B.1.1.7: To lock down or not?
ECONOMYNEXT – It’s been five days since Sri Lanka announced the detection of B.1.1.7, the highly transmissible UK-variant of COVID-19, within its borders, and opinion seems divided on whether the country should go for another lockdown to prevent an outbreak.
Officially, the government is of the position that Sri Lanka, cash-strapped and debt-ridden, cannot afford an island-wide lockdown. Co-cabinet spokesman Minister Udaya Gammanpila told reporters this morning that no restrictions will be imposed on any part of the country.
“We saw the downfall in the economy [during the first lockdown last year]. Hundreds of thousands lost their jobs,” he said.
Census Department data shows at least one hundred thousand job losses at the start of the lockdown in March 2020. Many more in the informal sector lost their livelihoods as a result of the two-and-a-half month quarantine curfew.
“Even if we want to, we don’t have the capacity to impose a lockdown. So the government is trying its best to solve this crisis while keeping the country open,” said Gammanpila.
“The challenge ahead of us is to learn to live with the virus. Under prevailing circumstances, we can continue to keep the country open,” he added.
Prof Neelika Malavige, whose team of researchers detected B.1.1.7 in Sri Lanka, also believes there is no need for a lockdown.
Malavige, Professor in Microbiology at the Department of Immunology and Molecular Medicine, Faculty of Medicine, University of Sri Jayewardenepura, told EconomyNext today that, however, some limit on public events may be advisable.
“The UK variant might spread; it might not. It is absolutely difficult to predict. Asian countries seem to have controlled it; so I don’t think we need to panic. What is important is to limit the functions and stop all unnecessary ones,” she said.
New Zealand, a country that has consistently come out on top in its battle against the pandemic, on Monday announced the detection of B.1.1.7 within its borders, prompting a lockdown in Auckland.
“Even in countries like New Zealand, where there are absolutely brilliant control measures, they did get an outbreak from this. These things happen and that’s how this virus is,” said Malavige.
“It’s true that they went for a lockdown. But I don’t think we can draw parallels between Sri Lanka and New Zealand, economically, in terms of mortality, etc,” she added.
The UK strain – also known as the Kent variant, after the county in which it was first discovered – has been detected in 82 countries including Asian countries such as South Korea, Thailand, Hong Kong, Bangladesh, Singapore, India, Malaysia and Pakistan. The strain is said to be 30 to 70 percent more transmissible and about 30 percent more lethal than others and, according to Sharon Peacock, director of the COVID-19 Genomics UK Consortium, is likely to “sweep the world”.
The strain was first observed in Sri Lanka toward end January this year. Researchers at the Jayawardenapura University sequenced 92 samples collected in different parts of the island including a number of quarantine centres. The variant was detected in samples from Colombo, Avissawella, Biyagama and Vavuniya and some of the quarantine facilities. The university told this website last Friday (12) that it is possible that Sri Lanka’s existing B.1.411 strain could’ve undergone de novo mutation owing to its wide and rapid spread in the country. However, Prof Malavige said later that the source is most likely a returnee from overseas.
With Sri Lanka extending its ongoing vaccination of frontline workers to members of the public starting yesterday, calls for a lockdown have been somewhat muted, though speculation persists that one may be around the corner. Army Commander Gen Shavendra Silva yesterday told a private TV station that a lockdown will not be imposed but the government will look at ways in which an outbreak can be prevented.
However, Sri Lanka’s public health inspectors (PHIs) have called for at least a partial lockdown.
“We saw what this variant did to the United Kingdom. It infected millions within 15 days,” PHI Union President Upul Rohana told reporters yesterday.
“The officials must lock down the country and control this situation because we do not know whether the new strain has already spread to other parts of the island,” he said, adding that no test has been conducted to determine the spread of the variant so far.
Meanwhile, President of the Association of Government Medical Laboratory Technologists Ravi Kumudesh claimed there is no systematic identification process of the new variant in Sri Lanka. Kumudesh told EconomyNext that a shortage in facilities in the country’s state-run labs to test for the new variant is a major stumbling block to preventing an outbreak
“We need Next-generation sequencing analysers to identify the new variants of the virus. We do not have such analyzers in any of the state-owned labs apart from the one at the Sri Jayewardenepura University. Not even the National Medical Research Institute has one,” he said.
Without determining the spread of the UK strain, Kumudesh said, it is not practical to impose travel restrictions only in areas where it has been detected. He called for increased testing to determine the extent of its presence in the country.
According to Kumudesh, the sequencing tests done at the Jayawardenapura University do not cover all districts and therefore any decision to not impose a lockdown must not be taken base on those tests alone. He claimed the university labs only sequences samples with S-gene target failure (SGTF) and therefore we might miss the detection of any other variants that may be present in Sri Lanka. SGTF is considered a biomarker to detect the UK variant in samples collected from a community.
Asked to comment on this, Prof Malavige said: “We sequence according to World Health Organisation (WHO) guidelines in a scientific manner. The epidemiology unit sends us samples from many locations, as and when required according to WHO guidance, which is common sense. We have sequenced 128 viruses vs 245 from India and 15 from Pakistan. Singapore has done 130,” she said.
According to Dr Chandima Jeewandara, Director, Allergy Immunology and Cell Biology Unit, University of Sri Jayewardenepura, whole genome sequencing (WGS) is the definitive test that tell researchers whether the strain has entered Sri Lanka. This is not routinely done but is part of research and surveillance.
“Interestingly, one of the PCR tests used (TaqPath) which looks for three genes in the viral RNA leads to one of three signals being negative for the mutant strain, and this could serve as a clue at the ground level. Labs should report this finding whenever they see it so that such samples can then be confirmed with WGS. Spike gene target failure (SGTF) can serve as a proxy for carriage,” he said, explaining the process.
Jeewandara is also confident that no other strain is present in Sri Lanka at the moment besides B.1.1.7, the current B.1.411 which was unique to Sri Lanka until it spread to Australia and Singapore recently, and the original B.1.42 strain that entered the country in March last year.
Based on the sequencing done so far, none of the other variants that are spreading in other countries are present in Sri Lanka, he told EconomyNext.
Jeewandara further said no official has contacted the team regarding a nationwide sequencing test to detect B.1.1.7 in other parts of the country. Despite its high transmissibility, he said, following basic health guidelines, wearing two masks at once, maintaining physical distancing and avoiding social gatherings can help prevent an outbreak.
Reported by Chanka Jayasinghe and Himal Kotelawala (Colombo/Feb16/2021)