Are we hiding our heads in the sand?

Has the authorities assessed the correct COVID-19 situation in the country? It doesn’t seem to be so. We seem to soothe ourselves with misleading numbers and attempt to contain the virus threat.  In short, the official numbers about the COVID-19 situation are apparently far below than the reality.

According to the website of the Epidemiology Unit of the Health Ministry the number of people infected with the coronavirus since March 11- the day when the first local COVID-19 case was detected - was 26,038 as at 10 am yesterday. However, the projections made based on the random Polymerase Chain Reaction (PCR) tests conducted in Colombo city suggests a totally different picture.

The city Mayor Rosy Senanayake had given more startling figures in an interview with the Daily Mirror of November 30. She had stated that 249 out of 991 PCR tests conducted by the Colombo Municipal Council (CMC) in one day had shown positive results

Last week, the Colombo Chief Medical Officer of Health, Dr. Ruwan Wijayamuni said that there should be currently around 30,000 infected people in the Colombo city alone. He had come to that conclusion after conducting a few hundred random PCR tests within the city limits. The results of the tests had suggested that five percent of little more than 600,000 people in the city were infected with the virus.

Two days later, the Government Medical Officers’ Association (GMOA) also confirmed his conclusion. GMOA Editor Dr. Haritha Aluthge told media that out of 400 PCR tests conducted randomly in Colombo had shown 19 positive results. What is alarming is that this is not a number accumulated since March, but the number of patients currently carrying the virus within the city. 

If a preventive measure such as curfew or lockdown is taken that would be more conducive for the pandemic to spread since outward movement from the “gardens” stops while the movement within it increases with the livelihood being hampered

The city Mayor Rosy Senanayake had given more startling figures in an interview with the Daily Mirror of November 30. She had stated that 249 out of 991 PCR tests conducted by the Colombo Municipal Council (CMC) in one day had shown positive results. Here, the percentage of positive results is 25 percent and it suggests that there are 150,000 virus carriers in the city alone. Since this is too large a number to digest and it is too shocking, if we imagine that the percentage is in between those given by the Mayor and Dr. Wijayamuni, still the number of infected people in the city stands at 90,000.  This too may be an overprojection, but there seems to be something wrong with official figures. The number of patients who are currently being treated in hospitals is around 6,000, according to the Epidemiology Unit. 

Sometimes we ought to think that the authorities are hiding their heads in the sand given the unfortunate incident that took place in the Mahara Prison where 11 inmates were killed and another over a hundred were injured on November 29. Despite various theories put forward by the government ministers about the outbreak of violence at the prison, the initial demand by the inmates which later turned into unrest had been to conduct PCR tests on them as they feared that they had been infected with the deadly virus. 

Now, the dead bodies of inmates and the injured inmates have proved that their fear and demand were extremely justifiable. According to latest reports, eight out of 11 dead inmates had been infected with the virus while 38 out of 105 injured inmates too had tested positive. Does it mean that at least 35 percent of inmates in Mahara prison are infected? If so, it is an extremely dangerous situation in our crowded prisons.

The situation in the Colombo city and Mahara Prison demands more PCR tests in densely populated areas and public and private institutions with thousands of employees which, if conducted might drastically change the official figures about the COVID-19 situation in the country. Colombo is a dangerous place in that sense. Mayor Rosy Senanayake says the situation in the city was serious and the Secretary of the Public Health Inspectors Union, M. Balasuriya had told the Daily Mirror last week that the COVID-19 situation in some areas in Colombo is uncontrollable. 

Poverty and high population density are to blame for the situation, apart from human errors. According to sources, the population density in Colombo city is 13,364 persons per square kilometre whereas the country’s average density is 325 persons per square kilometre.  Mayor Senanayake points out that 60 percent of the people who live in Colombo were underserved. They are the low-income groups and most of them live on daily wages, or they have their self-employment schemes. Many of these people are neither monthly wage earners nor businessmen who have a buffer saving that would help them to face this kind of situations. Most of them live in flats and what they call “gardens” or shanty areas which have an even higher density of population. 

These “gardens” are thick clusters of small houses with least basic common amenities. People in many of these houses use common bathrooms, toilets and water taps. So many persons sleep in one room. Children from all houses of a cluster play in the narrow corridor running through the houses. Despite many of the houses being very small, they sometimes give shelter to several families, especially to extended families. Poor education level among the majority of these people worsens the situation. Hence, it is extremely difficult to expect them to adhere to the health instructions such as social distancing, handwashing and wearing masks all the time when one goes out.

Since the COVID-19 is a pandemic spread from person to person, the only way to contain its spread, until a vaccine comes to the rescue, is to prevent people from physically contacting others. In a shanty area, this is extremely difficult unless impossible. If a preventive measure such as curfew or lockdown is taken that would be more conducive for the pandemic to spread since outward movement from the “gardens” stops while the movement within it increases with the livelihood being hampered. 

Unlike during the first wave of COVID-19, there seems to be a trend of people infected with coronavirus dying at home. A committee was appointed to look into this issue, but its report is yet to be handed over to the Health Ministry. Lack of accessibility to medical facilities due to lockdowns and the hesitation to seek medical assistance for fear of being tested positive for the virus could be reasons for these deaths. The cremation issue could be another reason for at least a section of Muslims to hide the disease until the patient dies. What they do not understand is that ultimately the body would be cremated even if the person dies at home. 

Three weeks ago Mayor Senanayake had suggested a total lockdown within the Colombo city limits after making projections on the COVID-19 situation in the city based on the results of PCR tests. However, its practicability seems to be remote given the poverty among the people and the financial constraints faced by the government. The recent demonstration by the people in locked-down areas in Colombo is a manifestation of the impracticability of such drastic actions for a long period. The insult thrown by Minister Wimal Weerawansa at these agitators for eating up within a week the Rs. 5,000 that was doled out to them in view of the isolation of their areas points to the problem that the government has faced with. 

During the first wave of COVID-19 in the country - from early March to early October – government claimed that they had given this dole for two months – May and June- for 7.5 million families. However, this time it was given to the people only in locked-down areas. During the first wave, when an infection is reported the patients have whisked away to hospitals and their family members were taken to a State-run quarantine centres the facilities of which were praised by those who were quarantined in them. Now the family members are left at home to undergo self-quarantine apparently due to financial burden that has to be borne by the State.

It is, no doubt a difficult task for the government. Yet, it has to be handled for which a correct assessment of the situation is imperative.