Op Centre to defuse new cluster
No community spread established yet; contact tracing to find source of infection,
An Operations Centre was established on Friday at the Health Ministry to act as a coordination mechanism among all sectors to respond speedily to the challenges posed by the latest Minuwangoda cluster with a garment factory as its nucleus.
The Minuwangoda cluster has not only affected the Gampaha district but has also spread its tentacles across the country.
Headed by Health Ministry Secretary Major-General Dr. Sanjeewa Munasinghe all stakeholders involved in battling the new coronavirus are represented at the Operations Centre, the Sunday Times learns, while a Technical Committee also based at the ministry has been functioning since the beginning of the COVID-19 pandemic in January, to provide technical guidance.
Currently, the other bodies which have as their focus, this pandemic that has swept through the world, are the National Operation Centre for Prevention of COVID-19 Outbreak (NOCPCO) headed by Army Commander Lieutenant General Shavendra Silva and the Presidential Task Force on COVID-19.
In a wide-ranging interview, the Sunday Times asked the Health Ministry’s Chief Epidemiologist, Dr. Sudath Samaraweera, about many concerns at the forefront of people’s minds.
To the question whether there is community transmission of the virus, he was specific that community transmission has not been established yet.
With many expressing worry over the holding of two public examinations (the Grade 5 Scholarship examination today and the
Advanced Level examination starting tomorrow), Dr. Samaraweera allayed fears and said that the authorities know the children who would be sitting the exams.
“We know the count. The previous plan was for the Gampaha students to go to their schools to do the exams in a designated transport system. Now they are going to set up centres in Gampaha. There is no need to worry,” he said.
Referring to instances where some students may have attended large-scale tuition classes in Gampaha, he requested all those who did so to place themselves in self-quarantine, as children from all over the country may have come to these classes.
With regard to the Minuwangoda outbreak, Dr. Samaraweera said: “We think it will be present only for a short period, we are just at the beginning of the outbreak. When you look at the bigger picture, we feel the ‘second line’ has spread on a smaller scale.”
Earlier, he said that the viral load of the first 60-odd people confirmed as positive in the Minuwangoda cluster was very high and that indicates that it may have been caught early.
When the Sunday Times checked what this means, we learnt that the patients may have been detected early, with other experts explaining that as soon as a person gets infected there is a high viral load but as that person’s immune system responds or kicks-in to battle the invader-infection, the viral load begins to reduce.
“But it seems to be a very active cluster,” an expert said, pointing out that whether the virus affecting this cluster is a different strain can only be ascertained by carrying out genome sequencing of the virus.
When asked not only about the Minuwangoda cluster but also the infections popping up outside the Gampaha district, Dr. Samaraweera said that other than three or four, all others have a link to that cluster. This may be due to factory workers sharing boardings, etc.
“Some of the other cases that were confirmed even if they didn’t seem to have a link, when they were thoroughly explored we could trace them back to something like going for a delivery. It takes time for us to find the link and there is no evidence that there is community transmission. It is only after we get the results from RT-PCR tests from the community, that we can decide whether there is community transmission or not,” he said.
Focusing on the ‘source’ of the infection which set off the Minuwangoda cluster, the Chief Epidemiologist said they are taking the case histories but the numbers are high (over 1,000) and it takes time. The possibilities for this outbreak could be the area's proximity to the airport, an airport worker could have accidentally contracted the infection and it could have leaked. It could be from an airline crew member. It could be an undetected case that came from abroad. The woman who sought treatment at the Gampaha Hospital was not the first patient in this cluster as there were cases of people who had been having symptoms from September 20.
“We are carrying out contact-tracing,” he assured, explaining that ‘first contacts’ are those who have had direct exposure to a COVID-19 positive case, while ‘second contacts’ are those who have been in contact with the first contacts.
Was there a flaw in the quarantining process?
Dr. Samaraweera said that there could not have been a gap in the quarantining centres or in homes because the system is well-established.
However, he conceded that there may have been a slip-up or two like the Matara incident where 15 Russians walked out of the Mattala Rajapaksa International Airport (MRIA) and lodged in a beach resort which was not a designated hotel quarantine centre. “There were no similar cases,” he added.
RT-PCR tests
As of Friday, Sri Lanka has conducted a total of 320,000 RT-PCR tests since the start of the COVID-19 crisis.
Dr. Samaraweera said that on Thursday alone 6,000 RT-PCR tests were conducted in the light of the new cluster.
Bed-strength in state hospitals
Meanwhile, discussing the bed-strength in state hospitals, the Health Ministry’s National Coordinator for Disaster Management, Dr. Hemantha Herath told a media briefing on Friday morning that around 2,000 beds have been made ready.
“We don’t think it will exceed this capacity because the cases are contained. However, if the need arises we can increase the bed capacity to around 3,000,” he said.
When asked about beds in Intensive Care Units (ICUs) in state hospitals, Dr. Herath said that currently there are 200 which can be increased to 700, which are more than enough to face the current situation.