Covid-19: Perhaps final warning for Sri Lankans

BBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL) 

Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.

Be warned, our dear countrymen and women. The die is cast…, well and truly. In addition to all our woes in this resplendent isle, as far as COVID-19 goes, things are getting totally out of control. We will have to pay for our sins. Whom do we blame now? Here are some facts and some well-considered thoughts.

It is our most unfortunate duty to warn the general public of the potential and quite imminent threat of a very nasty third wave of the COVID-19 outbreak over the next three weeks or so and the absolutely essential and indispensable need to take all possible precautions to avoid contracting the disease.

The little coronavirus is going on; in its merry way, rampaging right across the world. It is causing intolerable problems in several countries of the Western hemisphere. Our closest neighbour India is in absolutely dire straits. There are hundreds of thousands of new cases in India daily, deaths are soaring and the medical facilities are getting swamped. People are dying in India even due to a shortage of oxygen, a life saving medication that is of enormous value in saving lives during a pandemic of these magnitude.

Sri Lanka has now been caught right across the country in the cross-wires. During the last few days, there is a distinct and very rapid increase in the number of COVID-19 positive cases, as well as the number of patients requiring hospital admissions, oxygen and treatment in Intensive Care Units (ICUs). In fact, the dedicated COVID-19 ICU beds are all full. We have also observed an increase in the number of COVID positive reports at the laboratory settings. The numbers detected at random checks in the Colombo municipal limits also have increased. Doctors in the frontline have observed patients presenting with atypical symptoms and rapid deterioration leading to serious clinical scenarios. Possible rapid transmission has been suspected and presentation of younger patients with more serious symptoms has been noted. In a most disturbing development, those working at the Lady Ridgeway Hospital for Children, report on a rapidly increasing number of positive cases of COVID-19 amongst children. Children were generally resistant to the vagaries of the disease and now the situation with them is very bad news indeed. The presence of a new variant with possible rapid transmission has been suspected following preliminary laboratory studies. This awaits confirmation with further testing. The possible new variant could be a new mutation of the already prevalent index strain in Sri Lanka or a virus introduced anew from another foreign country.

It is important for every citizen to understand the potentially disastrous consequences of a third wave, especially with a possible new virus variant. If the new variant is able to exhibit features of rapid transmission, there will be a flood of COVID-19 cases leading to a greater number of seriously ill patients, potentially exceeding the capacity of hospitals to handle them. This is likely to lead to more deaths. The new variant may also affect the younger population even more than the older population leading to more deaths of young people in their prime of life. Mark my words, in spite of our trying our very best and the darndest from a medical angle, MANY LIVES WILL BE LOST in a third wave. At present the deaths are over 600., but it could go up to thousands over just a few days if we do not look sharp.

The real reason for this latest cataclysmic development is the utter nonchalance and irresponsible behaviour of our people. There was very definite ‘COVID Fatigue. The populace was well and truly completely sick of being dictated to and being restrained. They were just waiting for an excuse to let their hair down. Then came the Sinhala and Tamil New Year. It looked as if it was God’s own gift to mankind. It looked as if we have not had a New Year in decades. The New Year festivities showed complete disregard to the health guidelines. People from the urban areas made a bee-line to the usual holiday spots. The hotels were full, there was a one and a half hour long traffic snarl on the way to Horton Plains and Nuwara-Eliya was inundated. It is reported that there were even carnivals at some of these traditional holiday resorts.

One private bank reported that the Automatic Teller Machine (ATM) transactions from the 9th and 10th of April were to the tune of 8.818 billion rupees., YES, not even millions but BILLIONS. These transactions were not made by Haramaanises, Palas and Dasas from Thuththukudiya. These transactions were made by people from the metropolis and all other urban townships. They did not withdraw money to donate it to charity. They took it out to celebrate, go on holiday, and have a good time.

Shops were packed to capacity. People thronged the shops selling clothes as if they have been naked for a few years. All forms of transport were packed to capacity…, in fact, sardines would have been more comfortable. It was a matter of ‘to hell with the health guidelines’. With hundreds of thousands on a holiday rampage, there was no way in which physical distancing nor scrupulous hand washing could be implemented. There were stylish face masks covering the chins, rather than being worn properly to cover the nose and mouth. It was a virtual free-for-all. All it needed was just one case of an asymptomatic or mildly symptomatic COVID-19 in these crowds for it to spread right through, like a wildfire. The general impression created was that we are well over this COVID business and it was time to celebrate. My foot !!!!!!!!!!!!!

We will pay the price for our indiscretions. In the normal course of nature, what goes round will always come round. There is no other way. It may be better late than never and perhaps even never too late to start even now. The populace has to get it into their thick heads that there is a life-threatening emergency. It is absolutely pertinent and crucially vital that all possible stringent public health measures are strictly adhered to, by all citizens, to mitigate contracting the COVID-19 infection. In this regard, it would be absolutely essential to wear masks, maintain 1 meter or more of social distancing and frequently wash our hands. It is also absolutely critical to keep away from crowded places.

Furthermore, public education to alleviate stigma involved with the diagnosis of COVID-19 also is important. This virus infection should be treated like any other illness, by taking all steps to prevent contracting it. As the severity of the infection with a new variant is not all that familiar to the medical profession, all members of the public with respiratory symptoms are strongly recommended to seek medical advice followed by a COVID-19 test.

There are some of our people who did and still do obey the health guidelines. They are mostly those people from the more rural areas of the country. The buses plying in those rural areas are almost empty. Those people are scrupulously avoiding unnecessary travel and mass gatherings. The problem rests squarely with the more affluent and even more educated folk from the urban areas. They are the ‘know-alls’ who are inclined to throw caution to the winds at the drop of a hat. They need to take their public spiritedness and responsibilities to society ever so seriously. If they need a role model, they only need to just look once at the heart-rendering picture and the account of a Senior Lady Police Officer in India which appeared in the Island Newspaper of 22nd April 2021. It showed Mrs Shilpa Sahu, a five-month pregnant Deputy Superintendent of Police, in maternity attire rather than her Police Uniform, on a sun-baked street in a locked down area in India, wielding a stick and admonishing people who were out on the streets “Wapas jao. Ghar jao” (Go home. Stay at home). She is also reported to have said “we are out on the roads for your protection and you must remain at home for protecting everyone”. Need you look further? The lady is the sheer personification and the epitome of responsibility. Well, my countrymen and women, she is the one to follow.

I only hope and pray that I will be proved to be wrong as a prophet of doom, just for the welfare of our beloved Motherland and our people.