PCR Testing at Ports of Entry Crucial
By Dilanthi Jayamanne
December is the month of festivities and gaiety. But like last year, the end of 2021 has not been easy on the world and for the paradise isle of Sri Lanka which was assailed by two viral variants of deadly COVID-19, Alpha and Delta variants, leaving over 14,399 dead and boosting the daily case load till it has reached a whopping 565,471 by 3 December. Having controlled the Delta wave by end September 2021 at great cost to even the members of the State Health Services, Sri Lankans have been enjoying a bit of a breather or ‘Spring Time,’ as this period of relaxation was referred to.
Despite the cannon balls hurled by milk producers, bakeries, vegetable vendors, shops, groceries, supermarkets, the Petroleum Corporation and gas companies, the long-suffering Sri Lankan public have seized the moment. Certain town areas and even the famed Fort and Pettah markets are filled with shoppers.
Lowering the guard
In the midst of the chaos, the Health Ministry – the country’s health watchdog, with manoeuvring of the Ministry of Civil Aviation, and Tourism authorities who have been angling to boost the country’s tourism industry from the onset of COVID last year were able to convince the Director General Health Services (DGHS) to introduce further amendments to travellers returning after overseas travel or tourists coming into the country.
Introducing further revisions to travellers arriving from overseas on 30 September, the Health Ministry said that fully vaccinated locals and tourists arriving from overseas would not have to undergo an ‘on-arrival PCR testing’ if tests carried out prior to boarding the flight were negative. An official for the Health Ministry said that at the time the announcement was made based on discussions between Ministers of Health and Tourism, Keheliya Rambukwella and Prasanna Ranatunga, it was decided that foreign nationals who had not been fully vaccinated would be given the “opportunity to reach their hotels in a bio-bubble” where an on-arrival PCR would be carried out.
However, Sri Lankan nationals could undergo a PCR either at the airport or at the hotel. They could quarantine in their homes if the on-arrival PCR was negative.
And then the World Health Organisation (WHO) flagged the new variant of concern B.1.1.529 on 26 November, now identified as ‘Omicron’ – the 15th letter of the Greek alphabet and a triple star system in the constellation of Perseus. WHO designated it as a variant of concern, on the advice of its Technical Advisory Group on Virus Evolution (TAG-VE). “This decision was based on the evidence presented to the TAG-VE that Omicron has several mutations that may have an impact on how it behaves.”
Current knowledge about Omicron
WHO says that researchers in South Africa and around the world are conducting studies to better understand many aspects of Omicron and would continue to share their findings as they became available.
“WHO is working with technical partners to understand the potential impact of this variant on our existing countermeasures, including vaccines. Vaccines remain critical to reducing severe disease and death, including against the dominant circulating variant, Delta. Current vaccines remain effective against severe disease and death,” WHO said at the time.
The global health watchdog which has been on its feet since SARS COV-2 rocked the world said at the time that “widely used PCR tests continued to detect infection, including infection with Omicron.”
Enter the dragon
The College of Medical Laboratory Science Sri Lanka (CMLSSL) warned that it would be the “end of springtime for Sri Lanka after several months of being subject to travel restrictions due to COVID-19” if maximum caution was not taken to prevent the new variant detected from South Africa from entering the country.
They noted that the new variant would be a severe setback to all efforts made by the State health authorities and the Government in controlling the spread of the Delta variant during the recent months. “We have been able to control COVID to some extent because of natural immunity and the immunity provided by the coronavirus vaccine.”
According to preliminary research, it has been found that the new variant was highly infectious, while not even those who have already been infected by the Delta or Alpha variants could escape.
Kumudesh has repeatedly urged the health authorities to recommence on-arrival PCR tests before it was too late. “Stop being intimidated by the hotel and PCR mafia of the private sector, and recommence on-arrival PCR using the testing facilities of the Health Ministry and the Civil Aviation Authority, who can perform the test and issue the report within three hours.”
Lab facilities at BIA
Amidst the backstabbing, slanders and connivance of certain sections of the Health Ministry and the Civil Aviation Ministry with business interests and commissions to accept, on arrival PCR lab facilities were set up within Bandaranaike International Airport (BIA) and in its immediate environs where locals and tourists arrival could do their tests and obtain the report in three hours. “By the time the tourist gets to his or her hotel, they would get the report as to whether they’re positive or negative.”
By the time the overseas returnee goes back to his or her home, the local Public Health Inspector (PHI) and the Medical Office of Health (MoH) would have an account of the number of persons that have returned from abroad in their jurisdiction.
Sri Lanka’s first case of Omicron which was made known on Friday (3) was identified following an on arrival PCR test on a local who had travelled to Nigeria by the particular facility. It had been deployed to the Sri Jayewardenepura University (SJU) for sequencing as a precautionary measure owing to the case history.
The lab has been set up as a joint venture betweena German-based institution and reference to a lab facility in Dubai. However, it would be handed over to the Government of Sri Lanka at the end of two years when the said institution is able to recover its cost. A spokesman for the facility who requested anonymity said that Sri Lanka ran the risk by depending on the negativity of PCR tests that are carried out 72 hours prior to boarding the flight. There have been incidents where single vaccine passengers who had arrived with negative PCR only to test positive with their on-arrival PCR. “A week earlier we had four foreigners of whom three tested positive. They were fully vaccinated. There were possibilities of infection even after testing negative at a PCR taken 72 hours prior to embarkation while moving around.
He said that the Lab facility aimed at conducting the PCR test on the few passengers that trickled in for on-arrival PCRs with a little inconvenience as possible. A tourist or even a local should not get the impression that they are in a hospital or a similar environment. Currently there were 12 medical laboratory scientists, a lab director, 30 and 15 swabbing personnel and medical laboratory technologists working in it.
“We see ourselves as a border control lab facility and carry out testing on every single sample that is taken, so as to ensure that the people within the country are not at risk”.
The lack of accountability for the decisions taken by depending largely on certificate ‘fully vaccinated’, and being overridden by a few influential business-minded individuals would place so many more lives on the line if the Health Ministry fails to depend on its available resources.