Delays in travel restrictions have contributed to the current COVID-19 outbreak

Effective, strong and early action is critical at this time to prevent a large scale COVID-19 outbreak in Sri Lanka. Despite WHO advice to the contrary, travel restrictions have an important role to play, and are the most effective tool we have since we can still hope to prevent and contain a local epidemic. Unfortunately, despite taking early action to restrict and screen arrivals from China, Korea and Iran, the government delayed too long to impose further restrictions given what the data were saying. This and gaps in implementation have contributed to the sudden increase in cases starting on 10th March. Continue reading

COVID-19: How deadly is it?

A key question is how many people will die if we have a large COVID-19 outbreak?

R0 and fatality rates

Epidemiologists look at two numbers to assess how dangerous a contagious disease is. One is the number of people that an infected person will transmit the infection to – R0 or “R nought” to use the jargon. This tells us how infectious a disease is. Two is the percentage of infected people who will die: the case fatality rate (or mortality rate).

Both matter. How many people die is the multiple of how many people get infected and what percentage of patients die. The seasonal flu virus has a low fatality rate, but it is quite infectious. So each year millions of people get the flu and hundreds of thousands die. Continue reading

COVID-19: China is no longer the problem

I am posting here a slightly amended version of the article that the Daily Mirror published yesterday. I’ve just edited that to add back in some wording that the Editor decided to drop.


The COVID-19 crisis has changed for the worse

In February, China was the problem – the rest of the world feared Chinese travelers and hoped to ride out disruptions to China’s economy. Today, the problem is outside China, and the fear in China is of foreigners carrying disease.

Countries around the world are repeating China’s mistakes. If this continues, the epidemic might infect most people in the world, leave potentially millions dead, and cause a severe global recession. We are running out of time. I explain what has happened. Continue reading

Sri Lankan thinking on national issues, spending and taxes

To start this off, I am re-posting here an article that I wrote in the Island just before the 2019 Elections. It reports some preliminary results from what consumed our efforts at IHP during 2018/2019 – the Sri Lanka Health and Ageing Survey (SLHAS). The findings shed some light on what voters were thinking just before the election day. We’ll have to see if their hopes and aspirations will be realized in the days to come.



In the past month, there’s been no shortage of views in the media on what the country needs and what the public wants, but on November 16, the voters will have their say. That is all that counts in a democracy – but the ballot box inevitably simplifies public views to simple choices without nuance or caveats. Which means – especially if the elections are close – that we will continue to argue and debate what the public wanted.

A key weakness in our civic life is the lack of regular, independent polling of public opinion. Some of our political parties are busy polling even now, but what we will learn of this, if anything, will only be if it suits their interests. I share here some findings on current public opinion that I and some other researchers have collected in the past two months. These are from a larger national scientific study, which is interviewing and tracking a panel of thousands of Sri Lankans from all backgrounds and all districts. Although this has mainly focused on healthcare coverage, in recent months we have also asked people their views on a range of policy issues.
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.

Friday, 13 March 2020