It's community spread: Expert
“All indicators are that community transmission has been around in Sri Lanka”
Astrong voice of reason based on science and numbers with regard to the current COVID-19 crisis in Sri Lanka comes from a don in Rajarata.
“All indicators are that community transmission has been around in the country for some time and it would be very difficult to pinpoint whether the infection started in the Minuwnagoda factory of Brandix Apparel Limited or outside,” says Rajarata University’s Professor of Community Medicine, Faculty of Medicine & Allied Science, Prof. S.B. Agampodi.
He urges that Sri Lanka needs to change its strategy to keep the people safe.
Pointing out that the ‘claim and blame’ game about Indians visiting the factory etc may be unfounded, he explains that when looking at the numbers, there simply cannot be 1,000 positives within the factory in two weeks.
Prof. Agampodi says that the scientific explanation would be that the infection would have been there for a long period. The fact-based probable explanation is that a parallel infection would have been in the community with a slow rate of transmission. Insisting that it started in the factory is the wrong conclusion.
“Even if people other than those in the factory and their contacts who are supposed to be negative are tested, they may be positive. The plausible explanation would be that the infection was out there without being detected and got into the factory,” says Prof. Agampodi who is also a Visiting Research Scientist,
Department of Infectious Diseases, Yale School of Medicine, New Haven, United States of America (USA).
He underscores that it is still not too late to bring COVID19 under control. It should be right now rather than later – today is the best day to understand and accept what needs to be done, starting with the probability that Sri Lanka has community transmission as right now many people in several areas (21 districts of the total 25) are having the ‘COVID-19 condition’ seemingly unrelated to the Minuwnagoda cluster.
Lamenting that he has no access to data except what the media present to the public, Prof. Agampodi argues that the close contacts of the Minuwangoda cluster have all been quarantined but not the mild contacts who are not suspected of having come into contact with the original cluster. Therefore, which way the infection has gone – whether from the Minuwangoda cluster to society or the other way round is not clear.
“All positives cropping up from across the country are not a single cluster but several stand-alone clusters. This is why we need to take proper measures to be safe. The elderly or those with uncontrolled diabetes, renal (kidney) disease and other non-communicable diseases (NCDs) are at most risk,” he says, giving the experience in the USA where there was a death rate of up to 60-70% in some elderly care facilities on a daily basis.
Prof. Agampodi, looks back at early March and says there was a delayed response to COVID-19 in Sri Lanka but it picked up later. This was the time when he was in
America. When he came back to Sri Lanka, he realized that most people, including the authorities, didn’t understand the gravity of COVID-19. This may be due to Sri Lanka, unlike other countries, not experiencing a large number of deaths.
“The way risk communication was handled was completely wrong and very weak, with people not being told how to face the new normal. The simple measures required such as wearing face-masks, proper hand hygiene and physical distancing had been thrown to the winds,” he says, stressing that the urgent need is to understand and accept the threat. Just by wearing a face-mask, the risk of transmission reduces by 60-70%. If two people wear masks, the risk reduces by 90%.
Commending Sri Lanka’s excellent ‘contact-tracing’ by the ground-level health staff and the tri-forces, he points out that among the contacts, those who tested positive and who had symptoms were only 10-20%, while the majority was asymptomatic and formed 80%. This second group had a very low mortality rate.
He adds: “Unlike the USA, the United Kingdom and France, where only people who develop severe symptoms such as breathing difficulty were admitted to hospital and all others (those with mild symptoms
and those asymptomatic) stayed home, Sri Lanka hospitalized all those who tested positive with or without symptoms. But this strategy cannot be contained as it would cause an overload of the systems and this would be disastrous.”