Corona Management – Are We Diving Into The Deep End, And Knowingly?
Dr. Thangamuthu Jayasingam
An outbreak of pneumonia of unknown reason was first reported on 31 December 2019 from Wuhan city in Hubei Province of China. On 7th January 2020, it was diagnosed as “Novel Corona Virus”. On 30th January, WHO declared it as a Public Health Emergency of International concern (PHEIC). On 11 February WHO renamed the disease as COVID-19 and on 11 March 2020 declared as pandemic. The incubation period is reported as 2-14 days. ~ Situation report-26-4-2020, Epidemiology Unit, M/H&IM
The Government planned to open the country from lock down on 27th April 2020 which was then delayed for a week trying to bring back ‘normalcy’. But Corona has accelerated during this period and reached the 500 mark on 26th April just two days after reaching the 400 mark. The graphs below indicate that we are in the ‘exponential growth’ of the infection. Opening of this country at this time would be an unwise decision that could cost a serious setback to the reduction of the Corona Virus.
Fig. 1 is from the Ministry of Health, Epidemiology unit (26-4-20) and the cumulative figures calculated from the same and produced Fig 3. Fig 2 was the reported information by the same office on 18th March 20220. It is difficult to understand how the planners missed these indicators over time. One does not have to be an expert on Corona virus or its infection to be competent enough to study trends and analyze them and relate to Existing knowledge. The situation report for the 18th march is given below again from the same source.
Fig 1: Corona summary ( Epidemeology unit, Ministry of Health, 26-4-2020) The number at 10 am on 26th had been 460 which is 588 on 28th 10 am.
There is a trend line of increase of the cases that led to the closure of the schools on 12th March and the Universities on 16th March 2020. But though some areas such as Puttalam was locked down the rest of the country was open until 20th March 2020. Whether this was to accommodate the nominations for general election that closed on March 19 is commented upon, but earlier closure would have helped the country. The Airports were declared closed for arrivals on 19th March 2020.
Fig 2: trend of Corona patients from march 11 to 18 march 2020
The trend line shows a slow down in terms of patients recognized each day and then starts to climb again after 12th April 2020 (Fig1). Whether this was due to the relaxing of the curfew in most of the country except for the selected hotspot districts, needs investigation. However there had been reports of crowding during this period. However since then, the graph shows an acceleration that takes place, much faster than before. It needs to be reminded that during this period following the 16th April, intercity transport had been allowed and buses have been plying between cities including areas of earlier ‘restriction’. Whether this was also a cause for the rise is to be checked. It is hard to believe that the authorities were unaware of this trend as this is taken from the Ministry web and if so, it is a matter of utmost concern how were the plans made for opening the country on 27th of April for almost ‘business as usual’.
Fig 3 and 4 were computed on the same information of Fig 1 but on a cumulative basis for better representation.
Fig 3 shows that we were almost zero for the first 50+ days and it was around 11 March 2020, the numbers showed increase, which is detailed in fig.4.
Trends
It had taken us around 57 days for first 100 patients , 18 days for the second and 8 days for the third, 4 days for the 4th and two days for the 5th( it had reached 588 on 28th Morning at 10 am). It is vividly clear from the graphs that we are on the exponential growth trend and trying to ignore it and behave as ‘business as usual’ will not result in reduction in the spread but most likely the reverse.
I also had a chance to look at the article by Dr S. Ratnajeevan H. Hoole (Are we and Independent Commission?, Colombo Telegraph, 27-4-2020) where he discusses the postponement of the date for General Election which was to be on the 25th April by the declaration of the President on 2nd April 2020 and the associated scenarios. In the context of the possible catastrophe that the country faces, it is foolhardy that the Election Commission had not looked at these data but fixed the date based on an imagined end of the Corona saga on May 2nd, 2020. This questions the rationale and expertise of these eminent persons to decide beyond their realm. I think under the circumstances that we need to concentrate on coming out of the Corona spread as we are on the threshold of a major increase as shown in the graph and time will be a crucial factor.
Fig 5: Moderately increasing Sri Lanka had changed pace after 12 April, 2020 and is rising and perhaps faster than other countries in the region. (Graphs were taken from SanjeewaDayaratne@dayaS on Twitter.)
Fig 5 shows the comparison of trends in many countries and Sri Lanka does not show a leveling impact but an increased trend of escalation after 12th April to 24.4.2020 even before the 500 mark was reached. It just concurs that we have little time and need to act fast.
