“Contracting COVID 19 is not a sin. What is sinful is deliberately hiding contacts with a history of having the disease. This will cause it to spread to the rest of the society inflicting unnecessary worry and suffering to all who have been in contact with the patient”, Chief Medical Officer of Health, Colombo Municipal Council ( CMC) Dr Ruwan Wijayamuni told the Sunday Observer in an exclusive telephone interview .
He said, “Sri Lanka’s efforts to control the virus spread has been lauded by the World Health Organisation and the number of positive cases so far, over 185 at the time of going to press was low in comparision to many European countries such as Italy, Spain, US with more advanced equipment, etc. The number of recoveries too and low number of deaths (6) has been encouraging . This is because we have adopted very stringent measures”, he pointed out.
Asked at what stage of the disease curve the CMC area was, he said, “According to the WHO classification we are in the 3rd stage where we see clustering of cases within the families of the confirmed cases; there were eighteen from the city of Colombo area - where six were from one family, four from one house, two from another house, which means twelve cases clustering in three families. We were able to take immediate steps to prevent it from spilling into the nearby community.” He said there were six other separate cases under house quarantine observation which were being followed up carefully. “When we get information about a case the Public Health Department of the CMC takes it very seriously,” he said. “The moment we are notified of such a case by either the National Hospital or the Epidemiology Unit of the Ministry of Health or the Infectious Diseases Hospital ( IDH) we send a team comprising a doctor and two PHIs to investigate the case. For this purpose we have established a COVID -19 Operations Room where a Medical Officer of Health and four Public Health Inspectors are on duty round the clock. We are on call 24 hours a day”, he said.
Procedure
Asked about the procedure followed in the investigation process, he said , “They start collecting information about the occupants , their medical history, their recent movements. details of families, contacts, if they had travelled abroad and where. We then get in touch with all these contacts and get them to house quarantine. Thereafter we give this information to the Epidemiology Unit and the National Intelligence Unit.” Why the National Intelligence Unit, we asked. “Because they have the capacity to go deeper into the issue .They also provide us with their information. It is because of this well established infrastructure and sharing of information that we have succeeded where countries like Italy and Spain have failed, ” he said.
The infrastructure in Colombo includes six Medical Officers of Health from areas which come under the Chief Medical Officer, for all 46 municipal wards, Dr Wijayamuni explained. They list out the information of contacts of COVD 19 and place them in quarantine .They also paste notices on their doors with all the phone numbers of who to contact by those living in the vicinity, if those in self quarantine step out of their homes . These notices also stipulate penalties for those violating the quarantine , besides protecting those in the vicinity, and minimising COVID risks. “If the number of contacts are too many they will be sent to a quarantine centre at Punai . The infected area will be locked down while close contacts of people tested positive will be evacuated and their homes disinfected. This is what we did during the outbreak in Maradana last week,” he said.
He said the duties of the CMC Health Department do not end once patients have been sent to hospital and their contacts quarantined in their homes . “We keep a vigilant eye on all those in quarantine for 14 days and look out for any suspicious symptoms in them. If they show any symptoms even after that period , they must contact us.
“Don’t be afraid to inform us if you have a cold, cough or fever. Ring 1990 . Our team is ready to help you. If you have tested positive they will transport you to the National Hospital or IDH for treatment . As our recovery rate is very good you will be able to recover completely as most of the patients have”, he advised. ”Don’t wait till complications set in”, he warned.
In addition to this work, he said ongoing activities to control dengue spread and minimise risk of other communicable diseases will continue as usual along with disinfectant programs, under his purview.
Health Ministry offers guidelines to protect PHNOs from COVID 19 risks
The Ministry of Health Care and Indigenous Medical Services has issued a set of guidelines for protecting Public Health Nursing Officers ( PHNO) during the COVID outbreak. The Directive signed by Director Health Services Dr Anil Jasinghe and addressed to all regional provincial directors of health as well as heads of all institutions , has stated that the Ministry recognises the risks run by the PHNOs when attending to patients with non communicable diseases in home settings during the COVID 19 outbreak.
According to the Directive, PHNOs should postpone routine visits to patients in stable conditions. They are also advised to reduce home visits to patients with chronic illnesses except when their services are absolutely essential such as when changing a catheter, or NG tubes .
Prior to their visit, the Health Ministry has asked them to assess the condition of the patient, whether he/she or a member of the family are suffering from any respiratory symptoms suggesting coronavirus. They should also assess whether the patient or the family members had a recent history of travel in a foreign country and inquire if any of them are in self quarantine already.
All safety precautions should be taken when attending to a patient at home using appropriate Personal Protective Equipment ( PPE)when visiting a patient at home, the Health Ministry has emphasised. It has further stressed that all health care waste material used for the patient be safely and properly disposed of. Remind patients about taking their medications regularly and options of obtaining them at their residences , the statement adds.