Why did Jathika Chintanaya not save us from Western COVID thinking by taking PCR testing seriously?

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 virus may be spreading much faster than official data suggest

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 (Reff), 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

பி.சி.ஆர் பரிசோதனை திறன் குறித்து ஏப்ரல் மாதத்தில் எங்கள் ஐ.எச்.பி வெளியிட்ட மதிப்பீடுகள் இப்பொழுது பொருந்தாது – நம் தேவை கூடிவிட்டது

சமீபத்தில் பலரும் ஏப்ரல் மாத துவக்கத்தில். IHP-யில் நாங்கள் வெளியிட்ட பி.சி.ஆர் பரிசோதனை திறன் குறித்த மதிப்பீடுகளை பல முறை பார்த்துள்ளனர். இந்த மதிப்பீட்டை தொடர்ந்து புதுபிப்பதற்கு தேவையான ஆதாரம் IHP-க்கு இன்னும் கிடைக்கவில்லை, எனினும் இந்த மதிப்பீடுகளை நீங்கள் உபயோகிப்பவரானால் இது இப்பொழுது செல்லாது என்பதை உங்கள் கவனத்திற்கு கொண்டுவரவே இந்த வெளியீடு.

ஏப்ரல் மாதத்தில் ஒரு நாளில் சராசரியாக 6,000 பி.சி.ஆர் பரிசோதனைகள் செய்யப்பட வேண்டும் என வும், தேசிய பி.சி.ஆர் பரிசோதனை திறன் ஒரு நாளைக்கு 9,000 பரிசோதனைகளாக இருக்க வேண்டும் என்றும் மதிப்பிட்டிருந்தோம். எமது தற்போதைய தேவை அநேகமாக நாள் ஒன்றுக்கு 40 – 50,000 பரிசோதனைகளாக இருக்க வேண்டும்.
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Interview with EconomyNext (10 Nov 2020)

EconomyNext emailed me about the last post revising upwards our estimates of required PCR testing capacity. What I told them in this interview here:

PCR පරීක්ෂණ ධාරිතාව පිළිබඳව සෞඛ්‍ය ප්‍රතිපත්ති ආයතනය විසින් අප්‍රේල් මාසයේදී කරන ලද ඇස්තමේන්තු යල් පැන තිබේ – අපට තවත් වැඩි පරික්ෂණ ධාරිතාවක් අවශ්‍ය වේ.

මා විසින් අප්‍රේල් මස මුලදී පළ කළ COVID පරීක්ෂණ ධාරිතාව පිළිබඳ IHP විසින් සිදුකල ඇස්තමේන්තු අගයන් දෙස, පසුගිය සති කිහිපය තුළ දී බොහෝ දෙනෙක් බලා තිබුණි. එම ඇස්තමේන්තු අගයන් නැවත සංශෝධනය කිරිමට අප හට අවශ්‍ය සම්පත්* නොමැති නමුත්, ඔබ අපේ අප්‍රේල් ඇස්තමේන්තු භාවිතා කරන්නේ නම්, ඒවා තවදුරටත් වලංගු නොවන බවට මෙයින් ඔබව දැනුවත් කරමු.

අප්‍රේල් මාසයේ දී අපි ඇස්තමේන්තු කළේ සාමන්‍ය දෛනික PCR පරීක්ෂණ දිනකට 6,000 ක් විය යුතු අතර ජාතික PCR ධාරිතාව දිනකට පරීක්ෂණ 9,000 ක් විය යුතු බවයි. නමුත්, දැන් අපගේ දෛනික පරීක්ෂණ අවශ්‍යතාවය බොහෝ විට දිනකට පරීක්ෂණ 40-50,000 අතර වේ.

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Our IHP estimates in April of required PCR testing capacity are out of date – We need much more

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

Inadequate PCR testing capacity and testing remains our central problem

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 (Reff). 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

At the precipice—Reaching the limits in managing the crisis

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

Time to rethink our COVID-19 testing strategy

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

We’ve been busy for too long…and what we feared has happened

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