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Public health measures implemented after considering all implications – Dr. Hemantha Herath
All public health measures that are implemented follow the risk-benefit ratio being weighed carefully, said a high-level health official on Thursday evening.
“Anything can be suggested and ideas formulated, but we have to take all other implications into consideration. We need to deliberate, weigh the cost benefits, the adverse problems and risk ratios,” said the Head of the Disaster Preparedness and Response Division of the Health Ministry, Dr. Hemantha Herath, when asked whether what has been done is too little, too late.
He pointed out that in certain situations, quick action needs to be taken and has been taken. When the pandemic struck, nothing was known about the virus and knee-jerk reactions were common but now “we cannot take that kind of reflexive reaction. We cannot do it”.
Citing the example of suggestions for home-based care, Dr. Herath said that when case numbers are going up and hospital facilities are low, an option would be to keep asymptomatic people at home.
“But it is a very risky procedure. Now, we are looking after patients in 150 places (dedicated COVID-19 hospitals and intermediate care centres – ICCs). Just imagine, people being at home around the country in 150,000 places. Will we be able to ensure their safety? It will be a huge challenge, unless we have a very sound system in place to manage them,” he said.
On the other side, Dr. Herath reiterated that if home-based care is introduced for asymptomatic people, even those who are symptomatic and needing hospital care would decide on their own to stay home. What would the result be then? For this kind of disease, home-based management is not the best. It will have to be kept as a “last resort”.
He added: “This is why now we are looking at an ‘Integrated management of asymptomatic and mildly symptomatic patients’ in their homes. We have not changed the policy of hospitalization of positive patients to home-based care. We are looking into how those who are compelled to stay at home would be monitored properly. The Health Ministry is trying to draw a balance. With the increasing number of cases, there is a delay obviously, a legitimate delay in getting them into hospital. Our plan is to ensure that there will be no adverse impact or adverse repercussions on those people.”
Dr. Herath underscored that there is a need to make sure that everybody is treated in an appropriate treatment centre. Even if they are going to die due to the severity of the disease, it should be after giving the appropriate treatment. The health system tries its level best to save people from death and that is best done in a hospital.
Another reason that should be taken into account is that a majority of the population may not have adequate facilities in their homes for proper isolation and this can lead to the spread of the disease. To save lives as well as to prevent the spread, the most important thing is to get the positive cases into hospitals or ICCs, he said, adding that the dire need is also to reduce the number of positive cases through strong preventive measures.
Not risk managers but risk assessors
Looking at the health sector as a whole, Dr. Herath said that they are not risk managers, but risk assessors. They advise the government on the risk and the government, considering all socio-economic aspects as well as health, makes a decision on the course of action.
He added that the Health Ministry is also bound to manage affairs in a manner that there will be minimal impact on the people. “I’m not saying that to run the economy people should die, but on the other hand, if the entire economy is going to collapse, how will the other aspects work? This is why we have to manage the risk by carefully weighing the risk-benefit ratio and cost benefit.”
Reason for easing lockdown on May 25
When asked why the lockdown is being lifted for 19 hours on Tuesday (May 25), Dr. Herath said that it is not for people to break free of their cage like a bird and go here and there, but for those who do not have the money to stock up on food for long periods to get their necessities.
“When we had the initial lockdown, we took around one month to develop the delivery system, now it won’t take one month but just two weeks but the first ten days are extremely difficult for people, particularly daily-wage earners, to find food,” he added.