By Priyanka Jayawardena
Like many other countries, Sri Lanka faces numerous challenges in the battle against COVID-19. The pandemic has caused deep uncertainty and presented a colossal challenge for the country’s healthcare system. With the rapid increase in cases and the emergence of new variants, Sri Lanka began to face shortages of medical resources, including hospital beds and medical equipment.
The vaccination programme was beset with a host of problems early on due to the irregular and inconsistent supply of vaccines, disorganised deployment and deviation from the scientifically agreed prioritisation. There was also alleged misreporting of COVID-19 daily statistics in the Gampaha district and Eastern Province. The absence of real-time data acted as a hindrance to obtain a reliable risk assessment in the country. Against this backdrop, this blog examines the gaps in the ongoing pandemic control programme and outlines ways to bridge these gaps so that more lives could be saved from COVID-19.
COVID-19 Vaccination Programme
By mid-August 2021, more than 12 million Sri Lankans (55% of the population) had been vaccinated with at least the first dose. Other than the delayed supply of vaccines, there were issues related to getting approval for vaccine use and the vaccination prioritisation process. Moreover, many people were seen queuing up at vaccination centres aggravating health risks due to the lack of a properly planned system for vaccine deployment and the lack of an online appointment system. More recently, the government has taken several measures to improve the rollout, including expediting the procurement process and improving administration with the support of the defence services.
Gaps in Pandemic Control
Sri Lanka’s rate of COVID-19 screening has remained inadequate to prevent the spread of the virus. Systematic surveillance is crucial for the rapid identification and detection of suspected COVID-19 cases. With newer variants found to be more transmissible and deadlier, there is a need to identify mutants and track the nature of transmission. Currently, the University of Sri Jayewardenepura is the only institution equipped with laboratory facilities to conduct genomic sequencing to identify new variants.
Countries like Singapore, New Zealand and Australia systematically monitor the pandemic through extensive testing and contact tracing. These countries are conducting 10-100 times more tests than other countries with a similar number of new confirmed cases. Sri Lanka’s extent of testing relative to the scale of the outbreak (positive rate was around 10%), is on par with Thailand and Malaysia but lower than India, Vietnam and Cambodia where the positive rate is below 5%.
Further, a major challenge to the existing healthcare system is inadequate ICU beds, ventilators, oxygen supplies and other necessities required to care for patients with severe respiratory failure. The availability of ICU capacity plays a crucial role in critical cases, and constant and uninterrupted availability of oxygen supplied beds is needed to avert a disaster. Currently, less than 200 ICU beds are in isolation units for patients with severe COVID-19 symptoms, whereas just around 700 ICU beds are available in the hospital system of the entire country.
Equally, it is vital to have timely access to real-time data so that meaningful insights can be drawn but due to capacity constraints and administrative issues, PCR test results are reported to be delayed. In some districts, the delays are said to be longer than one week. Thus, delays in generating test results are a grave concern and represent a major obstacle in the COVID-19 control process. There is a growing need for immediate and accessible healthcare and digital healthcare resources to effectively respond to the challenges posed by COVID-19. However, Sri Lanka’s health information systems are weak and under-funded and the lack of an adequate central health database and IT infrastructure has hampered digital health services.
Towards a Stronger Healthcare Response
The healthcare system has to be streamlined to ensure a successful vaccination deployment and a smooth inoculation programme with online appointments including over the phone appointment facilities. Parallel to an efficient vaccination programme, an enhanced screening capacity is needed for the rapid identification of COVID-19 cases. Sri Lanka’s overall COVID-19 screening capacity remains low; therefore, expanding testing and increasing the health sector’s capacity to identify new mutants is vital to curb the pandemic. Random PCR testing too must be carried out in densely populated areas which are prone to be contagious, thereby taking additional precautionary measures.
There is a growing concern about the availability of medical supplies in emergency contexts. Sri Lanka has to effectively leverage its limited resources in response to the pandemic. The crisis response has seen local innovation in the manufacturing of ICU beds and lab consumables and there is further scope to encourage local enterprise and innovation for this purpose. For instance, a team of Sri Lankan scientists recently invented a new PCR test kit using NANO technology, which is said to drastically reduce the testing time from two hours to half an hour. There is now an opportunity to encourage local innovation and local production through such efforts, where they contribute to efficiency gains.
Furthermore, a robust laboratory strategy, which includes laboratory networking, communicating real-time information on COVID-19, quality assurance and adequate workforce capacity is important for rapid detection and case management. South Korea, for example, practised the disclosure of real-time information on COVID-19 by the government via dedicated websites, mass media, phone messages and mobile apps. Digitalisation of healthcare and effective use of technology for sharing real-time data, contact tracing and surveillance and coordinating the efficient use of clinical resources are vital for successful pandemic control. It is also necessary to improve systems to manage real-time data and decision-support systems. Improved functional integration and coordination in treatment centres and laboratory services bring in many benefits.
*This blog is based on the comprehensive chapter on “Coping with Pandemics: Sri Lanka’s Healthcare System” in IPS’ forthcoming ‘Sri Lanka: State of the Economy 2021’ report.
Link to original blog: https://www.ips.lk/talkingeconomics/2021/09/02/bridging-the-gaps-the-covid-19-crisis-and-sri-lankas-healthcare-response/
Priyanka Jayawardena is a Research Economist at the Institute of Policy Studies. Her research interests include education and skills development, labour economics, inequality analysis, health economics and child nutrition. She holds a BSc (Hon) in Statistics and an MA in Economics from the University of Colombo, Sri Lanka. (Talk to Priyanka – firstname.lastname@example.org)
SLT-MOBITEL donates fourth PCR machine to Matara District Hospital
Recognising the importance to enhance Sri Lanka’s PCR testing capacity to curtail the spread of COVID-19 and to protect citizens, SLT-MOBITEL continues its support by donating yet another vital PCR machine to the District General Hospital in Matara recently.
The donation of the PCR machine valued at over Rs. 5.7 million is part of SLT-MOBITEL’s ‘Sabandiyawe Sathakaraya’ CSR initiative in further strengthening the nation’s healthcare systems and assisting communities in need.
The equipment was handed over to the Deputy Director of the Matara Hospital Doctor Upali Rathnayaka in the presence of Rohan Fernando, Group Chairman, SLT-MOBITEL; Lalith Seneviratne, Group Chief Executive Officer, SLT-MOBITEL; Kiththi Perera, CEO, SLT; Shashika Senarath, CMO, Mobitel along with Regional GM, SLT; Regional Head – Mobitel and Hospital Staff.
Previously, PCR machines were donated to the Base Hospital, Karawanella, District General Hospital, Matale and the University Hospital of the Kotelawala Defense University. SLT-MOBITEL appreciates the support received from all Sri Lankans towards ‘Daana Paaramitha’ which was conceptualized as a platform to further increase community involvement in carrying out relief efforts to support families affected by the pandemic.
Extension of lockdown negatively impacts CSE
By Hiran H. Senewiratne
CSE trading activities commenced yesterday in a lacklustre manner with little share-buying interest and later on became negative following the government’s announcement on the lockdown extension until October 1, stock market analysts said.
The Colombo International Financial Centre (CIFC) at the Port City was set to commence this month and has been delayed until December owing to the current Covid 19 situation. This also affected CSE trading activities yesterday, analysts said.
Consequently, the stock market lost steam yesterday, closing on a negative note as investor sentiment remained erratic due to internal and external environmental factors. Both indices moved downwards or to negative territory despite healthy turnover in the market. The All Share Price Index went down by 46.09 points and S and P SL20 declined by 17.93 points. Turnover stood at Rs. 3.8 billion with two crossings. Those crossings were reported in Expolanka, where 600,000 shares crossed for Rs. 101.1 million, its shares trading at Rs. 158.50 and Sampath Bank one million shares crossed for Rs. 49.5 million, its shares traded at Rs. 49.50.
In the retail market, some companies that mainly contributed to the turnover were; Expolanka Holdings Rs. 1.2 billion (7.4 million shares traded), JKH Rs. 604 million (4.6 million shares traded), Browns Investments Rs. 540 million (58.3 million shares traded) and Hayleys Rs. 204 million (2 million shares traded).
It is said that following two sessions of gains, the indices closed in the red due to price declines in large-cap stocks as investors opted to book modest returns after the recent sharp rally. Stocks such as Expo, LOLC, and JKH, which saw sharp gains in the past two sessions witnessed profit-taking at higher levels and weighed on the momentum throughout the session.
Further, high net worth and institutional investor participation was noted in Sampath Bank. Mixed interest was observed in Expolanka Holdings, Tokyo Cement Company and LOLC Holdings, while retail interest was noted in Browns Investments, Lanka Orix Finance and Industrial Asphalts. During the day 153 million share volumes changed hands in 24000 transactions.
As of yesterday, the current exchange rate of 1 US dollar was equal to 199.607 Sri Lankan rupees. This is an increase of 7.856656 percent (or +14.5401 LKR) compared with the same time last year (17 September 2020), when 1 US dollar equaled 185.067 Sri Lankan rupees.
Lockdown takes toll on Sri Lanka’s manufacturing sector activities
The resurgence of the COVID-19 pandemic in August 2021 has slowed down the manufacturing activities in the country. Accordingly, the manufacturing PMI recorded an index value of 45.1 in August 2021 with a fall of 12.7 index points from the previous month, mainly driven by the decrease in New Orders, Production, Employment, and Stock of Purchases sub-indices. The decline in New Orders and Production, especially in the manufacture of food & beverages, furniture, and textiles & wearing apparel sectors, have mainly contributed to the overall decrease of the manufacturing PMI. Many respondents in those sectors highlighted that their local orders and distribution channels were affected due to the lockdown imposed as a measure of containing the pandemic. Further, many of them also emphasised that factory operations were disrupted due to the spread of the COVID-19 virus among employees. Employment sub-index also declined in line with these developments.
The decrease of Stock of Purchases was in line with the decline in New Orders and Production. Further, the difficulties encountered in placing purchase orders and in settling foreign payments also adversely affected the supply chain of raw materials and production schedules. Many respondents stressed that the continuous increase in the cost of imported raw materials adversely affected their profit margins. Meanwhile, Suppliers’ Delivery Time lengthened at a slower rate in August 2021. The manufacturers cautioned that the uncertainty over the COVID-19 pandemic would continuously hinder the prospects of the manufacturing sector, yet, overall expectations for manufacturing activities for the next three months remained above the neutral threshold.
Services PMI dropped to an index value of 46.2 in August 2021 with the restrictions imposed to contain the further spread of the COVID-19. New Businesses, Business Activity, Employment and Expectations for Activity sub-indices recorded declines. New Businesses decreased in August compared to the previous month mainly with the declines observed in wholesale and retail trade, insurance, real estate, and education sub-sectors. Business Activities across most of the sub-sectors such as, wholesale and retail trade, real estate, insurance and other personal activities reported considerable declines indicating the adverse effects of travel restrictions on their business operations. Nevertheless, transportation sub-sector recorded some improvements solely due to the growth in freight volumes. Moreover, financial services sub-sector also indicated improvements despite the disturbances from travel restrictions. Employment continued to fall at a higher pace as retirements and voluntary resignations exceeded the number of recruitments carried out during the month. Backlogs of Work increased at a higher pace in August along with the reduction in staff availability amid travel restrictions and growing COVID-19 infections of staff. (CBSL)
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