Lanka’s “unique” response to battling COVID-19 in the spotlight
Sri Lanka’s “unique” strategy in combating COVID19 came under the spotlight at the first international virtual conference on the disease ‘Breaking the transmission chain through community empowerment’.
Held by the Sri Lanka Medical Association (SLMA) and the Asia Pacific Academic Consortium of Public Health (APACPH) with an eminent panel and participants from 40 countries, the co-moderators were SLMA President & APACPH Vice President Prof. Indika Karunathilake and APACPH President Prof. Wah Yun Low from Malaysia.
Prof. Karunathilake focused on the host country, Sri Lanka, and how it had done “exceptionally well” in controlling the situation, with the “unique” response being identification of contacts and contact tracing of high-risk individuals and quarantining them and treating them if found to be infected. This was achieved through a combined effort of the Tri-Forces, the police, law enforcement, Health Ministry and the public administrative system.
The Head of the National Operation Centre for Prevention of COVID-19 Outbreak & Army Commander Lieutenant General
Shavendra Silva said there was a need for a national strategy to underpin the coordination, collaboration and recalibration of responsibilities of different agencies for which the National Operation Centre was set up.
As COVID- 19 goes beyond a health crisis, the response was strategized into three pillars: containment of affected cases; prevention of further spreading; and minimizing the loss of life.
“The containment is spearheaded by the Tri-Forces in collaboration with the health experts; the prevention of a further spread lies in best health practices, personal responsibility and law enforcing agencies, etc; and minimizing the loss of life is handled through patient management by our great health authorities,” he said.
Lt. Gen. Silva elaborated that containment and prevention of the spread were operationalized through the comprehensive quarantine process. Contact-tracing of the first, second and third tiers of those confirmed cases was carried out by the intelligence services of the Armed Forces and the police with the patronage of the health authorities, with PCR testing as and when required.
“With the distribution of the population in some congested areas, home-based quarantine is not possible. To negotiate this we introduced the ‘root-ball’ system, perhaps the first time in the world, in that we pulled out those who had had close contacts with confirmed cases as whole groups and transferred them to quarantine centres. The areas seemingly contaminated are designated as isolated zones, proscribing inward and outward movement,” he said.
Our approach became unique due to the ‘trinity’ of synergy, efficiency and public compliance.
Synergy – experts from different fields discussed, argued and agreed upon the best response before operationalizing it and efficiency – was ensured through calibration and prioritizing of roles, responsibilities and understanding whom to support in achieving some objectives, tasks and actions to regulate the overall strategy.
While elegant in its outlook, it was dependent on public compliance and came through messages sent out by the authorities through the national and private media.
The Director-General of Health Services, Dr. Anil Jasinghe, said that based on Sri Lanka’s strong public health system, the first objective was to prevent the infection coming in to Sri Lanka. But when the virus came in to the country, the next objective was to mitigate and control the infection.
“We have had at least eight recognized clusters and have been able to sort of finish off those clusters. There were two more very bad clusters especially in urban areas and sometimes linked to drug addicts etc., but even those clusters we have been able to curb, maybe 95%,” said Dr. Jasinghe.
Senior Physician from the Infectious Diseases Hospital, Dr. Ananda Wijewickrama said that at present the Health Ministry’s policy is to admit all positive cases, irrespective of their symptomatology.
“We can do that because up to now we have close to 700 patients. We have done more than 20,000 PCR tests and this number is being increased. Hospital admission, if positive, is to monitor whether they would develop symptoms and to detect any complications early and also to isolate them to curb the spread,” he said.
However, Dr. Wijewickrama cautioned that if there are more numbers, this strategy would have to be revised.