Vaccines and lockdown dominated the thoughts of the people in the country. As the lockdown or travel restrictions was extended till June 14 and the vaccination programme continued in many parts of the country, the people who had received the first dose of the AstraZeneca vaccine in February, March and early April were fraught with [...]

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Too early to see results of restrictions

Sinopharm, Sputnik V & Pfizer vaccines due but no confirmation on AstraZeneca
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A large number of vehicles seen entering Colombo city in spite of travel restrictions. Pic by M.A. Pushpa Kumara

Vaccines and lockdown dominated the thoughts of the people in the country.

As the lockdown or travel restrictions was extended till June 14 and the vaccination programme continued in many parts of the country, the people who had received the first dose of the AstraZeneca vaccine in February, March and early April were fraught with worry over how to get their second dose.

While the State Minister of Production, Supply and Regulation of Pharmaceuticals, Dr. Channa Jayasumana in a public broadcast this week said that 2 million doses of Sinopharm vaccines were due in the country today (June 6) and Wednesday (June 9).

Another 14 million Sputnik V vaccine doses had been secured, he said (but did not say when they were due), adding that 300,000-400,000 Pfizer doses were scheduled to arrive in July.

There was no indication when the 600,000 doses of AstraZeneca needed urgently for the second dose would be secured.

When asked whether Sri Lanka has seen benefits from the lockdown, a high-level health official told the Sunday Times that they would not be visible yet.

Urging every person to take collective responsibility to control the pandemic, the Health Ministry’s Head of the Disaster Preparedness and Response Division, Dr. Hemantha Herath said the results of the travel restrictions have not been seen yet. This is because even after implementing restrictions at maximum level, it will take an incubation period (the number of days between infection and appearance of symptoms) of at least 14 days to see the results.

He, however, pointed out that compared to the initial few days, more and more people and more and more vehicles are being seen outside their homes. It is the duty of the public as well as all stakeholders including the business community to ensure that this movement restriction is adhered to.

Dr. Herath said everyone should act with responsibility and not leave their homes unless absolutely necessary, either for essential work or to seek medical treatment. “Nithiyeng ringala giya kiyala, there would be no benefit to the country or to yourself. In the long term, we will all suffer,” he said.  

“Usually, a lockdown needs to be in place for more than one incubation period at least. The longer the better, but we know that restrictions enforced for long periods have other adverse effects. What is required is a ‘balance’ between ‘benefits’ and ‘adverse effects’. Unexpected repercussions would be certain if planned ‘mitigation’ activities are not happening,” he said.

When imposing travel restrictions, the most important thing is to ensure that good home delivery services for essentials such as food and medicines are in place, stressed this public health expert. Initially, the restriction process was carried out in a relaxed manner with planned relaxation days. Now the delivery system has picked up reasonably well and those relaxation days have been cancelled. This is needed to break the chain of transmission of the virus, with the country being in lockdown for a scientifically-acceptable period.

“If we are going beyond this, we need to arrange several other mitigation activities as well, like the distribution of drugs. This is because generally people have medication for two weeks or a month. Even though the government is trying to mitigate this issue in different ways, drug distribution is not happening in a reasonably good way because the Postal Department involvement is not established yet,” he said.

Focusing on “alternative measures”, Dr. Herath said that people needing treatment for tuberculosis (TB) are sent drugs to their doorstep once a month in health vehicles. But there are only a limited number of TB patients and it may not be feasible to deploy such a system for all patients suffering from non-communicable diseases (NCDs). Other aspects that need to be looked at closely are the livelihood of daily wage earners and how they are coping.

Need for social distancing

He had a strong message for all: Even after restrictions are eased, continue to adhere to preventive measures at the maximum level. Social distancing is shown to be a good deterrent in the spread of COVID-19.

“COVID-19 spreads only if we get droplets into our body or we touch certain surfaces which have got contaminated by the droplets left behind by a positive person. The carrier or vehicle is the human body. So we need to stop the movement of the virus through human bodies,” he added.

Getting down to testing, Dr. Herath said currently it is being maintained at around 20,000 tests “comfortably”. It can be increased but there are challenges such as machine-breakdowns and staff-exhaustion.

‘Random testing finds only about 25 in Colombo city daily; vigorous vaccination also on’Around 85-110 positive cases are detected per day, the vast majority being first-line contacts, while random testing detects around 20-25 cases, said Colombo Municipal Council’s Chief Medical Officer, Dr. Ruwan Wijayamuni on Friday.He assured that unlike in the second wave, Colombo city is not seeing “a rampant wildfire” sort of spread yet and attributed it partly to the very vigorous vaccination campaign.

Vaccination campaign

So far, about 190,000 people in Colombo city, which has about 600,000 people, have been vaccinated with either the AstraZeneca or Sinopharm vaccines. Therefore, 1/3rd of the city’s population has got the jab, said Dr. Wijayamuni.

He said that around 98,823 people are awaiting the second dose of the AstraZeneca vaccine. When these stocks will arrive, is the million dollar question. The government is trying very hard to get stocks. Vaccines are available in the international black market, but their quality is questionable. This is why the government is seeking an assurance from the manufacturer about the maintenance of the cold-chain and the authenticity of the product.

With America hoping to donate vaccines, he was hopeful that Sri Lanka could get some stocks to give the second jab.

Dr. Wijayamuni and his team are planning to vaccinate everyone who is over 18 years of age by the end of August, if they get adequate stocks. These could be different types of vaccines.

“Currently we are vaccinating those over 30 years of age, but we should ideally be vaccinating those over 18 because they are active and could take the disease home. Those 60 and above are at high-risk of dying but they are basically at home, so we have to focus on the economically and physically-active age-groups,” he said.

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