The recent outbreaks reveal serious problems in our elimination strategy

The surge in cases due to spread between residents of Colombo under curfew should not surprise the health authorities – it was entirely predictable. For several weeks, we have failed to take adequate action to build on our initial success, in particular to expand testing. Whilst we remain in a select group of countries with minimal community transmission, we are increasingly dropping behind in our response. This is making it more difficult to lift the lockdowns, it will continue to frustrate the government’s economic and political goals of restarting the economy and holding elections, and it is putting to waste the enormous sacrifices that the public have made during one month of lockdown.

To explain what is happening, we can divide the world into two groups of countries:
1) Countries where the goal is only to control the epidemic at a manageable level or “to flatten the curve”.
2) Countries where the goal is to keep the epidemic crushed, or something as close to “elimination” as possible.

(1) Countries that aim to flatten the curve

Most countries today are in the first group. Community or local transmission of virus is so widespread that it is impossible for health services to track each case, with thousands of deaths and new cases every day. These countries have no hope of stopping the epidemic locally, and the best they can aim at is to bring the rate of new infections down to a level that does not overwhelm their health services and which allows them to lift lockdowns, i.e., “flatten the curve”. Countries include the USA, the UK and continental Europe, India and Indonesia.

(2) Countries that aim at elimination

The second group contains only a handful of countries, many of them islands. All of them crushed the first global wave of infection from China, and then have made significant progress in crushing the second global wave of infection, which was mostly spread by travelers from Europe. In these countries, the goal is to stop sustained local transmission and to prevent a third wave by the virus again crossing their borders. In places like China, Hong Kong, Taiwan, Korea, Vietnam, New Zealand and the Faroe Islands this goal is often explicit, and in Australia where it is not, elimination remains an option. In this second group, the epidemic has two features. First, in all of them numbers of new cases have declined to small numbers close to zero in the past few weeks. The second is that most or all of their recent Covid-19 cases are in travelers or their immediate contacts.

The difference between these two groups is quite obvious when we look at the rising or flat trend in new cases in places like Brazil, India and Sweden compared with say the declines to almost zero in New Zealand, Taiwan and the Faroe Islands (Chart 1).

Chart 1: Trend in new cases in countries aiming for control versus elimination

Sri Lanka fits in the second group so far, but complacency is leading us to fall behind.

The first sign of this came in early April. After stopping foreign arrivals in March, we did not crush the second wave as rapidly as the others. Instead, the decline in new cases was less rapid, and then it was not sustained with numbers fluctuating from day to day, as shown by the red wriggly worm in Chart 2. This performance is particularly poor when we consider that places like Hong Kong, Australia, New Zealand and Taiwan not only closed their airports after us, but they also let in far more infected travelers during March than we did. As a result, they had far more imported cases in their second wave than us and their numbers peaked much later, but despite this they then brought their numbers down much faster.


The second indication of a problem comes from looking at how recent cases were infected. This is not that easy to do. We have a fundamental right to this information held by the government on our behalf, but our public servants in the health ministry still do not routinely share these data which are of such public interest and importance.

To compile our analysis, we used the last detailed report (27 March) by the Ministry of Health (MOH), combining it with what we could obtain from media reporting of subsequent cases. Chart 3 below shows the source of infection in cases in Sri Lanka by day from mid-January till the start of the current outbreak (20 April). Blue indicates an arrival who was infected outside Sri Lanka or people who were directly infected by them (light blue). Red and orange indicate people who were infected not by the imported case but were infected through a chain of transmission starting with the direct contacts of an imported case. MOH does not treat these cases as community transmission, but they all involve local transmission in Sri Lanka.

Our first wave in late February consisted of only one blue case in a Chinese visitor. It’s small not because our COVID response was exceptional, but because only a tiny proportion of Chinese tourist and business traffic is to Sri Lanka—Chinese prefer to go to Europe, USA or other Asian countries much more than come here. Paradoxically, our economic failure—to globalize like other Asian economies—protected us, but I suspect that the absence of cases in February then resulted in too much complacency.

The second wave starting in March is much bigger. Initially we had a peak of cases which were mostly blue. Case numbers then came down but did not continue declining. Instead, we see a resurgence of mostly red cases due to local transmission, indicating that we were failing to contain the virus to arrivals and their immediate contacts.

Chart 3: Epidemic curve of COVID cases in Sri Lanka by transmission category, 17 Jan–20 April 2020

Chart 4: Epidemic curve of COVID cases in Hong Kong by transmission category, 17 Jan–13 April 2020


Contrast this pattern with one published by Hong Kong (Chart 4), which closed its airport to foreign arrivals a few days after us. Note that this only groups the immediate contacts with imported cases (in blue), and treats other cases where the transmission chain was longer as local infections. It shows only a single blue wave of cases in late March. This peaks around 30 foreign arrivals a day in mid-March before dropping to essentially zero in mid-April. Hong Kong has since seen several days with zero cases, and its most recent cases are all in arrivals who are in quarantine.

Sri Lanka has failed to contain the virus to foreign arrivals

Hong Kong’s performance is similar to China, Taiwan and others in the elimination group. Sri Lanka differs from these other countries, because it has failed to contain the virus to foreign arrivals and their immediate contacts. Instead it has allowed the virus to jump to others, resulting in chains of transmission continuing into late April.

This serious failure has been camouflaged by labeling the subsequent cases as imported case clusters, and saying that we do not have community transmission. This is nothing more than semantics. “Community transmission” only means that we don’t know the chain of transmission from an imported case; it does not mean that local transmission has not occurred between people living in the community and outside a quarantine camp. Local transmission is what the other countries in the group have prevented and what we need to focus on.

Why have we failed to contain the virus?

If we examine the recent cases, we can see several problems which have contributed to the failure to contain the virus.

Self isolation or home quarantine of arrivals does not work. The Piliyandala fish vendor was infected by an arrival who was home quarantined in the same house. It is difficult for self isolation to work when people live in cramped housing and other problems arise from non-compliance with the rules. Developed countries like Australia and Singapore found this is too risky, and either mandated institutional quarantine (Australia) or only allow home quarantine after taking stringent measures to enforce compliance, including heavy fines for breaking the rules, electronic tagging and random daily visits and calls to check on individuals (Singapore). Although we now have mandatory quarantine for all new arrivals, given the likelihood that undetected cases may have entered earlier, we need to go back and test everyone living in a house with an arrival who was not quarantined from mid-March.

Fourteen days quarantine is not long enough to detect symptoms in infected people. We have known since February that many COVID cases never develop symptoms and others develop symptoms only after 3 weeks. The Bandaranayake Mawatha cluster was started by a returnee who only developed symptoms after completing 14 days of quarantine, and who was only diagnosed five weeks after her arrival. The only way to handle this is to combine testing with quarantine.

Infection control procedures have not been adequate at quarantine camps or at the airport. There have now been several cases of staff at these places being infected and of cross-infection between quarantine residents. More needs to be done to improve the design and operation of quarantine and airport facilities to stop this happening.

Curfew alone is not sufficient to stop community transmission. Many of the Bandaranayake residents were infected by social interactions in the middle of curfew. A family from another area was also infected by visiting and staying in a house in the area, again despite the curfew. Although enforcement of the curfew could be improved, it is not realistic to stop all interactions during curfew, especially in poor areas where families cannot sustain themselves for long periods. This suggests that we need stronger social distancing and hygiene measures combined with much more surveillance testing to slow transmission, both during a curfew and also after it.

Finally, the overall failure to adopt an aggressive testing strategy has resulted in the health services repeatedly missing chances to detect hidden cases of infection. The index case in the Bandaranayake cluster made several visits to a teaching hospital over several weeks with respiratory symptoms but was not tested. She almost certainly infected many others during this time. This is not an isolated case – this failure to detect cases has happened before. Although MOH has now allowed doctors to test OPD patients with relevant symptoms, this is not mandatory, and most are not tested in practice. Current MOH guidelines are not clear enough or do not mandate testing of many high risk groups as is done by Hong Kong, Singapore and others.

What do we need to do?

Half measures will not work and are not cost-effective with COVID. This is clearly demonstrated by the recent outbreaks and the huge failure of MOH to bring the new case count down to zero more than a month after the airport closed. To get back on track with the goal of elimination, and to ensure the country is safe to lift the lockdown, we need to fully copy the elimination strategies of Vietnam, Hong Kong, Taiwan, Australia, New Zealand and others. Incidentally, this also implies going beyond WHO recommendations which are not tailored for countries that are aiming at elimination.

First of all, this means that MOH needs to strengthen its testing guidelines to make testing mandatory for many patient groups where it is still discretionary. For example all ICU patients must be tested for COVID, and we need much more testing of patients in OPDs. In addition, quarantine and self-isolation procedures need to be tightened to prevent cross-infection and to include testing to identify any infected cases before release. As a remedial measure, all family members of arrivals in late March who underwent home quarantine should be urgently tested with PCR or antibody as appropriate.

Looking ahead, we need a better strategy for controlling transmission of the virus after lockdown is lifted. This needs to combine much more testing than now with stepped up social distancing, public education and hygiene measures. It would be foolhardy and irrational to assume that no virus will be circulating in the community. At the very minimum, we would need to have 28 days with zero new cases, but the country will not tolerate this. We can now see how many people just one or two hidden cases can infect in the space of a month under curfew. Imagine what will happen during five weeks of an election campaign.

We do not blame our political leaders for this fiasco. The failure clearly embarrasses the President and government with their plans to lift the curfew and to hold elections, and it adds to the damage the lockdowns do to our economy and people’s livelihoods. Whatever their faults, our politicians have deferred to the advice provided by our health officials. Instead, we must point to the continuing complacency and inability of these health officials to understand that half measures will not work against this virus. In particular, the failure to expand testing aggressively is nothing less than a scandal. This needs to end for the sake of the country.

Written by Ravi Rannan-Eliya with analysis by Nilmini Wijemunige, Nishana Guanawardana, Ruwanthi Elwalagedara, Dalreen Barthelot, Chathurani Sigera, Sachini Fonseka, Yasodhara Kapuge and Sarasi Amarasinghe and contributions by Ananya.


1 thought on “The recent outbreaks reveal serious problems in our elimination strategy

  1. I admire you because you are one of the few health professionals on social media who seem to understand that SL Covid strategy is suppression(crushing the curve) not mitigation (flattening the curve). Of course you can’t go by terminology alone as both supressionists and mitigationists sometimes use identical superficial terminology ‘flattening the curve’ but when you delve into their statements you can spot who is a suppresionist and who is a mtigationist. Do you know that there are community physicians, epidemiologists in Sri Lanka who believe that ‘our strategy’ is mitigation ? This is a facebook post of Dr. Manuja Perera a lecturer in community medicine. Though she does not use the English words ‘mitigation’ or ‘suppression’ in her Sinhala post, it’s very clear from the content that she is talking about ‘mitigation’. Notice she draws a parallel between dengue and covid 19 and says we(SL) are nowhere close to eliminating dengue; our strategy is controlling spread; ditto covid. It’s clear that although she seems to be a key player in preparing and disseminating Sri Lanka College of Community Physicians Covid guidelines and recommendations, she seems genuinely unaware that the larger professional body she belongs to (SLMA) has unambiguously recommended crushing the curve, suppression, hammer and dance, maintaining R below 1. This is part of what she says
    “උදාහරණයක් ලෙස අපි ඩෙංගු තුරන්කිරීම අහලකවත් නැත. අපි ඩෙංගු ගැන කතාකිරීමේදී භාවිතා කරන්නෙ “පැතිරීම පාලනය කිරීම” යන පදයයි. අපේ අරමුණ හැකිතාක් රෝගීන් ගණන අඩුකරගැනීමයි. කොරෝනා ගැනද අපි කතාකළේ ඒ පාලන ක්‍රමයමය. ගෝලීය වසංගතයක්වීම නිසා ගෝලිය ජනමාධ්‍ය භාවිතාකළ “flattening the curve” අපේ රටෙත් ජනප්‍රියවූ නිසා එම පදයම දිගින් දිගටම භාවිතාකරන ලදී.

    Curve එක flat කිරීමේ අරමුණ එක්වරකට වාර්තාවන රෝගීන් ගණන අඩුකිරීම සහා කවදා හෝ පැමිණෙන පීක් එක සඳහා සුදානම්වීමට කල් ලබාගැනීමයි. මෙහිදී පීක් එක කවදා හෝ පැමිණෙන අතර රෝගී සංඛ්‍යාව බිංදුවවීම හෝ බිංදුව වෙන දවස රෝගයේ ගතිලක්ෂණ මත විශාල ලෙස රඳාපවතියි. කොරෝනා වැනි ශ්වසන වෛරසයක් තුරන්කිරීමට නම් එන්නතක් සොයාගැනීම අවශ්‍යම වේ. එන්නතක් නැත්නම් ඒ සඳහා ඖෂධ සොයාගැනීම හෝ එම වෛරසය විසින්ම සාමාන්‍ය හෙම්බිරිස්සාව සාදන වෛරසයක් දක්වා අනුවර්තනයවන තෙක් එය අවම සෘණාත්මක ප්‍රතිඵල ඇතිවන සේ පාලනය කිරීම සිදුකරනු ලබයි. මෙහිදී රෝගීන් බිංදුව වීමේ හැකියාව ඉතාම අවමය”

    She seems honestly not to have seen the curves for China, other east Asian countries such as Viet, South Korea or even NZ or read the Imperial College paper in conjunction with the hammer and dance paper. is the link to her public post and notice how she implies in response to one comment that Vietnam may have done more tests than necessary. Has she heard of KErala at least? One wonders.

    The other person is Suneth Buddhika Agampodi who is an epidemiologist attached to Rajarata University who seems to be currently in Yale on some fellowship.

    This is his fb post ( which seems to follow the (faulty) model (based on limited epidemiological data?) of the Imperial College paper that what suppression does is merely postponing by six months or so the same peak which would have come much earlier if a ‘do nothing’ strategy had been adopted.

    Since then the hammer paper based on data from East Asia and China has pointed out that the hammer takes just weeks not months to crush the curve and bring R down to below 1. As I felt that these people may be an indication of why the chief epidemiologist is allegedly (alleged by the GMOA) resisting doing more tests (apparently saying we have to conserve our testing resources to be deployed more productively when we move to the community spread stage) and because these people seem to have large student followings who follow them uncritically, I commented anonymously below Suneth B Agampodi’s post. Also you can see in the comment thread below that post, a reply by a Sri Lankan epidemiologist with the WHO (Pushpa Ranjan Wijesinghe) apparently specifying 70% infections in the community as conferring immunity to that country and the possibility of a drawn out peak being able to achieve that. This despite current WHO uncertainty about learned immunity being useful against Covid 19. Of course my anonymous comment was deleted and my anonymous profile barred. You can see in the comment section self righteous, “I was a victim of political targeting” statements. But my aim was to educate and seek clarifications. As long as my comment was not abusive, psychotic or antisocial, anonymity is my right, I believe.

    This is that longish comment
    සුනෙත් බුද්ධික අගම්පොඩි ඔබ වැරදියි. ඔබ මොනවද මේ එෆ් බී එකේ දෙන මෙසේජස්? ඔබ සහ මනුජා පෙරේරා ගේ පෝස්ට් වලින් පෙනී යන බරපතල කරුනක් වන්නේ ඔබ “අපේ ස්ට්‍රැටජි’ එක කියා හදුන්වාදෙමින් ඔබේ එෆ් බී පේජ් වලින් ප්‍රමෝට් කරන මිටිගේශන් ස්‍රැටජි එක හෙවත් ෆ්ලැටනිං ද කර්ව් (වක්‍රය පැතලි කිරීම) රටේ ස්ට්‍රැටජි එක නොවේ. ස්‍රී ලංකා මෙඩිකල් ඇසෝසිඒශන් හා එහි ඉන්ටර් කොලීජියට් කමිටි මගින් රෙකමෙන්ඩ් කර ඇති, එපමනක් නොව බොහෝ විට ස්‍රී ලංකා මෙඩිකල් ඇසෝසියේශන් හි තීරන සමග එකග නොවන ජී එම් ඕ ඒ පවා යෝජනා කර ඇති ස්ට්‍රැටජි එක වන්නේ ක්‍රශිං ද කර්ව් (වක්‍රය තලා දැමීම) හෙවත් සප්‍රෙශන් ස්ට්‍රැටජි එකයි එනම් හැමර් ඇන්ඩ් ඩාන්ස් මෙතඩ් එකයි. මෙහිදී එකට අඩු ට්‍රාන්ස්මිශන් rate එකක් පවත්වා ගැනීම ඉලක්ක ගත කෙරේ.
    එස් එල් එම් ඒ එෆ් බී පිටුවේ අප් ලෝඩ් කර ඇති තොරතුරු සමග ෆැමිලිඇරිටි එකක් ඇති කර ගන්නා මෙන් ඉල්ලමි. එස් එල් එම් ඒ පෙර සභාපති  Dr. B. J. C. Perera අප්‍රේල් 17 නියුස් ෆස්ට් නියුස් ලයින් හි ( පවසන දේ බලන්න (9.28 පමන සිට) ඔහු කියන්නේ “what we really want rather than flattening the curve we want to crush it we want to really crush it and if we want to do it we have to plan the future very carefully” (අපට ඇත්තටම අවශ්‍ය වන්නේ වක්‍රය පැතලි කිරීමකට වඩා වක්‍රය තලා කුඩුකර දැමීමයි). එස් එල් එම් ඒ වත්මන් සභාපති Prof. Indika Karunathilake පවා පවසන්නෙ එයයි.   ඔහු මෙම ආටිකල් එකේ ( පවසන දේ බලන්න

    “Covid-19 trend in SL: Why we need to crush the curve

    A mathematical model for prediction was developed by SLMA Vice President Prof. Manuj Weerasinghe and Dr. Nishantha Perera from the Department of Mathematics of the University of Colombo (UoC). According to their predictions, tight control is required to maintain a manageable patient load; the maximum number of coronavirus cases we can handle at the moment is around 2,000, and anything more than that will put the healthcare system in serious jeopardy.

    In order to maintain active cases below this range, we cannot deviate from the predicted trend for Sri Lanka under strict regulation of movement and physical distancing. Hence, Prof. Karunathilake emphasised that it is in the country’s best interest for the SLMA to liaise with professional bodies to advise decision-makers of the country.

    In this regard, two fundamental strategies are possible:

    1. Flattening the curve – also known as a “mitigation strategy”. This focuses on slowing but not necessarily stopping the epidemic from spreading by reducing peak healthcare demand while protecting those most at risk of severe disease from infection

    2. The hammer and the dance method – this is total suppression which aims to reverse epidemic growth, reducing the case numbers to low levels and maintaining that situation indefinitely. However, each policy has major challenges since the bare minimum essential services need to function

    In Sri Lanka, we recommend the hammer and the dance method. This is the opinion of the experts, considering the strength of Sri Lanka’s public health system. The available data is changing every day, and hence we need to take a dynamic approach while monitoring the local trends very closely.”
    ඔබ රූපයක් විදියට දී ඇති රෝගීන් විශාල ප්‍රමානයක් කෙටි කාලයකින් හමුවීම එදිරිව රෝගීන් ඒ ප්‍රමානයම හෝ ඊට මදක් අඩුවෙන් දිගුකාලයක් තුල හමුවීම යන මොඩලය කොහෙන් ආවද කියල හිතාගන්න අමාරුයි. මොකද ලංකාවෙ සප්‍රෙශන් එක පොඩි අඩුපාඩු ඇතිව කලොත් ඇක්ටිව් කේසස් 170-200 න් කර්ව් එක මේ මාසේ පීක් වෙයි කියල එස් එල් එම් ඒ එක ප්‍රෙඩික්ශන් එකක් කරල තිබුන.අද ඇක්ටිව් කේසස් 297. ඒ කියන්නේ පොඩි පොඩි අඩුපාඩු (5%) සිනාරියෝ එක අපෙන් ගිලිහිල. හැබැයි සාමාන්‍ය අඩුපාඩු සිනාරියෝ එකකදී (10%) ඇක්ටිව් කේසස් 340- 400 මේ මාසෙ අන්තිම වෙනකොට පීක් වෙල ඊට පස්සෙ අඩු වෙයි කියල එස් එල් එම් ඒ මොඩල් එකෙන් කියනව. ඒක එහෙම වුනොත් හමු වෙන මුලු රෝගීන් ගනන රෝගය අපේ පාලනයෙන් ගිලිහුනොත් ඇතිවෙන එක්ස්පනෙන්ශල් වැඩිවීම වුනොත් හමු වෙන රෝගී ගනනට වඩා ගොඩක් අඩු වෙනව. ඔය ඉම්පීරියල් කොලේජ් පේපර් එකේ ගොඩක් ස්ට්‍රක්චරල් අඩු පාඩු තියනව ඔය හැමර් ඇන්ඩ් ඩාන්ස් පේපර් එකට අනුව ( ඒ අඩු පාඩු නිසා තමයි ඒ අයට හිතෙන්නේ ඩූ නතිං ස්ට්‍රැටජි එකක ඉක්මනින් එන පීක් එකම සප්‍රෙශන් උපක්‍රමයකදී මාස ගානක් පරක්කු වෙල එනවය කියල.
    “If you’re a politician and you see that one option is to let hundreds of thousands or millions of people die with a mitigation strategy and the other is to stop the economy for five months before going through the same peak of cases and deaths, these don’t sound like compelling options.
    But this doesn’t need to be so. This paper, driving policy today, has been brutally criticized for core flaws: They ignore contact tracing (at the core of policies in South Korea, China or Singapore among others) or travel restrictions (critical in China), ignore the impact of big crowds…
    The time needed for the Hammer is weeks, not months.”
    දැන් අර රාජිත වගේ දේශපාලයෙක්ට උපදෙස් දෙන දොස්තරල කියල දීල එයා ප්‍රෙස් එකක කිව්වේ මේ ක යටපත් කරාට පස්සෙ ලිහිල් කරාම එන පීක් එක ඩෙඩ්ලි කියල. ඒ උපදෙසත් මේ ඉම්පීරියල් පේපර් එකේ ස්ට්‍රක්චරල් අඩු පාඩු නිසා මිනිස්සු අතරට ගිය වැරදි මතයක් කියල තමයි මෙන්න මේ රිවියු එක කියන්නේ…_

    Neil Ferguson and an Imperial College team perform detailed
    simulations of outbreak response [1]. This is an important
    work because they model social/government response,
    not just contagion. They show suppression (lockdown so that
    R0 1, “flattening
    the curve”) necessarily results in massive overload of hospitals
    and many dead. This is an important conclusion that should
    inform policy makers.
    However, they make structural mistakes in analyzing outbreak
    response. They ignore standard Contact Tracing [2]
    allowing isolation of infected prior to symptoms. They also ignore
    door-to-door monitoring to identify cases with symptoms
    [3]. Their conclusions that there will be resurgent outbreaks are
    wrong. After a few weeks of lockdown almost all infectious
    people are identified and their contacts are isolated prior to
    symptoms and cannot infect others [4]. The outbreak can be
    stopped completely with no resurgence as in China, where new
    cases were down to one yesterday, after excluding imported
    international travelers that are quarantined.
    මට හිතෙන්නේ කොලෙජ් ඔෆ් කමියුනිටි ෆිසිශන්ස්  තියන ඔක්කොම ලිට්‍රචර් කියවල, ඉන්ටකොලිජියට් ෆෝරම් වල මේව ඩිස්කස් කරල රෙකමෙන්ඩේශන් දුන් නැත්නම් ඒ ගොල්ලන්ගෙ උත්සාහල ඉරෙලෙවන්ට් වෙනව. අනිත් එක අනිත් ඔක්කොම ප්‍රොෆෙශන් එක සප්‍රෙශන් හැමර් ඇන්ඩ් ඩාන්ස් ස්ට්‍රැටජි එකක් ගැන කියද්දී ඕගොල්ල විතරක් අවුට් ඩේටඩ් ඩිස්ක්‍රෙඩිටඩ් හර්ඩ් ඉමියුනිටි එකක් ගැන කිය කිය (ලෝක සවුක්‍ය සංවිධානය පවා කොවිඩ් ඇන්ටි බොඩි ලොන්ග් ටෙර්ම් ආරක්ශාවක් දෙයිද නැත්නම් ඩෙංගු වල වගේ දෙවන පාර ඉන්ෆෙක්ශන් එක තවත් සිවියර් කරයිද ඒව ගැන බර පතල සැක මතු කරද්දී උඩ කොමෙන්ට් එකක තියන හර්ඩ් ඉමියුනිටි විකාර කතා එම සංවිධානයේම කෙනෙක් ලංකාව ගැන කීම බරපතල සැක කටයුතුයි) මේ ලොක් ඩවුන් එක ඊස් කරල සෝශල් ඩිස්ටංසින් හා හයිජීන් වලින් විතරක් මේක කරමු කියල කියන එකත් සැක සහිතයි. ලංකාවෙ ඇවරේජ් මෙඩිකල් ග්‍රැජුවේට් මේව එච්චර තේරුම් ගන්න අය නොවුනත් ලංකාවෙ ඉන්නව මාර බ්‍රයිට් අවුට් ලයර්ස් ල. ඒ ගොල්ලන්ගෙන් මනුජා පෙරේරාගේ ෆ්ලැටනින්ග් ද කර්ව් පොස්ට් එකට දැනටමත් විරෝදයක් එල්ල වෙලා තියනව. යූ කාන්ට් ෆූල් ඕල් ද පීප්ල් ඕල් ද ටයිම් නේ. ඉම්පීරියල් කොලෙජ් පේපර් එක පවා මෙහෙම කියද්දී  “Given that mitigation is unlikely to be a viable option without overwhelming healthcare systems,
    suppression is likely necessary in countries able to implement the intensive controls required.” ඔය ගොල්ල විතරක් මිටිගේශන් එකක් යෝජනා කරමින් හර්ඩ් ඉමියුනිටි එකක් හා බැදෙන දහස් ගනන් මරන ලංකාවේ සිදුවන්න ප්ලෑන් කරන එක හරිද? විශේශයෙන්ම අනිත් ප්‍රොෆෙශනල් ලා එක්ක කොන්සෙන්සස් නැතුව. අනිල් ජාසින්හ පවා කීවේ ප්‍රතිශත මොනව උනත් ඇක්චුවල් නම්බර් ඔෆ් ඩෙත්ස් පිලිගත නොහැකි වෙන විදියට වැඩි වෙන මේ මිටිගේශන් ස්ට්‍රැටජි එක අපි වගේ පෙරදිග රටවල ක්‍රමය නොවෙයි කියල. අනික මේක අලුත් වයිරස් එකක් නිසා අපි හානිය අවම කරමින් ඉතාම කෝශස් විදියට හැම ජීවිතයක්ම රැකගෙන ඉස්සරහට යන බවයි ඔහු කීවෙ. එතනදී ඔහුගේ පිලිවෙත ජසින්තා ආර්ඩන්ට සමානයි. ඇය කීව දේ මතකයි නේ හර්ඩ් ඉමියුනිටි ගැන? ඒ නිසා හැමර් ඇන්ඩ් ඩාන්ස් ගැන වැඩි දුරට හදාරා ඒ ගැන සහ මිටිගේශන් හර්ඩ් ඉමියුනිටි ගැන ඉන්ටර් කොලීජියට් මට්ටමින් පුලුල් සංවාදයක් ඇති කර ගත් පසු පමනක් ෆේස් බුක් වලට පැමින “අපේ ස්ට්‍රැටජි එක” ගැන කතා කිරීම වඩා සදාචාරාත්මකයි නේද?
    මෙන්න හැමර් ඇන්ඩ් ඩාන්ස් ඇට් අ ග්ලාන්ස්*a9Lcz2g8DkKdnW0o_vk3ow.png

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