Experts have advised for weeks that we need to do 2,000–6,000 tests a day, but why has this not happened?

We, at IHP, have consistently advocated that the COVID response must include massive testing, not only to detect patients for treatment, but more importantly to break the spread of infection by reducing the time that hidden cases spend in the community.

On 6th April, IHP produced estimates that we need to be doing 6,000 tests/day ideally, and a minimum of 2,000/day if we could not do that. We shared that report with senior MOH officials, but we also made it publicly available though this blog. Countless medical experts outside MOH, including many of the most senior doctors in the island, plus the GMOA, have made similar calls.

Later that same day (6 April), we learnt that MOH experts themselves had come to the same conclusion. Continue reading

How much COVID testing do we need: (2) Technical Estimates

Sri Lanka needs to increase testing of COVID from ~250 to at least 2,000 RT-PCR tests a day. There is a large backlog in testing of contacts of known COVID cases that needs to be rapidly dealt with. We also need to put in place testing capacity that will allow the country and economy to get back to some level of normality during the next 12 months. 

We report target levels for daily testing, as well as how much capacity we need overall. Our analysis does not estimate requirements for antibody (IgG/IgM) testing, as this will be additional and is not appropriate as the first line of testing in this war against COVID-19. The most urgent priority for the country is to expand RT-PCR testing. Our initial estimates and analysis are given in our report (click to download) and the key numbers are summarized below. Continue reading

தேசிய COVID PCR பரிசோதனைகளின் தேவைகள் பற்றிய எங்கள் மதிப்பீடுகள்: (1) முன்னுரை

சோதனை விகிதத்தை அதிகரிக்க இலங்கைக்கு இன்று மிக அவசரமான தேவை. ஒரு நாளைக்கு 250 சோதனைகள் இருக்கும் தற்போதைய சோதனை விகிதம் முற்றிலும் போதாது. இது பூட்டான், மாலத்தீவு மற்றும் வியட்நாம் போன்ற வளரும் நாடுகளை விட மிகக் குறைவு. ஏப்ரல் இறுதிக்குள் இலங்கை அமல்படுத்த வேண்டிய ஆர் டி-பி.சி.ஆர் பரிசோதனைத் திறன் குறித்த எங்கள் ஆரம்ப மதிப்பீடுகளின் விவரங்களை இங்கு எழுதப்போகிறேன். அதைச் செய்வதற்கு முன், ஒரு சிறிய முனுரை. Continue reading

Visualization of the source of COVID-19 cases in Sri Lanka

Sri Lanka has still to start releasing daily details of its Covid-19 cases and the findings of the critically important contact tracing effort, as does Singapore and Hong Kong. See here, here and here for how Singapore’s health ministry keeps Singaporeans informed. This is unfortunate as doing so would help build public confidence and understanding of the difficult measures that are needed, as well as help to combat rumour and fake news. Doubly unfortunate, because greater transparency would probably reflect well on the efforts of the Epidemiology Unit of the Ministry of Health.

On the positive side, the Health Promotion Bureau has been innovative in its decision to publish a regularly updated data feed on overall numbers, and in the past few days the Epidemiology Unit has released online details of cases to date. Based on that initial release, which I really hope is updated daily, our team at IHP – Nilmini Wijemunige, Yasodhara Kapuge, Chathurani Sigera and Nishani Gunawardana– generated the graphic below summarising what we know about the first 78 cases (as of 22 March). Continue reading

Why this blog?

I’ve been thinking for a long time that we need to do a blog to share personal views and occasional research notes for a long time. There is so much work we do at IHP that never gets shared – for lack of time or lack money. So a blog to share some of that informally or in provisional form always seemed a good idea. Sadly, I just never got around to it with all the other things that keep us busy at IHP. However, the COVID-19 crisis finally made me think this is time to start one, even if Friday the 13th might not seem the most propitious. This is going to be an experiment to provide some space for sharing views and information, and I hope it will be of value to others, so let me know if it is, and what you like or don’t like.

Ravi
Colombo
Friday, 13 March 2020