I share this in advance of a proper article on our exit paths that I haven’t had time to finish.
The most successful countries so far have been the East Asian countries which experienced SARS two decades ago. I think this has created a mental block for us in copying them. This is despite them sharing many cultural similarities, and despite the fact that one or two of them are the most similar to us in terms of how they organize their health systems.
New Zealand has now explicitly chosen the goal of Elimination over Mitigation. They are the first and only non-Asian, Western country to have done so.
Like us, New Zealand has no experience of SARS. They are also an island and have had access to the same information on what has been done in East Asia. But their prime minister and all of government have been guided by epidemiology, public health and economics.
The key components of New Zealand’s strategy in order of importance are:
- Border controls
- Widespread testing to control future transmission
- Public hygiene
- Social distancing including lockdowns
- Public communication
Adopting the Elimination Strategy requires us to use the breathing space provided by the lockdown to put in place the testing capacity required for #2: “Widespread testing”. IHP has estimated that we need to be doing 2,000–6,000 tests each day by 1 May. MOH epidemiologists have concluded similar numbers.
Of all the countries in the world who are positioned to follow the Elimination Strategy, Sri Lanka is the only one which is not using lockdown to aggressively plug the testing capacity gap.
I continue to remain dismayed at our continuing national failure on this. Yesterday, we lost the chance to double MOH testing capacity by end of this month at very little cost to the government, owing to a kind offer by local donors to fund most of the cost. They were short by USD 100,000.
We need to do more to address the testing gap and we need to do it now.
This is not something we can tackle after lockdown in May. Global delivery times for equipment and supplies are lengthening every day, and the rich countries—USA and Europe—are using their money to push poor countries like us aside in the queue.
It is equally important to help or push other countries to control this COVID 19 otherwise we can not move with the world as we are in global economy.I think WHO have major role to play by assuring all countries are geard to addhere what WHO advised in controlling this issue.Also important practicing winning stories in other countries and and our own systems.
Dishantha: Yes, we can’t be completely safe unless other countries are also safe! but sadly it is unlikely that all countries will agree to take the necessary actions. So border controls will be important for us and New Zealand. Unfortunately, WHO has failed to provide real leadership on this. Through February and March, it chastised many countries for imposing border controls, and it may not be able to change its stance which reflects longstanding corporate policy. That was a big mistake since airport closures and quarantines made a major contribution to helping Sri Lanka and other countries avoid a large epidemic.