ECONOMYNEXT – The Sri Lanka Medical Association (SLM) has proposed a “restrained, phased, and well-monitored” exit strategy for the country’s ongoing COVID-19 restrictions starting Friday (01) in order to avoid another wave of the epidemic.
“The unrestricted re-opening of the country at the end of the current ‘lockdown’ will lead to a resumption of transmission. Because the prevailing case numbers are high, it is likely to lead to a more rapid rise of cases than previously, despite the high vaccine coverage,” the SLMA said in a statement on Wednesday (29).
Health authorities have also called for a staggered easing of the restrictions.
Critics, however, have argued that Sri Lanka’s lockdown – officially called a quarantine curfew – is not as stringent as it should be, with widespread reports on social media of life almost being back to normal, at least for a section of society.
Regardless, daily cases of COVID-19 have seen a not insignificant drop, six weeks into the lockdown. On Tuesday (28), 932 new infections were reported, with 55 deaths confirmed for Monday.
“The vaccination programme against COVID-19 is achieving relatively high rates of population coverage with 52% of the population being covered with two doses of the vaccine to date. Resulting from these measures, there is evidence that the number of new cases, hospital admissions, ICU patients and deaths due to COVID-19 are decreasing, calling for a review of the restrictions currently in place,” the SLMA said in its statement.
Sri Lanka’s vaccine rollout has been largely successful despite delays, though authorities have expressed concern over a disturbing reluctance among the country’s youth to get vaccinated against the virus.
“Although it is reassuring that the number of patients requiring critical care, oxygen and the number of COVID-19 related deaths are decreasing, it is evident that transmission of COVID-19, and in particular the more virulent delta variant, is still continuing at a very high rate. Even with the currently limited testing rates, the reported daily number of COVID-19 cases at over 1,000, and deaths at around 100 are still very high,” the expert body said.
The SLMA warned that, despite high vaccination rates, vaccine-induced immunity protects mostly against severe disease and deaths but is not as effective in reducing transmission.
“Resumption of transmission could lead to another wave of the epidemic which will have extremely negative consequences on the health of the people, and even on the economy (because it will call for further and longer periods of ‘lockdowns’) and will yet again be disruptive on the health system.,” the statement signed by SLMA President Dr Padma Gunaratne said.
The SLMA recommended in its statement that the lockdown be lifted gradually along the following lines:
“Activities based on the strategy outline below may be planned and implemented by the district/provincial level authorities, taking into consideration the number of new cases, their capacity to cope with the local case load of COVID-19 and other socio-economic and local factors. Further, it is essential to stress that the public must continue with all Public Health and Social measures (PHSM) in reducing the spread of COVID 19. Stringent monitoring of the COVID-19 cases and deaths would be a requirement for early detection of a potential next wave.”
Recommendations for 4 weeks commencing from 01 October 2021
Services and activities
1. Essential services, industries, agricultural work, work in outdoor sites
- Continue as at present with the functioning of essential services, industries, agricultural work strictly in accordance with prevailing health guidelines.
2. Sports-related activities
- Encourage individual sports (eg: badminton, tennis, cycling) rather than team sports (eg: rugby, football).
3. Home delivery services
- Encourage home delivery services for dry rations, food etc.
4. Inter-Provincial travel
- Continue to enforce restrictions on travel between provinces except for essential services.
5. Weddings, funerals, parties, conferences, political and other meetings, musical and theatre events
- Continuing to restrict large gatherings and events indoors. Permit outdoor functions under supervision with participation limited to 25 persons at an event.
6 Restaurants, bars, spas, salons
- Indoor dinning and drinking in restaurants and bars to be disallowed. Spas and salons to remain closed.
7. Government and private offices
- All offices to function with maximum productivity but with minimum staffing. Every office should function with only 50% of their staff capacity with workers performing in rotation. Others should be encouraged to work from home.
8. Shops, markets
- Commercial outlets/shops in a town area to accommodate 25% of customers while strictly adhering to PHSM
9. Public Transport
- Only seated passengers to be allowed with strict monitoring for adherence to PHSM
10. Places of worship: temples, mosques, churches etc
- To remain closed to the public.
- To open Schools with <200 students while practicing PHSM.
- Commence all other schools with 50% of children attending every other day in rotation while practicing all PHSM
12. Consolidating the ongoing vaccination programme until 100% people over 18 years of age are fully vaccinated with priority given for people over 60 years.
13. Plan for a booster dose with Pfizer (BioNTech)/ Moderna or AstraZeneca) for all people over 60 years
14. A stringent monitoring of the case incidence (based on sufficient testing) and deaths followed by a review of the COVID-19 situation at the end of 2 weeks at each level (Central, District, MOH), should guide the formulation of strategies for the period that follows.
15. Monitoring could be carried out using public health staff at district/ provincial levels.
16. The responsibility for planning for implementation of these strategies and monitoring to be given to the local authorities in each area/city/town.
17. Increasing capacity and facilities of the preventive health sector at district and divisional level (e.g. RD and MOH offices) on disease surveillance, and evacuation of patients when necessary.
18. Establish several sentinel monitoring sites and promote random testing for early detection of re-emerging outbreaks.
19. Increase testing capacity and continue with testing of all suspected COVID-19 patients and testing and quarantining all contacts.
General Public Health Measures
20. Continue implementing the “DReAM” strategy
- Distancing, Respiratory Etiquette, Aseptic Techniques, Mask especially at workplace, public places and during transportation.
The situation and the strategy to be reviewed after two weeks. (Colombo/Sep29/2021)