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Lessons from Lockdown – Keeping COVID-19 in Perspective

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by Anila Dias Bandaranaike

COVID-19 has caused a calamitous global crisis. While tens of millions have tested positive for this virus, over a million people have suffered and died from it. The first COVID-19 case was detected in Wuhan City, China, in December 2019. By November 15 2020, two sources of global statistics recorded about 54 million cases and 1.3 million deaths in 220 countries and territories (World Health Organisation (WHO), Worldometer). Today, medical research is being funded to find a vaccine to protect us humans against it. At the same time, countries are desperately trying to find ways to balance the fight against the spread of COVID-19 with keeping economic activities alive, so that people can have incomes, food, medicines and other basic needs to survive.

Lockdowns in many parts of the world and instructions to avoid crowds, ensure social distancing, wear masks and wash hands, have helped reduce further spread. However, many people, especially poor daily wage earners, have lost access to incomes, nutrition and medicines. Hence, the authorities have to balance these lockdowns, which minimise human interactions, with their economic consequences.

Meanwhile, the print and electronic media have gone more viral than the virus itself. COVID-19 takes priority over most news globally and locally. In Sri Lanka, posts early in this second wave reflected our penchant for playing the blame game. Unsourced video clips, WhatsApp forwards, articles and interviews, blamed, in turn and according to inherent prejudices, different players. These included the company which discovered the first case testing positive, all garment workers and manufacturers, the president, the government, Indians, etc. Rational, factual explanations on the subject were to no avail, such as procedures followed for quarantine of returnees from India and the difficulty in identifying positive but asymptomatic cases.

Perception and prejudice the Sri Lankan way conquered reality. A president, who was hailed a few months ago as being decisive and having everything “under control” the military way, is now blamed for being lax and allowing the virus to spread. Bogey-men of the past, Tamil “terrorists, Muslim “extremists” and Christian “convertors”, each irrationally equated with travel to India, gathering in mosques and churches, were blamed for the first wave. They have been completely overshadowed by “virus-spreading” garment workers of today. These workers have been ostracised in their neighbourhoods, their significant contribution to the economy forgotten, just because the first case identified in the second wave was a garment factory employee.

In the midst of this avalanche of information and misinformation, we need to get our own situation in perspective. In light of the rising number of positive cases in Sri Lanka since October 5, what exactly about COVID-19 is relevant for our future health and safety?

First, let us examine available statistics. We will need to rely on these statistics, despite some concerns about their accuracy. By November 15, Worldometer reported that in 39 million closed cases, 97% had recovered and 3% had died. Available medical evidence highlighted serious respiratory problems among severe or critical COVID-19 cases. Deaths related to those respiratory problems were usually complicated by other underlying health problems, often age-related.  This implied that the elderly and those with certain health problems were more vulnerable.

We already experienced in Sri Lanka a few months ago, the outcome of the young, fit and healthy Navy cohort, who had tested positive for COVID-19. They showed few symptoms, were minimally ill and recovered within a few weeks. By October 5, Sri Lanka’s Health Authority had reported a total of 3,400 cases, with 3,260 recoveries and 13 deaths, leaving about 130 active cases. These statistics indicated over 99.6% recoveries and less than 0.4% deaths in 3,273 closed cases. Hence, Sri Lanka’s fatality rate was much lower than the current 3% global rate.

On November 15, with 16,583 total cases, recoveries at 11,495 and deaths at 53, active cases were 5,305 (hpb.health.gov.lk). The fatality rate was still relatively very low, at 0.5%. Against this background, we need to know:

 

1) How likely are Sri Lanka’s COVID-19 cases to become serious?

2) How likely is death from COVID-19 in Sri Lanka?

3) Can our health services handle the number of serious cases?

4) Who in our population are vulnerable to becoming serious COVID-19 cases and need protection

 

We also need to remember that our entire knowledge of this virus is from global experiences of less than one year. Theories abound, on its long-term health impact, on possible tests, on preventive means and possible medication. It is too early for any ongoing research to be conclusive. Humanity is still groping in semi-darkness. According to one reputed source in the literature, there have been more 200 tests (around 170 different molecular (PCR) tests, 37 antibody tests and 2 antigen tests) made available. The available scientific literature does not provide certainty about the accuracy (false positives and false negatives) of these tests. As more tests are being performed under varying conditions across the globe, the level of accuracy could also be compromised. Hence, while the reported number of positive cases has been rising fast, we really do not know the true extent of the spread anywhere. So, let us try to find answers to our questions with the available evidence.

 

How likely are Sri Lanka’s COVID-19 cases to become serious?

 Regional comparison of available global statistics shows that  fatality rates have, thus far, been much lower in Africa and Asia, than in the West. The Americas and Europe, holding 23% of world population, accounted for 76% of COVID-19 deaths. Asia and Africa, with 77% of world population, accounted for 24% of deaths. (Source:

 Worldometer). Current global research is testing theories that in “developing” countries of Africa and Asia 1) greater previous exposure to viruses or 2) compulsory childhood inoculations against viruses, such as the  BCG vaccine, had provided a higher resistance to COVID-19. Others theorise higher resistance in those regions due to diet or climate or a milder strain of the virus. Whatever the conclusions, evidenc points to a relatively lower severity of the disease in Sri Lanka, thus far.

 

How likely is death from COVID-19 in Sri Lanka?

 Hard evidence up to November 15 indicated that the fatality rate was very low, at less than 0.5% of closed cases. Sri Lanka’s death rate from COVID-19, at 2 per million population, was also very low, ranking 185 among 220 countries and territories.

 

Can our health services handle the number of serious cases?

 The Health Authority previously conveyed that hospitals had adequate capacity to handle 2,000 cases. Early in the second wave, it was conveyed that this would be increased. By November 15, Sri Lanka had over 5,000 active cases, significantly higher than hospitalisation capacity. Thus far, mild cases have not needed hospitalisation.

 However, we do not know how many cases were serious and needed hospitalisation. From 8 months experience, we can expect the number of serious cases to be low. To date, the Health Authority has revised its strategies over time to meet changing needs in the country. It has not yet indicated inability to handle the changing hospitalisation load.

 Who in our population are vulnerable to becoming serious COVID-19 cases and need protection? Global experience over the past 10 months has shown that the elderly and those with certain health-related pre-conditions (cancer, diabetes, heart disease, etc.) are at higher risk of severe  respiratory complications from COVID-19. We need to ensure that those who are vulnerable in our homes and communities are protected from exposure to COVID-19. We can do so by following the precautionary instructions given by the Health Authority – wearing masks, washing hands, minimising exposure from and to others, avoiding crowds, social distancing, etc.

While positive cases rise, Sri Lanka’s experience of the past 8 months points to most cases recovering from a mild bout of the virus, unless they belong to an identified vulnerable group. Hence, it is not the spread of the virus per se, but to whom it is spreading, where and how, that should be our focus to bring it under control. We need to stop wasting time playing the blame game. We should refrain from all unauthenticated, unhelpful or sensationalised “forwards” or “news” in social or mainstream media.  This only adds to panic and irrationality. If we act calmly and responsibly and abide by the instructions given by the Health Authority, we can bring COVID-19 under control. We need to do so urgently, before it spreads among the vulnerable in our population or exhausts our hospitalisation capacity.

 

(The author is a former Assistant Governor and Director of Statistics of

the Central Bank of Sri Lanka)

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Scholar, Advisor, Innovator and Great Friend

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by AUSTIN FERNANDO

Dr. Wickrema Weerasooria, son of Queen’s Counsel NE Weerasooria, studied at Royal College, and entered the University of Ceylon, Peradeniya, and won Harvard Memorial Prize and the Governor General’s Prize. He graduated in Law from Peradeniya, with First-Class Honours, and was later called to the Bar, as an Advocate.

I have known and associated with Dr. Wickrema Weerasooria in different capacities. First, I knew him as a pioneer Law Educator at Vidyodaya University. His students at Vidyodaya, and later even at the Post-Graduate Institute of Management, recall how he lectured, without even a short note in hand, attracting students’ attention, and enthusiasm. Additionally, he focused on teaching Commercial, Administrative, and Constitutional laws, and published texts in Sinhala, one on the Law of Contracts, another on Commercial Law.

His vast knowledge as an author was exhibited, mostly in Banking Law. Some of his publications were on Australian banking systems. Later, he delved into Buddhist Ecclesiastical Law, which produced a monumental work and a Treatise on Sri Lankan Statute Law and Judicial Decisions on Buddhist Temples and Temporalities.

His book ‘The Law Governing Public Administration in Sri Lanka,’ is a text that must be read by all public administrators and politicians. Whilst at Monash University, he wrote ‘Links between Sri Lanka and Australia: A Book about Sri Lankans (Ceylonese) in Australia’, dealing with Sri Lanka- Australia links.

With President JR Jayewardene in Office, Wickrema was appointed as the Secretary to the Ministry of Plan Implementation– a completely different role for him in public service. Working with him was also a novel experience and challenge for officers too, since he pushed them to the deep end to make quick, practical, non-traditional, sometimes unsavoury decisions for the benefit of the public.

He was the innovator of Integrated Rural Development Projects, for which he harnessed foreign assistance, and a performer, evaluator, programmer, and institution builder, proven by the establishment of Secretariats for Women, Children, Fertilizer, Nutrition, Population under his Ministry.

Sri Lanka Planning Service was made a professional service in 1985, for which the initiatives and support given by Wickrema were substantial. Accordingly, planners were made responsible for planning to achieve the goals of the respective institutions, formulate policies, strategies, and evaluate the development projects and programmes.

Wickrema was responsible for enhancing human resources among cadres through foreign exposures, which culminated with some officers obtaining post-graduate degrees, some even PhDs, and reaching apex ranks in public services, i.e. Secretaries of Ministries.

Specifically, his contribution to my work when I served as Government Agent, Nuwara Eliya was substantial. He was the guide, mentor, and sometimes savior. His involvement was on behalf of his brother-in-law Minister Gamini Dissanayake. Wickrema was instrumental in planning Nuwara Eliya through the establishment of Nuwara- Eliya Development Commissioners Committee, where I served as Chairman, with professionals as Commissioners. The initial planning was done by the Urban Development Authority.

He was the key organizer of the Spring Festival in Nuwara-Eliya. I remember how he planned the city and revived the Car Racing event, after a lapse of some years. I remember Upali Wijewardena taking part in the first motor car road race. The new Motor-Cross racing event on the newly constructed track was added to the Mahagastota Hill Climb for motor racers. Motor-Cross racing spread to other areas later. He attended these events and enjoyed the great company.

A little-known fact about Wickrema is that the Sri Lanka Council for the Blind (as President) and Sri Lanka Federation of the Blind (as Advisor) still appreciate his services rendered to the blind community, especially in resource mobilization and housing.

He was a person with subtle wit and humour. While teaching, he used this talent, as a student has reminisced, for “easing the pressure and stress of learning.” His lighter vein utterances and behaviour in groups made him a more sought-after teacher, friend, relative, colleague, and boss. His wit and humour depicted by cartoons in political campaigning, (i.e. The Family Tree), left an indelible mark in canvassing votes at the 1977 Elections. It is recycled even today, making Wickrema’s talent eternal.

I am reminded that even regarding efficiency creation he had humorous comments. I remember his “evaluation of the efficiency” of public officers. He used to quip that when asked to produce relevant documentation within two days to send an officer on a foreign scholarship, knowing it would take weeks, he would swear with utmost certainty that the officer would fulfill the requirement within two days. The best litmus test of the efficiency of an officer is the offer of a foreign scholarship! He lamented that such efficiency is lacking to serve the people.

I have a personal regret. Just before I left for India as High Commissioner, he promised to visit me in Delhi with his dear wife Rohini, which he could not fulfill, bidding adieu in weeks. Hence, I missed his company, advice, wit, and humor before departure.

I may say, he was a great student, scholar, academic, educator, public officer, diplomat, social worker, an advisor, innovator, and above all a great friendly human being, who enjoyed life and made others enjoy too, with his friendship, and camaraderie. Sadly, we will miss him forever.

May he attain the Supreme Bliss of Nibbana!

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Ethiopia: War in Tigray

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By Gwynne Dyer

“Love always wins. Killing others is a defeat,” said Ethiopia’s Prime Minister Abiy Ahmed in June 2018, shortly after surviving a grenade attack at a rally in Meskel Square in the capital, Addis Ababa. How was he to know that just thirty months after saying that he would have to stop loving and start killing?

That’s the problem with being a reforming zealot who becomes Prime Minister: you have to deal with some really stubborn people, and sometimes it’s hard to shift them without a resort to force. That’s why Abiy launched an invasion of Tigray state on 4 November, and so far it’s been doing very well.

“The next phases are the decisive part of the operation, which is to encircle Mekelle using tanks, finishing the battle in the mountainous areas, and advancing to the fields,” Col. Dejene Tsegaye told the Ethiopian Broadcasting Corporation on 22 November.

Here we are only less than two weeks later, and the federal government’s troops have already captured Mekelle, a city of half a million people that is Tigray’s capital. It’s not clear how many people were hurt or killed in the fighting, but it went so fast that the butcher’s bill can’t be all that high.

In fact, it has all gone so well that Abiy Ahmed’s soldiers are probably thinking they might be home in time for Christmas. When Col. Dejene talked about “finishing the battle in the mountainous areas and advancing to the fields,” however, he was talking about the nine-tenths of Tigray that has seen no federal government troops at all, or at most a brief glimpse as they passed through.

Tigray is exactly the size of Switzerland, with about the same ratio of mountains to fields (although the mountains are somewhat lower). In other words, it is ideal guerilla territory, and a high proportion of the seven million Tigrayans are rural people who know the land. Moreover, they have long experience in fighting the central government’s troops.

That was the old central government, of course: the Communist dictatorship called the Derg, led by Mengistu Haile Mariam, that murdered the emperor and ruled the country with an iron fist from 1977 to 1991.

Tigrayans were the first ethnic group to rebel against Mengistu’s rule. They are only 6% of Ethiopia’s population, but the Tigrayan People’s Liberation Front (TPLF) was the most effective of the ethnically-based rebel groups that finally defeated the Derg.

The federal government that took over afterwards, called the Ethiopian People’s Revolutionary Democratic Front (EPRDF), was formally a multi-ethnic alliance. In practice, however, TPLF cadres controlled most senior posts and prospered greatly as a result – a situation that continued until the EPRDF appointed Abiy Ahmed prime minister in 2018.

It was a non-violent revolution, conducted not in the streets but in ranks of the federal bureaucracy. Abiy was the ideal candidate: in religion and ethnicity he is Ethiopian everyman, with a Muslim Oromo father and a Christian Amhara mother. (In person he is Pentecostal Christian, and very devout.)

As a young man Abiy fought in the war against Eritrea; he has served as a senior intelligence official and knows where the bodies are buried; he is well educated and speaks Amharic, Afaan Oromo, Tigrinya and English fluently. His first and most important job was to prise the fingers of the Tigrayan elite off the levers of government without a civil war.

Unfortunately, Abiy’s approach – merging all the parties based on the various ethnic militias into a single ‘Prosperity Party’ – didn’t work. The resentful TPLF cadres refused to join, and gradually withdrew to their heartland in Tigray. They don’t yet openly advocate secession, but they do point out that they have that right under the current federal constitution.

Whether or not the shooting war began with an unprovoked attack by the Tigrayan militia on the federal army’s base in Mekelle at the start of last month, as Abiy’s spokesmen claim, it was bound to end up here. All Tigray’s cities have now been taken by federal troops, but almost none of the rural areas.

This could be a brilliant victory for the federal troops that puts a swift end to the fighting. It’s more likely to be the result of a decision by the TPLF leadership to skip the conventional battles they were almost bound to lose, and go straight to the long and bloody guerilla war that they might eventually win.

That would mean secession, in the end, for they can never win power back in Addis Ababa. The risk is that if the war goes on long enough, other major ethnic groups may break away from Ethiopia as well. Abiy’s loosening of the tight centralised control that prevailed under the emperor, the Derg and the TPLF has already unleashed ethnic and sectarian violence that has rendered 2 million Ethiopians homeless.

Abiy recently got a PhD in peace and security studies from Addis Ababa University, but he’ll be concentrating on the ‘security’ part for the foreseeable future.

 

 

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Safety Equipment and Procedures and Exploding Fire Extinguishes

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by Capt. G A Fernando MBA

gafplane@sltnet.lk

RCyAF, SLAF, Air Ceylon, Air Lanka, SIA, SriLankan Airlines

Former SEP instructor/ Examiner Air Lanka

By law the Regulator Civil Aviation Authority Sri Lanka (CAASL) requires all Airline Crew to annually undergo continuous training and achieving proficiency in Safety Equipment and Procedures (SEP). At the end of the training, also answer a written examination to prove to all and sundry that the particular Flight Crew Member has sufficient SEP knowledge to continue serving in the Cabin or Flight Deck of that Airline, for another year. The SEP questions were relatively easy (no tricks) but each crew member had to score over 80% and carry out mandatory, practical proficiency tests such as operation of aircraft doors and Emergency exits, conduct evacuations, Life Raft operations (in the swimming pool), know the location and use of emergency equipment such as megaphones, Crash Axes, Asbestos Gloves, Emergency Locater Transmitters (ELT’s), the administration of Oxygen, First Aid and use of equipment such as smoke hoods and fire extinguishers to combat Cabin smoke and Fires, The airline is usually delegated to carry out these duties and functions at the behest of the Civil Aviation Authority.

The first year after Air Lanka was established (September 1979), crew members had to go to Singapore Airlines or get the instructors across to Colombo to carry out these checks on behalf of Air Lanka. After about the second year of existence, it was decided that a team SEP instructors/ examiners would be appointed ‘in house’ to carry out this training and mandatory checks. Three of us from the ‘Flight Deck’ crew were appointed to the team. They were First Officer Elmo Jayawardene, Flight Engineer Gerrard Jansz and yours truly. We had, had some experience in crew SEP training in Air Ceylon.

We were sent to the British Airways (BA) Flight Training (Cranebank), UK, during our regular stay overs in London, to undergo refresher training, so that we could incorporate some of the BA curricula in our own (Air Lanka) programs. The then Air Lanka Manager Operations had been an ex BOAC (British Overseas Airways Corporation) Captain. As a direct result of our visit to BA, the then airline doctor (Dr Mrs Sherene Wilathgamuwa) was inducted to the SEP team to lecture the ‘troops’ on not only First Aid but also on delivering babies, with limited facilities on board!  I believe that this information has been extremely useful many times during the last 40 years of Air Lanka. This was not taught to us in Air Ceylon. The training curriculum was developed by the SEP team.  

The early days of Air Lanka wasn’t easy. While an operational profit was made, the ‘debt servicing’ put an unbearable strain on the overall profitability. We had neither a designated training department nor proper equipment. Our ‘wet drill’ constituted jumping into the pool in shirts and trousers for the boys and ‘made up’ Sarees without the ‘fall’ for the Girls, wearing life jackets of course. Initially the Sri Lanka Air Force (SLAF) Katunayake pool was used and subsequently the pools of the two hotels down Katunayake airport road were used till Air Lanka got its own pool. We didn’t even have a permanently deployed Slide/ Raft either for teaching purposes. It all cost money. I was the Instructor in charge of the ‘wet drill’. In contrast SIA I worked for subsequently, had a pool with a ‘wave maker’ to give a realistic experience. There was no doubt Air Lanka at that point of time was ‘pinching pennies’ where crew SEP training was concerned.

To provide fire fighting experience to the Flight Crews we were forced to use regular Industrial Fire Extinguishing equipment to keep the costs down. That was acceptable since the basic fire fighting principles were the same. The fire fighting part of the training was carried out by the Ground Safety Section Instructors who were mainly ex SLAF types. A few months before, Lalantha one of the Chief Stewards was practicing the use of a Carbon Dioxide (CO2) extinguisher on a fire and the extinguisher exploded and flew off his hand, narrowly missing Leone who was just behind him. The on-board extinguishers were much smaller, lighter and more manageable than the industrial ones. A complaint was filed by me, but treated by the ‘Management’ as a one off case! It seemed as if one swallow doesn’t make a summer!  The extinguisher had been certified as serviced. The Administrative Executive in charge of SEP those days was a young man who had a degree in Marine Biology and perhaps was clueless on safety issues and couldn’t champion our cause.  We were all part time Instructors.

The annual recurrent training programme took two days. On one particular day, Chief Stewardess Jayantha and I were the instructors in charge. When it came to the Fire Fighting exercise, we handed over students of our class to the Air Lanka Ground Instructors and proceeded to the parking apron (opposite the Terminal Building), to check out a Lockheed L1011 ‘Tri-Star’ aircraft which was newly leased, by Air Lanka. It was a pre-owned, aircraft that had arrived the day before. Unfortunately, the locations of and the make of emergency equipment in the same type of aircraft (L-1011) differed from airline to airline. Therefore in the name of air safety and standardisation, it was important to resolve matters before the said aircraft saw service on the line on regular revenue flight services. It was a big deal as all Flight Crew had to know by memory as to where the specific locations of safety equipment were, so that when a ‘push’ came to a ‘shove’, no time would be wasted by the crew members involved, looking for these essential items. It could be a matter of life and death.

 I was not too happy sending the participant boys and girls by themselves for fire fighting and had an uneasy feeling. On other hand, our task too was also extremely important. So it was a case of ‘risk management’ and gave in. 

While we were checking out the new addition to our L 1011 Tri-Star fleet, we received a frantic message saying that another water type extinguisher had exploded and the injured had been removed to the Air Force Hospital across the runway to the Northern side.

Jayantha and I rushed to the SLAF Base Hospital in her ‘Mini -moke’ the long way around, up the Airport Road and via the 20th milepost main entrance along the Negombo road and found two crew members injured and in shock. Steward Senaka who had got the wheel shaped handle smack on his face, had injuries in the same shape and Naomal too had some minor injuries. We were assured by the Air Force doctor, Dr Narmasena Wickremasinghe that injuries were not too serious. We stayed there till the arrival of the next of kin who had been informed and went back to Office to meet Mr Wilmot Jayewardena, the Air Lanka Senior Manager Inflight Services.

When Jayantha and I sheepishly walked into his office he gave us the silent treatment initially and then softly declared that being responsible for the wellbeing of the participants, at least one of us Instructors should have been present when fire fighting was going on, even under the supervision of the Ground Safety Instructors. We accepted our mistake and defused the situation. When I look back now I am amazed as to how we coped with such limited resources to keep the National Carrier going. Safety Experts today, recommend that during risky activity, we should trust our ‘gut feeling’. It is usually correct as there is a connection between the brain and the gut resulting in feelings like ‘butterflies’ in the stomach. Needless to say the lesson was learnt.  

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