Community spread or not, act swiftly

We have been justifiably bragging until October 4 about our success in containing the deadly COVID-19 pandemic which has become a disaster in many countries such as the United States and India. With the first COVID-19 patient being reported from the Brandix apparel factory in Minuwangoda on October 4 everything has turned upside down and now we are struggling to arrest the spread of the disease. 

The number of infected persons by October 4 stood at 3400, while around 3250 of them had recovered and left hospitals. Only about 150 persons were being treated in hospitals. However, the number of reported cases reached the 8000 mark by yesterday with the new Minuwangoda cluster having been identified. The number of patients still being treated rose to around 4400 by yesterday. And still the cluster is expanding with hundreds of virus-infected people being traced daily and three deaths being reported within four days (October 22, 24 and 25). 
What happened? It is obvious that authorities as well as the ordinary people took the things easy. Politicians encouraged the people to ignore the danger that is lurking. Health guidelines were ridiculed at high profile funerals and public meetings prior to the Parliamentary election. They went among the people sometimes without face masks while hundreds of people, some even without face masks, were flocking in the vicinity. 
It has been now evident that proper safeguards had not been in place in the ill-fated Brandix factory at Minuwangoda otherwise which the infections could have been detected at the beginning of the invasion of the factory by the virus. There are thousands of workplaces in the country with large number of employees working in them and it is not clear whether the authorities have ensured the safety measures in place at least after the Brandix disaster. 

Infected persons are being tracked from around the country – even from the remote areas of the island. Parliament was closed for two days from yesterday for disinfection after several STF personnel serving there having been tested positive for coronavirus. The virus had spread to as remote places as Rikillagaskada from the fish market in Peliyagoda, forcing the health authorities in the Central province to close the Rikillagaskada Base hospital. By October 24, authorities announced that around 60 police areas had been kept under quarantine curfew which was earlier known as police curfew. That included the entire Gampaha District. 

We were unable to trace the origin of the clusters that sprang in Bandaranayake Mawatha, Colombo, Kandakadu Treatment and Rehabilitation Centre, and now in Minuwangoda. Since the authorities are satisfied that the other clusters such as the one in Peliyagoda have been branched off from the Minuwangoda cluster, they also claim that the current situation is not a community spread. But there are experts in the health sector who opine otherwise. In an interview with the Daily Mirror of October 20, international medical researcher and Executive Director at the Institute of Health Policy Dr. Ravindra Rannan-Eliya had put forward a strong argument in this regard. 
He had said “the problem with the WHO definition is, that it does not imply anything about how intense or widespread the epidemic is. For example, country A might have one new case a day without any increase over time, but not be able to identify the origin of these cases because its contact tracing is inefficient or not happening. Country B on the other hand, might be having ten new cases a day with this gradually increasing over time to 100 new cases/day, but be able to trace the origin of each case through contact tracing. According to the WHO, Country A would have community transmission, but not country B”.  

The authorities seem to prefer to accept the WHO definition perhaps for convenience or for fear of being blamed for the situation. Whatever the definition of the situation might be, we are in danger and it is more dangerous to attempt to hide it or to project it lightly. It is obvious that Sri Lanka cannot afford to a situation where other provinces have the density of spread of the disease similar to that of the Western Province. The health sector cannot afford to conduct tens of thousands of tests, supply thousands of hospital beds, especially ICU beds. 
Needless to say, the country also cannot be placed under lockdown or under nationwide curfew due to its collapsed economy. Yet, drastic actions might have to be taken to face the situation.