Not Out of the Woods Yet

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Warning! Watch your back because Covid-19 may make a comeback! This lull may be the calm before the storm! On 30 June 2022, only 13 cases were recorded, according the release issued by the Department of Government Information (GDI). Zero number of Covid-19 deaths was “confirmed” for 29 June 2022.

Unmasked

Director General Health Services (DGHS), Dr. Asela Gunawardena on 9 June 2022 said it is not mandatory to wear facemasks indoors and outdoors to avoid the coronavirus from 10 June 2022. However he said that it is preferable for persons with respiratory infections and those traveling in public transport to wear a face mask.

The release issued by the DGHS also noted that performing PCR or Rapid Antigen Test (RAT) was to be done as a screening test from 10 June 2022.

Earlier in April, assuming duties as the new Health Minister, Prof. Channa Jayasumana announced that wearing a face mask was not mandatory in public places. However hither too he stressed that the mask should be worn by those using public transport.

Public Reaction  

While several sections of the medical fraternity and the public lambasted Prof. Jayasumana for “unmasking” them, accusing him of conspiracy owing to the public rallies and protests taking place at the time, it is noted that the directive issued by the DGHS in early June has been taken to heart and many people, other than those using public transport, move around sans a mask.

Once again however the medical fraternity urged the public not to be too hasty in letting down their guard against the pandemic or any other respiratory infection prevailing in the country like the current Influenza.

Large gatherings and queues

The harassed public undoubtedly has thrown caution to the wind. Faced by the increasing cost of living and most essentially the fuel shortage, it is a wonder that they even remember to wear a mask while travelling in the cramped confines of public transport.

The severe blow dealt to the island’s transport service has reduced the number of buses to 10 per cent while even those using private transport have been forced to relinquish the comfort of taking their motorbike, three-wheeler or four-wheel vehicle to travel in the discomfort of public transport, not to mention the long lines of people queuing up to get cooking gas.

Is it a false reassurance?

For the outsider, the wide scale testing during the past two years when the country dealt with several months of lockdown may have dwindled. The number of PCR and RAT tests during the last two years have comedown drastically as the country is not facing an imminent Covid-19 threat.

According to informed medical sources, the National Hospital, Colombo and surgeons, Covid-19 testing was carried out at the Out patients’ Department (OPD) according to the clinical judgement of the medical practitioner. Even in cases of respiratory tract infections the physician decides as to whether the patient requires a PCR or a RAT.

Circulars and directives have been amended regarding PCR or RAT carried out prior to high-end surgeries such as transplants and even cancer surgeries where the patient in question is immune compromised and cannot afford the risk of being infected. During minor surgical interventions however the decision to perform a PCR or a RAT depends on clinical judgement, they said. However, there are instances where surgeons request for a PCR test for all patients undergoing surgery under him or her. Certain hospitals have requested for a RAT test for patients undergoing general surgery owing to the risk factor involved.

Fully vaccinated patients namely those who have been administered with the first, second and booster dose of the Covid vaccine are also given consideration depending on the surgeon requirement for a PCR or RAT, sources said.  

PCR/RAT for foreign travel

While there was a demand for PCR and RAT tests for inbound passengers during the pandemic keeping in accordance for Sri Lanka’s Quarantine Regulations Ordinance (as amended), the demands gradually relaxed according to the country’s need to the extent that currently testing is not carried out on fully vaccinated passengers arriving in the island. They should have both doses of the Covid vaccine and passed two weeks after getting the second dose to be considered fully vaccinated, according to a directive issued earlier by the DGHS who is the competent authority for the Quarantine Ordinance (as amended).

They said however that PCR/RAT for passengers leaving the country had to be done according to the requirement of the destination to which they were flying. Certain countries have waived this need while others strictly adhere to it, sources added. 

‘Pandemic changing ‘but it’s not over’

The World Health Organisation (WHO) has issued a warning. Its Director-General (DG), Tedros Adhanom Ghebreyesus, stressing that cases are rising in 110 countries, “fuelled by BA.4 and BA.5.” of Covid -19

To quote WHO, Dr. Ghebreyesus reiterated his concerns about the declining number of tests and genetic sequencing that was carried out, stressing that it reduced the world’s ability to “track outbreak and virus changes.”

Dr. Ghebreyesus said that only 58 countries have reached the mid-year target of vaccinating at least 70 per cent of their population, with the average rate in low-income countries at 13 per cent.

He appealed to countries to vaccinate 100 per cent of their health workers and people over 60 as soon as possible, pointing out that that 75 per cent of the group was now vaccinated.

He observed that it was important to keep strengthening the immunity of the general population, as it helped reduce the severity and longer-term impacts from the disease. “Even relatively ‘mild’ cases are disruptive and damaging, keeping children out of school and adults from work, which causes further economic and supply chain disruption,” the WHO DG said.

More Warnings

The Director of the Allergy and Immunology and Cell Biology Unit, University of Sri Jayewardenepura, Dr. Chandima Jeewandara in a tweet warned that while the country was “distracted” the latest Covid-19 lineage BA5 was infecting people in most other countries.

The BA5 a lineage of the Omicron variant of Covid-19 was highly transmissible and immune evasive lineage detected since the beginning of the pandemic. “Its not mild and has been detected in 63 countries, although no cases have been detected in Sri Lanka yet, he said.

The Acting Director of the Epidemiology Unit, Dr. Samitha Ginige urged the public to take the fourth dose of the Covid-19 vaccine as soon as possible. Those above 60 years, and those suffering from chronic diseases should take it.

He said the fourth dose would also be administered from the Pfizer-BioNTech and had been rolled out for all those above 20 years of age. Especially immune compromised patients, those with chronic diseases and the above 60s should take the fourth dose. Dr. Ginige urged the public to take the vaccine before it expired. The coronavirus vaccine could be taken from all Medical Offices of Health (MoHs), and hospitals above base hospitals.

The public are reluctant to take the fourth dose as their focus has changed since the last variant experienced earlier this year, he lamented. Informed health sources revealed that the coronavirus vaccine Pfizer was scheduled to expire by July 2022.

Nail in the coffin

True, to be overwhelmed by even a lineage of omicron would be the final nail in the coffin for a country which is shuddering by the weight of its debt, a collapsed economy, no fuel, no gas, a rising cost for survival and last but not least; a severe medicinal drug shortage both in the state and private sector. At a time when mother Sri Lanka has to beg and borrow (while the leaders of the nation steal) the island is in a state where it cannot afford to have expanding family trees of the corona pandemic.       

By Dilanthi Jayamanne