COVID-19: Current situation not a basis for complacency

by Dr B. J. C. Perera 

MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL) 

Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.

This article is a congruent extension to the excellent editorial that was published in The Island on 16 March 2022 under the title ‘Waltzing with virus’. That editorial, at least in the first three paragraphs, did not mince any words and definitely read the riot act to the populace of our country. This attempt, on my part here, is to try and evaluate the situation further, on a scientific basis.

On the evidence of the current scenario in the paradise isle, the numbers of positives for PCR and RTA testing for COVID-19 are going down. Many would rejoice, put the banners and flags up, and say that the dashed thing is under control. However, one has to interpret such information with some caution. It all depends on the denominator of exactly how many tests were done. As I have said before, just the raw value of the number of positives may be quite misleading. For example, 350 positives out of 10,000 tests done does not have the same significance as 350 positives out of 25,000 tests done. The percentage positives are quite different; 3.5 percent and 1.4 percent respectively. If more tests are done, more positives are likely to be detected. In fact, many countries have given up free random testing because of this. They believe that such information is not of much use from an epidemiological perspective. However, they do the testing when there is a strong suspicion on patients who show some symptoms that could be attributed to COVID-19.

The numbers of deaths are coming down. On the face of it, this is a very positive finding. However, one needs to know exactly how the cause of death is determined. People may be dying of other diseases who also show COVID-19 positivity. This may be quite coincidental. If these are attributed to COVID deaths, the numbers may be artificially inflated. In that case the actual real number of deaths attributed directly to COVID-19 may even be lower. There are deaths very definitely attributable to COVID-19, especially those who develop severe COVID lung disease. There is no problem about those being categorised as COVID deaths. Yet for all this, a significant fall of deaths is a very favourable finding. After all, we do worry about other consequences of COVID-19 but the primary aim of the health authorities is to try and reduce the deaths.

A contributory factor to this current state of affairs, regarding the deaths, may be the fact that the health services are not inundated with larger numbers of severely ill COVID patients who need intensive care. Such being the case, there is better and more appropriate medical attention being provided for those really needy patients. Another factor that we need to take into account is that the currently prevalent Omicron variant is known to produce disease of lower severity when compared to the original Wuhan strain and all other previous variants.

The developing scenario of a positive trend has to be balanced against certain other considerations. In addition to the vagaries of the Omicron mutant, the use of the vaccines in the country, varying trends in the age groups vaccinated, development of immunity following vaccination or contracting the virus, as well as herd immunity following extensive community spread of the Omicron variant, are all very important aspects that need to be taken note of. To compound the issue further, the currently prevalent Omicron strain is known to replicate very rapidly and spread quite fast, as well as widely. When viruses multiply and reproduce rapidly, the chances of the development of other variants are also increased. There is nothing to prevent a really virulent mutant coming through in the not-too-distant future and cause further mayhem in our country.

All these scientific connotations add up to support what is said in the aforesaid editorial: “Sri Lankans, who have apparently declared victory over coronavirus prematurely, had better sit up and take notice of what is happening in other countries. Nothing is stupider than to be lulled into a false sense of security in battling a pandemic. Coronavirus is far from vanquished; it has a remarkable ability to bounce back and spring surprises to humans after making tactical retreats, so to speak”.

As the editorial further stated, there are most worrying recent outbreaks in China and several European countries. They, with their strong economies, can afford even to institute lockdowns to control further spread. WE, IN SRI LANKA, JUST CANNOT AFFORD TO DO THAT. If we are forced to do it, then it would be kaput for all of us.

There is absolutely no room for complacency at the present time. As it stands, our people, in the face of many other day-to-day problems, seem to have forgotten about this miserable virus that causes COVID-19. Sinhala and Tamil New Year is just a few weeks away. So be warned people of our Motherland. Let us not make the mistakes that we made in April 2021 and be responsible for yet another wave of this dastardly microbe that has the potential to turn the entire country topsy-turvy.

Let us be determined to play safe. We should adopt the axiom ‘once bitten, twice shy’. Of course, everyone knows what to do. But the million-dollar question is whether they would do it. It is our fervent wish that they would, as responsible citizens of Mother Lanka.