Covid-19: The Epidemic & The Economy

By Rajan Philips –NOVEMBER 29, 2020

Rajan Philips

“What I have learned about pandemics is you have to be very humble. There is no mission-accomplished moment.” ~ Dr. Vin-Kim Nguyen 

Perhaps every medical professional would agree with the sentiment in the above comment by a Vietnamese Canadian Doctor, who is affiliated to two international hospitals, one in Montreal, Canada, and the other in Geneva, Switzerland. Unlike Doctors who would give you the unvarnished truth, governments and politicians generally have different arrangements with truth and humility. Lack of humility and premature celebrations of victory are all too common in government and politics in Sri Lanka and elsewhere. The country seems to be now paying the price for the government’s premature declaration of victory over Covid-19 and prodigal distractions thereafter – changing the constitution just for the heck of it and changing the heck out of the positions of doctors in  public health agencies. The infection total is now past 21,000 and the death toll is reaching 100. A sevenfold increase in both in just over seven weeks. What is worrisome, apart from the rate of increases, is the absence of any indication that the government is in control and is able to arrest the trend, let alone reverse it.  

Sri Lankan numbers are still pea nuts in the global context. At Sri Lanka’s rates, the US should have under 400,000 infections and 2,000 deaths. But the superpower has a staggering 13 million infections and over a quarter million deaths. But the finally-on-his- way-out Donald Trump, after singlehandedly leading America to become the super spreader of the coronavirus, maniacally believes that but for his brilliant stewardship tens of millions of more Americans would be infected by now and a million of them would have died. Americans have managed to get rid of Trump, thanks to their unsung heroes who faithfully counted nearly 160 million votes in the most contentious of situations and the judges who boldly rebuked and threw out every one of Trump’s vexatious pseudo-legal challenges. But America is stuck with the coronavirus which is still spreading in its deadly mutation. And vaccines, though the result of globally coordinated scientific efforts at the highest level, are not going to be overnight panaceas. Again, every medical professional is saying that. 

Logistically, there are several hoops to pass through even after one or more of the three lead vaccine candidates are approved for use. Their mass production, storage and transport are all huge challenges, which can be done but not in any hurry. And worldwide vaccination thereafter will be an unprecedented health intervention on a global scale. Then come the challenges of keeping records for multiple inoculation, verifying vaccine effectiveness, and tracking virus transmission after vaccination by pre-symptomatic and asymptomatic carriers. According to experts the now ongoing clinical trials alone are not sufficient to be conclusive about any of this, given the speed at which vaccine development is necessarily being undertaken. The consensus upshot is that masks and physical distancing cannot be dispensed with easily or quickly even after vaccination programs get underway in different countries. All of this would invariably lead to delaying the resumption of economic activity to pre-pandemic levels. Sri Lanka is not alone in this, but there are many things that individual countries will have to do themselves on their own.    

From Infection to Recession

Last week I referred to Dr. Tissa Vitarana’s statement on “Community action can end the Covid-19 pandemic,” where he very simply explains the basic facts about the virus, its current level of transmission in Sri Lanka, the difficulties Sri Lanka will face in obtaining a vaccine for the entire population within a short-time frame, and calls for “community action” to end the pandemic. He calls the current mode of transmission, “uncontrolled community spread.” He suggests there could be 80% asymptomatic transmission and cites a figure of 30% test positivity from a random PCR study in Colombo by the CMOH. He fears that waiting for the vaccine to control the virus could be a “distant dream.” The reason is that apart from logistical delays, Sri Lanka should be in a position to buy the available vaccine for 60% of the population in addition to the expected WHO’s free vaccine for 20% of the population, to vaccinate 80% of the population – the threshold “to break the chain of transmission in a population.”  

Until then, it is “community action” that should be relied upon, along with public health infrastructure and a knowledgeable population observing basic health practices, to contain the community spread of the virus. Dr. Vitarana is confident that “if a good example is set from the top (no large gatherings etc.) and the people follow the health guidelines, the country can get rid of the Covid-19 scourge.” 

In fairness to Dr. Vitarana, he is not asking to be in charge of this community action plan, and he is confident in the abilities of doctors in the Epidemiology Unit and of the armed forces for tracking and tracing. And if Dr. Vitarana is just a retired professional without political involvement, no one would be suggesting that he should be recalled from retirement to head this or that coronavirus task force. The only reason that some of us are puzzled about his apparent exclusion, is that he has been so much a part of the PA/UPFA/ULF/SLFP/SLPP governing political formation for twenty six years – all the way back from 1994, when some of the current bigwigs were in and out of the country and would not have known the difference between a parliamentary system and a presidential system.

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