Judging by the statistics revealed during the past few days, Covid-19 is on the rise again in Sri Lanka, driven possibly by Omicron and subvariants such as BA.4 and BA.5 of the novel Coronavirus. Around 200 cases are being reported daily, with an average of 5-6 deaths. Given the very limited scale of testing here, one should assume that the actual case numbers are much higher and that there could be another wave soon.
Factors
Many other countries, including our neighbours, have reported a similar spike and China, where the virus is said to have originated, had several major cities under a strict lockdown. Several factors can be attributed to the current surge in Covid infections here and abroad. The Government recently lifted the mask mandate, which was not a very prudent decision under the present circumstances.
Thousands of people took part in political protest campaigns and travelled in buses and trains sans masks after the mask mandate was lifted, which enabled the virus to jump from host to host easily. Many people had also abandoned other health protocols such as washing hands frequently, keeping the distance and staying home if not well.
Vaccination
Although there was a massive uptake for the first and second doses of the Coronavirus vaccine (17 million and 14 million), only around eight million people have received the third (booster) shot and less than 100,000 have received the fourth shot, which is still being administered at centres islandwide.
This is a tragedy, given that around eight million doses of the mRNA-based Pfizer booster vaccine are still available. Those who are yet to receive the third dose can also get it still. It is, therefore, advisable to get the booster dose of the Pfizer vaccine as soon as possible if you still have not got it. Prevention is still the best cure for any viral disease, including Covid.
It is also well-known that due to Sri Lanka’s foreign exchange crisis, many hospitals lack the drugs and equipment needed for acute cases of Covid or for that matter, any other disease. Medicines given to Covid patients with discernible symptoms, such as Paxlovid (Pfizer), Evusheld (AstraZeneca) and Lagevrio (Merck) are in short supply here. In this context too, the best approach is one of prevention through vaccination and health protocols. It is entirely possible that we might need yearly vaccinations for Covid, with vaccines adjusted and modified for any new variants. Indeed, vaccine makers are already trialling booster shots aimed at variants such as BA.5.
Sri Lanka is one of the few countries where free walk-in testing for Covid is not available. Not many can afford to fork out Rs.2000 for a Rapid Antigen Test (RAT) or Rs.6,500 for a Polymerase Chain Reaction (PCR) test at a private hospital. Sri Lanka is also one of the few countries where Over- The-Counter (OTC) RAT kits are not available for sale.
This shortcoming should be addressed immediately. During a recent visit to Singapore, I noticed vending machines that dispensed a set of five at-home RAT kits for around S$ 40 (Rs 10,000 approx). Once the forex situation improves, pharmaceutical companies should be allowed to import RAT kits and sell them on an OTC basis. This test, which I have performed several times myself, is very easy, swift and convenient, but a mechanism must be evolved for the reporting of results to health authorities. In any case, testing should be widened drastically to gauge the true picture of the Covid spread in Sri Lanka.
Zero attention
Sri Lankan health authorities also pay zero attention to the issue of Long Covid, whereby some symptoms including fatigue, chest pains, breathing difficulties, cough, headache, joint pains, depression and even memory loss/brain fog last for nearly one year after the patient tests negative for the Coronavirus. Recent survey data, analysed by the US Centres for Disease Control (CDC) was able to determine that women and people aged 50 to 59 are more likely to experience Long Covid. On July 20 and 21, 2022, the Global Virus Network (GVN) hosted the first-ever conference devoted solely to the science of Long Covid.
There, scientists spoke openly about what is known about the mysterious condition and the questions that remain. Last year, the Americans with Disabilities Act classified Long Covid as a disability due to its debilitating effects on some people.
Sri Lankan health authorities must immediately establish a separate unit to gather data on those who suffer from Long Covid and also keep an eye on international research into this subject.
Although data remains inconclusive, it is believed that some anti-Covid drugs and vaccines could prevent or minimise Long Covid.
Monkey pox
But Covid-19 is not the only danger that is lurking out there. Monkeypox is the latest disease to hit the mainstream, having been confined to only a few parts of the world earlier.
The monkeypox virus typically spreads through direct contact with respiratory secretions, such as mucus or saliva, or skin lesions. While it can be sexually transmitted, mostly within the MSM (Men having Sex with Men) community, it is not thought of as a Sexually Transmitted Disease (STD) as other people can also get it.
The virus causes a rash that can spread over the body. People who have caught the virus said the rash, which looks like pimples or blisters, can be very painful. Other symptoms usually include fever, swollen lymph nodes, fatigue and headache. Most people recover from monkeypox in two to four weeks, according to the CDC and deaths are rare.
The World Health Organization (WHO) has declared Monkeypox as a Global Public Health Emergency of International Concern, as cases in nearly 80 countries have exceeded 15,000.
The rare designation means the WHO now views the outbreak as a significant enough threat to global health that a coordinated international response is needed to prevent the virus from spreading further and potentially escalating into a pandemic like Covid-19. Sri Lankan health authorities must be on alert lest Monkeypox enter Sri Lanka, as several neighbouring countries have also reported a few cases.
Another threat
The story does not even end there, with this week’s discovery of the Novel Langya Henipavirus (LayV) in China. This virus is also Zoonotically transmitted (from animals to humans), like the Novel Coronavirus.
In people, the virus causes symptoms including fever, fatigue, cough, loss of appetite and muscle aches. Luckily, there have been no deaths from LayV to date.
We have already experienced one pandemic and found out how woefully unprepared we were for it. As the above news item shows, new viruses are lurking in animals and humans, ready to begin a new pandemic, perhaps. Led by the WHO, Governments around the world must craft a more cohesive, global response to the next pandemic, which is only a matter of time.