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Prevention best remedy, says State Minister
Prevention, prevention and prevention. These are the surest short, middle and long-term measures to beat back and control COVID-19.
This is the specific answer from the State Minister of Primary Health Services, Pandemics and COVID-19 Prevention, Dr. Sudarshini Fernandopulle who knows what she is talking about as she is a Community Physician.
“The short-term strategy is prevention because the public health safety measures have been proven to work. We need the unstinting cooperation of the people, otherwise it will be very difficult,” said Dr. Fernandopulle in an interview sandwiched between many official meetings on Thursday afternoon.
Dr. Sudarshini Fernandopulle
Prevention comes with:
Hand-hygiene
Face-mask wearing
Keeping to physical distancing whenever in a public place and avoiding the Three Cs
The Three Cs to be avoided are:
Crowded places with many people close-by
Close-contact settings, especially where people have close-range conversations
Confined and enclosed spaces with poor ventilation
Pointing out that many are asking whether Intensive Care Unit (ICU) and High Dependency Unit (HDU) capacities are being increased, the State Minister stressed that while that needs to be done, there is an upper limit any country can go to. There is also the issue of trained healthcare staff to handle the skilled work in such facilities.
Dr. Fernandopulle, reiterating that “public health safety measures are the key strategy”, said that the answer to controlling COVID-19, bringing down the infections and minimizing deaths, is to get people to stay at home and avoid social gatherings. The law (Quarantine and Prevention of Diseases Ordinance) also has to be enforced properly. This is because in some cases, people only listen to the law and are only scared of the law.
Immunization is the medium-term answer, as it takes at least 10 to 12 weeks from the day of vaccination to give protection from COVID-19. Vaccines are hard to come by, she conceded, assuring that the government is doing everything possible to secure vaccine doses for the people, but “until we get them, we are not sure”.
“Just because you are vaccinated, you cannot forget the health measures. Vaccination prevents severity of disease and mortality, but you can still get infected and you can transmit it. As variants are produced by the virus, people may have to get boosters every year and in the long term, the system needs to be prepared for this,” she said.
Acknowledging that there is a problem in securing the AstraZeneca vaccine, Dr. Fernandopulle stressed “we are trying very hard to get 600,000 doses to give the second jab to those who have already got the first one. We are looking to buy 10 million doses and Cabinet has approved the purchase of COVISHIELD at any amount. We are in discussion with Norway, Sweden, Dubai and the United States of America (USA). Everyone in the government is trying”.
The State Minister added that the long-term strategy is also basically prevention, while improving and upgrading the facilities we have.
| Algorithm for systematic testing An algorithm for both RT-PCR and rapid antigen testing is being prepared by a technical committee appointed by the Health Ministry, to prevent an overload on testing capacity, said Dr. Sudarshini Fernandopulle. Currently, the capacity is around 20,000-25,000 samples per day.
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| Balancing of duties in hospitals importantIn these difficult times when hospitals are crowded, they have to balance their duties carefully and always adhere to the health precautions to prevent the staff from getting infected, said Dr. Sudarshini Fernandopulle. She said that those seeking hospital admission for other illnesses or procedures are being triaged for COVID-19. As the new strain (the UK variant) is highly infective, the vaccination of healthcare staff was advanced to April 29. It will take at least another two to three weeks for them to get full protection. Even though there is no guarantee that they will not catch the infection if they get exposed, they will get only mild disease. “Normal services in hospitals are also being cut by 50%. While such reduction is to keep the capacity for COVID-19 patients, we must ensure that other patients are not compromised. Most hospitals are only gradually decreasing their normal services, not cutting them by 50% all at once. If there is a surge of COVID-19 and there are large numbers of cases, there’s no option,” she said, adding that the government is also increasing the number of Intermediate Care Centres (ICCs). Around 300 medical personnel following M.Sc and diploma courses have been mobilized to help healthcare personnel. Any plans for home-based care? “We are still working on home-based care. Today’s (Thursday’s) Task Force meeting discussed home-based care at length, with different opinions being expressed. Some are for it, others are totally against it,” said Dr. Sudarshini Fernandopulle. She said that the possibility of home-based care for asymptomatic (without symptoms) COVID-19 positive patients with strong monitoring through a hotline is being looked at closely. A decision may be made next week. General Practitioners (GPs) have volunteered to monitor patients if such home-based care is introduced. We may start with the Western Province. The system would be to call the asymptomatic patients day and night and check whether they need hospitalization at some point, added the State Minister. Dr. Fernandopulle requested support from international agencies for a major risk communication campaign. |