As the more dangerous Covid-19 Delta variant began to spread like wildfire in Colombo and the rest of the country, with a 48 percent increase in the number of deaths, the Government clamped an inter-provincial travel ban once again on Friday, responding to health experts’ repeated warnings to lock down the country.
Leading scientists at the Sri Jayewardenepura University said that disturbingly almost 90 percent of the new cases found in Colombo belonged to the Delta variant, the strain which originated in neighbouring India and caused a tragic death wave there. The variant has now spread to over 100 countries including Sri Lanka. Yet, this highly transmissible and more contagious variant is still not widespread outside the Western Province.
Dr. Chandima Jeewandara of the Department of Immunology and Molecular Biology at Sri Jayewardenepura University said the dominant strain found elsewhere was still the less dangerous and less transmissible Alpha variant. He explained that the country was still witnessing the onset of Delta. Its full force will be felt after five weeks when the infections curve will reach its peak. “With the rate of transmissibility of the Delta variant, the virus can spread exponentially if nothing is done to stop it,” he stressed. It has been estimated that it is 100 percent more transmissible than the original Coronavirus detected from Wuhan, China, in December 2019.
So far Delta cases have been found in Jaffna, Mullaitivu, Kilinochchi, Vavuniya, Trincomalee, Dambulla, Kandy, Ampara, Ratnapura, Galle and Matara districts in addition to the three districts of the Western Province (Colombo, Gampaha and Kalutara).
Dr. Jeewandara said five seconds without a mask was enough for someone to get infected by the new variant and the infected person could give it to his entire family within hours, emphasizing the need to follow Covid-19 guidelines such as social distancing, washing hands (with soap and water or sanitizer) and wearing a mask.
The health experts including the Sri Lanka Medical Association (SLMA) have thus called for strict travel restrictions and a lockdown to contain the disturbing trend and avoid a possible health crisis due to overcrowding of Intensive Care Units (ICUs) and rising cases of Oxygen dependent patients.
The soaring numbers of daily Covid-19 deaths (from the 40s a fortnight ago to over 150 after Thursday) and related deaths in the country since late last month have been attributed to the Delta variant by Health officials. From last Tuesday to Friday the country recorded 124, 156, 155 and 160 deaths respectively. The daily count of positive cases has exceeded 3,000 since Thursday.
So far Sri Lanka has recorded 348,270 Covid-19 positive cases and 5,775 deaths with 34,870 active cases in the country at present, according to official data of the Health Ministry.
Sri Lanka with a 1.61 percent high death rate is in the fifth place among all countries, recording a worse death rate than even neighbouring India. The only four countries with worse death rates than Sri Lanka are Brazil, Russia, France and USA (Source: Health Promotion Bureau).
Health officials said both the State hospitals and private hospitals have reached their full capacity in Covid treatment wards last week, compelling the State sector to add more wards to cater to the rising numbers. Earlier, social media posts showed Ragama and Kalubowila Hospitals exploding with Covid-19 patients with the critically ill strewn all over the corridors and even out on the lawn.
State Minister Prof. Channa Jayasumana after visits to these hospitals later assured that the situation has been rectified. He said overcrowding in hospital morgues had also been addressed with unidentified (non-Covid) bodies left unattended for many years, being released for burial after recording their DNA and fingerprint data.
President Gotabaya Rajapaksa consults Health officials and experts regularly in a bid to discuss the crisis situation and the ways and means to overcome the challenges, but he has ruled out the possibility of another complete lockdown, after a crucial meeting with Health officials on Friday.
The President, however said the vaccine roll out must continue at a heightened pace to cover the target of vaccinating 60 percent of the population by end September. He noted that studies revealed that most of the recent deaths were among the unvaccinated in the Western Province. He told Health officials to give priority to over 60 year olds and people with long-term chronic Non Communicable Diseases (NCDs), as this is the most vulnerable group.
The meeting was attended by Health Minister Pavithra Wanniarachchi, State Ministers Prof. Channa Jayasumana and Sisira Jayakody, President’s Principal Advisor Lalith Weeratunga, Health Secretary Major General Dr. Sanjeewa Munasinghe, Health Services Director General Dr. Asela Gunawardena and the Army Commander.
Following the meeting Army Commander General Shavendra Silva announced that people will be required to carry the (physical) Vaccination Card to enter public places like supermarkets, shops and restaurants from September 15. A digital version that can be stored on smartphones and scanned by the relevant authorities is also in the works. This will comply with international standards.
A complete ban on inter-provincial travel was also imposed with relaxed rules for staff of essential services as well as the banking, agriculture, apparel, port, airport, health and tourism sectors. Inter-provincial public transport services (bus and rail) also ceased from midnight Friday.
Sri Lanka has fully vaccinated 3.78 million people which is 17.3 percent of the population. The number partially or fully vaccinated is 15.3 million. September end has been set as a target for vaccinating the entire eligible population. Sri Lanka has also received nearly 20 million vaccines, with Sinopharm being the majority. Pfizer, Moderna, Oxford AstraZeneca and Sputnik V vaccines are also in use here. Out of the WHO-approved vaccines only the Janssen/Johnson and Johnson single dose vaccine and the Sinovac vaccine are not in use here.
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The WHO Sri Lanka also convened a meeting of independent Health experts to take stock of the situation. The recommendations and observations made by the Fifth Independent Expert Group Meeting on the current COVID-19 situation and way forward, were made public on August 11.
The recommendations and observations
The current situation: The Experts noted with great concern the current surge in Covid-19, nearly overwhelming the capacity of the Health systems to provide the required care for the people. The trends given below indicate that Sri Lanka could soon face a health crisis of unprecedented proportions.
* Sri Lanka is showing a rapid increase in the daily reported number of cases and deaths (111 deaths reported on August 9, 2021, representing a doubling of deaths in a short space of time).
* Bed occupancy rates at all levels of care facilities (over 85 percent) and ICUs (over 90 percent) have increased progressively and is now in full capacity. Patients dependent on oxygen have significantly increased from 528 last week to 646 patients yesterday. If this trend continues, there is inevitability of a serious shortage of oxygen supply and interruption of care.
* Many areas of the country show a high PCR test positivity rate of over 20 percent.
* As of July 31, 2021, more than 60 percent 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 Delta variant spreads rapidly as has been shown in several countries. The crisis will be magnified once the Delta variant has spread countrywide because most of the other provinces are not as well vaccinated as the Western Province.
* For the vaccine that is used most widely, community vaccination will take two to three weeks after the second dose to provide adequate protection from severe disease and death. As of August 9, less than 15 percent of the population has been fully vaccinated. The newly vaccinated, single-dose vaccinated or unvaccinated groups are at very high risk of severe illness and it is very likely that there will be further increase of cases and deaths, particularly in densely populated areas.
* A significant number of Health workers are getting infected with a consequent pressure for curtailment and closure of services. All indications are that the Health staffers are exhausted and struggling.
* Amidst this situation, there is a sustained high level of mobility and social mixing among the population despite the nationwide restrictions (Oxford ‘Stringency Index’ was 85 percent (i.e., very effective restrictions in movement) in May, 49 percent in July and 29 percent by this week (i.e., dangerously low levels of movement restrictions).
Sri Lanka will avert about 18,000 deaths by January 2022 if the level of stringency is immediately increased similar to May 2021 for four weeks.
This will give the required time to accelerate vaccination and achieve the level of protection following the second dose of vaccines, as well as for the Health system to recover from the overwhelming case load.
(Key observations and recommendations indicated above represent the consensus achieved by the national experts at the August 10, 2021, meeting and the views do not necessarily reflect those of the WHO).
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