- Current level of restriction should continue for now and be reviewed after the New Year
- There is increasing frequency of people sowing ethnic disharmony through social media
- Everyone should wear face masks
- Ease restrictions if rate of infections remain flat
- Make health workers systems stronger
- Enforce strong system of surveillance
Six Chair Professors of Medicine (and Specialist Physicians) in Sri Lanka have expressed their opinion on an exit strategy from the current COVID-19 lockdown in Sri Lanka, recommending the current level of restriction should continue for now and be reviewed after the New Year among others.
Prof. Janaka de Silva (University of Kelaniya), Prof. Sarath Lekamwasam (University of Ruhuna) Prof. S.A.M. Kularatne (University of Peradeniya), Prof. Sisira Siribaddana (Rajarata University of Sri Lanka), Prof Saroj Jayasinghe (University of Colombo), Prof. Kamani Wanigasuriya (University of Sri Jayewardenepura) have written a letter to Lt. Gen. Shavendra Silva, Chairman of the COVID-19 National Task Force and Dr. Anil Jasinghe, Director General of Health Services, expressing their opinion with some recommendations.
“The current level of restriction should continue for now and be reviewed after the New Year.
If the level of transmission is not high as evidenced by the daily number of new cases and a slow doubling time of cumulative cases, the curfew can be relaxed in stages, district-wise (e.g. one district per province on given days of the week). The chaos that occurred on Tuesday 24 March, when curfew was lifted for just a few hours, should not be allowed to recur. However, areas with high numbers of patients could be cordoned off and kept under stricter control measures or lockdowns,” the letter stated.
Six recommendations are
1. Supermarkets, hospitals, food markets, more petrol stations and pharmacies could remain open for a period of time, to be decided by the task force, on a daily basis. As in China, each household could be issued one pass to allow one person to go out to get essentials in their own neighbourhood. Travel between towns and cities should be discouraged. The Colombo port, utilities, medical suppliers, logistics companies and food processing firms should remain open, as they are now, to ensure availability of supplies.
2. Require everyone to wear a face mask and practice social distancing in public, and follow guidance on hand washing in order to avoid infection. Large gatherings (e.g. more than 10 people) should not be allowed.
3. We need to strengthen capacity in the health sector. This includes the following measures:
a. Increase testing capacity so that all those with contact with COVID-19 positive persons can be tested, and not just those with symptoms. Seek advice from virologists regarding what tests are most appropriate for use in specific scenarios, and make every effort to stock up on supplies.
b. Continue public health measures such as contact tracing, self-isolation and quarantine as at present.
c. Provide all health personnel who are at risk of exposure to infection with personal protective equipment. Take immediate steps to purchase adequate stocks, locally produced whenever possible, of masks, personal protection equipment, ventilators and ICU beds, and even test kits, to cope with a possible surge in cases.
d. Harness capacity in the private health sector, under stringent regulatory control, for testing and patient care if the need arises.
4. Enforce a strong system for surveillance and reporting from all around the country, so that if the incidence goes above a certain level (e.g. more than 50 cases a day, as in Singapore), stringent measures can be re-imposed.
5. Consider further easing of controls if the number of new cases remains flat over a period of time (e.g. 2 – 3 weeks). E.g., lift the ‘work from home’ policy, to resume work in government offices, factories, and other important areas, re-open schools and universities. The airport could be opened for inbound passengers, initially only from countries with low transmission rates, and particularly for Sri Lankan citizens who wish to return home. However, this should be done in a tightly controlled fashion, with continued imposition of the compulsory 14-day quarantine on all returnees, regardless of their country of origin.
6. There is increasing frequency of people sowing ethnic disharmony through the social media. The TV stations too seem to highlight issues in a manner that promotes stigma. They should report situations with respect. Stigma and the trend to blame certain groups could push the epidemic underground with devastating consequences for all.