Is Sri Lanka ready to face inevitable Covid deaths?

(Based on an exclusive interview with a leading specialist doctor on the subject by Lankasara)

The Christmas holiday is now over. The result of the manner it was celebrated while facing a pandemic will become evident in a matter of 14 days. Thousands of people who have been temporarily living and working in Colombo, Katunayake and Negombo areas where the Covid 19 virus is highly concentrated will go home for the New Year. The risk of the virus spreading simultaneously across the country cannot be averted in such an environment.

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As a result there are a number of practical issues before us. It is more likely that we will have to start the new year with a growing epidemic situation. Are we ready to face that danger as a country? This unplanned process of combating the pandemic led by the military as if it were a war, has not even given us a definite assessment of the Covid 19 situation faced by Sri Lanka.

The situation in Colombo

A crowded cross street in Pettah, Colombo

The population of Colombo is over 600,000. Most of the population are low-income earners that live in urban slums. The Chief Medical Officer of the Colombo Municipal Council Dr. Ruwan Wijayamuni estimates that at least 30,000 of this population may be infected with Covid. Dr. Pradeep Kariyawasam was the former Chief Medical Officer of the Colombo Municipal Council.

His estimation is that at least half of Colombo’s population has been infected with Covid. According to him, if proper testing is done at least 300,000 Covid 19 patients will be reported in Colombo alone.

Despite what the statistics may be there is a practical reality that we are experiencing at the moment. The epicenter of Covid 19 in the city appears to be Colombo central and Colombo North. The highest number of Covid deaths were reported within the Colombo city limits. PCR tests of people who die at home on a daily basis show that many of them had developed antibodies to the virus proving that at some point they had contracted Covid 19.

But we have not taken necessary action despite knowing this truth. The government ignored the travel restrictions recommended by the health sector. Suggestions on how to manage the society during the festive season went ignored. The government was moving towards opening up the country to tourism, leisure spaces and the normal way of life when health experts assessing the real threat demanded at least three weeks of isolation. It is now all over.

Are we ready for the danger?

The country now faces the challenge of how the health sector will cope with the impending danger. The country’s health system is already broken. If a person who is hospitalized for a back problem leaves the hospital as a Covid patient, the social fear caused by it has left people opting to die at home rather than seek treatment. At present the beds at the Colombo National Hospital are half empty. The people are delaying coming to the hospital until they are in their last moments. The unseen result we are currently experiencing is an increase in non-communicable diseases in the country. The number of deaths due to such diseases has increased. A deadly fear of the Covid epidemic was created among the populace and in practice, we failed to design the country’s hospital system to face the situation.

What is our real capacity to deal with the Covid epidemic, which is expected to increase in the coming months? When the truth is revealed, there is nothing to do but stay home in fear.

The over capacitated IDH Hospital

The hospital system we created to deal with the epidemic is centered around IDH Hospital. It then extended to the Mulleriyawa Hospital and the Homagama Hospital. But the IDH hospital has less than 200 beds. Its ICU has 8 beds. The Mulleriyawa hospital has less than 200 beds. The intensive care unit has 04 beds. The special treatment unit has 4 beds. The Homagama hospital can accommodate 200 patients but out of its 8 ICU beds only 5 are currently in use. In fact, the three major Covid hospitals have less than 600 beds, 17 ICU and 5 special treatment beds to manage the critical moment of the entire pandemic.

The Covid bosses who come in front of the media are trumpeting about combatting Covid by sweeping this reality under the carpet.

The Missed Places

There are about 2000 TB patients in Colombo city limits alone. These people live in the densely populated slums of Colombo. In addition to the city limits of Maligawatta, Maradana, Panchikawatte, Kettarama and Colombo North, these patients are also commonly reported from Wellampitiya and Kolonnawa. Today, the Covid virus is most prevalent in these areas. All of these patients are currently in critical danger. The preparation of the Welisara Hospital for that risk should be done now. But however there is no such plan. Even at the time of writing, there is no section to place Covid infected TB patients at the Colombo National Hospital. These helpless patients are dying in the blink of an eye while endangering the whole health system itself.

A significant number of people in the country are kidney patients. The Homagama Hospital is the only hospital in the country that has a blood transfusion facility for Kidney patients with Covid infection. If a patient from Jaffna is reported he or she must be brought to Homagama. Even now the Homagama Hospital is not able to withstand that patient capacity. Covid patients who are not able to get an opportunity for blood transfusions are being kept at the Colombo National Hospital until a space is found in Homagama. The Mulleriyawa Hospital, which treats patients with heart disease and bone problems, is not equipped with the required number of specialists.

The Neville Fernando hospital

This is a question that is always avoided. We do not understand the value this government’s Sihta Arambepola places on this hospital which appears to be more than they value the lives of the people of the country. The impending pandemic is a reality. Hundreds are about to die as a result of it. This hospital has more beds and ICU beds than any of the three major Covid 19 hospitals in the country. Dr. Neville Fernando claimed that this hospital has been handed over to the government.

The Neville Fernando Hospital

However, this hospital, which is located in a safe environment outside Colombo and has 1005 beds and 2 intensive care units has not been converted to a Covid treatment hospital. In the face of Covid and death the highly practical proposal will not be implemented. Politics that truly loves the country would not allow for the senseless death of its society in this manner.

But we are destined to die before their insensitive eyes. What should happen now is the preparation of the Welisara Special Unit for Covid patients with respiratory issues, development of one major hospital identified in each province as a Covid Treatment Hospital and keeping the National Hospital System away from Covid cases as far as possible and ensuring the confidence of the people in the hospitals, including the Neville Fernando Hospital in this treatment system as well as entrusting and empowering health professionals to take up the challenge of combating Covid 19 while pulling back the military from the process and limiting them to support functions. This government has not yet lost the opportunity to do what it really needs to do for the country. The future of the government will depend on the extent to which it manages it.

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