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Covid-19 control: The spread of missing links

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Much has been talked and written about how to control the present Covid-19 epidemic in the recent past. The most valuable contributions recently made were from Prof. Malik Peiris and Dr. Kamini Mendis. I too had mentioned some of the concerns they had, with regard to lockdowns covering Grama Sewa Divisions only, and not in larger areas encompassing at least the adjacent Grama Sewa Divisions. People may not move within one area before identification as a Covid positive patient, and they could have travelled to at least the nearby areas while being infected. Then comes the length of the lockdowns. We have to have a minimum of a 14-day lockdown if we want to avoid large graveyards in the country, whether we like it or not, if we want to shorten this third wave.

The third wave happened because we did not close down the country during the April holidays. The ideal time would have been from 10th to the 24th April this year. Usually, many institutions are practically closed down, and there is less economic activity anyway during this period. I am mentioning it because next year we should not say this again, with hindsight that we should have done this, after not doing so. This is a lesson that we learnt the hard way.

Even now we have problems in controlling this epidemic. One thing that is missing is teamwork. Many have ideas but do not come forward with them at the correct forum. There are many at these meetings who do not have an iota of an idea of epidemic control or experience in controlling one. What is in the books do not apply in these situations. I believe that the Task Force should be pruned down, so that only a few people attend it from relevant fields, who will have to come armed with the relevant proposals; as then it is easy to have a proper discussion and make decisions and agree on policies. With regard to other supportive services, there could be a separate meeting to discuss logistics, manpower, funds, etc.

The information about the situation should be simple, so that even a layman could understand, and maps should be available to indicate hotspots, high risk areas, etc., so that timely action could be taken. Information given late, or PCR test results given 2-3 days later, do not help the control teams; as by the time they receive the information to take action, more patients join the queue as they infect more people with time. With regard to information and maps, we should use the services of any competent person if the Epidemiology Unit cannot handle it alone. The GMOA has taken some positive steps in this regard, they have enough resources among their membership, and they should be allowed to work with the Epidemiology Unit to carry out this work. We need more automated PCR systems in the country, because we cannot wait for days to get to know whether a patient is positive or not. Although the initial cost will be high, in the end it will save a lot of money for the country, by lessening the number of patients with Covid-19 in the long run.

There is a debate about whether the disease has spread beyond our control. In epidemiology there is a saying that only 10% of the patients down with a communicable disease are found. In the case of Covid-19, with all these PCR and Antigen tests being done, contact tracing, quarantines in place, I believe we are still missing at least 30-40 % patients. Around 80% patients do not show any symptoms, but they could infect others, but with the present Covid-19 variant it could be less. However, the numbers could be high and they may be never identified unless antibody tests are done. At present, antibody tests are done but only using the patients who come for vaccinations. Manpower is an issue, as the same PHIs, Nurses and Midwives are used for PCR testing and Immunizations. Colombo was shown as being less prone to the present third wave, but yesterday it was found that the Narahenpita area had more than 100 people in a day, perhaps due to PCR testing in that area. I do not know from which areas within that ward they are found, and such information is important for the general public. Similarly, infected areas could be found in Borella, Wanathamulla, Dematagoda, Grandpass, Modera, Mattakkuliya, etc., where population densities are high. Priority in future vaccination programmes should be given to these areas. Similarly, in other cities and townships, such areas should be identified to carry out vaccinations. We need proper planning in place to carry out these actions, and to identify the hotspots. We need the services of personnel who have the necessary knowledge to obtain, collate, analyze and disseminate information not only district-wise, but within major cities too. Unless we do that and provide information to the Task Force or decision-makers, we will not win this battle soon. We do not have a proper people- centered awareness programme for high population density areas, where they might not get the information through radios or TV. Unless we do that, the health messages on the need for wearing a mask, keeping social distance and handwashing will not sink in. Let’s hope some action will be taken to implement the above actions.

 

Dr. PRADEEP KARIYAWASAM

Former Chief Medical Officer of Health

Chairman, Standing Committee on Health/CMC



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Opinion

Happy birthday, Mahinda!

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Mahinda

I wish ex-President Mahinda Rajapaksa a very happy birthday as he achieves another milestone. As he is joining the ranks of octogenarians today, it probably is as good an occasion as any to look back at his achievements, which are many, as well as his failings, which are not insignificant. Although my association with him has not been as close as I would have wished for, it spans more than six decades. Our fathers were close associates of S. W. R. D. Bandaranaike; his father left the UNP with SWRD to form the SLFP, but my father opted to stay with the UNP. It was at my late wife Primrose’s place, in Kirulapone, that I met Mahinda in the early 1960s, when I was a medical student. A student of Thurstan College, he was a classmate of Primrose’s younger brother, Panduka, and very friendly with the other brother, Nihal. I remember Mahinda coming to their place, quite frequently, on his bicycle.

Those of us who knew Mahinda as a teenager never imagined that he would turn out to be a politician of such immense significance. He was just a playful young lad and I wonder whether politics was ever on his mind at that time, as I cannot recollect any political conversations during our meetings. But he turned out to be a politician, a superb one at that; one that gave the lead to defeat one of the most ruthless terrorist groups the world has ever known and that against all odds, disregarding the machinations from the West. Although some revile Rajapaksas, led by Mahinda, the fact that he is still the hero of the masses was well illustrated by the crowds that thronged to see him in Carlton, Tangalle, where he went after being made to leave his official residence in Colombo.

Whatever his failings may be, the war would have dragged if not for the steely determination of Mahinda and the political leadership he gave for the war to defeat the LTTE. J. R. Jayewardene had the opportunity to nip Northern terrorism in the bud. But he made matters worse. President Ranasinghe Premadasa opted for a honeymoon with the LTTE and paid for his blunder with his dear life. CBK dilly-dallied and Ranil capitulated to the West. Luckily, Mahinda was able to become the Leader of the Opposition in 2002, Prime Minister in 2004 and President in 2005.

Memories are short and gratitude is in short supply in Sri Lanka. The Sri Lankan youth are totally unaware of the enormous damage to the economy done by the two uprisings of the JVP and the dastardly actions of the LTTE although some attempt to blame Mahinda for the economic mess we are in. If one looks at records, the decade Mahinda was President saw the highest growth figures despite the colossal expenditure on the war. What was borrowed in Mahinda’s time was spent on development unlike during the Yahapalana regime. We are boasting of an increase in tourist arrivals today but would tourists be interested in visiting Sri Lanka, if not for the infrastructure developments Mahinda initiated and the defeat of terrorism?

In early 2009, when Prabhakaran was cornered, foreign ministers of the UK and France came unashamedly to rescue him. Mahinda and the then Defence Secretary Gotabaya told them where to get off. They have since become targets of a western witch-hunt. Sarath Fonseka played a significant role in the war, but wanted to take the credit to himself, and Ranil Wickremesinghe and the JVP pitted Fonseka against Mahinda in the 2010 presidential election. The fallout from Fonseka’s loose talk during the election continues to haunt the armed services. One big mistake Mahinda made was going after Fonseka, after winning the 2010 presidential election.

Another big mistake Mahinda made was amending the Constitution, enabling himself to seek a third term and advancing a presidential election on astrological advice. Not being content with fielding Fonseka, Ranil got Sirisena to turn against Mahinda. Interestingly, Ranil was able to achieve his lifelong ambition of being the head of state, with the support of Mahinda’s party—by a quirk of fate!

The biggest mistake Mahinda made was not leaving Temple Trees peacefully during the Aragalaya. Instead, his supporters attacked the protesters which enabled an NPP government to come to power. Had he done so, or retired gracefully after the loss in 2015, Mahinda would not have suffered affronts to his dignity.

Mahinda has made some mistakes, just like any other politician, but what he has done for Sri Lanka, overall, can never be forgotten. While wishing him a very happy eightieth birthday and many more years of healthy life, may I remind Mahinda that all grateful Sri Lankans will never forget that he saved the country from terrorism.

by Dr Upul Wijayawardhana

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Opinion

Contempt of Court: Between Reverence and Reform

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Contempt of court, as Joseph Moskovitz describes, is “the Proteus of the legal world, assuming an almost infinite diversity of forms.” This ancient metaphor captures the elusive nature of an offence that defies precise definition. Often irreverently termed a legal thumbscrew, a device once used to crush dissent, it encompasses a wide spectrum of conduct: from overt defiance of judicial orders to subtler acts that may erode public confidence in the administration of justice.

Historically, contempt included any behaviour that tended to bring the authority of the law into disrespect or interfere with legal proceedings. Yet, this traditional understanding is increasingly challenged by the imperative to uphold freedom of expression, a cornerstone of democratic society.

While I accept that the courtroom must command respect, I resist the notion of it being a sanctified space of worship. Justice must be dispensed not from a pedestal, but from a platform of fairness, transparency, and accountability. A legal system worthy of public trust must be foolproof, not fear-proof.

Sri Lanka: A System Under Strain

No human is infallible. As a surgeon, I know that errors can cost lives. When medical negligence occurs, there are mechanisms, however imperfect, for redress. Licences may be revoked, and families may seek compensation. But when a judicial error occurs, particularly at the apex level, the consequences are often irreversible. The aggrieved party may find no recourse, no reversal, and no restitution.

Appeals exist, yes, but they are often constrained by procedural finality. I have witnessed judgments that, to any trained eye, appear to be travesties of justice. Yet to publicly question such outcomes risks invoking the very offence of contempt.

In medicine, we rely on a battery of diagnostic tools, CT scans, MRI scans, PET scans endoscopies, and a whole host of simple and complex investigations to arrive at informed decisions. The judiciary, by contrast, often leans on archaic precedents and century-old statutes euphemistically labelled “settled law.” The assimilation of evidence oral, forensic, documentary, is entrusted to legal minds who may lack expertise in the disciplines they adjudicate upon.

In criminal trials, especially murder cases, the presence of a jury offers a buffer. But in civil disputes, particularly land cases, judges are not infrequently, left to navigate outdated legislative terrain with limited interpretive tools. The risk of error is not negligible. This is precisely why public discourse on judicial outcomes must be protected, not punished. The current climate in Sri Lanka, where even reasoned critique risks triggering contempt proceedings, is adversative to democratic health.

The UK Experience: A contrast in calibration

In the United Kingdom, the common law offence of “scandalising the judiciary” was abolished in 2013 under the Crime and Courts Act. Criticism of court rulings, even robust criticism, does not automatically amount to contempt. However, it may cross the line if it spreads misinformation, imputes improper motives, or undermines public confidence in the justice system.

The distinction is subtle but vital: truth, even if uncomfortable, is not contempt. The UK judiciary, bolstered by civic consciousness and institutional maturity, has managed to avoid head-on collisions with public opinion. The Contempt of Court Act 1981 empowers courts to act, but the threshold is high, and the process transparent.

There is an old adage, tongue-in-cheek perhaps, that to be a judge in England one must hail from a public school and a good family; knowing a bit of law is merely an added qualification. Whether such cultural filters apply to East Asian or African judiciaries is left to the reader’s discernment.

Sri Lanka’s legal framework: A call for clarity

Sri Lanka’s contempt laws are governed by:

• Contempt of Court Act No. 4 of 1999: Addresses disobedience of orders, interference with proceedings, and scandalising the judiciary.

• Contempt of a Court, Tribunal or Institution Act, No. 8 of 2024: Introduced to unify contempt provisions across judicial bodies, balancing dignity with free expression.

• Article 105(3) of the Constitution: Grants the Supreme Court and Court of Appeal authority to punish for contempt, including imprisonment and fines

Despite these enactments, the offence remains vaguely defined. Critics argue that this ambiguity violates principles of fair trial and equality before the law. Trials for contempt often lack the procedural safeguards afforded to other criminal offences, and the discretion exercised by courts is not always cemented in statutory clarity.

Towards a more equitable balance

Contempt of court must not become a shield against scrutiny. Respect for the judiciary should not preclude accountability. As long as criticism is factual, reasoned, and does not obstruct justice, it should be welcomed, not feared.

Sri Lanka must move towards a legal culture that embraces transparency, defines offences with precision, and allows room for civic engagement. The judiciary, like any other public institution, must earn its reverence, not demand it.

by Dr.M.M.Janapriya

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Opinion

Prioritise drug education over sex education

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In a country grappling with numerous challenges, it’s perplexing that one of our most frequently debated topics is sex education in schools. While this subject has its place, an even more urgent issue continues to be overlooked: drug education.

Current statistics reveal a disturbing rise in drug use, not only among youth but also within the very institutions meant to guide them—schools. Alarmingly, reports suggest that even some school principals and elected representatives are implicated in the drug trade. This is not just a social concern; it’s a national crisis.

If we are serious about safeguarding future generations, we must shift our focus. Introducing comprehensive drug education in schools is no longer optional—it’s essential.

S. K. Muthukumara

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