Our Lucky has published this in a peer-reviewed journal. Well done Lucky!
Asia
Pacific Journal of Public Health
Opinion
Sri Lankan COVID-19 response: opinion from a senior public health specialist
Lakshman Abeyagunawardene, Public
Health Specialist
Correspondence:
adnl1102@gmail.com
DOI:
https://doi.org/10.4038/jccpsl.v26i5.8344
Received on 25 May 2020 Accepted
on 6 June 2020
Going through epidemics and
outbreaks is not a novelty to Sri Lanka, which has been facing yearly outbreaks
of dengue and leptospirosis for the past so many decades. When COVID-19
appeared, however, it was not to be contended with implementation of the 'usual'
measures conducted for outbreak control that Sri Lanka was 'familiar' with.
Fortunately, those at the forefront of decision-making in the country and
battling COVID-19 understood the need of changing tactics depending upon the
dynamics of the disease from the initial stages. Sri Lanka's COVID-19 response
has been successful up to date and is driven onwards due to the strong
political leadership and commendable administrative and technical backing.
Since the very first case was reported in Sri Lanka on 27 January 2020, and thereafter when the first local citizen was reported, Sri Lanka too underwent difficult times in implementing robust prevention and control measures including enforcement of a modified-lockdown status, undertaking strong surveillance measures and in-depth contact tracing and, of course, practising the key WHO Guidelines.
The healthcare workers, both in the fields as well as the hospitals rose admirably to the challenge. The professional associations, medical consultants, consultant community physicians and even trade unions like the GMOA played a remarkable role with timely technical advice being given to an equally receptive government. However, dark the clouds may seem, the silver lining now driving the impetus has been the absence of community spread of the disease as yet.
Much of the effort in containing COVID-19 has also been due to the admirable service rendered by the tri-forces and police. From the top level of a militarily-trained President and Task Force leaders, all the way down to the grass-root level military personnel engaged in contact tracing, these heroes have the grateful thanks of the entire country for their excellent performance in a completely different arena, using alien and hitherto unused 'battle' tactics. The utilization of Army Intelligence for epidemiological investigations as Sri Lanka has done maybe a global first as well. The decision made by the political leadership in recruiting the help of trained military personnel other than the healthcare workforce has proved to be a sound one.
The COVID-19 outbreak has been terrifying as well as it has been monumental in changing lives and reshaping the future of the country, possibly for better. Not only the healthcare system, but the entire country has been tried and tested and proved worthy of praise.
The massive public support for the control programme and the practice of key public health practices such as hand washing and personal distancing have had positive results and the country is now geared to move to the next level with innovations being reported in manufacturing locally- made healthcare equipment and novel thinking taking root in terms of home gardening and becoming self-sufficient. This level of empowerment is extraordinary and should be capitalised upon by the political leadership. Who knows, with the right backing, Sri Lanka may rise to these challenges as well as it has risen to overcome COVID-19.
Congratulations Lucky.Excellent article.
ReplyDeleteIt is always a pleasure to read articles by Lucky written elegantly and with expertise. He has the wonderful ability write concisely and clearly. I am delighted that I can assume Lucky has returned back to his normal self after the recent setback. We can now expect more contributions about his memories of the past and the facts of the present.
ReplyDeleteCovid has taken over our lives completely. Speaking with friends from USA, Europe and Australasia none of them are happy with how their governments have managed the situation. With lockdowns and restrictions no one’s happy to be prisoners in their own homes. It is only when we hear from epidemiologists and Public Health personnel we get the true picture. Some countries have muzzled the media to prevent the truth becoming public. Whatever the politics and wherever we live let us take the tried and tested precautions and accept the vaccine with open arms hoping for the best.
In this global pandemic what has come to light is the ineffectiveness of the WHO. It has got embroiled in political controversy and its presence as an important source of information and advice has been conspicuous by its absence. Once the dust settles it would be time to look for an alternative source of information for Global Healthcare.
ReplyDeleteThe WHO advice about face masks stand out like a sore thumb
ReplyDeleteIf the vaccines did not emerge, the unfolding scenario would have been unbearable. It is my fervent hope that the vaccine will succeed and would be available in call Countries irrespective if their wealth. Health matters far more than Wealth.
ReplyDeleteI too thought that Luck's article is very well written.
Lucky has put in a few words, each of which carries the relevant meaning, in summarising the history of Covid in Sri Lanka from 27-1-2020 when the first case was reported, till now. Glad to know that it appeared Journal accessed by 'Asia and Pacific'. We need similar action in other countries even as late as this if we are to see the back of 'Covid'.
ReplyDeleteI heard from the relevant authorities that Sri Lanka would be receiving the Covid 19 vaccine by late February or early March this year The WHO through the COVAX programme has offerred the vaccine for 20% of our population,free of charge. The first priority group would be those over 65 years of age followed by the health care workers and armed forces personnel, involved in the pandemic activities. Some companies have stepped in to improve our storage and cold chain facilities.
ReplyDeleteGlad to hear that Sanath. I thought MPs would be first , followed by BiG business!
DeleteSanath
ReplyDeleteThe availability of vaccine soon in Sri Lanka is wonderful news. Astra Zeneca has pledged that they will not profit from the sale of the vaccine during the pandemic. That is very generous and noble of them. I hope the other vaccines will offer the same no profit deal. The prediction is that Covid-19 will be with us for many years to come. It is important that the WHO make it possible for every country to benefit from the availability of vaccine. The companies must ramp up the production as time is of the essence. In the Uk at present nearly 1000 die every day of Covid related causes.
I wonder how things are going to be managed in the future. Presumably, there will need to be annual vaccinations of entire populations as I am told the immunity beyond an year is questionable, setting aside the need for responding to probable mutations.
ReplyDeleteLucky, congratulations on having this article published in a peer reviewed journal. It will get a well-deserved wider readership. About the handling of COVID-19 in Sri Lanka; I was very impressed at how the contact tracing and quarantine proceeded at the beginning of the pandemic. I think there was an element of 'overkill' where travelers to the country (mostly Sri Lankan returnees) were required to undergo draconian quarantine, supervised by the army for two weeks, and then two more weeks of self-quarantine at home after that. Now I hear that charter flights from Ukraine are bringing tourists to hotels in the southern beach-towns of Sri Lanka. There are requirements to take the COVID test prior to boarding and on arrival. But that does not exclude people who are incubating the virus and turn positive a few days after arrival. These tourists are being taken to places like the Dalada Maligawa in Kandy, where they wander around without masks, exposing the Sri Lankan residents! Where is the logic in doing this before the vaccine is widely available in the country? Anyway, I am happy to hear that the vaccine will be available in Sri Lanka soon. I had read about a company in Pune, India (Serum Institute of India) which was producing the AstraZeneca-Oxford vaccine while the Phase III clinical trials were in progress. They have pledged to make 50% available to India and the rest to low income nations.
ReplyDeleteI think the vaccine will be available in Connecticut soon. All my friends in the UK, please be careful, because you have the highly contagious variant near you. It won't be smart to catch the virus now, when the vaccine is just around the corner. We need to be patient for a just little longer.
Hi Srianee
DeleteCovid restrictions have confined us to home. As you had mentioned elsewhere Netflix is a wonderful way to spend one’s time. I took the plunge and watched the all time favourite “Rebecca”. This is a remake of the 1940’s old black and white film produced by Alfred Hitchcock starring Laurence Olivier and Joan Fontaine. The new version is brilliant only lacking in a haunting melody like Lara’s theme for it to be remembered forever. I recall most fondly reading through the Daphne Du Maurier collection as a teenager. Her descriptions of the rugged and beautiful landscape of Cornwall enhanced the interest in her true to life stories. Being a great fan of her books I have visited her beloved Fowey in Cornwall where she lived and also the Jamaica Inn the Public House made famous in her book.
The film begins with those famous words “Last night I dreamt I went to Manderley again.”
Despite having seen it for the umpteenth time to see the mansion gutted by fire at the end brought great sadness. I’m certain you have read the book and also seen the Alfred Hitchcock version. But here’s a recommendation for the new version just in case you’ve missed it.
Nihal, I am delighted to discover that you are a fan of Daphne du Maurier! Yes, I have seen the new version of 'Rebecca' on Netflix and thought it was very good, but I think I should watch the original again. I read many of du Maurier's books as a teenager and still love to re-read them whenever I get the chance. As you said she described and created the mysterious and rather spooky settings for her stories very skillfully. Perhaps I will get a chance to visit the Jamaica Inn someday soon! One interesting thing is that we don't get to know the first name of the narrator (the second Mrs. de Winter) in 'Rebecca' do we? That adds to the mystery. I thought that Kristin Scott Thomas as Mrs. Danvers was great!
DeleteThese days, because of the overwhelmingly depressing situation in the US, I try to transport myself to another country and another time (if possible) by watching something on Netflix or Amazon Prime. I just finished watching 'Tess of the d'Urbervilles on 'BritBox,' another streaming service. It was a 4 part BBC series and did justice to the hauntingly sad Thomas Hardy novel. I'm glad that they stretched it out to four episodes, because I find it rather frustrating when books that I have enjoyed get condensed into a two hour movie. It is often a disappointment.
'BritBox' is my mental escape route!
Srianee
DeleteAh! lovey to know you too are a fan of Daphne DM. I had the full collection until 4 yrs ago when I gave them to charity when I downsized. I do regret this now as I love to read them again as you do.
I wonder if you remember the Du Maurier cigarettes they sold in Ceylon in the 1950's. Daphne's father had a connection to this company. Daphne's life story is as interesting as her books with incest and adultery thrown into the intrigue. Human life is never simple if one is prepared to get to the bottom of it all.
I'm watching "The Crown" on Netflix. It is beautifully done of a time when we were young and can recall much of it. I still remember the day King George VI died. We lived opposite the Anglican Church when the bells rang for hours non stop. Without TV the BBC News reached us amidst the hiss and the crackle of short wave radio.
Politics is a mess worldwide. It is more apparent in a democracy.
Take care and stay safe
Enjoy "The Crown" Nihal. I have to say that those streaming services (Netflix, Amazon Prime, Apple TV) have saved my sanity this past year! I don't watch TV 24/7, but it is there for me to enjoy when I want to. It may be be a bit costly, but since I am stuck at home, I think I deserve it! I am also a fan of many British detective series. I feel the characters are far more true to life and not so unrealistically glamorous as in the American TV versions.
DeleteI remember reading something about D. du.M's life in an article in one of the Sri Lankan newspapers when I was visiting, and also have a vague recollection of the cigarettes.
Srianne.my wife and myself had the firsty dose of Pfizer vaccine and waiting for the second within the next 12 weeks.I was to have the second 3 weeks later,but according to the New guidelines.I may have wait a bit longe.I am sure Srilanka will have the stocks from India very soon.People are iresponsible all over the world and no wonder it has spread beyond the limits of the Health Services.
ReplyDeleteSrianne,I am sure you will have the Pfizer vaccine or the other brand that has been approved in US.Do your meditations and the Yoga.as before.
Congratulations Sumathi! Things here are rather confusing, but I think they will get better after the new administration takes over. Yesterday, on the Connecticut state website I followed the rather complicated instructions and signed up for the Covid-19 vaccine. The date I got for the first dose was March 2. While signing up I thought to myself, how many people over 75 years can navigate this? It should be simpler. I'm definitely hoping for some improvement very soon. Thanks for the advice on Yoga and meditation, which I have been neglecting :((
DeleteNice to hear from you,Srianne.We were licky to have the vaccine delivered to our surgery,fairly early and it was the Pfizer vaccine.They ran us giving the appointments and online booking system was not allowed owing to the fear of people dafaulting
DeleteI wish you will have the best vaccine under the sun.Do not miss your Yoga and the healthy diet that should boost your immune system.
May sanity return to US with dawn of new era.I never sat EFMG,the passport to US.US was notorius for high crimes and no go areas.
Correct EFMG to ECFMG,
ReplyDeleteLucky
ReplyDeleteHeartiest Congratulations for that excellent article.
Our 1st wave of Corona was managed very well and we were 2nd in the list of best Corona managed countries. But unfortunately the 2nd wave has not been managed well with the arrival of Brandix workers from India.
We should be thankful to the Healthcare and Army Personnel for their excellent service.
Lets hope that we will get the Vaccine soon and everything will be under control without a problem. Chira
Lucky my Congratulations on your excellent article. An achievement indeed.
ReplyDeleteBut sad to say Sri Lanka has not held on to it's initial success. Fortunately for us for some reason the virus has not resulted in the severe infections here in Sri Lanka as abroad. I know for a fact that though many needed ICU care very few required ventilation . Most they needed was Oxygen by face mask and some needed CPAP. Had large numbers required invasive ventilation we would not have been to cope. I know this as being an Anaesthetist, I am well aware of the facilities available throughout the country.
The fact the new strain of virus from the UK has been imported to us ( by the visiting cricket team) is really bad news. This together with the fact that our people don't seem to comprehend the importance of following health guidelines as shown by complete disregard to wearing face masks properly in public ( and not having it round that neck but not connecting the nose and mouth ) till it became punishable by law, and ignoring social distancing particularly among the powerful and privileged who keep having Tamashas and even the poorer classes who were seen to flock in their thousands to get the so called magic " Paniya". All add to the very real danger of uncontrolled spread as indicated by escalating number of new cases reported each day.
The vaccine is of course light at the end of the tunnel but inspite
of assurances given by politicians I am not at all certain when it will be available here soon. Even when it is, whether it will be available to everybody who wants it and the cost is very questioable.
We can only live in hope.
This is very sad to hear Suri. If those who wield power do not set an example, how can we hope the ordinary people to follow. I am not suggesting this to be done but I bet you if the Buddhist clergy utters an edict that wearing masks will accrue a lot of merit or if Christian clergy says that wearing a mask will guarantee a place in Heaven, people in droves will follow. The most powerful influence on people is with doubt, fear and guarantee of rewards in the next life..
ReplyDeleteHi Speedy I detect your tounge in the cheek in your comment and I know you are not serious. But the what the various religious leaders Could and Should do is to set an example in wearing a mask correctly when ever they are in public places / giving press interviews / conducting worship activities. Though some do, a large majority don't. But the biggest offenders are of course the politicians !
ReplyDeleteSuri, thank you for your input about the COVID-19 situation in Sri Lanka. I have been curious about why the patients in SL have not been getting severe respiratory complications. Is it the climate? The high humidity? The "kothamalli?" So many in the US seem to end up in the ICUs on ventilators and serious complications like multi organ failure. I understand that there are only a limited number of ICU beds. I'm sorry to hear that the highly contagious strain has arrived in Sri Lanka. I do hope that the government gets the vaccine soon and will distribute it efficiently and fairly. As you said we can only hope!
ReplyDeleteOn a positive note the COVID-19 situation in the US should improve in the next few weeks and months with our new administration in charge. I'm hoping too!
Hi Bunter infact this has been a much discussed topic among those who are directly involved in the management of patients. It could be any of the things you suggested One thing I do know is that Kotthamallli is freely available to the patients at IDH which is the main treatment center in Colombo. After all it can do no harm . I only pray that this trend will continue as the health services will be completely overwhelmed if there are large numbers of more seriously ill patients needing ventilation and multi organ support .
ReplyDeleteSuri,As an Anaesthetist,who must have done multiple intubations,resuscitations,in your long lasted carrier,you must have experienced some cases who have risen from near death.
ReplyDeleteWith a large number of obese,overweight,heart disease,type 2 diabetes,renal failures,surely there must have been several deaths among those categories.We no thaty age is a very high risk factor and experts reckon that chance of death is over 80% in over eighties.
Coriander(cilantro)is known for several thousand years as a remedy for viral infections causing simple cough and cold.I have used ginger and coriander combination boiled for several minutes until it turn rather dark brown.Add a sweeetener and drank on severla occasions.
My fever went down with profuse sweating and there was diuresis as well.Body aches and pains went through the windows.I hated taking paracetamol,popular remedy marked as panadol(GSK).Ginger has several medicinal values and you watch youtube and learn that speakers from USA and India always speak highly of the values of ginger.
I have been making decoction daily by blending cucumber,ginger and lemon juice.It is supposed to promote weight loss.Mind you healthy diet and exercises are paramount importance in addition to suplementory diets.
Another medication that I have read over and over againt is Apple cider vinegar whch has weight loss properties,lowering bad cholesterol,lowering blood pressure etc.Apple cider vinegar has to be diluted in a glass of warm water or mix with lime juice and honey and consume once or twice a day.continue for several weeks to see the results.
My wife,who is a regular follower of SriLankan news told me that a person has discovered an Ayurvedic dicoction for the prevention of Covid19.I was told that prominent Parlimentarian have tasted it.Why the Hell the scientists in SriLanka analyse it,failing that send it to Oxford or Cambridge to do the job for them.