Medi snips | Sunday Observer

Medi snips

19 April, 2020

Positive response to COVID:

Continue adhering to preventive practices - Epidemiology Unit

“The public so far has positively responded to close contact tracing, adhering to quarantine advice, and other preventive practices. However, it is very important to adhere to other preventive practices such as keeping one-metre distance between persons in social activities, cough etiquette, frequent and thorough hand washing. These will prevent most of the transmission among the population,” Consultant Epidemiologist, Epidemiology Unit, Ministry of Health, Dr Deepa Gamage told the Sunday Observer in an exclusive online interview. “As this is a coronavirus infection and the scientifically proven method of transmission is through droplets it is essential to adhere to these preventive practices,” she added.

She said the implementation of policies such as enforcing curfew helped the Ministry of Health in controlling community transmission and active case search, such as population movements being restricted. “It helped the surveillance system and public health staff to identify close contacts early for testing at the correct time,” she explained.

She said during the last one week period, almost all COVID 19 patients detected were based on the active case search detected through the surveillance of close contacts follow up of confirmed patients and high-risk communities followed up at quarantine centres. “All suspected patients investigated throughout the country from hospitals became negative for COVID-19 during the last week. In this background, health professionals and the community may fall into a comfort zone thinking that the country is going to get rid of this immense outbreak situation. We need to understand that we are maintaining this condition under very stringent control and prevention measures strategically implemented in the country,” Dr Gamage pointed out.

She said there is a well-established public health care system for communicable disease control and prevention in the country which is implemented mainly through the Central Epidemiology Unit, Ministry of Health. This includes the identification of close contacts of COVID-19 patients early and active case search for further prevention of community transmission. Explaining how the system operated she said , “ At the district level, Regional Epidemiologists are working closely with the Epidemiology Unit, under the administrative structure of the Provincial and Regional Directors of Health Services. Each District or the Health Region with the geographical division of Medical Officer of Health (MOH) areas are involved in providing community services in this procedure. The MOH together with Public Health Nursing Sisters, Public Health Inspectors and Public Health Midwives are involved in service provision at the community level.”

She said each public health inspector provides household services to around 10,000 people and each public health midwife provides services to around 3,000. In addition, Specialists who are technically competent called Consultant Community Physicians are working at provincial and district level coordinating and facilitating all public health care at the community together with the Epidemiology Unit at the central level.

“This in-built public health infrastructure was the strength in our country for active case search and prevention of continuation of chains of COVID-19 transmission,” she noted.

Dr Gamage also paid tribute to the help received from non health personnel in implementing the program. She said the assistance received from personnel such as military forces, National Intelligence, Sri Lanka Police, Grama Niladari and others markedly helped the Ministry of Health in following up close contacts as they had extended their collective support to the public health staff in tracking some difficult contacts at different places.

“ We have to understand, we are still maintaining country transmission at this stage while all infected countries are showing a high rise of cases after the initial reported case. A further stage of community sample testing of high-risk categories and potential geographical locations has been done in identifying early cases at community level and also to exclude the possibility of community transmission from possible undetected leakages of any asymptomatic cases.

She urged the public to adhere to the guidelines on quarantine and other preventive practices such as keeping one-metre distance between persons in social activities, adhere to cough etiquette, frequent and thorough hand washing. These will prevent most of the transmission among the public as it has been scientifically proved that the method of transmission is through droplets”, she reiterated.

She said that once the curfew is lifted gradually, the districts should start movements under very carefully planned strategies including health instructions and recommendations in preventing the transmission among the community. Otherwise, unexpected high transmission of this COVID-19 in the country is unavoidable, she warned.

Reduce Domestic violence impact during COVID by assertive communication, relaxing hobbies – psychologist

Following reports that domestic violence has risen sharply during the COVID outbreak mandatory lockdowns, by advocates and researchers in women’s rights groups, the Sunday Observer asked Counselling Psychologist Nivendra Uduman how the COVID 19 curfews could impact on women trapped in their homes and are vulnerable to domestic violence. Was there an increase in domestic/intimate partner violence, sexual abuse and other forms of violence in family environments during this pandemic likely? If so why?

Responding to our question he said, “There is naturally tension and frustration that people would feel at a time like this, and sometimes due to the inability to regulate one’s emotions, they could manifest in the form of violence against another family member or one’s partner. There is also the tendency for people to feel a loss of control, and a loss of status that can be difficult to cope with, especially when under curfew. A rapid change in gender roles, and power dynamics in a home can lead to violence because at the centre of domestic violence lies the need for power and the need to assert control,” he said. Curfew can also prevent people experiencing violence from getting help and in getting out of the house if there is a risk of harm to their life. There are services available to support women and children who go through violence that can be accessed over the phone. The numbers to call are:

Women in Need: 0114718585

Women and Children’s Desk - 0112444444

We asked him how they could deal with the problem. Following are some of his suggestions: Assertive communication: Regulate one’s emotions by for example: Practise deep breathing: Engage in a hobby: Listening to music: , Reading:, Speak to someone you trust . He also suggested limiting exposure of perpetrators to media and news. “This can help prevent tension escalating into violence,” he said, adding that a person using violence in a relationship and a person experiencing violence can both ask for help, emphasising that ” violence is not a solution to one’s problems.”