Looming preventable Covid crisis: Let experts handle or else… by Ranga Jayasuriya

Sri Lanka’s health sector is on the verge of collapse. Hospitals are over-pouring with patients. Dedicated Covid wards have split into corridors. The number of patients relying on lifesaving oxygen has increased by 75% over the past week. An inevitable further rise of patients would exceed the capacity and compel the medical professionals to pick and choose whom to administer limited medical oxygen, a decision generally taken based on the chance of survivability.

Corpses are piling up in the mortuaries. Crematoria in the worst affected areas are running 24 hours. In order to avoid further grisly sights, the government ministers have been assigned to speed up cremation.  42 bodies in Gampaha hospital were cremated on Sunday through the intervention of State Minister Nimal Lanza, who has been assigned by the President in the job.

Early this month, the government revoked all previous Covid related administrative circulars and ordered the government servants, including expecting mothers, to report to work. The absurdity of the decision was soon registered. However, since the President should not lose face, the decision was revisited to allow the departmental heads to decide whether their employees should come to work or not

Similarities with India’s tragic experience in the recent past are warned if the soaring third wave is not stopped in its tracks. Some indicators may give credence to doom’s day predictions, though some of the local indicators, which are grossly under-reporting, tell only a fraction of the story. Sri Lanka’s daily new cases may not grab headlines. There were 2956 new cases during the last 24 hours ending noon yesterday. What is alarming is the test positivity rate. The seven-day average in test positive rate in Sri Lanka ending August 5 is 16.8%. That is more than two-thirds of Indonesia’s (23%), which like Sri Lanka is under-recording the true scale of the pandemic. But due to the sheer size of the population, has accounted for the highest number of daily Covid deaths at present.
Sri Lanka’s Covid positive test as a percentage of total tests is still more than half the rate of India during the height of the pandemic in April and May. (Whereas India currently very much in control of the curve.  India’s seven-day average of positive tests is 2.3 %).

The number of deaths is soaring, and the toll passed 5000 quietly. There were 94 new deaths on Sunday, and 98 on Saturday. All indicators suggest that Sri Lanka is still at the foothills of a monumental health emergency, a situation that has no historical parallel.

This is however not a fate unique to Sri Lanka. Some countries, rich and poor, that were successful in holding back the pandemic in the previous waves have lost their grip against the current wave of the highly contagious Delta variant. Australia has announced a lockdown.  Protestors in Thailand, which rode off the early stage of the pandemic, are fighting street battles with the military government over mishandling of the new wave. Thailand is grappling with over 20,000 daily new cases. Vietnam, another success story, is recording 7000-8000 daily new cases.

However, walking deliberately into the trap is quite a different story. That is what the current government of Sri Lanka is doing.  Intriguingly enough, it also has quite many clowns who not only rationalize but also celebrate the gullibility of such decisions. 

Early this month, the government revoked all previous Covid related administrative circulars and ordered the government servants, including expecting mothers, to report to work. The absurdity of the decision was soon registered. However, since the President should not lose face, the decision was revisited to allow the departmental heads to decide whether their employees should come to work or not. 

The government also relaxed travel restrictions as the fresh cases of delta variant are spiking. According to Dr. Chandima Jeewandara, the Director of the Department of Immunology and Molecular Medicine of the University of Sri Jayawardenapura, patients with Delta variant has increased from 19.3% in the first week of July to 75% in the fourth week, in gene sequencing samples analyzed by his lab.

Sri Lanka is heading towards a multi-pronged crisis. It is among the worst-hit emerging market economies by the pandemic. Revenue from tourism has dried up and expat remittances have declined. The rupee is on a free fall and shored up by an artificial price ceiling. Banks have run out of dollars and foreign reserves are all-time low

The Association of Medical Specialists, the professional body of specialist doctors warns that further relaxation of Covid restrictions will add “fuel to the fire”. “In our opinion, relaxation should have commenced once we have achieved vaccination targets along with declining number of Covid-19 daily cases, may be in four to eight weeks from now.” they observed.

Sri Lanka is heading towards a multi-pronged crisis. It is among the worst-hit emerging market economies by the pandemic. Revenue from tourism has dried up and expat remittances have declined. The rupee is on a free fall and shored up by an artificial price ceiling. Banks have run out of dollars and foreign reserves are all-time low. 
Every time the government digs into the foreign reserves to repay its sovereign debt, fresh worries are adding up to an impending disorderly default. Credit ratings, already junk is awaiting another downgrade.  The government has deluded itself into believing that piecemeal measures would help it ride off the debt crisis, and spare it from the troubles of IMF mediated debt restructuring. Its Covid strategy itself smacks of similar misgivings. And that ignorance will kill people in large numbers. 

Danger though is while a full-blown economic collapse maybe a year or two away (and could probably be avoided should sanity prevail later), the carnage of the mishandling of the fresh wave of the pandemic will be immediate.
Who makes health policies, oblivious to the impending catastrophe is now a life and death question. Medical experts at best play a subordinate role to the military brass and political acolytes, who have no clue of what they are confronted with. A fatal cocktail of delusions, egotism and sheer incompetence are guiding the overall government policy. Covid strategy is not different. Irrationality is driving the pandemic and death toll. 
Political expediency has replaced medical caution and commonsense.  As it should be clear to many, Sri Lanka fought the pandemic with its current modest success thanks to the well-established health service and dedicated professionals. That modest success was achieved inspite of the government.  At least now, the government and its handpicked political and military officialdom should let the experts run the Covid strategy. Else they will reign over a self-inflicted carnage. 

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