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