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WHO brainstorming meeting among public health experts: Observations and recommendations

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Covid-19 surge in Sri Lanka

Public health experts representing diverse specialties held a brainstorming meeting convened by the World Health Organisation (WHO) Sri Lanka to discuss the current spike in cases in Sri Lanka recently, according to a media statement issued by the WHO Colombo Office. The key observations and recommendations to policy and decision-makers indicated below are documented based on proceedings and the consensus achieved at the meeting. The views expressed on the situation are those of the experts and do not necessarily reflect those of WHO.

The following crucial factors were considered:

The COVID-19 situation in Sri Lanka is very likely to get worse over the next few weeks. The decisions we take NOW will affect the lives of millions of Sri Lankans. Therefore, the next 3-4 weeks are critical in controlling transmission and saving lives.

The epidemiological trend of the past weeks shows a rapid exponential increase in the number of cases, this trend is likely to continue for some time if no effective interventions are made.

There is a lag of 1-2 weeks between infection and case detection and a further lag of an additional 2-3 weeks between an increase of reported cases and an increase in reported ICU admissions and deaths. Thus, the deaths and ICU admissions we are seeing now are the consequence of infections that took place at the early stage of this third wave (3-4 weeks ago).

The public sector health system is stretched to the limit, making it difficult to manage COVID-19 cases as well as other essential services. More health professionals and preventive staff (e.g. PHIs) are getting infected and HR policies need to be geared to meet the urgency. There is a “tipping point” beyond which the system can rapidly go out of control. 

The more transmissible and severe variants detected in India and other variants have already been detected in the country, these can spread faster and may even circumvent vaccine-induced immunity.

Vaccines will be crucial to controlling the epidemic in the medium-term but will not address the immediate crisis we now face. Some vaccines are only effective after the second dose. Therefore, it will take a minimum of 6-8 weeks to see the effects of vaccination in the number of new cases.

In the context of the above, there are two URGENT actions we can take to save lives – stop new infections as effectively as possible and prepare for the predictable increase in severe cases and deaths.

1.

Globally, evidence shows that strict and immediate measures to restrict mobility are the only measures that quickly and drastically reduce cases. Sri Lanka will also benefit from strict mobility restrictions whilst maintaining major economic activities and essential services. There is a need to stop inter-district travel and introduce severe restrictions on non-essential human mobilities and the congregation of people. Universal adherence to ‘precautions’ such as appropriate masking, physical distancing, hand hygiene, and avoiding the 3Cs – crowds, confined and enclosed spaces, and close-contact settings is a must. High transmission areas must be shut down for 2-3 weeks to stop or limit transmission. There should be a national mobilization effort to accelerate vaccination.

2.

Reconsider the management of asymptomatic cases, revise clinical management protocol to include home management.  Increase focus on intermediate care centres to detect cases early, properly monitor patients, and appropriately manage cases, thereby minimizing the need for more intensive care. Prepare for an increase in hospitalization and the need for adequate HDU and ICU care.

Participants

Dr. Palitha Abeykoon, WHO Consultant and WHO Director-General’s Special Envoy For COVID-19 Preparedness and Response for SEAR 

Prof. Malik Peiris, Chair/Professor – School of Public Health, The University of Hong Kong, Faculty of Medicine, Hong Kong

Dr. Ananda Wijewickrama, Consultant Physician and Past President of the College of Physicians

Prof. Neelika Malavige, Professor and Head, Department of Immunology and Molecular Medicine, Sri Jayewardenepura University

Dr. Vinya Ariyaratne  

Public Health Specialist,  President- Sarvodaya (CSO)

Dr. Padma Gunaratne, Consultant Neuro Physician and President, Sri Lanka Medical Association

Prof.  Indika Karunathilake, Prof. in Medical Education, Department of Medical Education, Faculty of Medicine and Former President – SLMA

Prof. Asita de Silva, Senior Professor of Pharmacology, University of Kelaniya and President, Sri Lanka Association of Clinical Pharmacology & Therapeutics

Prof. Manuj Weerasinghe , Professor in Community Medicine, Faculty of Medicine, Colombo 

Dr. LakKumar Fernando, Consultant Pediatrician and President, Association of Medical Specialists

Dr. Nihal Abeysinghe, Consultant in Community Medicine and Former Chief Epidemiologist in Sri Lanka and President of the College of Community Physicians in Sri Lanka

Prof. Saroj Jayasinghe, Consultant Physician and former Prof. of Medicine, Faculty of Medicine, Colombo 

Prof. Kamini Mendis , Professor Emeritus, University of Colombo; Public Health Expert and former WHO Malaria expert  

Dr. Olivia Nieveras, Officer In-Charge, WHO Sri Lanka 

Dr. Sapumal Dhanapala, WHO Sri Lanka

Dr. Padmal de Silva, WHO Sri Lanka

Prof. Nalika Gunawardena, WHO Sri Lanka

Mr. T  Suveendran, WHO Sri Lanka

Dr. Preshila Samaraweera, WHO Sri Lanka

Ms. Sahani Chandraratna, WHO Sri Lanka

Dr. Mizaya Cader, WHO Sri Lanka

Ms. Sadhani Rajapakse, WHO Sri Lanka

Dr. Anjalee De Silva, WHO Sri Lanka

Dr. Roshan Sampath , WHO Sri Lanka

Dr. Shreenika De Silva, WHO Sri Lanka



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Wife, counsel seek regular access to ex-Spy Chief Sallay held under President’s detention order

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Suresh Sallay

Wife of former State Intelligence Chief Maj. Gen. (Retd.) Suresh Sallay has asked CID Director retired SSP Shani Abeysekera to allow her, her family members and lawyers to visit her husband in the National Hospital, Colombo. Sallay’s counsel has also written to Abeysekera, asking for permission to visit the former spy held on a detention order signed by President Anura Kumara Dissanayake.

The text of Manori’s letter: “I respectfully request your assistance in granting me, and my daughter or alternatively my son, permission to visit my husband, Rtd. Major General Suresh Sallay, who is currently at the National Hospital, Colombo.

“As you are aware, my husband is presently engaged in a fast-unto-death campaign. His physical condition and emotional well-being are of deep concern to our family. During this difficult period, the presence and support of his immediate family are extremely important to him.

“I firmly believe that regular visits from me with our daughter or our son would help uplift his spirits, provide him with much-needed emotional strength, and may encourage him to reconsider continuing this course of action. Family support can play a vital role in preserving his mental and emotional health while he remains hospitalised.

“In view of these exceptional circumstances, I kindly request that permission be granted for either me and my daughter or my son to visit him daily during the period of his hospitalisation.

“I would be most grateful for your compassionate consideration of this request.”

“The text of the counsel’s letter: “I write in my capacity as Counsel for Rtd. Major General Suresh Sallay, who is presently under detention and admitted to the National Hospital, Colombo.

As you are aware, Major General Sallay has embarked on a fast-unto-death campaign, giving rise to serious concerns regarding his physical and mental well-being. In these circumstances, it is imperative that I be granted reasonable and regular access to my client during his hospitalisation.

As his legal representative, I have a professional obligation to monitor his condition and obtain instructions from him so that I may accurately apprise the relevant courts of his health status and any developments affecting his rights and welfare. Effective legal representation requires continuous communication with my client, particularly in light of the grave circumstances presently confronting him.

I also wish to respectfully highlight that Major General Sallay has placed explicit trust and confidence in me as his counsel. Indeed, I was the first person he contacted following his arrest.

Given the trust he reposes in me, I believe I am uniquely positioned to engage with him constructively and persuade him to discontinue this campaign and instead place his confidence in the legal remedies and judicial processes available to him.

For these reasons, I respectfully request that I be granted permission to visit my client on a daily basis during the period of his hospitalization.

Such access would not only facilitate the discharge of my professional responsibilities but may also contribute meaningfully towards safeguarding his health and encouraging a resolution through lawful and institutional means.

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CIABOC summons Yoshitha over his participation in British Navy training programme

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Yoshitha

Yoshitha Rajapaksa, who served as a Lieutenant in the Sri Lanka Navy, has now been summoned to the Commission to Investigate Allegations of Bribery or Corruption next Tuesday (16) for questioning over his participation in a Royal Navy training programme in the United Kingdom outside established procedures.

The Commission is expected to record statements in relation to several complaints received regarding his recruitment and subsequent service in the Navy after he enlisted on December 14, 2006.

According to sources, the investigation focuses on allegations concerning the educational qualifications considered at the time of his enlistment, as well as foreign training opportunities he is said to have received while in service, which are suspected to have been granted in violation of due process.

The Bribery Commission has launched the inquiry under the provisions of the Anti-Corruption Act, officials said.

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Communist Party condemns ill-treatment of Sallay, calls for review of PTA

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Dr. G. Weerasinghe

Sri Lanka Communist Party has urged the NPP government to initiate a credible review of the PTA (Prevention of terrorism Act) and related practices that enable arbitrary detention and torture.CPSL General Secretary Dr. G. Weerasinghe issued the following statement regarding the arrest of retired Maj. Gen. Suresh Sallay:

The CPSL expresses its deep concern over the continued detention of former Intelligence Chief Major General (retd.) Suresh Sallay, who was arrested on 25 February and has now been held for 95 days under the PTA.

Maj. Gen. Sallay’s initial detention under the PTA was for 90 days, after which the Colombo Magistrate extended his period of custody. The CPSL notes that the PTA was specifically referenced in the 2024 manifesto of the ruling New People’s Power (NPP) — “A thriving nation, a beautiful life” – which promised the “abolition of all oppressive acts including the Prevention of Terrorism Act (PTA) and ensuring civil rights of people in all parts of the country.” The party calls attention to this commitment and urges that it be honoured in both letter and spirit.

 The CPSL is alarmed by reports from legal counsel and medical personnel alleging that Major General Sallay has suffered both physical injuries and severe psychological distress while in custody. President’s Counsel Shavindra Fernando informed the Court that the Judicial Medical Officer’s report diagnosed Maj. Gen. Sallay with post-traumatic stress disorder, anxiety and depression, and identified injuries at five locations on his body. The report, counsel says, indicates alleged torture.

Further, counsel and family members have raised serious complaints about inhumane treatment in detention. Mrs. Manori Sallay has filed a formal complaint with the Inspector General of Police alleging inadequate food, lack of basic sanitation and other inhumane conditions. Additional court submissions stated that Maj. Gen. Sallay was denied proper meals, and on one night was reportedly served rice with gravy on a piece of newspaper placed on the cell floor. By contrast, media reports indicate that some detainees have been permitted access to the CID canteen.

The CPSL acknowledges the necessity of lawful procedure in the investigation and prosecution of criminal and terrorism cases. At the same time, the party is compelled to note credible allegations that proper procedure has not been followed in this case. These lapses reinforce concerns that the arrest and continued detention may be politically motivated.

 Human rights organisations have long criticised the PTA as a draconian statute that facilitates prolonged arbitrary detention without trial and creates opportunities for torture and coerced confessions. The CPSL reiterates these concerns and underscores the contradiction between the NPP’s manifesto pledge to abolish oppressive legislation and the continued use of the PTA in this instance.

The Communist Party of Sri Lanka therefore calls on the Government and relevant authorities to:

Immediately ensure that Major General Suresh Sallay receives full medical care and protection from further mistreatment.

Make public the full medical report of the Judicial Medical Officer and permit independent medical examination by a qualified neutral body.

Adhere strictly to legal procedure in the investigation and prosecution of this matter, ensuring access to counsel, adequate food, sanitation, and humane detention conditions.

Provide transparent justification for any further extensions of detention under the PTA and allow timely judicial review in accordance with constitutional safeguards.

Honour the NPP manifesto pledge by initiating a credible review of the PTA and related practices that enable arbitrary detention and torture.

The CPSL stands for the rule of law, human dignity and civil rights. While recognising the state’s responsibility to investigate genuine security threats, the party will not remain silent where there are credible reports of abuse, procedural irregularity, and possible political motivation. The CPSL will monitor the case closely and urge civil society and human rights bodies to do the same.”

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