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Opinion

Ivermectin for COVID-19 management

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Prof Saroj Jayasinghe’s candid view, published in The Island of September 17, 2021, on Ivermectin use, both in treatment and prevention of COVID-19, has been based on scientific analysis of multiple meta-analyses on the subject. Therefore, his educated opinion must be viewed with great positivity.

Quite correctly, a doctor has to make decisions in good faith in an emergency situation, where any delay in the commencement of treatment could be disastrous. In a life-threatening condition, the treating doctor has no time to wait and waste until the evidence is available scientifically. Instead, the doctor has to make a decision using his clinical acumen and experience in order to save the life of the patient under his or her care.

Another example is: In an instance where an unconscious patient is brought to the accident and emergency department with life-threatening bleeding after an accident, the treating surgeon has no time to obtain the patient’s informed consent (usually a requirement before any surgical procedure), but to attend to (perform surgery on) the patient in all-good faith, in order to save the life. It may require even the amputation of a leg or hand.

Hence, treating a critically ill patient with Ivermectin is more than justified, particularly in the backdrop of the World Health Organization (WHO) declaring COVID-19 as a public health emergency. Further, under this context, the usage of Ivermectin in the prevention of COVID-19 is quite justified. Since no antiviral drug is available hitherto, its usage is further warranted.

As mentioned, Ivermectin is a time-tested and safe drug with no known serious side effects. The call for its usage in the management of and prevention of COVID-19 is time appropriate.

A veterinary surgeon, Prof Asoka Dangolle of the University of Peradeniya, has also expressed his opinion based on his experience with Ivermectin in mammals. In the current context, the world’s attitude is much in favour of the ‘One Health’ concept.

Therefore, in a helpless situation or pandemic of this nature, the consideration of the use of Ivermectin in all good faith is justifiable.

Prof ANANDA JAYASINGHE

Professor in Community Medicine

University of Peradeniya.



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Opinion

Haphazard demolition in Nugegoda and deathtraps

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A haphazardly demolished building

The proposed expansion of the Kelani Valley railway line has prompted the squatters to demolish the buildings and the above photograph depicts the ad-hoc manner in which a building in the heart of Nugegoda town (No 39 Poorwarama Road) has been haphazardly demolished posing a risk to the general public. Residents say that the live electric wire has not been disconnected and the half-demolished structure is on the verge of collapse, causing inevitable fatal damages.

Over to the Railway Department, Kotte Municipality Ceylon Electricity Board and the Nugegoda Police.

Athula Ranasinghe,

Nugegoda.

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Opinion

Aviation and doctors on Strike

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Crash in Sioux city. Image courtesy Bureau of Aircraft Accident Archies.

On July 19, 1989, United Airlines Flight 232 departed Denver, Colorado for Chicago, Illinois. The forecast weather was fine. Unfortunately, engine no. 2 – the middle engine in the tail of the three-engined McDonnell Douglas DC 10 – suffered an explosive failure of the fan disk, resulting in all three hydraulic system lines to the aircraft’s control surfaces being severed. This rendered the DC-10 uncontrollable except by the highly unorthodox use of differential thrust on the remaining two serviceable engines mounted on the wings.

Consequently, the aircraft was forced to divert to Sioux City, Iowa to attempt an emergency crash landing. But the crew lost control at the last moment and the airplane crashed. Out of a total of 296 passengers and crew, 185 survived.

The National Transportation Safety Board (NTSB) declared after an investigation that besides the skill of the operating crew, one significant factor in the survival rate was that hospitals in proximity to the airport were experiencing a change of shifts and therefore able to co-opt the outgoing and incoming shift workers to take over the additional workload of attending to crash victims.

One wonders what would have happened if an overflying aircraft diverted to MRIA-Mattala, BIA-Colombo, Colombo International Airport Ratmalana (CIAR) or Palaly Airport, KKS during the doctors’ strike in the 24 hours starting March 12, 2025? Would the authorities have been able to cope? International airlines (over a hundred a day) are paying in dollars to overfly and file Sri Lankan airports as en route alternates (diversion airports).

Doctors in hospitals in the vicinity of the above-named international airports cannot be allowed to go on strike, and their services deemed essential. Even scheduled flights to those airports could be involved in an accident, with injured passengers at risk of not receiving prompt medical attention.

The civil aviation regulator in this country seems to be sitting fat, dumb, and happy, as we say in aviation.

Guwan Seeya

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Opinion

HW Cave saw Nanu Oya – Nuwara rail track as “exquisite”

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Plans to resurrect the Nanu Oya – Nuwara Eliya rail track are welcome. The magnificent views from the train have been described by H W Cave in his book The Ceylon Government Railway (1910):

‘The pass by which Nuwara Eliya is reached is one of the most exquisite things in Ceylon. In traversing its length, the line makes a further ascent of one thousand feet in six miles. The curves and windings necessary to accomplish this are the most intricate on the whole railway and frequently have a radius of only eighty feet. On the right side of the deep mountain gorge we ascend amongst the tea bushes of the Edinburgh estate, and at length emerge upon a road, which the line shares with the cart traffic for about a mile. In the depths of the defile flows the Nanuoya river, foaming amongst huge boulders of rock that have descended from the sides of the mountains, and bordered by tree ferns, innumerable and brilliant trees of the primeval forest which clothe the face of the heights. In this land of no seasons their stages of growth are denoted by the varying tints of scarlet, gold, crimson, sallow green, and most strikingly of all, a rich claret colour, the chief glory of the Keena tree’.

However, as in colonial times, the railway should be available for both tourists and locals so that splendid vista can be enjoyed by all.

Dr R P Fernando
Epsom,
UK

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