{"id":117065,"date":"2021-08-13T14:29:09","date_gmt":"2021-08-13T21:29:09","guid":{"rendered":"http:\/\/www.lankaweb.com\/news\/items\/?p=117065"},"modified":"2021-08-13T14:32:06","modified_gmt":"2021-08-13T21:32:06","slug":"key-observations-and-recommendations-of-independent-experts-on-current-covid-19-situation-and-way-forward","status":"publish","type":"post","link":"https:\/\/www.lankaweb.com\/news\/items\/2021\/08\/13\/key-observations-and-recommendations-of-independent-experts-on-current-covid-19-situation-and-way-forward\/","title":{"rendered":"Key observations and recommendations of independent experts on current COVID-19 situation and way forward"},"content":{"rendered":"

Courtesy Hiru News<\/em><\/span><\/h2>\n\n\n
\"Key+observations+and+recommendations+of+independent+experts++on+current+COVID-19+situation+and+way+forward\"\/<\/figure>\n\n\n\n

The key observations and recommendations by the national experts suggest that at current levels of mobility restrictions, the number of cases would increase up to mid-September at 6000 cases per day.<\/p>\n\n\n\n

The key observations and recommendations of the 5th Independent Expert Group Meeting convened by WHO Sri Lanka which was held on 10 August 2021 has been released. Please click here for full report\u00a0,<\/p>\n\n\n\n

https:\/\/drive.google.com\/file\/d\/1nl_7IkouTOWISQtLnUv9MjdJfz38yNEr\/view?usp=sharing<\/a><\/p>\n\n\n\n

Independent Expert full report<\/p>\n\n\n\n

They state that deaths up to early October would peak around 220 deaths\/day. ICU admission will peak around 275 by early October\u00a0with cumulative deaths around 30,000 by Jan 2022. However, they state that since we have not\u00a0yet achieved the vaccine coverage assumed in the model, the projections are an\u00a0under-estimate.<\/p>\n\n\n\n

The contents of the report are as follows;
The current situation<\/strong>
The Experts noted with great concern the current surge in COVID-19, nearly overwhelming\u00a0the capacity of the health systems to provide the required adequate care for the people. The\u00a0trends given below indicate that Sri Lanka could soon face a health crisis of unprecedented\u00a0proportions.<\/p>\n\n\n\n

Sri Lanka is showing a rapid increase in daily reported number of cases and deaths<\/strong>\u00a0(111 deaths reported on 09 August 2021 representing a doubling of deaths in a short\u00a0space of time).<\/p>\n\n\n\n

Bed occupancy rates at all levels of care facilities (over 85%) and ICU\u2019s (over 90%)\u00a0<\/strong>have increased progressively and is now in full capacity. Patients dependent on oxygen\u00a0have significantly increased from 528 last week to 646 patients yesterday. If this trend\u00a0continues, there is inevitability of a serious shortage of oxygen supply and interruption of\u00a0care.<\/p>\n\n\n\n

Many areas of the country show a high PCR test positivity rate of over 20%.<\/p>\n\n\n\n

As of 31 July 2021, more than 60% of sequenced samples are Delta varian<\/strong>t, which is\u00a0highly transmissible with shorter incubation period. It is now the dominant variant in\u00a0Western Province and will soon spread to other areas. Delta variant spreads rapidly as\u00a0has been shown in several countries. The crisis will be magnified once Delta variant has\u00a0spread countrywide because most of the other provinces are not as well vaccinated as\u00a0the Western province.<\/p>\n\n\n\n

For the vaccine that is used most widely, community vaccination will take 2-3 weeks after\u00a0the second dose to provide adequate protection from severe disease and death. As of\u00a009 August, less than 15% of the population is fully vaccinated. The newly vaccinated, single-dose vaccinated or unvaccinated groups are at very high risk of severe illness and\u00a0it is very likely that there will be further increase of cases and deaths, particularly in densely\u00a0populated areas.<\/p>\n\n\n\n

Significant number of health workers are getting infected <\/strong>with a consequent pressure\u00a0for curtailment and closure of services. All indications are that the staff are exhausted and\u00a0struggling.<\/p>\n\n\n\n

Amidst this situation, there is sustained high level of mobility and social mixing among\u00a0population despite the nationwide restrictions (Oxford \u2018Stringency Index\u2019 was 85% (i.e.\u00a0very effective restrictions in movement) in May, 49% in July and 29% by this week (i.e.\u00a0dangerously low levels of movement restrictions).<\/p>\n\n\n\n

The figure given in the Appendix shows a very clear inverse relationship between Sri\u00a0Lanka\u2019s stringency index value (black line) and the number of cases and deaths\u00a0brown areas.<\/p>\n\n\n\n

The Projection<\/strong>
The Monash University, Australia in collaboration with WHO SEAR and Sri Lanka County\u00a0Office did some projections on notified cases and deaths using the MoH Epidemiology Unit\u00a0data. The projections assumed that 50% will be fully vaccinated by end of August 2021. The\u00a0details are given in Appendix 2. (pls refer full report)<\/p>\n\n\n\n

In summary:<\/strong>
a. At current levels of mobility restrictions, the number of cases would increase\u00a0up to mid-September at 6000 cases\/ day, deaths up to early October coming to a\u00a0peak around 220 deaths\/day. ICU admission will peak around 275 by early October\u00a0with cumulative deaths around 30,000 by Jan 2022. But note that since we have not\u00a0yet achieved the vaccine coverage assumed in the model, the projections are an\u00a0under-estimate.
b. At increased levels of stringency (similar to May-June 2021) for 4 weeks,\u00a0the country will have less numbers of cases of around 1000 \/day, deaths less than 25\u00a0\/day and ICU care to less than 25 \/day (by October 2021) and avert 18,000 deaths by\u00a0Jan 2022.<\/p>\n\n\n\n

Recommendations:
We need to ACT NOW.<br \/>Our urgent priority is to SAVE LIVES. Sri Lanka will avert about 18,000 deaths by Jan\u00a02022 if the level of stringency is immediately increased similar to May 2021 for 4 weeks.<\/p>\n\n\n\n

This will give the required time to accelerate vaccination and achieve the level of protection\u00a0following the second dose of vaccines; as well as for the health system to recover from the\u00a0overwhelming case load.<\/p>\n\n\n\n

Immediate actions are crucial and critical because it takes a few weeks before measures show\u00a0a positive impact on the number of infections and hospital admissions. Any delay in\u00a0implementation will lead to increase in deaths and will require even more stringent measures\u00a0with longer duration to regain control.<\/p>\n\n\n\n

More detailed recommendations are that Sri Lanka should:
Strictly enforce movement restrictions, including inter-district travel except for essential\u00a0services. The effective implementation of these measures may require the enforcement\u00a0of a curfew for a short period, in large geographic areas or nationally.
Restrict \/cancel all public events for 3 weeks.
Provide care and protect the health workers and augment staffing in hospitals to\u00a0minimize disruption of essential health services.
Develop and implement an effective communication plan to engage the public and to\u00a0update them on the control measures.
Accurate reporting of both cases and deaths to get a better picture of the ground\u00a0situation. May also use proxy indicators such as observed Test Positivity Rate (TPR),\u00a0trends measured using weekly moving averages and time series analysis, mobility data,\u00a0etc.
Prioritize to vaccinate all those over 60 years old and those with co-morbidities,\u00a0preferably with Pfizer, Moderna or Astra Zeneca because even a single dose of these\u00a0vaccines provides some degree of protection until the second dose is given.<\/p>\n\n\n\n

List of Experts and Participants \u2013 10 August 2021
1. Dr Palitha Abeykoon\u00a0(Facilitator)\u00a0WHO Consultant and WHO Director-General\u2019s Special Envoy For COVID-19\u00a0Preparedness and Response for SEAR
2. Dr Nihal Abeysinghe Consultant in Community Medicine and Former Chief Epidemiologist in Sri\u00a0Lanka and President of the College of Community Physicians in Sri Lanka
3. Dr Vinya Ariyaratne Public Health Specialist, President- Sarvodaya (CSO)
4. Prof Asita de Silva Senior Professor of Pharmacology, University of Kelaniya and President, Sri\u00a0Lanka Association of Clinical Pharmacology & Therapeutics
5. Dr Rajiva de Silva Consultant Immunologist and Head of the Department of Immunology-MRI\u00a06. Dr LakKumar Fernando Clinical Head, Centre for Clinical Management of Dengue & Dengue\u00a0Hemorrhagic Fever; Consultant Pediatrician; President, Association of Medical Specialists
7. Dr Padma Gunaratne Consultant Neuro Physician and President, Sri Lanka Medical Association
8. Prof Saroj Jayasinghe Consultant Physician and Prof Emeritus of Medicine, University of Colombo
9. Prof Indika Karunathilake Prof. in Medical Education, Department of Medical Education, Faculty of\u00a0Medicine and Former President \u2013 SLMA
10. Prof Neelika Malavige Professor and Head, Department of Immunology and Molecular Medicine, Sri\u00a0Jayewardenepura University
11. Prof. Kamini Mendis Professor Emeritus, University of Colombo; Public Health Expert and former\u00a0WHO Malaria expert
12. Prof Malik Peiris Chair\/Professor \u2013 School of Public Health, The University of Hong Kong,\u00a0Faculty of Medicine, Hong Kong
13. Prof Manuj Weerasinghe Prof in Community Medicine, Faculty of Medicine, Univ of Colombo
14. Dr Ananda Wijewickrama Consultant Physician, National Institute of Infectious Diseases and Past\u00a0President of the College of Physicians WHO\u00a0Experts and\u00a0Participants\u00a0
1. Dr Alaka Singh (Chair) WHO Representative to Sri Lanka
2. Dr Paba Palihawadana WHO Indonesia Medical Officer
3. Dr Olivia Nieveras Public Health Administrator, WHO Sri Lanka
4. Dr Sapumal Dhanapala WHO Sri Lanka
5. Dr Padmal de Silva WHO Sri Lanka
6. Prof. Nalika Gunawardena WHO Sri Lanka
7. Dr Virginie Mallawaarachchi WHO Sri Lanka
8. Mr T Suveendran WHO Sri Lanka
9. Dr Preshila Samaraweera WHO Sri Lanka
10. Ms Sahani Chandraratna WHO Sri Lanka
11. Dr Mizaya Cader WHO Sri Lanka
12. Ms Sadhani Rajapakse WHO Sri Lanka
13. Dr Priyanga Senanayake WHO Sri Lanka
14. Dr Roshan Sampath WHO Sri Lanka
15. Dr Chatura Wijesundara WHO Sri Lanka
16. Dr Anjalee De Silva WHO Sri Lanka <\/p>\n","protected":false},"excerpt":{"rendered":"

Courtesy Hiru News The key observations and recommendations by the national experts suggest that at current levels of mobility restrictions, the number of cases would increase up to mid-September at 6000 cases per day. The key observations and recommendations of the 5th Independent Expert Group Meeting convened by WHO Sri Lanka which was held on 10 […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":true,"template":"","format":"standard","meta":{"footnotes":""},"categories":[122,174],"tags":[],"class_list":["post-117065","post","type-post","status-publish","format-standard","hentry","category-health","category--19-"],"_links":{"self":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts\/117065","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/comments?post=117065"}],"version-history":[{"count":0,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts\/117065\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/media?parent=117065"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/categories?post=117065"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/tags?post=117065"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}