr. Herath said.
Political decision makers are also of the same opinion. The State Minister for Primary Health Care, Epidemics and Covid Disease Control, Dr. Sudarshani Fernandopulle noted that it would take some time for the country to benefit from the sacrifices it had made by imposing travel restrictions.
“Though the number of COVID-19 infections has decreased slightly, it will take another two or three weeks to witness a significant decrease in the number of deaths,” Dr. Fernandopulle noted. Accordingly, the Government will have to consider further extending the travel restrictions, the State Minister said.
The restriction will only be lifted gradually, Dr. Fernandopulle explained. Even when travel restrictions are lifted at a particular time, public gatherings will not be allowed until there is a considerable decrease in the number of COVID-19 infections in the country, she said.
Most worryingly for the Government, deaths from the virus continue to increase. This week, 63 deaths were recorded in a day, the highest number in a single day to date. This brought the total number of lives claimed by the pandemic in Sri Lanka to 2,260 in about fifteen months, most of them this year.
The pandemic also spares no one. Among its latest casualties is Leader of the Opposition and the leader of the Samagi Jana Balavegaya, Sajith Premadasa and his wife Jalani Premadasa. Having developed the infection, Premadasa and his spouse made a full recovery and left hospital this week.
Premadasa has not been vaccinated against the virus. “We refused the vaccine because we wanted to prioritise the public. As a result, we were infected with the virus,” Premadasa said speaking to the media from the Gangaramaya Temple in Colombo, upon his recovery and release from hospital.
“I will not take the vaccine until the population of the country is vaccinated. This is a time we must put others before ourselves,” Premadasa said, but health experts have questioned this stance. When a leading public figure refuses to be vaccinated, it can send a negative message to the public, they say.
Having controlled the first wave of the pandemic in an exemplary manner and being hailed by health experts as a model for other nations to follow, Sri Lanka even managed to rein in a second wave of the pandemic through timely precautions without allowing the number of infections to escalate.
The demographic of the pandemic in Sri Lanka changed only around April this year. This was the result of a sense of complacency among the public during the holiday season having withstood the virus for more than a year and the lack of adequate stocks of the Coronavirus vaccine.
In addition, there was also what is described as ‘vaccine hesitancy’ in the population, a lack of urgency in accepting vaccines because there was no rampaging infection in the community. This is not a phenomenon seen in Sri Lanka alone and was seen in countries such as Taiwan and Australia.
Vaccination programmes
In such countries, the lack of significant numbers of infections and deaths in the community led to delays in securing adequate vaccine stocks and delays in establishing rapid vaccination programmes. This then led to second and third waves of the pandemic occurring in these nations.
Conversely, countries which experienced massive infections and deaths in the initial phases of the pandemic were quick to purchase the limited numbers of vaccines that were being produced and rush them through to the public at a rapid pace, allowing them to return to relative normality sooner.
Britain and the United States are examples of this. Sri Lanka and other countries in similar circumstances are learning from this experience and are trying to follow suit. However, the stumbling block is the lack of ready availability of vaccines from their manufacturers, even at market prices.
Until now Sri Lanka has been heavily reliant on vaccines gifted by the World Health Organisation (WHO) which supplied the AstraZeneca vaccine and China (Sinopharm), Russia (Sputnik V) and India (Covishield). The country will now also receive a donation of Pfizer and AstraZeneca vaccines from the United States.
Sri Lanka is also actively considering the possibility of giving ‘combination’ vaccines to those who had received the first dose of the AstraZeneca vaccine but could not access a second dose due to a shortage in supply. It is estimated there is a shortfall of about 600,000 such vaccine doses in the country.
The Government this week sought the advice of the Advisory Committee on Communicable Diseases on the possibility of administering Pfizer vaccines to those who were deprived of the second dose of the AstraZeneca vaccine. This was after research indicated this strategy also led to strong immunity.
While dealing with these issues, the Government also had to contend with alleged irregularities in the distribution of the vaccine as well. In one instance, Police have filed charges against officials who are alleged to have distributed the vaccines destined for the Galle region to persons from Colombo.
Many persons are alleged to have travelled from Colombo to Galle on the Southern Expressway earlier this month to receive the second dose of the AstraZeneca vaccine. Police investigations are now continuing to ascertain the scale and nature of this alleged incident.
Previously, there was also public dissatisfaction over attempts by members of the doctors’ trade union, the Government Medical Officers’ Association (GMOA) to vaccinate their family members on a priority basis, after lists of such family members were leaked and appeared on social media.
Frontline health workers
Members of the GMOA and its leadership came in for heavy criticism from the public after it was pointed out that other frontline health workers were exposed to similar risks as doctors - and possibly even more - and their family members also deserved to be vaccinated on a high priority basis.
The Government is very mindful of the impact of the current travel restrictions on daily life, the economy and other everyday activities. However, in the current circumstances, with infections and deaths continuing, it sees the restrictions as an absolute necessity to contain the pandemic.
Among the sectors that have been seriously affected is the education system with schools and universities being shut and competitive national examinations such as the Ordinary Level and the Advanced Level examinations being postponed numerous times, disrupting normal schedules.
At a meeting presided over by Prime Minister Mahinda Rajapaksa it was agreed that any plan to re-open schools would have to necessarily include a programme to vaccinate teachers and other school staff. It is estimated that this would amount to about 300,000 persons requiring vaccines.
Prime Minister Rajapaksa had instructed that the re-opening of schools be undertaken only after consulting with paediatricians regarding its feasibility from a medical perspective. It would be done in stages and students in grades 11 to 13 would be given top priority, education officials said.
The bitter reality is that the COVID-19 pandemic is currently at a stage of moderate containment in Sri Lanka. The on-going travel restrictions have helped curb its escalation to some extent but not to a point where these measures can be relaxed at this time when infection numbers are still significant.
Despite several other issues- such as the price hike on fuel- which the government also had to grapple with this week- it is certain that it is the Coronavirus pandemic which will be top priority for health authority and policy makers alike, at least in the coming weeks and months.
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