Professor Indika Karunathilake

Dear Members of Sri Lanka Medical Association,

In February, SLMA News+ cover page carried the question “COVID-19, Are we ready to face it?” Now the same question has become even more pertinent.

Less than three months have passed since COVID-19 came into international notice. The situation is very volatile at present. The global case fatality rate appears to be 3-4%. The virus has now spread to every continent (except Antarctica) and has caused over 16000 deaths. More and more cases are detected and confirmed in Sri Lanka.

The problem is the unknown. A lot of basic epidemiological and pathophysiological aspects are yet to be understood and we do not have a vaccine or medication like we have for influenza. The COVID-19 pandemic might become as bad as the influenza pandemic in 2009 (influenza A (H1N1)pdm09 virus) which caused more than 250000 deaths worldwide.

Considering what is happening in the US, UK, Australia and many other countries, Sri Lanka’s response so far is commendable. Sri Lanka has been able to keep the situation under control mainly due to the strength of our public health system, the efforts of the government, Ministry of Health and the World Health Organization (WHO). The Epidemiology Unit and Health Promotion Bureau have been working tirelessly. Armed forces have played a major role in providing quarantine facilities.

As the apex medical professional body of the country, we are already working in close collaboration with the Ministry of Health and the World Health Organization (WHO) on many fronts, mainly enhancing awareness of healthcare professionals and the general public.

Still we cannot afford to be complacent. It would be a fatal pitfall to believe that Sri Lanka is safe due to its hot weather. The WHO has already dispelled it as a myth. If we are to learn by Korean example where one mass gathering triggered o an epidemic, one mistake is enough. We can only hope Sri Lanka was not too late in implementing strict quarantine regulations.

The strength of the Sri Lankan health system is in disease prevention. However, we have limited resources in the curative sector and highly inadequate intensive care facilities to optimally mange the critically ill during an epidemic. We must capitalise on the unique forte of our health system and focus even strongly on preventive measures such as sanitation, health education, disease monitoring, and quarantine measures, as well as isolation of proven or suspected cases. The situation calls for return to the basics. The Sri Lankan health system has long experience in implementing these basic preventive approaches. Coupled with stringent preventive strategies and strict enforcement of regulations, Sri Lanka can contain the spread of this epidemic.

Everyone has a responsibility during this national crisis. It is a time for vigilance, social responsibility, collaboration and rm decision making.

Professor Indika Karunathilake,
President, Sri Lanka Medical Association