On Thursday 19 March, we reached a significant milestone in the current epidemic which should not go without comment.

China reported reported zero local cases throughout all its provinces including Hubei. The handful of cases it has had in the past few days have all been imported infections in visiting foreigners (mostly Italians) or returning Chinese. China is where the epidemic started three months ago, but it is now on the verge of being able to declare that first wave over and done with.

I wrote an article earlier to explain why the epidemic is no longer a Chinese problem. It was an attempt to alert everyone in Sri Lanka to the need to refocus on the infection threat from other countries, especially Europe. Unfortunately, it took over a week for me to get that published, and during that time the government continue to allow unrestricted arrivals from a range of countries with major and out-of-control outbreaks, such as the UK, France, Spain and Italy. As I wrote a few days ago, it is not therefore surprising that we ended up with the current outbreak with over 50 detected cases and almost certainly over a hundred undetected so far.

Continue reading →

We just came across this continuously updated tracker of Sri Lankan COVID cases developed by Isanka Wijerathne, a researcher at Kyoto University: http://covidsl.com. It reports current and changes in total cases, tests done and recovered patients. Continue reading →

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 →

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 →

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.

COVID-19: CHINA’S NO LONGER THE PROBLEM

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 →