Is the Country on Autopilot Mode as Health Experts Warn of Unprecedented Health Crisis?
|By Gagani Weerakoon|
The Government this week instructed authorities not to charge money from families to cremate their COVID-19 dead. It was also decided that steps will be taken by the Central Government to pay for the cost of cremation incurred by Local Government institutions
These decisions were reached during a virtual discussion held with the heads of Local Government institutions and Minister of Public Services, Provincial Councils and Local Government Janaka Bandara Tennakoon. During the discussion, Tennakoon questioned officials on issues that have arisen when cremating the bodies of COVID victims. The officials said one of the main problems was that of bodies accumulating in hospitals and that the bodies of those who succumbed to the virus have been sent to the nearest crematoriums.
They stated that owing to this, certain crematoriums under Local Government institutions have exceeded their capacities due to which they also have to promptly be subjected to maintenance.
They added that the North Colombo Teaching Hospital in Ragama is overcrowded with COVID-19 dead bodies as the nearest crematorium was operating at maximum capacity. Tennakoon acknowledged difficulties due to the shortage of gas and labour in crematoriums and stated that the Government will take steps to provide gas for crematoriums free of charge while the labour shortage will be filled by those with minimum skills who had been recruited recently.
He added that while there are 240 functioning crematoriums, a mechanism will be adopted to effectively cremate bodies in collaboration with the Ministry of Health and the National Operations Centre for Prevention of COVID-19 Outbreak (NOCPCO).
Delta Bomb explodes
The decision comes at a time where State Minister Prof. Channa Jayasumana, comparing the COVID-19 Delta variant to a bomb, admitted it has already exploded in Sri Lanka.
He added the next two weeks would be extremely crucial for the country. "The Delta variant is like a bomb. It exploded in New York, London, India and Indonesia, and we need to admit that it has exploded in Sri Lanka too, Prof. Jayasumana told the Media, following his visit to the Ragama Teaching Hospital.
Whilst commending the efforts of Sri Lanka's health sector in controlling the spread of COVID19, the State Minister stated that the next two to three weeks will be crucial, and that all necessary precautions will need to be taken. "The only way we can get over this is if we tell the public the truth and make them aware of the reality of the situation, so that they can take all the necessary precautionary measures," he said.
Meanwhile, based on an analysis of the current COVID-19 situation in the country, the Institute for Health Metrics and Evaluation (IHME) predicts that the number of COVID-19 deaths in Sri Lanka will rise to 12,613 by early December.
Taking into account the number of both unreported and reported COVID related deaths, the IHME estimates that the total number of deaths will be 27, 246 by 1 December.
Whilst the current daily death toll is over 100, the IHME warns that it could rise to 350 daily deaths.
Affiliated with the University of Washington, USA, the IHME said that by December, 6,931 hospital beds and 1,528 Intensive Care Unit beds will be needed for the treatment of COVID patients.
A general consensus on the current domestic COVID-19 situation was reached at the 5th Independent Expert Group Meeting, with experts recognising key observations and proposing recommendations for an improvement in the situation.
Experts, including Professor Dr. Neelika Malavige of the Department of Immunology and Molecular Medicine, University of Sri Jayewardenepura, noted with great concern the current surge in COVID-19 cases, overwhelming the health sector to provide adequate care for the infected.
Trends observed indicate that the country could soon face a health crisis of unprecedented proportions.
The number of cases and deaths reported daily in the country show a rapid increase. On 9 August 2021, 111 deaths were reported. This represents a doubling of deaths within a short period of time.
Bed occupancy rates and the number of oxygen-dependent patients have significantly increased. If this trend continues, a serious shortage of oxygen supply and interruption of care is inevitable.
Many areas of the country show a high PCR test positivity rate of over 20%. As of 31 July 2021, more than 60% of sequenced samples are Delta variant, which is highly transmissible with a shorter incubation period. It is now the dominant variant in the Western Province and will soon spread to other areas.
The newly vaccinated, single-dose vaccinated or unvaccinated groups are at a very high risk of COVID-19 infection. More cases and deaths are likely to be reported, particularly from densely populated areas.
Further, a significant number of health workers suffer from consequent pressure following exhaustion and burn-out.
Amidst the prevailing situation, there is a high level of mobility and social mixing amongst people despite the nationwide restrictions. The Oxford Stringency Index, which is a composite measure based on nine response indicators including school closures, workplace closures and travel bans to record the strictness of lockdown policies, was 85% in May (very effective restrictions in movement), 49% in July and 29% by this week.
”Sri Lanka will avert about 18,000 deaths by January 2022 if the level of stringency is immediately increased similar to May 2021 for 4 weeks,” they say, adding that this will give sufficient time to accelerate vaccination and for the health system to recover from the overwhelming case load.
Experts recommend Sri Lanka should:
- Strictly enforce movement restrictions, including inter-district travel except for essential services.
- Restrict /cancel all public events for three weeks.
- Provide care and protect the health workers and augment staffing in hospitals to minimise disruption of essential health services.
- Develop and implement an effective communication plan to engage the public and to update them on the control measures.
- Accurate reporting of both cases and deaths to get a better picture of the ground situation. May also use proxy indicators such as observed Test Positivity Rate (TPR), trends measured using weekly moving averages and time series analysis, mobility data, etc.
- Prioritise vaccinating all those above 60 years and those with co-morbidities, preferably with Pfizer, Moderna or AstraZeneca because even a single dose of these vaccines provides some degree of protection until the second dose is given.
The Bill to provide for the declaration of a state of public health emergency that seeks to provide for special measures in the interest of public health, and is imminent owing to the COVID-19 situation in the country, is yet to be passed and enacted.
Claiming that the COVID-19 Task Force is a failure, UNP National List MP Ranil Wickremesinghe previously criticised Army Commander, General Shavendra Silva’s role in the Task Force, stating that according to the Constitution, it is the Cabinet and the Premier who should be in charge of pandemic control in the country.
According to the said Bill purported to be brought forward by health authorities, Parliament, Cabinet of Ministers, Courts, the Public Health Emergency Council, and any other such authority may sit, convene through the use of contemporaneous audio-visual links and hold sessions during the period of a public health emergency.
A Public Health Emergency Council for the purpose of this Bill which would be constituted in the event of a public health emergency would consist of the President who would be the Chairman of the Council, the Prime Minister who would be the Vice-Chairman, Leader of the Opposition, Ministers in charge of Health, Social Welfare, Environment, Home Affairs, Science and Technology, Defence, Police, Finance, Foreign Affairs, Education and any other Minister deemed relevant by Parliament, the Director General of Health Services and five persons from the MPs of the Opposition nominated by the Speaker of Parliament with the consultation of the Leader of the Opposition.
The functions of the Council would include that of formulating and implementing a national plan and programme for the effective use of resources for the detection and containment of the contagious disease, the enhancement of public awareness and training, uninterrupted supply of goods and services, provision of goods and services to those unable to access and the adoption of all other measures necessary to counter the contagious disease.
The Council shall recommend to Parliament the allocation of all technical, infrastructural and monetary resources required to implement the national plan. With the recent restrictions imposed on public gatherings including protests, human rights activists and lawyers questioned the manner in which the Government could restrict the right to freedom of expression and peaceful assembly.
This has been addressed by the Bill which provides for the temporary restriction of fundamental rights by which the Minister, upon written advice of the Director General of Health Services, by order published in the Gazette and a period not exceeding fourteen days, prohibits or restricts public assemblies, religious worship or observance in public, engagement in an occupation not specified in the Act, travel to and from places of residence, being on any public place, except under the authority of a written permit.
Any such order should be communicated to Parliament, which may by resolution revoke such order, and non-compliance with such order will amount to an offence. The Bill also provides for what constitutes essential services including that of, healthcare, the provision of public utility service, the production, transport and delivery of medicines, healthcare technologies and medical surgical devices, the production, transport of agricultural and food products, law enforcement and defence and any activity functional to the facing of the public health emergency.
The Bill provides for the manner in which the Minister could on the written advice of the Director General of Health Services, by order published in the Gazette, require maintenance or construction of establishment for quarantining purposes, requisition any premises for quarantining persons, requisition of privately-owned hospitals to provide healthcare, and to temporarily recruit workers to be deployed in hospitals.
Further provisions include measures to be followed for the purpose of preventing the spread of the disease. The Bill also states that the Minister may, by order published in the Gazette, require the closure of any educational premises for a period specified in the order and to provide lessons to students through contemporaneous audiovisual linkage during such period.
Further, Parliament may, by resolution, declare certain industries and sectors that employ large number of workers to be “protected industries” or “protected sectors” to receive special monetary assistance to ensure that persons employed in such industries are retained in employment during a period of public health emergency
Meanwhile, Secretary General of Parliament Dhammika Dasanayake said the Coronavirus Disease 2019 (COVID-19) (Temporary Provisions) Bill will be taken up for debate in Parliament on 17 August,.
The Coronavirus Disease 2019 (COVID-19) (Temporary Provisions) Bill was tabled in Parliament on 8 June by Justice Minister Ali Sabry. The Bill proposed to make temporary provisions in relation to situations where persons were unable to perform certain actions required by law to be performed within the prescribed time periods due to COVID-19 circumstances.
It also proposes to assign alternative Courts where a Court cannot function due to COVID-19 circumstances, to conduct Court proceedings using remote communication technology to facilitate the control of COVID-19, and to grant relief in relation to parties to certain contracts who were unable to perform contractual obligations due to COVID-19 circumstances and for matters connected therewith or incidental thereto.
Will there be a Lockdown?
The Government is currently under immense pressure to go for a complete lockdown and rumours were spreading that imposing lockdown was ruled out due to a VIP wedding.
State Minister of Money and Capital Market and State Enterprise Reforms, Ajith Nivard Cabraal has denied recent claims that the declaration of a state of lockdown in the country is being delayed due to his son's upcoming wedding.
He tweeted stating that there was no truth to the claims currently being circulated on social media.
"I am informed that there is a #FB message that is circulating as follows: "Delay of the lock down is due to the wedding of Nivard cabral junior. Soon after that a longer lock down is planned. Pl stock up provisions." This is a completely false story. #fakenews", Cabraal tweeted.
Meanwhile, State Minister Dr. Sudarshani Fernandopulla has cancelled her son's wedding reception due to the current situation in the country.
The wedding will now take place as a personal event without the participation of any invitees, it was reported.
However, following a meeting held between President Gotabaya Rajapaksa and the Presidential Task Force on COVID-19 on Friday (13), the President said he was not ready to impose a countrywide lockdown but opted for tougher travel restrictions.
President Rajapaksa, at the meeting, had also urged the task force to go ahead in full speed with the vaccination programme and finish inoculating the targeted population as soon as possible.
The meeting held with the President today was attended by Minister Pavithra Wanniarachchi, Lalith Weeratunga, State Minister Channa Jayasumana and DG Health Services, Dr. Asela Gunawardena.
State Minister Channa Jayasumana, following the meeting with the President said that while a decision was taken not to impose a lockdown, the discussion also focused on controlling the prevailing situation.
SJB calls it a murder wave
Leader of the Opposition and Leader of the Samagi Jana Balawega (SJB) Sajith Premadasa was in Tissamaharama last weekend. When Sajith went to Tissamaharama, his supporters told him that the Government was spreading rumours that the coronavirus had spread due to ongoing teacher trade union protests.
‘Some ministers too have got coronavirus; have they also contracted the virus by participating in teacher protests?” Premadasa asked with a smirk on his face.
On his way back to Colombo from Hambantota, he- inquired about the corona situation in the country.
"If we want to save the country from the current situation, we have to close the country. But the Government is not closing the country. The Government will not go for a lock down because the people will have to be given relief after the closure of the country,” the Opposition Leader said.
After assessing the situation, he informed his secretaries to stop all public meetings.
Meanwhile, his attention was also drawn to a statement made by a senior Cabinet Minister that the fate of the COVID-19 patients and country’s situation lie in the hands of God.
"Sri Lanka is number one in the world in terms of corona patients and deaths rate. In such a situation, the Government is behaving in a manner that humiliates the 6.9 million people who voted for it,” he said.
As the COVID-19 Pandemic spreading across the country few volumes higher than it used to be, attention of the SJB leaders also was drawn to the dire situation of the country.
"Keheliya has said that saving the people from Coronavirus is up to God," the discussions were kicked off by MP Gayantha Karunatilake.
“In that case, they should handover handling entire country to Almighty God,” former Health Minister Rajitha Senaratne responded.
"Let others aside. These people are insulting the 6,900,000 who voted for them," Opposition Leader opined.
"Actually, leader, now it has proven you were right from the beginning as all the things you said, is becoming true day by day. Unfortunately, Government did not pay any heed to these things,” MP Harin Fernando joined the conversation.
The spread of the Delta COVID variant has placed Sri Lanka in a very dangerous position, Premadasa warned.
The Delta variant has threatened the Sri Lankan health sector, he said.
The Opposition Leader said the delay in implementing a vaccination process resulted in lives being lost.
He said the Government attempted to build trust among the people via various media institutions on mythical tonics and the dropping pots into rivers.
If the Government had moved to order the vaccines in at an early stage, Sri Lanka would not be in its present dangerous state, Premadasa stressed.
‘Today, hospitals are running out of beds and patients are in the yards. There is also a shortage of facilities at ICUs as well as oxygen etc,’ said the Opposition Leader.
He called on the Government to go before the international community and appeal for help and more vaccine doses.
“Do not live in a dreamland; the situation is heading for a more dire condition. These are not waves of deaths, but waves of murder,” said the Opposition Leader.
Worse than Easter Attacks
Criticising the Government’s failure to intervene in preventing Covid mortality, JVP General Secretary Tilvin Silva said that the Government should be responsible for Covid deaths even more than the previous Government that was responsible for Easter Attacks deaths.
The party is of the opinion that the previous Government had to take the responsibility for failing to prevent the Easter Attacks, even when the intelligence apparatus warned of such an attack.
He said similarly, the Government is keeping mum and ignoring recommendations of the health authorities and health experts when daily Covid mortality is on the rise quite dangerously.
“The Ranil-Maithri Government had to bear the responsibility for failing to prevent the Easter Sunday attack and was unable to save more than 300 precious lives, albeit there was intelligence alert. This Government is also not taking any action to prevent the Covid deaths even when data and information were available of the worsening pandemic and health experts urging to take prompt action. The Government was ignoring experts' recommendations, he said.
He also added that this Government should be held responsible for Covid deaths rather than their predecessors who turned a blind eye to prevent the Easter Sunday Attack deaths.
He said 971 people have lost their lives due to Covid-19 during the past ten days and added that with all those unfortunate scenarios, the Government is still tight-lipped.
UNP WC meeting
UNP Leader Ranil Wickremesinghe has called an emergency meeting of the UNP Working Committee to discuss the party's 75th General Convention, which will be held on 6 September. Furthermore, the Working Committee was given a paper containing 21 ideas that the party intends to present to the G overnment.
Wickremesinghe oversaw the development of these policies, which Deputy Leader Ruwan Wijewardene submitted to the party working committee.
Wijewardene noted that, while all Opposition parties criticise the Government's role and offer no alternative strategy to address the country's problems, Wickremesinghe has always offered one.
According to the UNP's Chairman, Vajira Abeywardena, the UNP is the only party with a plan to move the country forward. He claimed that as a party, they criticize the administration while also proposing a strategy that the Government could implement if it so desired.
The UNP General Secretary, Palitha Range Bandara, addressed a number of committees formed as part of the UNP reorganisation. The Legal Committee, led by President's Counsel Ronald Perera and Attorney-at-Law Nissanka Nanayakkara, established several committees, including the Environment Committee, chaired by Dr. Ajantha Nanayakkara, and the Communications Committee, chaired by Sudath Chandrasekara-.
As part of the reorganisation, the party's Central Bureau was given most of Wickremesinghe's powers, and the party convention was then held in depth. The Working Committee meeting was held in the Sirikotha main hall rather than the Committee Hall due to the COVID-19 pandemic.
On Wickremesinghe's recommendation, the Working Committee met on Thursday evening. Only half of the Working Committee members were invited, and chairs were placed at a one-meter distance.
Prior to the Working Committee meeting, Wickremesinghe met a group of party activists at his official quarters at the Sirikotha party headquarters, including Wijewardene, Range Bandara, Abeywardena, and Akila Viraj Kariyawasam, to discuss the current political situation.
Wickremesinghe read out Wijewardene's 21-point proposal, which he updated with a few new topics. Meanwhile, when Abeywardena said the pandemic had reached a critical stage, everyone nodded in agreement.