(By Hasrindu Rajapaksa | Translated by Akitha Wijayasinghe)
Covid-19 spread throughout the country because isolating process was not carried out regionally, Dr. Haritha Aluthge of the Government Medical Officers’ Association said.
He said that the isolation of local areas could prevent the spread of the virus and that failure to do so has led to its spread across country. Dr. Aluthge pointed out that his main objective was to prevent the closure of the country and if it happens, it would have a severe impact on the country’s economy as well as the lives of the people.
He said the risk of Covid-19 should be communicated to the public and although it is the responsibility of the Epidemiology Unit and the Health Promotion Bureau and the Ministry of Health, serious shortcomings in that process could be seen.
He added that there is a risk that the next wave of Covid-19 would form around the bars and pubs just like the clusters formed around fishing stalls.Meanwhile, Colombo, Gampaha, Kalutara, Kurunegala and Kegalle districts could be designated as high-risk areas, he said.
Read excerpts of his interview with Media.lk below:
Have we reached the level of community spread ?
Patients are reported from the community. We cannot deny that. More patients are now being reported from the community than were reported from quarantine centers. When we consider the Minuwangoda cluster and the Peliyagoda fish market cluster, although about 700 patients were reported from those clusters, they had spread throughout Sri Lanka.
That means patients are found in the community. Therefore, a big debate has arisen as to whether this disease has spread to this stage.
According to the World Health Organization definition, three factors must be met for community spreading. That is to say, there should be multiple clusters of infected people, they should be identified in different parts of the country and they should not be connected to each other.
Therefore, the Epidemiology Unit and the Security Forces continue to say that all the patients reported so far have in some way some connection with the Minuwangoda Garment Factory cluster. We have no evidence to prove or deny it.
That information too is only available in the Epidemiology Unit. We do not have a way to confirm or disprove them. Because that information was not given to us.
Shortcomings in Communication
The present risk must be properly communicated. Only then will the people seek protection. This information should come from reliable sources.
This is why the issue of expansion of the virus in the society has become so ridiculous on social media. An issue like this should not be taken lightly like that.
Therefore, we all need to work together to stop community spreading. We also handed over several proposals to the President in this regard.
The number of investigations into Covid-19 should be increased. Some laughed when we first mentioned it. But now the number of tests being carried out is gradually increasing. We also proposed to increase the number of tests by taking random samples.
That is because it should be tested everywhere in Sri Lanka. It is impossible not to investigate that the risk in Anuradhapura and Polonnaruwa is low. Tests should be done in areas with a lower risk too.
There should also be a review of quarantining process. What is being done now is to take away many people and quarantine them within the institutions. It is a huge burden on the government as well as the security forces.
Therefore, we requested that only those who should be quarantined in the center should be directed for a certain category. There are people who can be quarantined at home. Some can also be quarantined in an institution. We need to identify the instances that fit these two.
Otherwise, if all those who are sent to quarantine are sent to the centers, our quarantine system will collapse.
Thirdly, we proposed to make changes in the number of hospitalizations in order to not to exceed the capacity in hospitals. That is because there are three main categories of these patients. The first group is the group that shows no symptoms.
They do not even know that they have the virus in their body. Only if they do a PCR test will they know that they have the virus. The second group is those with few minor symptoms. They have a few symptoms such as a cold, a cough, a sore throat, a change in smell and a fever.
The third group is the group with serious conditions. They have a high fever and sore throat, difficulty in breathing, and a severe coughing. These people are the most vulnerable. People with noncommunicable diseases, such as diabetes and high blood pressure, are more likely to develop the disease than adults.
These three groups should be treated in three ways. But what is happening now is that all these people are being hospitalized. When that happens, there is an unnecessary congestion. The number of hospital beds in our country is limited. Patients with other diseases should be treated too.
We cannot ignore the other patients just because there’s a Covid-19 outbreak right? Those patients also need to be taken care of. We need to take care of those who are hospitalized with a heart attack and those who are hospitalized due to accidents. If we want to do all that, we have to stop unnecessary hospitalization.
People who do not have symptoms should be hospitalized and treated in a different way. For example, the Punani Education Center in Batticaloa is now a quarantine center and it has a capacity for about another 1,000. These people can be referred to such a place and only those who develop symptoms can be hospitalized.
If we do so, we can protect our system and move forward without risking our lives. It is also important to take care of our health staff. That is because if the number of patients increases due to social expansion, there will be no staff to treat them.
Also, the existing risk should be assessed and the risk should be communicated to the people. It is the responsibility of the Epidemiology Division and the Health Promotion Bureau, Ministry of Health. But we can observe that there are serious shortcomings.
Shutting down the country is not practical
Also, our main objective is to prevent the country from being closed. Because if that happens it will severely affect the economy of the country as well as the lives of the people. For that, right decisions have to be taken. This situation can be prevented by isolating areas regionally. It must be done without a delay. Because it wasn’t done initially, the virus is spreading all over the country. At present we have identified five high risk districts.
These are Colombo, Gampaha, Kalutara, Kurunegala and Kegalle districts. I suggested to the government that at least the boundaries of those districts be closed. That way the spread of the virus can be limited. We see it as something that needs to be done to move the country forward and stop community spreading. The World Health Organization also says that countries should not be closed.
Covid-19 is a disease associated with the immune system of humans. Then we must take action to increase our immunity. The people should be informed about this. Rest is essential at this time for us to increase immunity. No matter how busy you are, you should get at least the minimum hours recommended to sleep during this time.
Drink plenty of water. It is best to drink hot water. We need to strengthen our diet. Eating artificial food can damage our immune system. We should avoid it and focus on local traditional foods. It is also important to cultivate spiritual qualities.
We must avoid the use of alcohol and drugs. That’s because both of these damages the immune system. Also, queues at pubs are unnecessarily congested and the disease is more likely to spread. The next wave could be as imminent as the cluster associated with fishing stalls.
If there is a wave associated with pubs, it can be a very dangerous situation. So, people have to stay away from bad habits.
Also, it is very important for people to wear face masks, wash their hands and keep a distance of meters. You have to act responsibly.
The reason for the decrease in the mortality rate of patients
Experience in other parts of the world shows how many people died as a result. But such a situation is not seen in Sri Lanka. The main reason for this is that Covid-19 has not yet spread to a severe community level in Sri Lanka like other countries. If there is a community spreading, this situation will be completely reversed.
It is because of some control over the disease, that the death toll has been reduced. If there is a social spread, we do not know who has the disease or who does not. Then the disease spreads rapidly. In such a case, caring for an adult could seem impossible.
The hospital system will collapse. Quarantine centers will overflow. The death toll will increase. Therefore, according to what we can see at this time, if we work like we wouldn’t die from this even if we catch the virus, it will be inevitable to stop a social spreading. We have to be careful about that. This is why it is important for everyone to act responsibly.