As we as a nation and the government grope for answers on how to best tackle our second COVID-19 wave, there is no global consensus amongst experts or even amongst countries as to what are the most effective interventions or even what the goal is.  Continue reading →

The daily case reports from the Epidemiology Unit are the only data we have to assess the spread of the virus. A better measure would be a regularly updated or “now-casted” estimate of the current effective reproduction number (R_eff), but the Epidemiology Unit does not publish this, and I have no idea if they estimate it on a regular basis. If they do, then maybe the spirit of the RTI legislation should encourage them to share it.

The data we do have are not reassuring. Continue reading →

In the past few weeks, a lot of people have been looking at the IHP estimates of required PCR testing capacity that I posted back in early April. We have not had the resources to revise these yet,* but if you are using our April estimates, this is to alert you that they are no longer valid.

In April we estimated that average daily PCR testing should be 6,000 tests/day, and that national PCR capacity should be 9,000 tests/day. Our daily testing need right now is probably in the range of 40-50,000 tests/day. Continue reading →

The increasing COVID-19 deaths in the past few days is a sign that the outbreak may be larger than our current constrained PCR testing is able to track. As I and others warned six months ago, we needed to ramp up PCR testing to keep the virus at bay and prevent future outbreaks. The President and PM gave instructions to that effect, but in reality this did not happen. Why remains a mystery, but the current outbreak is the inevitable consequence.

Increasing PCR testing reduces COVID-19 transmission (R_eff). In combination with contact tracing and isolation, it is the most effective intervention we have to control the virus. Better by far than lockdowns, masks, school closures and asking people to wash their hands… Other countries that were doing well back in May did continue to ramp up PCR testing, despite in some cases having no local cases. All these countries have managed to avoid a second wave.

Whatever happens, the most important gap in our current strategy and by far the most important one we need to fix remains PCR testing. It’s not ventilators, it’s not quarantine or contact tracing, and it’s not our border controls. Continue reading →

*I am reposting here with some edits and added links the article I wrote in the Daily Mirror on 29^th October 2020.

As a country, we’re in a moment of great peril. More than at any time during this pandemic. Unless we shift course, single-mindedly focus on the critical issues, and make the correct decisions and implement them decisively, we face not only an out-of-control epidemic, but economic disaster. Fixating on how the Minuwangoda outbreak started or who is to blame, or whether we have community spread or not, or is utterly pointless and has become a dangerous distraction from the real challenges. Continue reading →

*I am reposting here with some edits and added links the article I wrote in the Daily Mirror on 7^th October 2020.

The Minuwangoda incident should come as no surprise. The problems were obvious with the Kandakadu outbreak, but I remained silent in the hope that lessons would be learnt, but it seems that I was wrong.

We must recognise that as long as the global COVID-19 pandemic continues, we can never declare final victory against COVID-19 in Sri Lanka. To do so is to fool ourselves and the public. Wise leaders, like Jacinda Ardern, the New Zealand PM, warned their nations not to let their guard down, even after months of no local cases, because they understood that (a) no set of border controls can be 100% guaranteed to keep the virus out; and (b) it is impossible to know with certainty that there is no COVID-19 virus circulating unseen in
the community. Continue reading →

It’s been six months since I last posted here. Far too long.

When I stopped writing here, it was to work on something else. I think we succeeded earlier in the year in helping the public and colleagues better understand the challenge we faced with COVID-19 and countering the complacency. I think we had some impact, but clearly it wasn’t enough to really change things. Continue reading →