Major plans to brace for future health crises
Isolation facilities in every district, NIID expansion & strengthening of testing on the cards through World Bank loan
As Sri Lanka gradually eases the lockdown, many plans are underway to strengthen the health service to face future contingencies including infectious diseases such as COVID-19.
“We are hoping to set up isolation facilities, one in each of the 25 districts under a loan of US$ 128.6 million extended by the World Bank,” said the Project Director of the ‘Sri Lanka COVID19 Emergency Response and Health Systems Preparedness’ Project, Dr. Jayasundara Bandara on Thursday.
Among other important plans are the construction of an isolation centre within the premises of the National Institute of Infectious Diseases, Angoda, with all facilities including negative pressure rooms, ICUs and separate waste disposal and drainage systems.
The emergency response and preparedness project due to be completed by December 31, 2023, has the following components: Emergency COVID-19 Response – this includes the establishment and strengthening of an Emergency
Operation Centre to improve coordination and timeliness of national level activities in emergencies of pandemic nature; building capacity of health workers in case identification, contact tracing, prevention, counselling, risk communication and reporting through the existing surveillance information; providing personal and protective equipment (PPE); supplying diagnostic and other essential equipment, drugs; and increasing ICU beds and equipment.
Strengthening national and sub-national institutions for prevention and preparedness – this includes the establishment and strengthening of regional/ district emergency operation centres and the setting up of a Biosafety Level 3 (BSL-3) laboratory at the Medical Research Institute (MRI). Strengthening multi-sectoral national institutions and platforms for One Health – this includes conducting a needs assessment of national protocols for detection, surveillance and response systems for animal and human health infections; establishing a mechanism for the detection of existing and emerging zoonoses; and conducting awareness on anti-microbial resistance among human health, agricultural, and veterinary and enforcement of related legislations. (A zoonosis is a disease or infection naturally transmissible from vertebrate animals to humans. Zoonoses may be bacterial, viral or parasitic, or may involve unconventional agents.) Explaining that it is a long-term health systems strengthening project, he said that there were also short-term measures that have been taken since COVID-19 came to Sri Lanka.
“The country needed a lot of things like PPEs and modifications to hospitals treating infected people. Other aspects included contact-tracing and PCR testing,” said Dr. Bandara, adding that 500,000 PPEs have been procured under this project.
He said “we are also looking ahead” through the project. This is why isolation facilities are being planned for each district. Which hospital in a particular district would have such an isolation facility would be decided by the Health Ministry. A rough list of the potential hospitals which should have isolation facilities has been provided to the Health Ministry Secretary to make a decision by next week.
Reiterating that these policy decisions should be based on epidemiology, he said that in case a hospital in a remote setting cannot be designated to have an isolation facility, a base hospital may be selected. When an epidemic breaks out, the usual patients of such a hospital can be transferred to other hospitals, allowing for infectious patients to be accommodated there. Such isolation facilities will be backed by ICU facilities, laboratory testing capability and facilities for sterilization of equipment, all under one roof.
“These isolation facilities can be used in epidemics including dengue but when the epidemic eases they can be used to treat other patients,” he said.
On a different track, Dr. Bandara pointed out that a country should have an emergency response team which gets activated when the need arises. This is why there would be a National Health Emergency Operation Room with branches in every district to respond immediately.