Geographical Information Maps for Covid-19 control

Around six months ago, the issue about lack of spatial information about the whereabouts of Covid-19 patients, came up, but, unfortunately, it has not been resolved yet. At that time the GMOA gave an ultimatum to the Ministry of Health that it will withdraw from the Technical Committee for Covid-19 control, if analyzed Geographical Information System (GIS) maps of Covid-19 patient-locations will not be made available. Although most don’t agree with the GMOA with some of their actions, on this matter I was more than 100% with them. The GMOA is an organization, which has many knowledgeable specialists in the areas of epidemiology, disease control and Information Technology, and I believe their knowledge, attitude and valuable inputs made it easy for the control teams to prevent the escalation of this epidemic.

The geographical maps are valuable tools to the MOHs, PHIs for their control work, and also to the general public to know of the locations of the patients, at least at the street level, so that they can avoid such areas. I think the Presidential Task Force also should be shown these maps, if they have not seen it yet, to make informed decisions. This week again, the President of the GMOA stated, over a private TV channel, that they, in fact, put up a GIS room next to the Director General of Health Services’ room, and that is a right move. He vented his frustrations when he came out with the difficulty in getting the maps done through the Epidemiology Unit to get this genre going. To fight a war there should be a central command and control room, and maps are a very important tool. Even 30 years ago, the officers in the field sent in the data about the spread of diseases, or they took samples, such as of stools of cholera patients, but they never got the analyzed reports, as someone was keeping them in the centre to write a paper to a journal.

Twenty years ago, when I was the Chief Medical Officer of Health of the CMC, realizing the value of GIS maps, I used them for dengue control in Colombo; and it provided great information to plan and implement control measures. We could see clusters of patients, and the gradual movement of the cluster into newer areas with time. My maps were used by at least the Peradeniya University to train Medical Officers in Health Mapping. I was also invited as the keynote speaker, by the Geographical Information Society. Many came to me from the Ministry of Health, KDU and other institutions to learn what we had done. Since then, the Ministry has trained some doctors who are now experts in GIS mapping, and they could be used to map the patient locations, show high, medium and low risk areas and also put in other information. The Public Health Department of CMC gave Geographical Position System-GPS training to Public Health Inspectors those days, to send in the information from the patient’s location to the GIS centre at the Town Hall, where all such information was collated. We then prepared the maps and sent them out to the MOHs and also discussed the situation at meetings.

I hope they have continued that work and, if so, they also should put out the maps of present patient locations in the CMC website, so that the people in Colombo will also know which areas in the city they should avoid. Colombo city was the centre of transmission of Covid-19 in the country a few months ago as nothing materialised. It is a pity that I can’t even get any information about Covid-19 patients in the CMC area, although I am the Chairman of the Standing Committee on Health and Sanitation at the CMC. The system I built up has come to a standstill, and sometimes even after eight months, I can’t get any answers to my questions given at Council meetings. Frustrated, I even wrote to the Epidemiology Unit asking for information about patient locations to better plan our prevention programmes, at least to prevent patients dying at home. But after listening to the GMOA President, yesterday, I now know it is a futile exercise. Information is power, but why not give it at a time of national crisis for the greater good of the people?

Technology should be used in disease prevention as much as possible, especially in this case, but the people in top positions are scared to use newer technology mostly because they don’t know about such technologies, or do not know how to use them. When PCR testing was started, a few leading private firms wanted to donate the latest automated PCR machine, but it was turned down by the people who were to use it, as they wanted a machine that could be used manually. That was my personal experience. There are other interests involved, too. Now I believe only the Sri Jayewardenepura University has an Automated machine which is 4-5 times faster in giving results.

Similarly, through GIS mapping we can put together a lot of information in a short time, and the analyzed information can be made available to the people who make decisions, and those in the field. Seeing the ground situation with one’s own eyes, is better than seeing some numbers. I hope the President, the Ministers and the Presidential Task Force will seriously take note of this, as this is very valuable public information that can be used to control this epidemic, at this critical juncture. For example, the information through maps could be used at least to know whether we should lock down a city or a district, or a province, or a few of them, etc., to prevent further escalation of this Covid-19 epidemic. There could be even a working sub-committee set up to do this work. Please do not put away this information in cold storage as someone’s private property. Let saner counsel prevail.

Dr. PRADEEP KARIYAWASAM

Former CMOH/CMC,

Chairman, Standing Committee on Health/CMC