Communities everywhere are faced with a dichotomy – disregard the likelihood of public health issues and build the economy—or endure some more months or parts of a year with slow growth and low growth, in the interest of saving the lives of thousands from infection and possible death. The feelings and responses have touched on extremes.
Protests against lockdown or curfews are observed all over. There is much spoken about the need for more caution and increased responses for emergency care, wider vaccination programs and better testing to mitigate the pandemic. In order to address these challenges, a webinar titled ‘Smart lockdowns – the need of the hour in Sri Lanka?’ was organised by ICC Sri Lanka in association with the Daily FT, the Alumni of the MBA Program University of Colombo and the Rotary Club of Colombo recently.
Interestingly, some nations, even in Asia, such as Pakistan, have touted the value of ‘Smart lockdowns’. They have already experimented with that.
However, such a controlled lockdown calls for even more vigilance and the exercise of comprehensive coordinated responses, that involve tracing, data management, science, correlated action plans from medical, public health operatives, commercial, logistical, manufacturing businesses, medical suppliers, financial resources, law enforcement, food suppliers, communications, and garnering public support in specific locations where exigencies are likely to emerge.
The panel of eminent persons who were invited to the conversation were, Minister of Youth and Sports, Development Coordination and Monitoring, and State Minister of Digital Technology and Enterprise Development Namal Rajapaksa, Ceylon Chamber of Commerce Chairman Vish Govindasamy, Sri Lanka Medical Association Former President Dr. Ruvaiz Haniffa, IDH Senior Consultant Physician Dr. Ananda Wijewickreme, Dialog Axiata PLC CEO Supun Weerasinghe, Hotels Association of Sri Lanka President Sanath Ukwatte, Jetwing Hotels Chairperson Shiromal Cooray, Aitken Spence PLC Director Stasshani Jayawardene, Rotary Club of Colombo President Aroshi Nanayakkara, and JKH Retail Industries Group Head Charitha Subasinghe.
The keynotes were sounded by renowned virologist and specialist in respiratory diseases working in Hong Kong Prof. Malik Peiris, CBSL Former Senior Deputy Governor W.A. Wijewardene, and NHSL Senior Cardiologist Dr. Gotabhaya Ranasinghe.
Vish Govindasamy introduced a phrase (which he had been acquainted with from another source), which he thought was preferable – the term being ‘Movement Control Order’ (MOC). He clarified that it was not about suffocating the community by restrictions that are ‘imposed’ but that an MOC should be ‘data driven’, and operational within a very closely monitored process and plan. This tallied well with the presentation by Prof. Malik Peiris, in which he explained that ‘early interventions’ are vital, and the purpose, clearly understood and implemented is with the specific end in view, of ‘limiting full scale’ infections in the community of Lanka.
When cautions are ignored
He was able to trace the peaks in the incidents with his diagrams/charts and showed the increased incidents as being sparked by what is called the Minuwangoda incident in 2020, and then the reduction of the cases in early 2021, when in April there was an early release of the cautionary measures around the ‘new year’, and then how there was a rapid rise countrywide of sickness and deaths, with an alarming increase in the daily death rates. This shows that there are good results that can be notable when there is caution, and how that is overturned quickly, when those cautions are ignored.
However, there are ways to make this a less fearsome disease. Principally with full vaccination. There will be a level of immunity to the disease that can measurably be seen when the larger number of citizens are vaccinated. Even if there are infections, the chances are much greater that the infected one will be less likely to endure critical scenarios with hospitalisation. Statistics were shared which were able to endorse that view.
Maintaining the MOC will usually deliver results within 10 to 15 days. He introduced the allegory of the super-tanker in the ocean – such a vessel cannot easily be stopped or even made to turn direction in an instant. It usually takes several nautical miles before the vessel can change direction or even be brought to a stop. The ‘Smart’ lockdown or MOC will also deliver results similarly. Slowly but surely, the daily death rates and infections will begin to dip. The goal will be to preserve the health system’s capacity and not allow it to reach ‘tipping point’.
There have to be epidemiology-based interventions, a monitoring of the reproduction number and to intervene early, based on this number. Herd immunity is not achievable, and the primary aim is ‘not’ to stop transmission, which is unrealistic to achieve with the current vaccination program and given the current variants that are operating. The achievable goal is to save lives and severe disease, hospitalisation and stressing the healthcare system.
Balance in planning and implementation
Cardiologist Dr. Gotabhaya Ranasinghe provided further insights into how things are in Sri Lanka’s health system. He acknowledged the presence of a ‘double jeopardy’, with the health impact on the one hand, and the economic fallout on the other. Therefore, he too proposes that there needs to be ‘balance’ in the planning and implementation of an MOC.
His suggestions – Relatively larger areas must be focused on rather than small locks or streets selected for lockdown. This is to facilitate administration and increase feasibility. Further, the period of MOC should be based on scientific information and could last for two weeks, and may be modified as needed. Then, there has to be increased epidemiological interventions such as testing, tracing and quarantine and isolation of those who are confirmed cases of infection. Above all, excellent communications should be maintained with the residents of the lockdown area before and after the implementation of the MOC; while no business activities should be allowed within the lockdown area, except essential services, such as pharmacies, grocers, and emergency services which should maintain strict Standard Operating Procedures that are current under the pandemic protocols. With these guidelines Dr. Ranasinghe offered, he was optimistic that these controls and methods of mitigation can be implemented successfully in this country.
There needs to be a priority
W.A. Wijewardene underscored the point that humans are not ‘a commodity’, and therefore it would not be proper to consider human life in the same context as an item in the assessment of profit. There needs to be a priority, and that priority is the health of humans. The aim of an MOC will obviously need to be the maintenance of low incidence of both infections and deaths. There are and for the foreseeable time ahead, serious issues that are to be faced by the economy of Sri Lanka.
The quicker that businesses, manufacturing, and key earnings areas such as tourism are able to resume, the better for the country to be able to come out of the dire circumstances that it now faces with balance of payment issues and the building of the foreign reserves. The longer the time taken to come within the platform of a ‘green’ list the more difficult for the economy. Again, the matter of adequate vaccination of the population was seen as a sensible and planned approach required. There has to be an adequate response in making available the supply of vaccines to be administered to the whole community.
Ceylon has had a pandemic before, and he was referring to the Spanish Flu of the 20th century. This was from 1918 onward for four years. The estimated real death toll at the end of two years of that pandemic was in the region of 300,000 lives! Which is a huge segment of the population. With that massive number of deaths, it was still possible for the nation to recover and proceed on its way into the future. So, such historical events also indicate that survival and success is possible.
The status quo with regard to the pandemic response, was articulated by Minister Namal Rajapaksa; he indicated that the Government was cognisant of the challenge that is being faced by the country. He also indicated that it would not be possible for the Government alone to tackle every aspect of the management of the pandemic, and therefore voiced the appeal for a collective response. He hoped that this collective response would be able to mitigate the rise of COVID-19 cases and the deaths, and was in favour of the idea of a ‘Smart’ lockdown. He too referred to the accelerated vaccine admin program that is currently being pursued.
Dr. Ananda Wijewickreme spoke about the matter of hospital capacity, even as he recognised that businesses must operate, or else there could be an even greater crisis that fundamentally affects the wellbeing and mental health of the community. Dr. Ruvaiz Haniffa whilst echoing similar sentiments pointed out that public health depends on public trust. Going forward he also suggested that a booster jab is required, if the immunity levels drop.
The hospitality business in Sri Lanka has been seriously and severely impacted by the pandemic. This is one of the major earners of foreign exchange, and this setback has really had an impact, as was clearly mentioned by Sanath Ukwatte and also was underscored by Shiromal Cooray and Stasshani Jayawardene. The hotels are vital to maintain, and the staff retained. It has been difficult to do so, given that there is little or no business for the past nearly two years. Whatever means are required to mitigate the infection rate and the numbers in daily deaths is vital.
The idea and the hope, is to be able to be classified as Sri Lanka being in the ‘Green List’ for tourism and travel. The target for this to be possible is December 2021. It will not be possible for the tourism industry to wait until 2022 or 2023 to ‘recover’. In the meantime, medical, logistical and other travel-related areas are conferring and will continue to do so, to be able to offer a safe experience to travellers. Even if complete eradication of the COVID-19 infection rate is unlikely, the provisions and methods of delivery of services will take cognisance of the responsibility. And toward this end, MOC as a means to reduce the incidence of infections, as well as a comprehensive vaccination program is needed.
Consistency in policy
Vish Govindasamy recommended that there has to be consistency in policy. Piecemeal measures and changing dates and weeks of lockdown with very poor communication from reliable and credible sources has also exacted a heavy price from industry and commerce. All of this means that confidence is eroded, and it augurs very poorly for the image of Sri Lanka in the eyes of the world. He too insisted that a data-driven MOC is what is really required. And science has to be invoked to be able to play its part, and not posit other un-ratified figments that appear from different (conflicting) sources.
Telco is also expected to play a part in providing the services for the data-managed MOC. Supun Weerasinghe mentioned how the framework and the groundwork is being set up. Identifying hot spots where infections are emerging and are likely to emerge, etc., will need the support of telco. On the other hand, there is also a great need for the community also to be ‘on board’ with modern tech or else none of this data-driven management is possible. There is another attendant area – namely homecare services that would obviate the need for persons seeking hospitalisation. This aspect will also depend on telco to deliver.
It was made clear by Aroshi Nanayakkara that there are responses from the bankers in extending special consideration to those industries that are the hardest-affected by the pandemic. However, these structured responses with extending credit facilities cannot be practically continued endlessly. The general view echoed, that critical measures that can be implemented to return the level of business activity to normality, need to be taken and the ‘Smart lockdown’ or MOC would be one of the options that the country and policymakers should take on board.
Already the lessons learned from the exigencies of the pandemic at JKH was revealed by Charith Subasinghe. In their systems the staff and workforce are using the available resources and ‘thinking’ in harmony with the principles as would govern a well-organised national response under the banner of a ‘SMART’ lockdown or MOC.
The session was chaired by Arun Dias Bandaranaike, and moderated by Daily FT Editor Nisthar Cassim and ICCSL Chairman Dinesh Weerakkody.