What went wrong?

By Dr Upul Wijayawardhana

I am stuck in the UK, badly missing trips back home, but I have been closely following the developments in Sri Lanka, especially with regard to the Covid-19 epidemic and the engulfing political drama. It was no great effort either, as plenty of time was available, being almost totally housebound, dreading to go out as the virus was killing thousands and thousands in the UK. What was remarkable, initially, was how badly the UK controlled the pandemic and how well Sri Lanka did. Total number of deaths in Sri Lanka remained very low for months whilst the Brits were dying in large numbers. It is the other way around, now; deaths due to Covid-19 in Sri Lanka are exceeding that of the UK now. What went wrong?

Whilst Sri Lanka is grappling with a resurgence, caused by the excesses indulged during the Sinhala and Tamil New Year festivities, the British government recently announced significant relaxation of pandemic preventive measure. It expects the country to be ‘near-normal’ by mid-June, if the present trends continue. One may argue that normalcy cannot be guaranteed until the virus is controlled, globally, as well stated in the editorial “All hat and no cattle” (The Island, 10th May). The editor argued that “the only way out is to follow the motto—unus pro omnibus, omnes pro uno (‘one for all, all for one’).”

Although both are island nations, admittedly, the UK and Sri Lanka are poles apart, on many counts, most significant being the availability of resources. The UK is rich enough to buffer the resultant economic downturn, whereas Sri Lanka was struggling, economically, even before the epidemic. Therefore, attempts by the Sri Lankan government, to keep the economy afloat, are mandated by sheer necessity, although the Opposition accuses it of endangering lives. The big question is how to strike the right balance. At the time of Independence, our economy was in better shape than that of the Brits, but where are we, now? That, however, is another story.

At the start of the pandemic, the UK was slow to close its borders. Again, it was a tough call because Heathrow is one of the busiest airports in the world. The UK paid heavily, in terms of lives lost, because of this. UK politicians took the advice of expert committees, and whether the initial failures were due to wrong advice by scientists or not, we will not know until the findings of the committee, to be appointed by the British government, is available. However, the UK government took serious notice of the advice by scientists, regarding the need for mass vaccination, and placed orders for vaccines, even before trials for their effectiveness were concluded. That strategy paid off. Already, two-thirds of the adult population in the UK has received one dose and one-third of has received the second dose, as well. It was interesting to follow the progress: as the vaccination drive proceeded, the number of cases, the numbers in intensive care, and the number of deaths, progressively plummeted.

If there are any vaccine doubters, they need to look at what happened in the UK. I am personally aware of many ‘so-called educated’ vaccine-doubters. The responses in a WhatsApp group, started by a friend of mine, are very illuminating. There is a nutritionist who argues against vaccination, suggesting that boosting immunity, by nutrition, is the way forward. Professor Emeritus Saman Gunatilake has addressed this issue, academically, in his illuminating piece “Boosting immune system to fight Covid-19: Is it possible?” (The Island, 7 May). There is a media lawyer who supports the nutritionist and sends contrasting messages. Three hours, after forwarding a message which states that CDC data shows the survival rate, for under 69, is over 99%, he forwards another message stating that a site by the University of Washington predicts Sri Lanka will soon have 200 deaths daily. Both ‘experts’ take part in TV discussions and are very likely to be passing on wrong messages, as they are continually forwarding anti-vaccine messages, the latest being that vaccination has made the epidemic worse. Wonder why they callously disregard the success of the UK. Covid-19 has given rise to a plethora of experts who give widely differing opinions about many things, including the UK variant, but the UK is successfully controlling the epidemic, with vaccination, which is estimated to have saved at least 10,000 lives so far.

It is a pity these vaccine-doubters overlook the fact that some diseases are eradicated, thanks to vaccines. The most successful vaccine ever is the smallpox vaccine, which enabled the eradication of the dreaded disease that existed for millennia, killing more than 300 million, in the 20th century, and around 500 million, during the last 100 years of its existence, including six monarchs. Initially, before Edward Jenner introduced vaccination, with the cowpox virus, in 1796, direct inoculations, with smallpox virus, were used, which had a mortality rate of 3% but this was acceptable as the mortality rate of smallpox was around 30%-40%.

Some exaggerate the risks of vaccination. There is no drug, without side-effects, and vaccines are no exception. Concern about the Oxford AZ vaccine causing Superficial Cerebral Vein Thrombosis was made use of by the German Chancellor to promote the Pfizer vaccine, which was developed by a German bio-tech company. Medicine and Healthcare Regulatory Agency of the UK made a detailed study and recommended, when possible, those under 40 should be offered an alternative vaccine but emphasized the safety of AZ vaccine. To put in perspective, the birth control pill poses a greater risk of causing venous thrombosis; so does Covid-19 itself.

What went wrong, in Sri Lanka, is putting sentiment over science. The government failed to establish an expert committee, which could have been done easily as we are not short of real experts in the relevant fields. The decisions made by that committee could have been translated to practice by the committee, headed by the Army Commander. Another failing was the lack of proper communication. In the UK, the Prime Minister, or one of the senior ministers, together with senior scientists, hold regular press conferences.

Instead, what did we do? Our Health Minister polluted rivers with pots, devised by a faith-healer, and then drank a syrup, made by a charlatan. She wasted the valuable time of Professors of Medicine, as well as resources, to investigate a piece of garbage that was found to be useless, whilst the kapuwa minded money, at the expense of the gullible. Now, a member of my profession also has joined the band-wagon of deception. A non-specialist doctor has joined hands with his brother to sell a concoction of herbs etc.! Why hasn’t the Minister taken action against this errant medic?

We have a State Minister, a Professor of Pharmacology, who sees the benefits of Ayurveda for political reasons! The mother country of Ayurveda, meanwhile, is reeling with Covid-19. If Ayurveda is effective, surely that cannot happen!

All this happens while we have a State Minister, a specialist in communicable diseases, who speaks sense but is largely ignored!

The Minister of Transport reverses the decisions of Medical officers of Health and then blames the poor government servants, stuck between the devil and the deep blue sea, for carrying out his orders. The virus is having a hearty laugh and now infecting his voters!

We thought the President would act decisively once he regained full executive powers from the 20th Amendment, but he seems less powerful than before! The need of the hour is not to protect errant politicians, or unproven systems of treatment, but directing all efforts at getting adequate stocks of vaccines to overcome the epidemic.

It is high time the President considered sacking the incompetent and idiotic ministers. Otherwise, he might as well forget about a second term!