Features
From Delta to Omicron: Will there be a tsunami of patients?
Dr. Pradeep Kariyawasam
Former Epidemiologist/Chief Medical Officer of Health
Colombo Municipal Council
All over the world the Delta variant of the Covid-19 virus has been replaced by the Omicron variant. It is happening in Sri Lanka, too, according to reports issued by the Ministry of Health recently. At present it is said that between 60-90% of patients found in various parts of the country have been infected with Omicron. The percentages are higher in the cities than in the suburbs. This is because the population densities are higher in the cities and the it is easily transmitted from one person to another. The other aspect is the transmissibility of the variants, and it is said that the Omicron variant has a 1.5 times higher transmissibility rate than the Delta variant. I believe that the change from Delta to Omicron took place as there were hundreds of thousands of people infected with Delta virus and the chance of creation of mutations increased with time. Omicron has a higher transmission rate and there could be many more variants that we have to face with and already a sub-variant has surfaced.
The changeover to Omicron has happened but the numbers are low because we don’t have enough facilities to do genomic sequencing to identify the variants. It is only the Sri Jayewardenepura University that has such facilities and not even the MRI seem to be having a facility to do these investigations. This is a wake-up call to our policymakers to have proper laboratories in the country and that is to have at least one laboratory each in the North, South and Central provinces. The Western Province could be covered by the Sri Jayewardenepura University laboratory. It is a pity that no one seems to care to improve the facilities at their own laboratories. I remember meeting Prof. Sirimali Fernando the architect of this Sri Jayewardenepura university Immunology and Molecular Medicine Unit around 15 years ago when she came to see me with Professor Malavige, then a lecturer, most probably, to tell me that the dengue virus had changed to D-3 and that an epidemic was imminent as people didn’t have immunity against the D-3 virus. What I understood was that the Ministry of Health or the Epidemiology Unit were not interested in that and someone had told them to tell me. I took that seriously and started to carry out prevention and control measures. I started to improve laboratory facilities and we had a top-class laboratory then carrying out 53 types of investigations, basically helping the urban poor to get costly laboratory tests done free of charge. We were the first government laboratory to have NS1 test to identify dengue infections. Today, sad to say our laboratory network at the CMC is almost non-existent and there in no proper City Microbiologist in place and the City Analyst unit, too, was without work and hardly any work was done under the Food Act. It is interesting to note that the City Microbiological Laboratory staff are not at all involved in PCR or antigen testing when there is a global epidemic taking place, although it is a Public Health Laboratory where the plague carrier, a flea, was identified around 1918. In the past few years, it had been a difficult task to even get the much-needed chemicals to run the laboratories. The testing of food and water was stopped while such work in other cities and countries in the world are improving. We are going backwards in laboratory investigations, the regulatory work has suffered immensely, and I think we were better off 50 years ago compared with the situation in those countries then. So, forget about finding new variants on time and taking preventive measures like in advanced and not so advanced countries, as we cannot even run a normal laboratory today and provide the needed information to the patients as well as the authorities.
It is a known fact that hospitalisations and visits to clinics by patients amount to only 10% of the total number of patients suffering from a communicable disease. So, when we say there are 1185 patients on a single day now that means our daily total could be as much as 11800! This figure could be more as many of the patients don’t have symptoms as in any other communicable diseases. When one analyses the figures given out by the Ministry of Ministry of Health daily there is an increase of 5-10% of patients and therefore It is obvious that Omicron is in the community and is spreading rapidly. The hospital beds are full and ICU units are running almost at full capacity. Although Omicron is not a killer as such, compared with the Delta variant, the numbers are high and it seems those not vaccinated with the three doses that the government provided free of charge are the ones who have got the full-blown disease. The deaths due to Covid are also climbing slowly and silently and it is expected that by March we will have a break or make situation. Much depends on the vaccinated numbers and I hope the people will realise that they are helping not only themselves but also the society.
Take for example the covid-19 situations in the UK and Australia and compare them with our situation where the spread is mainly due to the Omicron variant. The UK is experiencing the winter season, Australia the summer and in Sri Lanka we are experiencing a dry hot weather. Earlier it was cold and rainy in December here in our country. On the 12th of December, 2021 the UK registered 48,000 patients for the day. Then the numbers rose sharply within three weeks and rose to reach 218,000 on 4th January 2022. That is more than a four-fold increase! Today, the daily number has gone down to 92,000 but it is still high. Now UK’s population is three times that of Sri Lanka. Take Australia a country with a population just above our country. They had just 1843 new patients on that day, 12th December 2021. By 12th January 2022 the number of new cases for the day peaked at 175,000. By the 3rd February 2022, the numbers had come down to 32,000. During this period what were the numbers here in Sri Lanka? On 12th December 2021 we had just 714 new patients for the day. By 9th January the number of cases went down to 430 and then started to gradually go up and by the 3rd of February, 2022, we had 1183. Compared with the numbers in December 2021 this is almost a three-fold increase. But then why are our numbers so low? Very few people get themselves tested for the Covid-19 virus. The laboratory facilities are difficult to get at. The private sector charges exorbitant prices. So, many wait at home, some use Ayurvedic remedies, but others go to work with the runny nose, sore throat, fever, etc. Of course, they check the temperatures at the entrances but the machines are never calibrated. The workers with the infections hide behind the masks and no one knows whether they are infected or not. There is no social distancing at work.This is so even in medical facilities. There are no proper awareness programmes even in the cities. Parties, demonstrations and meetings are held involving hundreds of people disregarding that we might have an imminent outbreak of Omicron here in the country.
What will happen in the near future? My guess is that there will be a sharp increase in the number of patients during the next few weeks and this will go on till the April holidays. The numbers will not be that high like in Aussie land or the UK due to the hot and dry weather conditions that we experience and also as many of the infected citizens will be not going to a medical facility for treatment or a laboratory for testing and we will not know the exact numbers anyway.
The country should not be locked-down at any cost and people should learn to live with it and at the same time take precautions. The tourism industry has just picked up and statistics show that hardly a tourist is infected with Covid-19 according to PCR tests although the southern coastal line has a large number of infected persons. I think it is the local tourists from Colombo and suburbs that travel to the southern areas that take the disease with them. There should be an increased awareness created among people by using the electronic media to get people’s attention to the need of taking preventive measures and staying put if they have the disease.
All government institutions and the private sector as well should first ask their staff members to get fully vaccinated as they deal with first their own members of staff and then the outsiders or customers. They should ask the staff members to keep away from work if they have a runny nose, sore-throat headache etc. The heads of these institutions should see that no infected persons come to work as bringing in one person with the virus can infect all in one division especially, when they work in a closed air-conditioned room or a hall. In each division a health officer should be appointed to check whether any infected person has come to work. If there are many persons down with covid-19 then all should undergo antigen testing. I think it is better if the government informs these institutions to keep the staff levels at work to 50-70 % during the next few weeks and watch the situation. I am totally against road-side antigen testing as that is trying to find a needle in a haystack. It is better to use the same resources to find the infected people in high-risk institutions and offices which will be more productive.
CMC which is spearheading the covid-19 control campaign should start with their own organization first and put the house in order at the Town Hall as a large number of patients are found there. Colombo and suburbs are the most important areas that the government should concentrate in the vaccination drive as almost all the communicable diseases are spread to other areas from the above areas. Take the month of January this year, out of the 200 dengue fever patients in Colombo District, the Colombo Municipality area has 166 patients. Unlike Delta Omicron infected persons’ lungs will be less affected but then if one is over 60 years of age there could be complications. Therefore, booster vaccinations are a must and the service should be taken to the people and not expectT hem to come to the centers.
So, a massive awareness campaign coupled with an intensive vaccination drive that can cover at least 80% of the eligible persons in the next few weeks will slow down the spread of Omicron variant. Government statistics show that 16.7 million persons were given the first dose of the vaccine, 14 million the second dose but only 5.6 million the third dose showing the decline in interest of citizens to get the vaccine. If this will continue the disease will rapidly spread and the numbers will be high and new variants will emerge. In that case we will have to wait it out while doing our normal day to day work risking our lives until 80% of the population has either got the disease or vaccinated to stop Covid-19. If one wishes to take the risk and not get vaccinated then it is that person’s right. But they have no right to infect others. So be conscientious and think of others, get the vaccines and all will be well.
Features
Trump’s Interregnum
Trump is full of surprises; he is both leader and entertainer. Nearly nine hours into a long flight, a journey that had to U-turn over technical issues and embark on a new flight, Trump came straight to the Davos stage and spoke for nearly two hours without a sip of water. What he spoke about in Davos is another issue, but the way he stands and talks is unique in this 79-year-old man who is defining the world for the worse. Now Trump comes up with the Board of Peace, a ticket to membership that demands a one-billion-dollar entrance fee for permanent participation. It works, for how long nobody knows, but as long as Trump is there it might. Look at how many Muslim-majority and wealthy countries accepted: Saudi Arabia, Turkey, Egypt, Jordan, Qatar, Pakistan, Indonesia, and the United Arab Emirates are ready to be on board. Around 25–30 countries reportedly have already expressed the willingness to join.
The most interesting question, and one rarely asked by those who speak about Donald J. Trump, is how much he has earned during the first year of his second term. Liberal Democrats, authoritarian socialists, non-aligned misled-path walkers hail and hate him, but few look at the financial outcome of his politics. His wealth has increased by about three billion dollars, largely due to the crypto economy, which is why he pardoned the founder of Binance, the China-born Changpeng Zhao. “To be rich like hell,” is what Trump wanted. To fault line liberal democracy, Trump is the perfect example. What Trump is doing — dismantling the old façade of liberal democracy at the very moment it can no longer survive — is, in a way, a greater contribution to the West. But I still respect the West, because the West still has a handful of genuine scholars who do not dare to look in the mirror and accept the havoc their leaders created in the name of humanity.
Democracy in the Arab world was dismantled by the West. You may be surprised, but that is the fact. Elizabeth Thompson of American University, in her book How the West Stole Democracy from the Arabs, meticulously details how democracy was stolen from the Arabs. “No ruler, no matter how exalted, stood above the will of the nation,” she quotes Arab constitutional writing, adding that “the people are the source of all authority.” These are not the words of European revolutionaries, nor of post-war liberal philosophers; they were spoken, written and enacted in Syria in 1919–1920 by Arab parliamentarians, Islamic reformers and constitutionalists who believed democracy to be a universal right, not a Western possession. Members of the Syrian Arab Congress in Damascus, the elected assembly that drafted a democratic constitution declaring popular sovereignty — were dissolved by French colonial forces. That was the past; now, with the Board of Peace, the old remnants return in a new form.
Trump got one thing very clear among many others: Western liberal ideology is nothing but sophisticated doublespeak dressed in various forms. They go to West Asia, which they named the Middle East, and bomb Arabs; then they go to Myanmar and other places to protect Muslims from Buddhists. They go to Africa to “contribute” to livelihoods, while generations of people were ripped from their homeland, taken as slaves and sold.
How can Gramsci, whose 135th birth anniversary fell this week on 22 January, help us escape the present social-political quagmire? Gramsci was writing in prison under Mussolini’s fascist regime. He produced a body of work that is neither a manifesto nor a programme, but a theory of power that understands domination not only as coercion but as culture, civil society and the way people perceive their world. In the Prison Notebooks he wrote, “The crisis consists precisely in the fact that the old world is dying and the new cannot be born; in this interregnum a great variety of morbid phenomena appear.” This is not a metaphor. Gramsci was identifying the structural limbo that occurs when foundational certainties collapse but no viable alternative has yet emerged.
The relevance of this insight today cannot be overstated. We are living through overlapping crises: environmental collapse, fragmentation of political consensus, erosion of trust in institutions, the acceleration of automation and algorithmic governance that replaces judgment with calculation, and the rise of leaders who treat geopolitics as purely transactional. Slavoj Žižek, in his column last year, reminded us that the crisis is not temporary. The assumption that history’s forward momentum will automatically yield a better future is a dangerous delusion. Instead, the present is a battlefield where what we thought would be the new may itself contain the seeds of degeneration. Trump’s Board of Peace, with its one-billion-dollar gatekeeping model, embodies this condition: it claims to address global violence yet operates on transactional logic, prioritizing wealth over justice and promising reconstruction without clear mechanisms of accountability or inclusion beyond those with money.
Gramsci’s critique helps us see this for what it is: not a corrective to global disorder, but a reenactment of elite domination under a new mechanism. Gramsci did not believe domination could be maintained by force alone; he argued that in advanced societies power rests on gaining “the consent and the active participation of the great masses,” and that domination is sustained by “the intellectual and moral leadership” that turns the ruling class’s values into common sense. It is not coercion alone that sustains capitalism, but ideological consensus embedded in everyday institutions — family, education, media — that make the existing order appear normal and inevitable. Trump’s Board of Peace plays directly into this mode: styled as a peace-building institution, it gains legitimacy through performance and symbolic endorsement by diverse member states, while the deeper structures of inequality and global power imbalance remain untouched.
Worse, the Board’s structure, with contributions determining permanence, mimics the logic of a marketplace for geopolitical influence. It turns peace into a commodity, something to be purchased rather than fought for through sustained collective action addressing the root causes of conflict. But this is exactly what today’s democracies are doing behind the scenes while preaching rules-based order on the stage. In Gramsci’s terms, this is transformismo — the absorption of dissent into frameworks that neutralize radical content and preserve the status quo under new branding.
If we are to extract a path out of this impasse, we must recognize that the current quagmire is more than political theatre or the result of a flawed leader. It arises from a deeper collapse of hegemonic frameworks that once allowed societies to function with coherence. The old liberal order, with its faith in institutions and incremental reform, has lost its capacity to command loyalty. The new order struggling to be born has not yet articulated a compelling vision that unifies disparate struggles — ecological, economic, racial, cultural — into a coherent project of emancipation rather than fragmentation.
To confront Trump’s phenomenon as a portal — as Žižek suggests, a threshold through which history may either proceed to annihilation or re-emerge in a radically different form — is to grasp Gramsci’s insistence that politics is a struggle for meaning and direction, not merely for offices or policies. A Gramscian approach would not waste energy on denunciation alone; it would engage in building counter-hegemony — alternative institutions, discourses, and practices that lay the groundwork for new popular consent. It would link ecological justice to economic democracy, it would affirm the agency of ordinary people rather than treating them as passive subjects, and it would reject the commodification of peace.
Gramsci’s maxim “pessimism of the intellect, optimism of the will” captures this attitude precisely: clear-eyed recognition of how deep and persistent the crisis is, coupled with an unflinching commitment to action. In an age where AI and algorithmic governance threaten to redefine humanity’s relation to decision-making, where legitimacy is increasingly measured by currency flows rather than human welfare, Gramsci offers not a simple answer but a framework to understand why the old certainties have crumbled and how the new might still be forged through collective effort. The problem is not the lack of theory or insight; it is the absence of a political subject capable of turning analysis into a sustained force for transformation. Without a new form of organized will, the interregnum will continue, and the world will remain trapped between the decay of the old and the absence of the new.
by Nilantha Ilangamuwa ✍️
Features
India, middle powers and the emerging global order
Designed by the victors and led by the US, its institutions — from the United Nations system to Bretton Woods — were shaped to preserve western strategic and economic primacy. Yet despite their self-serving elements, these arrangements helped maintain a degree of global stability, predictability and prosperity for nearly eight decades. That order is now under strain.
This was evident even at Davos, where US President Donald Trump — despite deep differences with most western allies — framed western power and prosperity as the product of a shared and “very special” culture, which he argued must be defended and strengthened. The emphasis on cultural inheritance, rather than shared rules or institutions, underscored how far the language of the old order has shifted.
As China’s rise accelerates and Russia grows more assertive, the US appears increasingly sceptical of the very system it once championed. Convinced that multilateral institutions constrain American freedom of action, and that allies have grown complacent under the security umbrella, Washington has begun to prioritise disruption over adaptation — seeking to reassert supremacy before its relative advantage diminishes further.
What remains unclear is what vision, if any, the US has for a successor order. Beyond a narrowly transactional pursuit of advantage, there is little articulation of a coherent alternative framework capable of delivering stability in a multipolar world.
The emerging great powers have not yet filled this void. India and China, despite their growing global weight and civilisational depth, have largely responded tactically to the erosion of the old order rather than advancing a compelling new one. Much of their diplomacy has focused on navigating uncertainty, rather than shaping the terms of a future settlement. Traditional middle powers — Japan, Germany, Australia, Canada and others — have also tended to react rather than lead. Even legacy great powers such as the United Kingdom and France, though still relevant, appear constrained by alliance dependencies and domestic pressures.
st Asia, countries such as Saudi Arabia and the UAE have begun to pursue more autonomous foreign policies, redefining their regional and global roles. The broader pattern is unmistakable. The international system is drifting toward fragmentation and narrow transactionalism, with diminishing regard for shared norms or institutional restraint.
Recent precedents in global diplomacy suggest a future in which arrangements are episodic and power-driven. Long before Thucydides articulated this logic in western political thought, the Mahabharata warned that in an era of rupture, “the strong devour the weak like fish in water” unless a higher order is maintained. Absent such an order, the result is a world closer to Mad Max than to any sustainable model of global governance.
It is precisely this danger that Canadian Prime Minister Mark Carney alluded to in his speech at Davos on Wednesday. Warning that “if great powers abandon even the pretense of rules and values for the unhindered pursuit of their power and interests, the gains from transactionalism will become harder to replicate,” Carney articulated a concern shared by many middle powers. His remarks underscored a simple truth: Unrestrained power politics ultimately undermine even those who believe they benefit from them.
Carney’s intervention also highlights a larger opportunity. The next phase of the global order is unlikely to be shaped by a single hegemon. Instead, it will require a coalition — particularly of middle powers — that have a shared interest in stability, openness and predictability, and the credibility to engage across ideological and geopolitical divides. For many middle powers, the question now is not whether the old order is fraying, but who has the credibility and reach to help shape what comes next.
This is where India’s role becomes pivotal. India today is no longer merely a balancing power. It is increasingly recognised as a great power in its own right, with strong relations across Europe, the Indo-Pacific, West Asia, Africa and Latin America, and a demonstrated ability to mobilise the Global South. While India’s relationship with Canada has experienced periodic strains, there is now space for recalibration within a broader convergence among middle powers concerned about the direction of the international system.
One available platform is India’s current chairmanship of BRICS — if approached with care. While often viewed through the prism of great-power rivalry, BRICS also brings together diverse emerging and middle powers with a shared interest in reforming, rather than dismantling, global governance. Used judiciously, it could complement existing institutions by helping articulate principles for a more inclusive and functional order.
More broadly, India is uniquely placed to convene an initial core group of like-minded States — middle powers, and possibly some open-minded great powers — to begin a serious conversation about what a new global order should look like. This would not be an exercise in bloc-building or institutional replacement, but an effort to restore legitimacy, balance and purpose to international cooperation. Such an endeavour will require political confidence and the willingness to step into uncharted territory. History suggests that moments of transition reward those prepared to invest early in ideas and institutions, rather than merely adapt to outcomes shaped by others.
The challenge today is not to replicate Bretton Woods or San Francisco, but to reimagine their spirit for a multipolar age — one in which power is diffused, interdependence unavoidable, and legitimacy indispensable. In a world drifting toward fragmentation, India has the credibility, relationships and confidence to help anchor that effort — if it chooses to lead.
(The Hindustan Times)
(Milinda Moragoda is a former Cabinet Minister and diplomat from Sri Lanka and founder of the Pathfinder Foundation, a strategic affairs think tank. this article can read on
https://shorturl.at/HV2Kr and please contact via email@milinda.org)
by Milinda Moragoda ✍️
For many middle powers, the question now is not whether the old order is fraying,
but who has the credibility and reach to help shape what comes next
Features
The Wilwatte (Mirigama) train crash of 1964 as I recall
Back in 1964, I was working as DMO at Mirigama Government Hospital when a major derailment of the Talaimannar/Colombo train occurred at the railway crossing in Wilwatte, near the DMO’s quarters. The first major derailment, according to records, took place in Katukurunda on March 12, 1928, when there was a head-on collision between two fast-moving trains near Katukurunda, resulting in the deaths of 28 people.
Please permit me to provide details concerning the regrettable single train derailment involving the Talaimannar Colombo train, which occurred in October 1964 at the Wilwatte railway crossing in Mirigama.
This is the first time I’m openly sharing what happened on that heartbreaking morning, as I share the story of the doctor who cared for all the victims. The Health Minister, the Health Department, and our community truly valued my efforts.
By that time, I had qualified with the Primary FRCS and gained valuable surgical experience as a registrar at the General Hospital in Colombo. I was hopeful to move to the UK to pursue the final FRCS degree and further training. Sadly, all scholarships were halted by Hon. Felix Dias Bandaranaike, the finance minister in the Bandaranaike government in 1961.
Consequently, I was transferred to Mirigama as the District Medical Officer in 1964. While training as an emerging surgeon without completing the final fellowship in the United Kingdom, I established an operating theatre in one of the hospital’s large rooms. A colleague at the Central Medical Stores in Maradana assisted me in acquiring all necessary equipment for the operating theatre, unofficially. Subsequently, I commenced performing minor surgeries under spinal anaesthesia and local anaesthesia. Fortunately, I was privileged to have a theatre-trained nursing sister and an attendant trainee at the General Hospital in Colombo.
Therefore, I was prepared to respond to any accidental injuries. I possessed a substantial stock of plaster of Paris rolls for treating fractures, and all suture material for cuts.
I was thoroughly prepared for any surgical mishaps, enabling me to manage even the most significant accidental incidents.
On Saturday, October 17, 1964, the day of the train derailment at the railway crossing at Wilwatte, Mirigama, along the Main railway line near Mirigama, my house officer, Janzse, called me at my quarters and said, “Sir, please come promptly; numerous casualties have been admitted to the hospital following the derailment.”
I asked him whether it was an April Fool’s stunt. He said, ” No, Sir, quite seriously.
I promptly proceeded to the hospital and directly accessed the operating theatre, preparing to attend to the casualties.
Meanwhile, I received a call from the site informing me that a girl was trapped on a railway wagon wheel and may require amputation of her limb to mobilise her at the location along the railway line where she was entrapped.
My theatre staff transported the surgical equipment to the site. The girl was still breathing and was in shock. A saline infusion was administered, and under local anaesthesia, I successfully performed the limb amputation and transported her to the hospital with my staff.
On inquiring, she was an apothecary student going to Colombo for the final examination to qualify as an apothecary.
Although records indicate that over forty passengers perished immediately, I recollect that the number was 26.
Over a hundred casualties, and potentially a greater number, necessitate suturing of deep lacerations, stabilisation of fractures, application of plaster, and other associated medical interventions.
No patient was transferred to Colombo for treatment. All casualties received care at this base hospital.
All the daily newspapers and other mass media commended the staff team for their commendable work and the attentive care provided to all casualties, satisfying their needs.
The following morning, the Honourable Minister of Health, Mr M. D. H. Jayawardena, and the Director of Health Services, accompanied by his staff, arrived at the hospital.
I did the rounds with the official team, bed by bed, explaining their injuries to the minister and director.
Casualties expressed their commendation to the hospital staff for the care they received.
The Honourable Minister engaged me privately at the conclusion of the rounds. He stated, “Doctor, you have been instrumental in our success, and the public is exceedingly appreciative, with no criticism. As a token of gratitude, may I inquire how I may assist you in return?”
I got the chance to tell him that I am waiting for a scholarship to proceed to the UK for my Fellowship and further training.
Within one month, the government granted me a scholarship to undertake my fellowship in the United Kingdom, and I subsequently travelled to the UK in 1965.
On the third day following the incident, Mr Don Rampala, the General Manager of Railways, accompanied by his deputy, Mr Raja Gopal, visited the hospital. A conference was held at which Mr Gopal explained and demonstrated the circumstances of the derailment using empty matchboxes.
He explained that an empty wagon was situated amid the passenger compartments. At the curve along the railway line at Wilwatte, the engine driver applied the brakes to decelerate, as Mirigama Railway Station was only a quarter of a mile distant.
The vacant wagon was lifted and transported through the air. All passenger compartments behind the wagon derailed, whereas the engine and the frontcompartments proceeded towards the station without the engine driver noticing the mishap.
After this major accident, I was privileged to be invited by the General Manager of the railways for official functions until I left Mirigama.
The press revealed my identity as the “Wilwatte Hero”.
This document presents my account of the Wilwatte historic train derailment, as I distinctly recall it.
Recalled by Dr Harold Gunatillake to serve the global Sri Lankan community with dedication. ✍️
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