Features
From Delta to Omicron: Will there be a tsunami of patients?
Dr. Pradeep Kariyawasam
Former Epidemiologist/Chief Medical Officer of Health
Colombo Municipal Council
All over the world the Delta variant of the Covid-19 virus has been replaced by the Omicron variant. It is happening in Sri Lanka, too, according to reports issued by the Ministry of Health recently. At present it is said that between 60-90% of patients found in various parts of the country have been infected with Omicron. The percentages are higher in the cities than in the suburbs. This is because the population densities are higher in the cities and the it is easily transmitted from one person to another. The other aspect is the transmissibility of the variants, and it is said that the Omicron variant has a 1.5 times higher transmissibility rate than the Delta variant. I believe that the change from Delta to Omicron took place as there were hundreds of thousands of people infected with Delta virus and the chance of creation of mutations increased with time. Omicron has a higher transmission rate and there could be many more variants that we have to face with and already a sub-variant has surfaced.
The changeover to Omicron has happened but the numbers are low because we don’t have enough facilities to do genomic sequencing to identify the variants. It is only the Sri Jayewardenepura University that has such facilities and not even the MRI seem to be having a facility to do these investigations. This is a wake-up call to our policymakers to have proper laboratories in the country and that is to have at least one laboratory each in the North, South and Central provinces. The Western Province could be covered by the Sri Jayewardenepura University laboratory. It is a pity that no one seems to care to improve the facilities at their own laboratories. I remember meeting Prof. Sirimali Fernando the architect of this Sri Jayewardenepura university Immunology and Molecular Medicine Unit around 15 years ago when she came to see me with Professor Malavige, then a lecturer, most probably, to tell me that the dengue virus had changed to D-3 and that an epidemic was imminent as people didn’t have immunity against the D-3 virus. What I understood was that the Ministry of Health or the Epidemiology Unit were not interested in that and someone had told them to tell me. I took that seriously and started to carry out prevention and control measures. I started to improve laboratory facilities and we had a top-class laboratory then carrying out 53 types of investigations, basically helping the urban poor to get costly laboratory tests done free of charge. We were the first government laboratory to have NS1 test to identify dengue infections. Today, sad to say our laboratory network at the CMC is almost non-existent and there in no proper City Microbiologist in place and the City Analyst unit, too, was without work and hardly any work was done under the Food Act. It is interesting to note that the City Microbiological Laboratory staff are not at all involved in PCR or antigen testing when there is a global epidemic taking place, although it is a Public Health Laboratory where the plague carrier, a flea, was identified around 1918. In the past few years, it had been a difficult task to even get the much-needed chemicals to run the laboratories. The testing of food and water was stopped while such work in other cities and countries in the world are improving. We are going backwards in laboratory investigations, the regulatory work has suffered immensely, and I think we were better off 50 years ago compared with the situation in those countries then. So, forget about finding new variants on time and taking preventive measures like in advanced and not so advanced countries, as we cannot even run a normal laboratory today and provide the needed information to the patients as well as the authorities.
It is a known fact that hospitalisations and visits to clinics by patients amount to only 10% of the total number of patients suffering from a communicable disease. So, when we say there are 1185 patients on a single day now that means our daily total could be as much as 11800! This figure could be more as many of the patients don’t have symptoms as in any other communicable diseases. When one analyses the figures given out by the Ministry of Ministry of Health daily there is an increase of 5-10% of patients and therefore It is obvious that Omicron is in the community and is spreading rapidly. The hospital beds are full and ICU units are running almost at full capacity. Although Omicron is not a killer as such, compared with the Delta variant, the numbers are high and it seems those not vaccinated with the three doses that the government provided free of charge are the ones who have got the full-blown disease. The deaths due to Covid are also climbing slowly and silently and it is expected that by March we will have a break or make situation. Much depends on the vaccinated numbers and I hope the people will realise that they are helping not only themselves but also the society.
Take for example the covid-19 situations in the UK and Australia and compare them with our situation where the spread is mainly due to the Omicron variant. The UK is experiencing the winter season, Australia the summer and in Sri Lanka we are experiencing a dry hot weather. Earlier it was cold and rainy in December here in our country. On the 12th of December, 2021 the UK registered 48,000 patients for the day. Then the numbers rose sharply within three weeks and rose to reach 218,000 on 4th January 2022. That is more than a four-fold increase! Today, the daily number has gone down to 92,000 but it is still high. Now UK’s population is three times that of Sri Lanka. Take Australia a country with a population just above our country. They had just 1843 new patients on that day, 12th December 2021. By 12th January 2022 the number of new cases for the day peaked at 175,000. By the 3rd February 2022, the numbers had come down to 32,000. During this period what were the numbers here in Sri Lanka? On 12th December 2021 we had just 714 new patients for the day. By 9th January the number of cases went down to 430 and then started to gradually go up and by the 3rd of February, 2022, we had 1183. Compared with the numbers in December 2021 this is almost a three-fold increase. But then why are our numbers so low? Very few people get themselves tested for the Covid-19 virus. The laboratory facilities are difficult to get at. The private sector charges exorbitant prices. So, many wait at home, some use Ayurvedic remedies, but others go to work with the runny nose, sore throat, fever, etc. Of course, they check the temperatures at the entrances but the machines are never calibrated. The workers with the infections hide behind the masks and no one knows whether they are infected or not. There is no social distancing at work.This is so even in medical facilities. There are no proper awareness programmes even in the cities. Parties, demonstrations and meetings are held involving hundreds of people disregarding that we might have an imminent outbreak of Omicron here in the country.
What will happen in the near future? My guess is that there will be a sharp increase in the number of patients during the next few weeks and this will go on till the April holidays. The numbers will not be that high like in Aussie land or the UK due to the hot and dry weather conditions that we experience and also as many of the infected citizens will be not going to a medical facility for treatment or a laboratory for testing and we will not know the exact numbers anyway.
The country should not be locked-down at any cost and people should learn to live with it and at the same time take precautions. The tourism industry has just picked up and statistics show that hardly a tourist is infected with Covid-19 according to PCR tests although the southern coastal line has a large number of infected persons. I think it is the local tourists from Colombo and suburbs that travel to the southern areas that take the disease with them. There should be an increased awareness created among people by using the electronic media to get people’s attention to the need of taking preventive measures and staying put if they have the disease.
All government institutions and the private sector as well should first ask their staff members to get fully vaccinated as they deal with first their own members of staff and then the outsiders or customers. They should ask the staff members to keep away from work if they have a runny nose, sore-throat headache etc. The heads of these institutions should see that no infected persons come to work as bringing in one person with the virus can infect all in one division especially, when they work in a closed air-conditioned room or a hall. In each division a health officer should be appointed to check whether any infected person has come to work. If there are many persons down with covid-19 then all should undergo antigen testing. I think it is better if the government informs these institutions to keep the staff levels at work to 50-70 % during the next few weeks and watch the situation. I am totally against road-side antigen testing as that is trying to find a needle in a haystack. It is better to use the same resources to find the infected people in high-risk institutions and offices which will be more productive.
CMC which is spearheading the covid-19 control campaign should start with their own organization first and put the house in order at the Town Hall as a large number of patients are found there. Colombo and suburbs are the most important areas that the government should concentrate in the vaccination drive as almost all the communicable diseases are spread to other areas from the above areas. Take the month of January this year, out of the 200 dengue fever patients in Colombo District, the Colombo Municipality area has 166 patients. Unlike Delta Omicron infected persons’ lungs will be less affected but then if one is over 60 years of age there could be complications. Therefore, booster vaccinations are a must and the service should be taken to the people and not expectT hem to come to the centers.
So, a massive awareness campaign coupled with an intensive vaccination drive that can cover at least 80% of the eligible persons in the next few weeks will slow down the spread of Omicron variant. Government statistics show that 16.7 million persons were given the first dose of the vaccine, 14 million the second dose but only 5.6 million the third dose showing the decline in interest of citizens to get the vaccine. If this will continue the disease will rapidly spread and the numbers will be high and new variants will emerge. In that case we will have to wait it out while doing our normal day to day work risking our lives until 80% of the population has either got the disease or vaccinated to stop Covid-19. If one wishes to take the risk and not get vaccinated then it is that person’s right. But they have no right to infect others. So be conscientious and think of others, get the vaccines and all will be well.
by Dr Gotabhya Ranasinghe
Senior Consultant Cardiologist
National Hospital Sri Lanka
When we sought a meeting with Hon Dr. Ramesh Pathirana, Minister of Health, he graciously cleared his busy schedule to accommodate us. Renowned for his attentive listening and deep understanding, Minister Pathirana is dedicated to advancing the health sector. His openness and transparency exemplify the qualities of an exemplary politician and minister.
Dr. Palitha Mahipala, the current Health Secretary, demonstrates both commendable enthusiasm and unwavering support. This combination of attributes makes him a highly compatible colleague for the esteemed Minister of Health.
Our discussion centered on a project that has been in the works for the past 30 years, one that no other minister had managed to advance.
Minister Pathirana, however, recognized the project’s significance and its potential to revolutionize care for heart patients.
The project involves the construction of a state-of-the-art facility at the premises of the National Hospital Colombo. The project’s location within the premises of the National Hospital underscores its importance and relevance to the healthcare infrastructure of the nation.
This facility will include a cardiology building and a tertiary care center, equipped with the latest technology to handle and treat all types of heart-related conditions and surgeries.
Securing funding was a major milestone for this initiative. Minister Pathirana successfully obtained approval for a $40 billion loan from the Asian Development Bank. With the funding in place, the foundation stone is scheduled to be laid in September this year, and construction will begin in January 2025.
This project guarantees a consistent and uninterrupted supply of stents and related medications for heart patients. As a result, patients will have timely access to essential medical supplies during their treatment and recovery. By securing these critical resources, the project aims to enhance patient outcomes, minimize treatment delays, and maintain the highest standards of cardiac care.
Upon its fruition, this monumental building will serve as a beacon of hope and healing, symbolizing the unwavering dedication to improving patient outcomes and fostering a healthier society.We anticipate a future marked by significant progress and positive outcomes in Sri Lanka’s cardiovascular treatment landscape within the foreseeable timeframe.
by Fr. Emmanuel Fernando, OMI
Jesuit Fr. Aloysius Pieris (affectionately called Fr. Aloy) celebrated his 90th birthday on April 9, 2024 and I, as the editor of our Oblate Journal, THE MISSIONARY OBLATE had gone to press by that time. Immediately I decided to publish an article, appreciating the untiring selfless services he continues to offer for inter-Faith dialogue, the renewal of the Catholic Church, his concern for the poor and the suffering Sri Lankan masses and to me, the present writer.
It was in 1988, when I was appointed Director of the Oblate Scholastics at Ampitiya by the then Oblate Provincial Fr. Anselm Silva, that I came to know Fr. Aloy more closely. Knowing well his expertise in matters spiritual, theological, Indological and pastoral, and with the collaborative spirit of my companion-formators, our Oblate Scholastics were sent to Tulana, the Research and Encounter Centre, Kelaniya, of which he is the Founder-Director, for ‘exposure-programmes’ on matters spiritual, biblical, theological and pastoral. Some of these dimensions according to my view and that of my companion-formators, were not available at the National Seminary, Ampitiya.
Ever since that time, our Oblate formators/ accompaniers at the Oblate Scholasticate, Ampitiya , have continued to send our Oblate Scholastics to Tulana Centre for deepening their insights and convictions regarding matters needed to serve the people in today’s context. Fr. Aloy also had tried very enthusiastically with the Oblate team headed by Frs. Oswald Firth and Clement Waidyasekara to begin a Theologate, directed by the Religious Congregations in Sri Lanka, for the contextual formation/ accompaniment of their members. It should very well be a desired goal of the Leaders / Provincials of the Religious Congregations.
Besides being a formator/accompanier at the Oblate Scholasticate, I was entrusted also with the task of editing and publishing our Oblate journal, ‘The Missionary Oblate’. To maintain the quality of the journal I continue to depend on Fr. Aloy for his thought-provoking and stimulating articles on Biblical Spirituality, Biblical Theology and Ecclesiology. I am very grateful to him for his generous assistance. Of late, his writings on renewal of the Church, initiated by Pope St. John XX111 and continued by Pope Francis through the Synodal path, published in our Oblate journal, enable our readers to focus their attention also on the needed renewal in the Catholic Church in Sri Lanka. Fr. Aloy appreciated very much the Synodal path adopted by the Jesuit Pope Francis for the renewal of the Church, rooted very much on prayerful discernment. In my Religious and presbyteral life, Fr.Aloy continues to be my spiritual animator / guide and ongoing formator / acccompanier.
Fr. Aloysius Pieris, BA Hons (Lond), LPh (SHC, India), STL (PFT, Naples), PhD (SLU/VC), ThD (Tilburg), D.Ltt (KU), has been one of the eminent Asian theologians well recognized internationally and one who has lectured and held visiting chairs in many universities both in the West and in the East. Many members of Religious Congregations from Asian countries have benefited from his lectures and guidance in the East Asian Pastoral Institute (EAPI) in Manila, Philippines. He had been a Theologian consulted by the Federation of Asian Bishops’ Conferences for many years. During his professorship at the Gregorian University in Rome, he was called to be a member of a special group of advisers on other religions consulted by Pope Paul VI.
Fr. Aloy is the author of more than 30 books and well over 500 Research Papers. Some of his books and articles have been translated and published in several countries. Among those books, one can find the following: 1) The Genesis of an Asian Theology of Liberation (An Autobiographical Excursus on the Art of Theologising in Asia, 2) An Asian Theology of Liberation, 3) Providential Timeliness of Vatican 11 (a long-overdue halt to a scandalous millennium, 4) Give Vatican 11 a chance, 5) Leadership in the Church, 6) Relishing our faith in working for justice (Themes for study and discussion), 7) A Message meant mainly, not exclusively for Jesuits (Background information necessary for helping Francis renew the Church), 8) Lent in Lanka (Reflections and Resolutions, 9) Love meets wisdom (A Christian Experience of Buddhism, 10) Fire and Water 11) God’s Reign for God’s poor, 12) Our Unhiddden Agenda (How we Jesuits work, pray and form our men). He is also the Editor of two journals, Vagdevi, Journal of Religious Reflection and Dialogue, New Series.
Fr. Aloy has a BA in Pali and Sanskrit from the University of London and a Ph.D in Buddhist Philosophy from the University of Sri Lankan, Vidyodaya Campus. On Nov. 23, 2019, he was awarded the prestigious honorary Doctorate of Literature (D.Litt) by the Chancellor of the University of Kelaniya, the Most Venerable Welamitiyawe Dharmakirthi Sri Kusala Dhamma Thera.
Fr. Aloy continues to be a promoter of Gospel values and virtues. Justice as a constitutive dimension of love and social concern for the downtrodden masses are very much noted in his life and work. He had very much appreciated the commitment of the late Fr. Joseph (Joe) Fernando, the National Director of the Social and Economic Centre (SEDEC) for the poor.
In Sri Lanka, a few religious Congregations – the Good Shepherd Sisters, the Christian Brothers, the Marist Brothers and the Oblates – have invited him to animate their members especially during their Provincial Congresses, Chapters and International Conferences. The mainline Christian Churches also have sought his advice and followed his seminars. I, for one, regret very much, that the Sri Lankan authorities of the Catholic Church –today’s Hierarchy—- have not sought Fr.
Aloy’s expertise for the renewal of the Catholic Church in Sri Lanka and thus have not benefited from the immense store of wisdom and insight that he can offer to our local Church while the Sri Lankan bishops who governed the Catholic church in the immediate aftermath of the Second Vatican Council (Edmund Fernando OMI, Anthony de Saram, Leo Nanayakkara OSB, Frank Marcus Fernando, Paul Perera,) visited him and consulted him on many matters. Among the Tamil Bishops, Bishop Rayappu Joseph was keeping close contact with him and Bishop J. Deogupillai hosted him and his team visiting him after the horrible Black July massacre of Tamils.
Sri Lanka-Singapore Free Trade Agreement
By Gomi Senadhira
senadhiragomi@gmail.com
“You might tell fairy tales, but the progress of a country cannot be achieved through such narratives. A country cannot be developed by making false promises. The country moved backward because of the electoral promises made by political parties throughout time. We have witnessed that the ultimate result of this is the country becoming bankrupt. Unfortunately, many segments of the population have not come to realize this yet.” – President Ranil Wickremesinghe, 2024 Budget speech
Any Sri Lankan would agree with the above words of President Wickremesinghe on the false promises our politicians and officials make and the fairy tales they narrate which bankrupted this country. So, to understand this, let’s look at one such fairy tale with lots of false promises; Ranil Wickremesinghe’s greatest achievement in the area of international trade and investment promotion during the Yahapalana period, Sri Lanka-Singapore Free Trade Agreement (SLSFTA).
It is appropriate and timely to do it now as Finance Minister Wickremesinghe has just presented to parliament a bill on the National Policy on Economic Transformation which includes the establishment of an Office for International Trade and the Sri Lanka Institute of Economics and International Trade.
Was SLSFTA a “Cleverly negotiated Free Trade Agreement” as stated by the (former) Minister of Development Strategies and International Trade Malik Samarawickrama during the Parliamentary Debate on the SLSFTA in July 2018, or a colossal blunder covered up with lies, false promises, and fairy tales? After SLSFTA was signed there were a number of fairy tales published on this agreement by the Ministry of Development Strategies and International, Institute of Policy Studies, and others.
However, for this article, I would like to limit my comments to the speech by Minister Samarawickrama during the Parliamentary Debate, and the two most important areas in the agreement which were covered up with lies, fairy tales, and false promises, namely: revenue loss for Sri Lanka and Investment from Singapore. On the other important area, “Waste products dumping” I do not want to comment here as I have written extensively on the issue.
1. The revenue loss
During the Parliamentary Debate in July 2018, Minister Samarawickrama stated “…. let me reiterate that this FTA with Singapore has been very cleverly negotiated by us…. The liberalisation programme under this FTA has been carefully designed to have the least impact on domestic industry and revenue collection. We have included all revenue sensitive items in the negative list of items which will not be subject to removal of tariff. Therefore, 97.8% revenue from Customs duty is protected. Our tariff liberalisation will take place over a period of 12-15 years! In fact, the revenue earned through tariffs on goods imported from Singapore last year was Rs. 35 billion.
The revenue loss for over the next 15 years due to the FTA is only Rs. 733 million– which when annualised, on average, is just Rs. 51 million. That is just 0.14% per year! So anyone who claims the Singapore FTA causes revenue loss to the Government cannot do basic arithmetic! Mr. Speaker, in conclusion, I call on my fellow members of this House – don’t mislead the public with baseless criticism that is not grounded in facts. Don’t look at petty politics and use these issues for your own political survival.”
I was surprised to read the minister’s speech because an article published in January 2018 in “The Straits Times“, based on information released by the Singaporean Negotiators stated, “…. With the FTA, tariff savings for Singapore exports are estimated to hit $10 million annually“.
As the annual tariff savings (that is the revenue loss for Sri Lanka) calculated by the Singaporean Negotiators, Singaporean $ 10 million (Sri Lankan rupees 1,200 million in 2018) was way above the rupees’ 733 million revenue loss for 15 years estimated by the Sri Lankan negotiators, it was clear to any observer that one of the parties to the agreement had not done the basic arithmetic!
Six years later, according to a report published by “The Morning” newspaper, speaking at the Committee on Public Finance (COPF) on 7th May 2024, Mr Samarawickrama’s chief trade negotiator K.J. Weerasinghehad had admitted “…. that forecasted revenue loss for the Government of Sri Lanka through the Singapore FTA is Rs. 450 million in 2023 and Rs. 1.3 billion in 2024.”
If these numbers are correct, as tariff liberalisation under the SLSFTA has just started, we will pass Rs 2 billion very soon. Then, the question is how Sri Lanka’s trade negotiators made such a colossal blunder. Didn’t they do their basic arithmetic? If they didn’t know how to do basic arithmetic they should have at least done their basic readings. For example, the headline of the article published in The Straits Times in January 2018 was “Singapore, Sri Lanka sign FTA, annual savings of $10m expected”.
Anyway, as Sri Lanka’s chief negotiator reiterated at the COPF meeting that “…. since 99% of the tariffs in Singapore have zero rates of duty, Sri Lanka has agreed on 80% tariff liberalisation over a period of 15 years while expecting Singapore investments to address the imbalance in trade,” let’s turn towards investment.
Investment from Singapore
In July 2018, speaking during the Parliamentary Debate on the FTA this is what Minister Malik Samarawickrama stated on investment from Singapore, “Already, thanks to this FTA, in just the past two-and-a-half months since the agreement came into effect we have received a proposal from Singapore for investment amounting to $ 14.8 billion in an oil refinery for export of petroleum products. In addition, we have proposals for a steel manufacturing plant for exports ($ 1 billion investment), flour milling plant ($ 50 million), sugar refinery ($ 200 million). This adds up to more than $ 16.05 billion in the pipeline on these projects alone.
And all of these projects will create thousands of more jobs for our people. In principle approval has already been granted by the BOI and the investors are awaiting the release of land the environmental approvals to commence the project.
I request the Opposition and those with vested interests to change their narrow-minded thinking and join us to develop our country. We must always look at what is best for the whole community, not just the few who may oppose. We owe it to our people to courageously take decisions that will change their lives for the better.”
According to the media report I quoted earlier, speaking at the Committee on Public Finance (COPF) Chief Negotiator Weerasinghe has admitted that Sri Lanka was not happy with overall Singapore investments that have come in the past few years in return for the trade liberalisation under the Singapore-Sri Lanka Free Trade Agreement. He has added that between 2021 and 2023 the total investment from Singapore had been around $162 million!
What happened to those projects worth $16 billion negotiated, thanks to the SLSFTA, in just the two-and-a-half months after the agreement came into effect and approved by the BOI? I do not know about the steel manufacturing plant for exports ($ 1 billion investment), flour milling plant ($ 50 million) and sugar refinery ($ 200 million).
However, story of the multibillion-dollar investment in the Petroleum Refinery unfolded in a manner that would qualify it as the best fairy tale with false promises presented by our politicians and the officials, prior to 2019 elections.
Though many Sri Lankans got to know, through the media which repeatedly highlighted a plethora of issues surrounding the project and the questionable credentials of the Singaporean investor, the construction work on the Mirrijiwela Oil Refinery along with the cement factory began on the24th of March 2019 with a bang and Minister Ranil Wickremesinghe and his ministers along with the foreign and local dignitaries laid the foundation stones.
That was few months before the 2019 Presidential elections. Inaugurating the construction work Prime Minister Ranil Wickremesinghe said the projects will create thousands of job opportunities in the area and surrounding districts.
The oil refinery, which was to be built over 200 acres of land, with the capacity to refine 200,000 barrels of crude oil per day, was to generate US$7 billion of exports and create 1,500 direct and 3,000 indirect jobs. The construction of the refinery was to be completed in 44 months. Four years later, in August 2023 the Cabinet of Ministers approved the proposal presented by President Ranil Wickremesinghe to cancel the agreement with the investors of the refinery as the project has not been implemented! Can they explain to the country how much money was wasted to produce that fairy tale?
It is obvious that the President, ministers, and officials had made huge blunders and had deliberately misled the public and the parliament on the revenue loss and potential investment from SLSFTA with fairy tales and false promises.
As the president himself said, a country cannot be developed by making false promises or with fairy tales and these false promises and fairy tales had bankrupted the country. “Unfortunately, many segments of the population have not come to realize this yet”.
(The writer, a specialist and an activist on trade and development issues . )
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