Lift ‘Lockdown’ – Open economic activities

by Dr. Pradeep Kariyawasam
Former Chief Medical Officer of Health, Colombo

Most citizens will wonder why I am asking for the lifting of the so-called ‘Lockdown’ now when Health Authorities continue to reiterate that we are not yet out of the woods. Health is a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity, says the World Health Organization (WHO). Even during the current COVID-19 pandemic, while we are striving to eliminate this dreaded disease, it is a valid statement: It is ‘Health for all’ and not only for a group of people in our society, divided by religion, race, caste and societal status.

I had mentioned in a previous letter that a week-long island-wide curfew would have met the same target we have achieved with this type of Lockdown, during the past month or so. This Lockdown will not severely affect government servants, as most of them are at home, and every month, whether they work or not, their salary gets deposited in their bank accounts. In the private sector, a large number who worked in smaller enterprises have lost their jobs in the last two years. Similarly, a large number of vendors and small business holders have lost their income and closed down their businesses or are gasping for breath after 18 months of agony, trying to survive. What about the daily wage earners? Most of them may not be recipients of any social benefit and may not have any savings; to them, surviving is out of the question if this lockdown continues, as they are the people who suffer most from these closures. Some have resorted to begging by the roadside, others are going from house to house asking whether there are any household chores they could do for a few hundred rupees; but who wants to invite anyone to their homes these days!

I believe that except for the rich and upper-middle-class, all the others in this country have suffered a lot during the last one and half years, and they make up the vast majority of this country. Consequently, the physical, social and mental wellbeing of Lankans has suffered immensely, and needless to say, they are sick if we follow the definition of the WHO, and in that case, the vast majority in this country are sick!

Even with this kind of a mild lockdown, which looks like it is only affecting the lower rungs of our society, the number of infected and deaths due to COVID-19 goes down with each passing day. The rich and powerful carried out their activities without any hindrance, evident by the number of vehicles on the streets. Some went on vacation, even crossing provincial borders without being stopped, others went to Nuwara-Eliya or Kataragama, or booked hotels to stay there during this period. Indeed, they would not have carried the disease to those areas or brought the disease to Colombo, but the message they give to the ordinary citizen leaves much to be desired. It is due to this kind of behaviour that ordinary citizens in urban areas also roamed the streets during the lockdown, as it was very difficult to be crammed inside small houses or mid-level apartments, where five to six people live in 400 to 500 square feet. Therefore, a lockdown is practically impossible to implement in areas with economic constraints, and the best we could do is to concentrate on such areas when taking preventive action.

Alas, the old tried and tested preventive measure of ensuring community participation in disease control is a thing in the past in Colombo. The breakdown in communication between such communities and the health authorities is alarming, which was the reason for more than 100 deaths at home in Colombo this year. The real numbers should be available with the Epidemiology Unit, but unfortunately, information is not forthcoming and health authorities don’t seem to care. Civil societies and NGOs that took part in these activities physically are not to be seen, and that has contributed immensely to the failure of preventive measures. I have wondered why only tail end COVID-19 prevention activities, such as PCR and antigen testing and quarantining, are being focused on, while no real effort is made to prevent the spread of the disease by carrying out large scale awareness campaigns in vulnerable areas, imposing strict lockdown conditions in areas where new variant outbreaks take place; as it happened in Dematagoda where the spread of the Delta variant started; vaccinating people in vulnerable areas first, looking after their daily needs and putting in place a system to provide emergency relief to such areas.

We could have then stopped the Delta variant from spreading into other areas, and to other parts of the country. I do not understand it when health officials in Colombo say 50 percent of PCR samples are positive for the Delta variant and at the same time say that they have contained the spread of the disease. It is a pity that Colombo city so far has no qualified epidemiologist in their ranks, to analyze data, make proper decisions, and implement prevention and control measures.

The hit, the economy of the country took, is not reversible for a long time to come. We have to get economic activities running again from next week without waiting any longer if we don’t want to hit rock bottom. Factories, shops, bakeries, malls and garages should open under strict health guidelines, and the country should move forward again. How should we do that? Wearing a mask all the time, hand washing, maintaining social distance, not stepping out if one has at least one symptom, are the key to success. For this, every institution and each individual should contribute.

When considering the public service, only 20 percent of staff members should be allowed to report to work on a single day during the next few months, but top officials should report to work daily as otherwise, the system cannot function. This will ensure that at least one day a week everyone will be working. They should be advised to work longer hours on such days and to cover all priority work they are usually assigned. Once they report to work they will have to follow strict health guidelines, and government offices have to issue health protocols and implement the same.

Private sector organisations should also stick to the 20 percent quota of office staff, but factories and stores should be allowed to operate with the full team under strict health protocols. These protocols may vary depending on the functions of each organisation, nature of work carried out and the number of workers. Private transport should be arranged for all staff members, including labourers. This will not be an issue as there must be enough idling school vans due to school closure. Public transport should allocate only 50 percent of seats to passengers, at least for the next three months; and if the number of those who test positive further reduces to less than 1,000 per day, passengers may be accommodated according to the number of seats available, but no more. Shops and small-time trade should be allowed to open with minimum staff, and customers allowed inside should correspond to the floor area; at least a minimum of four to five square metres should be allocated per each customer entering such establishments.

The tourism sector should be allowed to function by getting tourists to travel in bubbles without hindrance and even by restricting access, to destinations of tourism value, for locals for some time. This is a very important measure to improve our economy. The testing facilities at the airport should be improved for locals as well as tourists, to allow the release of PCR test reports before they leave the airport.

No demonstrations, protests, gatherings of more than five people in public place should be allowed for at least the next three months and may be controlled using even emergency regulations. Vaccination programmes should be continued, and perhaps vaccinators can work in shifts to provide this service late into the night. A mobile vaccination drive is desirable in certain areas, rather than getting people to travel long distances and then wait in line. The excellent service rendered by the tri-forces and the police during the vaccination programmes in Colombo must be commended. All children above 12 should be vaccinated with a recognized vaccine, and schools should be reopened at least by November this year. PCR and antigen testing should be done only on those who display symptoms and their contacts, as I believe that carrying out random tests can only give us an estimation of the people who have contracted the disease, and is not an accurate sample of the total population. To achieve the latter, we will have to test all the people in the country within a day or two, but that is not practical. Consequently, random testing is a waste of money, time and resources.

The key to success in this endeavour is discipline. All authorities concerned must ensure that health protocols are followed, the number of meetings and gatherings are kept to a minimum, such activities are not allowed in public places and economic activities are carried out following maximum safety measures. The public must exercise individual responsibility in getting vaccinated not only for the sake of their safety but also for the safety of others, limiting unnecessary travel, looking out for neighbours in their hour of need and helping health personnel to carry out their duties.

There had been complaints against officials about pilfering vaccines and vaccinating for money, charging commissions for PCR testing, allocating certain hotels only for quarantined persons, and lately about playing favourites with funeral parlours when releasing bodies for cremation. These allegations should be inquired into, as there can’t be smoke without fire. We must encourage people to have faith in the ongoing activities, as otherwise, they will also not fall in line. The Delta variant will not be around forever. It will subside but come back one day in another form or variant. However, we should be better prepared to face it next time, by having in place preventive measures and getting all concerned to participate in this endeavour.