Whither Covid-19

The “Ceylon epidemic” as it used to be called, has been extensively studied, and in the 1950s the British epidemiologist George MacDonald used the Ceylon case study in developing the first application of ‘basic production number’ (or rate) for epidemics, the celebrated R0 (R naught or R zero). R0 represents the number of additional infections that one infected person can generate in a population. MacDonald has used estimates of 7.9 and 10 as R0 the malaria epidemic. Based on these numbers the herd immunity (R0-1)/R0) for malaria without DDT would have been around 90%.

Imagine if the Coronavirus was carried by a Mosquito Vector

R0 for Covid-19 is considered to be between 2.5 and 3.5 ( depending on countries and locations), and that would suggest a herd immunity threshold of 60 to 70%,i.e., 60 to 70% of the population will have to be infected before virus transmission can be stopped. Until a vaccine arrives on the scene, social isolation and lockdown measures are the only tools available to reduce the value of R0.

Virus transmission ends when R0 is reduced to being less than one, but that is not the end of the virus.

There is optimism that a vaccine breakthrough might come as early as January 2021. There is ‘ethical’ potential for a new therapy in Remdesivir, a "broad-spectrum antiviral medication" with established safety profile which has been previously developed as treatment for SARS, MERS and Ebola. These efforts may or may not come to fruition, and in the desired short time line, according to experts. The same experts also acknowledge when nothing else is working against the coronavirus it is natural to be enthusiastic about every new development that is going on.

Whither Covid-19

Outside South Asia, the general assessment is that the first wave of the virus is now over, the transmission has either stopped or is significantly slowing, and the affected countries can begin to ease up, while being fully prepared for the next wave.

For South Asian countries, including Sri Lanka, there is no certainty as to whether or not the first wave is past them, and there is no clarity about what is ahead in the next few weeks and months.

There were 600 cases in India, when the Modi government began the lockdown, on March 25. Now, just over a month after, the cases have multiplied fifty times and the total is past 33,000 and the number of deaths is upward of 1000.

The stories in Pakistan and Bangladesh are not any different.

Sri Lanka’s Covid-19 numbers - less than 700 cases and seven deaths - are mercifully lower than what would have been the daily tally during the malaria epidemic. The low numbers should be a cause for cautious optimism, and the country should be in a position like New Zealand. The island country of five million people has about 1000 cases and 19 deaths, and it is confidently returning to normalcy but fully prepared for the second wave of the coronavirus. New Zealand’s much larger neighbour, Australia, an island continent, is almost equally well placed.

In Sri Lanka, there is no certainty or assuredness about what lies ahead.

The country is under a prolonged curfew to enforce social isolation.  As many people are in custody for breaking the curfew as have been tested for Covid-19, or sent to quarantine without being tested. Every time there is an announcement of relaxation, there is a spike in the number of cases and the curfew is extended. And the most recent spikes in cases are among the custodians of Covid-19 quarantines – the armed forces.

There is growing skepticism about even the Covid-19 statistics that are put out by the officials.

In yesterday’s Island, Dr. Vinoth Ramachandra called it strange that after six weeks of lockdown, "the ‘official’ deaths have remained static for the past two weeks and ‘official’ infections are miniscule in comparison with other countries."

He went on to ask the officials "is there another purpose that the lockdown serves?"

But my assessment is doctoring data for political reasoning and advantage!

The Alliance of Independent Professionals have been raising similar questions in their periodical ‘statement of facts’ on the Covid-19 crisis. Is testing being deliberately kept under capacity to keep the case numbers low?

Are clinical case definitions being ignored or tampered with where Covid-19 testing is not available?

Are patient deaths being properly recorded with causes prior to cremations?

It is unethical and illegal to tamper with official data or their collection. Where data involve helpless patients, it is also heartless and immoral to tamper with them or destroy them.

And monkeying with data involving Coronavirus will boomerang spectacularly, because without reliable information there cannot be a plan to break the chain of transmission of the virus.