The Covid -19 pandemic continues to spread at an alarming rate in Sri Lanka and in most countries. This is mainly due to the lack of people based campaign with proper leadership.
In Sri Lanka the coronavirus was introduced into the country by identified individuals coming from abroad. By identifying each case and the contacts who formed a cluster and isolating each cluster for the required period the spread to the community was prevented.
This was done effectively by Sri Lanka’s good Public Health Service and well supported by the Security Forces. But with a high percentage of those infected not showing any symptoms (maybe as much as 80 percent) the virus began to spread among the community.
Community
But that is well passed and today there is extensive spread among the community islandwide. Community spread began in the Western Province with Colombo as the focus.
Had there been early recognition of this change, a campaign to create awareness of the public and effective action been taken to perform effective crowd control measures, spread could have been controlled to a considerable extent.
For some strange reason this was publicly accepted, as if a natural epidemiological effect was a sign of failure, and the public campaign was continued on the basis of the cluster concept.
The health services backed by the Police and Security Forces is bearing the brunt of the present campaign.
Epidemic
Fever is being tested with PCR and RAT and positives are being hospitalised. Due to the shortage of hospital beds some milder patients are being isolated at their homes. Other public health measures are being implemented. But the epidemic is spreading fast. This is not surprising with the large number of asymptomatic infections in the community.
This calls for a community based approach which is carried out nationally. We have a multi cultural society and the practices of each community should be accommodated in the campaign,
My first suggestion was that all political leaders be brought into Covid control committee so that it becomes a National Campaign.
This Committee should interact with Minister of Health both within and outside Parliament in a supportive manner. The most important step is to ensure that the whole community, every household is involved and made fully aware.
Intense health education using all media would achieve this in a week or two, from children right up to the elderly.
The core message should be that one has to presume that everyone in society is infected and that for one’s own protection the three health practices must be carried out: wearing a face mask properly at all times, especially when one goes outside the home, and even at home when any outsiders come in, practice social distancing (two meters is better), and frequent hand washing, especially when touching any object that someone else may have touched. Avoid crowd gathering.
This should be practised by everyone, with political and social leaders setting the example. The reaction of people in the country should be that if anyone is seen to break the rules others should point this out to him at once.
Committee
This practice should prevail in town and village at home and work place. Sharing of towels, handkerchiefs, pillows and sheets should stop. Everyone should carry one’s own small hand towel in the pocket or handbag.
A Covid Committee should be established in every village, at street level in every town and in all workplaces. Beside its preventive role, it must help the family of an infected person when supplying food and other needs and give moral support.
The Committee must ensure that the contacts do not infect anyone else. If any person develops any possible symptoms the patient should be shown to a doctor at once.
The Covid Committee should have a health official such as a PHI or Mid-Wife or be in contact with one. The Committee should ensure that people do not crowd together.
All social and political meetings should not be allowed. Essential meetings should be confined to the smallest number of essential people, who must observe the health guidelines.
At the entry and exit to all public places soap and water with washing facilities must be provided and their use made compulsory. If possible hand washing facilities with 80 percent alcohol sprays could be provided.
All Government officials especially the Police should prevent and failing that control people crowding together in shops, at bus stands and buses. They should ensure that the three health practices are observed. Stern action should be taken against violators.
Finally, a little essential virology knowledge: The Covid-19 virus is new to the world and there is no herd immunity. We have much through research to learn about it so that we can better control its spread and treat it.
The Coronavirus that causes Covid-19 is fairly large (80 to 160 nm) and generally multiplies in the human respiratory tract cells.
Multiply
As other viruses can enter our body through the mouth and the multiply in the bowel, this is a theoretical possibility, but any indications to that occurring have not been established to my knowledge.
It is generally transferred from an infected person to another from nose, mouth and possibly from the eyes through sneezing (nasal secretions) and tears.
Recent mention has been made of a new variant that can be airborne carried by air (currents) just as virus particles. If true this means that the masks should be able to block the small virus particles and the social distance rule needs to be further lengthened.
But as a single or a few virus particle are unlikely to transfer the infection we can let events justify the need to take these extreme steps.
As is well known viruses multiply and grow only in specific living cells, in this case those of our respiratory tract.
If they fall elsewhere in a matter of hours they die. Therefore let us focus on practising our health rules. But everyone must do this as a habit. In this way we can protect ourselves and at the same time protect everyone else. If everybody does this the virus will die out.
Vaccines
Much effort and money is being spent on obtaining vaccines to protect people. But it usually takes several years, about seven years on an average, before the ideal vaccine that is safe and effective, is developed.
What is being offered may not work, or be safe considering the short period. The duration of protection is unknown, it may need to be repeated in a year or two.
Even the best vaccine only protects that particular individual (as this is not a live virus). To protect everybody it must be given to each and every one.
Then only will transmission stop, with luck it may stop with about 80 percent coverage.
Vaccinating those who run the risk of dying (vulnerable people) such as elderly and those with heart and disease or debilitating conditions such as Diabetes is to be recommended.
Those who are exposed repeatedly to infected persons such as doctors and nurses should be well covered.
Taking our financial status as a country and the outcome, limiting vaccination to vulnerable groups are more sensible.