Sri Lanka changes Coronavirus measures as Covid-19 surges, home quarantine, centres as hospitals

ECONOMYNEXT – Sri Lanka is giving up mass institutionalized quarantine and turning them into treatment as centres daily Coronavirus cases surged and test results were delayed officials said amid warnings by doctors of imminent community transmission.

Sri Lanka confirmed 541 new Coronavirus cases on October 28, taking the total to 8,412 on October 26, amid a delay in test results.

Institutionalized Quarantine

Sri Lanka is ending institutionalized quarantine of first contacts and will now resort to home quarantine, Sri Lanka’s army chief Shavendra Silva said.

“Until today all first contacts of a confirmed patient was taken to a quarantine centre,” General Silva said.

“But in the future, the first contacts will be home quarantined. When home quarantining we hope that they will stay at home and engage in quarantine. We expect they will not go out, and be a threat to their neighbhours or society.”

“We appeal to everyone to stay at home and engage in quarantine.”

Sri Lanka has about 8,500 persons in quarantine.

About 35,000 persons are already in self-quarantine, Deputy Inspector General Ajith Rohana had said.

General Silva said contacts from highly congested areas especially if the community shared bathrooms or the Public Health Inspectors thought it necessary, people would be taken for institutionalized quarantine.

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“Many people had practical difficulties in going to quarantine,” he said. “Some had to close their houses, others were looking after animals so this decision was made.

“But people will have to be responsible and not go shopping.”

Sri Lanka has underserved settlements in the capital Colombo and some areas with a high population density including, Borella Maradana and Keselwatte are under Coronavirus curfew.

Departure

The new procedure is a departure from the process followed by the most successful countries like Vietnam which has completely killed the epidemic in the first half of 2020 and had only one outbreak in July-August 2020, which was also killed.

However similar processes are followed in Korea, where there is a steady trickle of cases, which surge from time to time.

South Korea which has a population of 51 million and is an OECD country has had reported 25,955 cases and 457 deaths.

Korea has extra-corporeal membrane oxygenation (ECMO) machines to supply oxygen directly to the blood for patients whose lungs are too damaged to for mechanical ventilators to help and continuous renal replacement therapy (CRRT) a type of permanent dialysis when kidneys fail.

Such techniques allow patients with complications to be kept alive longer for the body to fight back.

Sri Lanka however has around 500 beds with mechanical ventilators.

Korea has seen 457 deaths compared to 35 in Vietnam, where the authorities follow a principle of ‘working like ants’.

Vietnam, which has a population of 97 million has reported 1,161 cases up to October 26 and 35 deaths, all in the July – August outbreak, which has now been stamped out.

Sri Lanka has so far seen 16 deaths but now cases are rising.

By October 26, before the 541 new cases, 3,900 Coronavirus patients are in hospital and another 527 cases were suspected and under observation.

Turning Quarantine into Treatment

Sri Lanka’s Government Medical Officers Association (GMOA) had called for tiered treatment of patients where younger mostly asymptomatic cases are kept at monitored treatment centres and older patients and those with underlying conditions are kept in hospital.

General Silva told Sri Lanka’s Derana Television that some of the quarantine centres would be converted to treatment centres.

“Some of the infected persons from the Minuwangoda factory left as early as 10 days,” he said. “We had operated the Kandakadu as a treatment centre at one time. So we can do this.

“Also hotels have separate bathrooms for each room. They can also be used, and people will have better facilities,” he said.

Arrangements would be made to give people in home quarantine PCR test, he said.

Sri Lanka’s GMOA warned of imminent community transmission and named five districts as high risk.

“If we look at the factors that indicate community transmission, we are almost there,” GMOA Editor Haritha Aluthge told reporters.

“The overwhelming majority of new confirmed cases are from the community. When there is community transmission, there will be congestion in intensive care units. There will an unusual increase in deaths.

“We have identified as high risk districts Colombo, Gampaha and Kaluthara and in addition Kegalle and Kurunegala. A risky situation is emerging in several other districts.

“We have proposed that travel restrictions be brought to the borders of these districts to stop other districts also turning into risky areas.

“If these decisions are delayed, very dangerous results will come to the country.”

China locked down Wuhan when the community transmission took place in that area.

Sri Lanka’s Chief Epidemiologist Sudath Samaraweera said there was no community transmission yet and and control measures were ongoing.

Resources Stretched

Sri Lanka’s PCR testing labs have been overwhelmed and results are getting delayed.

“At the moment we are getting samples to fill the capacity,” Deputy Director of Health Services Ananda Jayalal told reporters.

“As a result there is a delay in releasing results.

“Because our PCR testing capacity is exceeding, we are bringing World Health Organization approved rapid antigen tests. This can be done in 15 to 20 minutes.”

Sri Lanka’s Public Health Inspectors Union said they are working hard at tracing contacts, but first and second contacts have already developed the disease in some cases and the numbers were getting too large to cope.

“Some areas in the Colombo municipal areas and in the Western province are almost moving out of the control of our control,” President of Sri Lanka’s Public Health Inspectors Union said on October 26.

“The health and intelligence services are engaging a massive effort to keep control. We had to work till 2 am to find contacts. So we cannot work today.”

New cases were turning up mostly linked to fish traders who had visited the Peliyagoda market.

Large numbers visit the market everyday. Fish traders had also travelled to many parts of the country. (Colombo/Oct27/2020)

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