Columns

Even as the sudden burst of showers this week was welcome to wet the arid earth and to ease the prevalent heat, the recommendations this Tuesday of six chair medical professors of Lanka’s universities on an exit strategy from the current COVID curfew and lockdown, was a welcome dose of pure ozone infused into an atmosphere made stuffy with far too many shades of opinion fouling the air.

In a letter to Lt. Gen. Shavendra Silva, Chairman of the Covid-19 National Task Force and Dr Anil Jasinghe, Director General of Health Services, the top level medical team expressed their opinion on an array of issues concerning the COVID crisis and also made their recommendations.

The eminent panel of professors who are medical specialists as well, are Prof. Janaka de Silva (University of Kelaniya), Prof. Sarath Lekamwasam (University of Ruhuna), Prof. SAM Kularatne (University of Peradeniya), Prof. Sisira Siribaddana (Rajarata University), Prof Saroj Jayasinghe (University of Colombo), Prof. Kamani Wanigasuriya (University of Sri Jayewardenepura).

They have stated: “The current level of restriction should continue for now and be reviewed after the Sinhala and Tamil New Year. If the level of transmission is not high as evidenced by the daily number of new cases and a slow doubling time of cumulative cases, the curfew can be relaxed in stages, district-wise (e.g. one district per province on given days of the week).

They have warned that the chaos that occurred on Tuesday March 24, when the curfew was lifted from 6am to 12pm and then extended to 2 pm, should not be allowed to recur. According to them, ‘however, areas with high numbers of patients could be cordoned off and kept under stricter control measures or lockdowns.”

The group has taken note that after the first two positive coronavirus cases had been identified in Lanka, the spread of infection has been relatively slow. They note the good news: ‘it took nearly a week for the case load to double from 50 to 100 (from 19 to 25 March); and in the 10 days since then (26 March to 4 April), the case load has not yet doubled – the Ministry of Health has reported 12 cases and five deaths up to 5 April 2020.’

‘The government acted swiftly,’ the group’s letter continues,’ in order to contain the outbreak in Sri Lanka; schools and universities were declared closed on March 13; people were asked to work from home from March 16 onwards; and the international airport at Katunayake was closed to inbound passengers from March 19 onwards. An all-island curfew was declared on March 20 and everyone except those working in the essential services has been required to stay home. In the most affected (and highly populated) districts, curfew has not been lifted since then, except for 8 h on March 24. Most importantly, our security forces and the health authorities have been very successful in contact tracing and isolation of contacts, as well as in quarantine of returnees from countries with the high incidence of COVID-19.’

‘However, ‘they point out, ‘this lockdown has come at a cost.’

And, what are these costs?

• The doctors state that during these lockdowns and curfews many people with other illnesses had experienced difficulties in accessing treatment and medication. They have found it difficult to obtain their medicines during the lockdown, as evidenced by long queues outside pharmacies which reduced after they were kept open.
• In terms of economic productivity, the cost to the apparel industry alone estimated at LKR 2 billion, while the tourist industry is at a standstill. Daily wage earners have no means of supporting their families.
• The curfew has also resulted in a fear psychosis in our society, with wild rumours being spread and false treatments being suggested. Even health workers are reluctant to treat patients with fever and cough. The fear of this illness has also led to severe social stigmatization of patients.
• The professorial doctors then state that while it is clear that Lanka will have to come out of lockdown, ‘the basis on which this decision is made should be very carefully considered based on scientific evidence and could be informed by the strategies followed by other Asian countries, such as, China, South Korea, Vietnam and Singapore that have been successful in containing transmission.’
• Then the panel makes its recommendations,
• Supermarkets, hospitals, food markets, more petrol stations and pharmacies could remain open for a period of time, to be decided by the task force, on a daily basis. As in China, each household could be issued one pass to allow one person to go out to get essentials in their own neighbourhood. Travel between towns and cities should be discouraged. The Colombo Port, utilities, medical supplies, logistics companies and food processing firms should remain open, as they are now, to ensure availability of supplies.
• Require everyone to wear a face mask and practise social distancing in public, and follow guidance on hand washing in order to avoid infection. Large gatherings of more than 10 people should not be allowed.
• The Health sector must be strengthened. In this regard a bundle of measures to be taken are recommended which include increased testing capacity, continued contact tracing, self-isolation and quarantine, personal protective gear for health staff at risk of exposure.
• Apart from harnessing the private health sector, the professors also call to ‘enforce a strong system for surveillance and reporting from all around the country, so that if the incidence goes above a certain level (eg: more than 50 cases a day, as in Singapore) stringent measures can be re-imposed.’

The panel, keen to get the country back to work, asks the Government to consider further easing of controls if the number of new cases remains flat over a period of time (eg: 2-3 weeks). In that event, they propose ‘lift the ‘work from home’ policy, to resume work in government offices, factories, and other important areas, re-open schools and universities.’ The airport could be opened for inbound passengers, initially only from countries with low transmission rates, and particularly for Sri Lankan citizens who wish to return home

No doubt the Government will take good note of the strategies outlined in the dossier on beating COVID and getting Lanka back to work. It also raises the importance of using the expertise of these men and women who with vast medical experience behind them have risen to the top most positions in their professions and are ideally placed and suited to form a medical A Team to express their considered and unanimous opinions on the present crisis as it develops.

A team who can monitor the crisis, make its recommendations to prevent its spread while Dr. Anil Jasinghe, the Health Services Director, and his team of medical men concentrate on getting their patients back on their feet. A team whose prime objective will be to get the nation back at work, not from home but at office.

This Thursday, a meeting between President Gotabaya Rajapaksa and medical experts representing various fields was held at the Presidential Secretariat. Its aim: obtaining much needed expert medical opinion on how to prevent the spread of coronavirus in the country promptly.

The meeting was attended by the Secretary to the President, Dr. P.B. Jayasundara, Chief Adviser of the President, Mr. Lalith Weeratunga, Secretary Defence Major Gen (Retd) Kamal Gunaratne, Chief of Defense staff and Army Commander Lieutenant General Shavendra Silva, Acting Inspector General of Police, C.D. Wickramaratne, Former Governor, Dr. Seetha Arambepola, Director General of Health Services Dr. Anil Jasinghe, Specialist doctors Vajira Senaratne, Ananda Wijewickrama, Prof. Sarath Jayasinghe, Prof. Arjuna de Silva, Dr. M.C. Weerasinghe, Prof. Neelika Malavige, Prasad Katulanda, Prof. Vajira Dissanayake, Prof. Ranjani Gamage, Kumuduni Ranathunga, Amitha Fernando, Indika Lanerolle and Jude Samantha.

None of the six medical Professors mentioned above were present.

During this meeting the steps that have been taken by the government, security forces and the health sector officials to prevent the spread of coronavirus as well as the steps that should be taken were discussed. The specialists pointed out the importance of conducting investigations on groups that were in close contact with infected persons and who have had contact in two stages further.

The group of specialist doctors commended the President’s quarantine programme launched with the aim of preventing the spread of the virus and  said that further strengthening of the existing quarantine process was the most effective approach to prevent the spread of the virus.

As reported in the Daily Mirror, these specialist doctors said that the first step is to ensure that everyone stays at home to the extent possible following the “Panchayuda” system which includes the use of face masks when leaving the house, avoid touching the face, maintaining a distance of one meter at all times, and the washing of hands.

The medical specialists also said that people with diabetes, asthma and heart ailments need to be vigilant and they should take the medication as prescribed by the physicians. They also pointed out the importance of drinking liquids to maintain throat’s moisture.

With respect to all those who participated at this meeting, it was an ad hoc meeting summoned to ask ad hoc questions and be given ad hoc answers. For instance, all that the medical experts contributed at the meeting were to highlight the importance of wearing masks and washing of hands, to advice people to look after the high risk patients, the importance of patients taking their medication as prescribed and to keep the throat moist by drinking liquids. That will not do. Such meetings will only be talking shops.

What is envisaged is an independent medical task force, an A Team, as the six medical professors represent, to produce the blueprint of the strategic battle to destroy COVID and articulate its strategies taking the broad unfolding picture and seeing it through, with improvisations if need be depending on the ground situation, to its triumph.

They must, however, remain an independent body, not a tool of the Government and the Health Authorities to be used as a rubber stamp for certain decision that may well have a political hue. When a sea of diverse opinions are being expressed from all quarters leading to a tumult of confusion, these six medical professors, with their profound knowledge, wisdom, integrity and maturity, can be the authoritative voice, Lanka’s Oracle of Delphi on all matters Coronavirus.

Year the Avurudu diedWhile the superpowers’ nuclear arsenal is safe in their underground missile silos and their conventional weapons under lock and key in their armories, while the combined sum of its fighter planes are in their hangers and aircraft carriers idly sway anchored at ports, while millions of soldiers are confined to barracks, the world lies under siege, brought to its knees, rendered helpless before a common microscopic foe which had indelibly stamped its foot print across the globe and turned it topsy-turvy, turned it into a Pandemonium. THE LIGHT OF HOPE: This Monday night the nation will unite at 10.43pm to light the Avurudhu lamp. But this year, in a lockdown Avurudhu, they will be lighting the lamp at the other end of the long tunnel Lanka has not been exempted from the coronavirus itinerary. COVID hadn’t forgotten Lanka was a top tourist destination, had not failed to give her the once over in its country hopping, continent jumping five month disease spreading sojourn. Thus, alas, with the lights gone off for Lanka, too, no wonder the koha did not herald the advent of the Sinhala and Hindu New Year as it traditionally does with its familiar caw. No rabans thump its Avurudu beat, no young damsels dressed in their avurudu best walk the catwalk vying for the Avurudu Kumari title, the gaiety is gone, a pall of gloom has descended on the village. And the Sun God, blind to the mundane happenings on Planet Earth below, begins its annual crossing from the Constellation of Pisces at 1.59pm on Monday the 13th . Six hours and twenty four minutes later, it becomes exalted in the constellation of Aries at 8.23pm on 13th night dawning the New Year. But the Suriya Namaskareya will have to wait this year. The time taken in the crossing where it is neither in Pisces or in Aries but on its cusp is referred to as the ‘nonagathe’ period or the period where there are no auspicious times. During the period tradition has long advised the people to spend their time in religious rites. This year the temple bell will scarcely be rung and the hallowed ground will be bare even as the kovils will remain empty and invocations to the Gods will remain unsung. This year, the nonagathe period will not be restricted to a mere six hours but will extend to God knows when:  Like the holding of elections, to be decided by the coronavirus at its whim and fancy. Till the day ever dawns when this country is rid of COVID, Avurudhu for the Sinhalese and the Hindus will only be a nostalgic memory. The entire nation, though deep in despair over COVID, will be wide awake in anticipation for the auspicious hour to dawn when communities unite as one to kindle prosperity’s hearth at 10.05 pm on 13th night, dressed in white and facing East. The traditional milk will be boiled in a new pot over a firewood hearth until the milk, signifying prosperity, runneth over. Now dawns the time to light the lamp of hope to herald the advent of another new year. Except this year, it will be the lamp at the end of the tunnel they will all be lighting, their hearts pregnant with prayer. On April 13th night at the auspicious time of 10.43pm, dressed in white and facing east, millions will almost in unison rise from their respective family tables to light the flame of the traditional oil lamp with their cherished expectations and cloistered prayers. It is a unique moment in time when a nation strikes a match to flare the hope soaked wick of happiness, goodwill and blessings to all. After the lamp has been lit, the first meal of the New Year will be consumed. Generally it would have a grand family reunion but this year, many of the seats at the table would be unoccupied.  For the Sinhalese, after the meal is concluded, it will be the time for ganu denu, the first transaction for the New Year to be made. In keeping with age old traditions, the young ones will offer a sheaf of betel to their elders and pay homage and respect to them in worship. The older generation will not have experienced a lonelier and more desolate avurudhu than this one. Meanwhile, the Hindu community celebrates the dawn of Puththandu by first cleansing the house with sprinkled water mixed with turmeric, the antiseptic herb of Asia. While incense is burned, a coconut is broken open by the head of the family; it is a symbolic act to remove evil and invite blessings. Immediately after the New Year meal is made and the lamp lit, Hindus will make their pilgrimage to the nearest kovil to make offerings. It is a pooja of specially selected food offered to the Sun God or Surya Bhagavan and God Ganesh, the lord of wisdom and remover of obstacles. This year they will be holding the poojas at their household shrines. Then after their prayers haven concluded, they will start to consume the new year meal, which will consist of paal soru (milk rice) or pongal, vadai, and other sweetmeats. It is followed by kai-vishesham, the auspicious time for transactions. Before the first bath of the New Year, marutha neer, or herbal water, is applied on the forehead. Out in the open air, the customary entertainment of the season begins. In Sinhalese homes, both the young and old, gather around a banku rabana, a circular one sided drum, about four feet in diameter and, using both hands, beat out a steady staccato rhythm to accompany the raban pada they sing. But this year the rabana will not be thumped, the raban pada will not be sung but all will lie mute till the day the corona is trumped. The New Year is also time for the people to renew old family ties and friendships and streams of visitors flow into households to offer their best wishes and taste the plates of sweetmeats, filled with kavun, kokis, aggala, mung kavun, athiraha, aahsme. Ah where are those sweet delicacies all pined for and eagerly awaited avurudhu to come? Probably, not even made this year for shortage of ingredients and lack of custom. The young men take part in hotly contested cycle races and marathons (gama haraha divima) to win the cup and perhaps the heart of the Avurudu Kumari. During the Avurudu season, young girls present themselves in the village pageant to be named the princess of the village. But this year even beauty has been put on hold and time has become its thief. Many also attempt to prove their prowess during kotta pora, a friendly fight upon a suspended horizontally placed pole. It’s a single combat fight with pillows where the aim is to dislodge the rival with one big smack of the feather filled bag. It may look easy, but not when one has to balance on the pole with one hand tied behind his back. Another entertaining game to watch is lissana gahey nageema where one attempts to climb a greasy pole and grab the prized flag on top. Kana mutti bindima is a game where blindfolded contestants try to smash a pot. Banis kaema is a race to finish eating a bun suspended off a string while one’s hands are tied behind. But even in this forlorn times, one favourite game will still take place both outdoors and indoors. And it is the intriguing task of guessing the identity of the ‘hidden stranger’ or ‘sangawunu amuththa’ in the villagers’ midst. And in this COVID  year, no prizes for guessing right who that invisible, invincible, silent spectre in our midst maybe. The SUNDAY PUNCH wishes all a peaceful, healthy COVID free, blissful New Year.