Who is to take action, people or the State?

An alarming disparity between the statistics issued by the Health Ministry and the Gampaha Regional Director of Health Services (RDHS) on COVID 19 cases was reported by the media on Wednesday. According to those reports the number of daily COVID 19 cases in the Gampaha District documented by the Gampaha RDHS was three times higher than the number issued by the Health Ministry in Colombo.  

Even if the numbers issued by the Gampaha RDHS tallied with that of the Health Ministry, it is obvious that the real numbers with regard to the COVID 19 situation are far higher than the official numbers in any country. A random google search would attest to it. For instance, the COVID related death toll in the US on May 7 stood at 580,000, according to John Hopkins whereas another analysis by researchers at the University of Washington put the death toll at 905,000.  

Similarly Russia’s official COVID-19 death toll, published by the government’s coronavirus task force, stood at around 155,000 on July 30. However, the ABC News said that the data suggested the true death toll may already be over a half-million people. Last Friday’s Mexico News Daily reported that while health authorities were saying that Covid-19 is currently infecting some 20,000 people a day, the actual number was 25 or 30 times higher, according to an infectious disease specialist.  

It is a popular belief that China, North Korea, Cuba and Iran – all are countries looked down upon by the Western World and its media – hide the real pandemic situation in their countries. Yet, it is a global phenomenon. Hence it is no surprise that there is a yawning gap between the daily COVID 19 infections in Gampaha District, or any other district for that matter, reported by the Health Ministry and the relevant district health officials.  

The number of persons infected with coronavirus is counted on the basis of results of the PCR or Rapid Antigen tests conducted. Nonetheless, it is a well-known fact that only a small segment of the society is being subjected to PCR or Rapid Antigen tests, if they had shown symptoms of COVID 19 or when it comes to light that they have been contact persons of confirmed patients. Besides, some people are being tested on their arrival in Sri Lanka from another country.   

Hence, there seems to be a large number of undetected people infected with the virus. Media reported on Wednesday that a trishaw driver who was critically injured in an accident and two passengers who had been killed in the same accident had tested positive for coronavirus during tests conducted after the incident. Hadn’t the accident occurred, those three COVID 19 cases would have gone undetected and they would still be spreading the virus among their friends, relatives and others in buses, trains, shops and work places.   

The very health authorities claim that 20 to 30 percent of people in Colombo – between 150,000 and 180,000 people only in Colombo city alone - may have currently been infected with the highly contagious Delta variant of coronavirus. However, the number of patients under medical care including those who are home-based, according to the Epidemiology Unit of the Health Ministry on Wednesday was 36, 333.   

The high number of deaths in the country due to the pandemic in the past few days as reported by the authorities is another indication of the real spread of the virus in Sri Lankan society, or at least in the Western Province. Since last Sunday the daily death tally has surpassed the 100 mark. The Tuesday’s death toll announced by the Director General of Health Services (DGHS) on Wednesday is 124 and the authorities claim that the mortality rate of COVID 19 in Sri Lanka is below one percent. Even if the death rate is estimated as one percent, the patients tally on Tuesday should have been 12,400, despite the official count which stood at 2904. On the other hand, if we rely on the official patient count (2904), the current mortality rate should be a staggering four percent. All in all, these numbers indicate that we cannot rely on them at all.  

Health workers who are at the frontline of defence were themselves becoming victims of Covid-19 and Patients with other disease conditions, some requiring urgent life-saving measures were being deprived of treatment because the health system is overwhelmed with the COVID-19 response

Notwithstanding the numbers, the simple truth is that the situation is grave and demands action by the State and the people. The Sri Lanka Medical Association said last week in a letter to President Gotabaya Rajapaksa that there was a rapid escalation of the COVID-19 epidemic, particularly in the Western Province that has reached an extremely serious point now, with all intensive care beds and COVID-wards in hospitals being fully occupied by COVID-19 patients, and there being no medical facilities available to many seriously ill COVID-19 patients. It further stated that the health workers who are at the frontline of defence were themselves becoming victims of Covid-19 and Patients with other disease conditions, some requiring urgent life-saving measures were being deprived of treatment because the health system is overwhelmed with the COVID-19 response.  

Health sector experts, especially those who are attached to the SLMA and the Association of Medical Specialists (AMS) are of the view that some sort of restrictions has to be imposed on the people to avert a disaster. The SLMA in it is letter to the President had said that only stringent measures to restrict human movement and avoidance of crowds, combined with the practices currently being enforced and practiced will have an impact on this wave of the pandemic. AMS President Dr.Lakkumar Fernando had told media last week that “relaxation should have commenced once the country had achieved vaccination targets along with declining number of COVID 19 daily cases, may be in four to eight weeks from now.”   

However, the government which is concerned about the economy that is already in the doldrums seems to be thinking the other way around, i.e. people must understand the situation and
restrict their movement.  

After more than a year’s awareness campaign by the health sector specialists one should not be a doctor or a nurse to understand that the coronavirus spreads from person to person and not through water, food or vectors such as mosquitoes. Therefore, the logical remedy is to keep everybody in the society away from others, or to maintain social distance. However, any health-conscious man would attest to the difficulty to do so due to the indifference towards this fact by other fellow citizens.   

This is where the State has to intervene by way of restrictions such as curfews and lock downs on the people in general, irrespective of whether they are health-conscious or not. This surely would bring more pressures on the economy. But, on the other hand a more disastrous pandemic situation might demand more heightened actions tomorrow to prevent mobility among the people. This is the catch 22 situation the government is faced with now.