Where Sri Lanka’s England Medical Training derailed Its Covid-Discovery Programme

Darshanie Ratnawalli

Having a technocrat as President, we started off well following in the footsteps of China and East Asia. We also introduced innovations such as using intelligence services for contact tracing and root ball operations, trying to cut out the infection paths from society the same way a malignant tumour is cut from the body.

But just like in cutting out a malignancy it is vital to catch all the malignant cell mass or else face resurgence at a faster rate, it was crucial to uproot the entire infection route and isolate it. To do this we needed the entire root ball operation or contact tracing operation to be fully supported and complemented by a very aggressive and expansive testing criterion. This became our Achilles Heel.

Our contact tracing was very Asian, but testing remained very English –– intensely restricted. This is probably because our health ministry- epidemiology mandarins had their post graduate qualifications in England and were looking to England for ideological guidance. So, from the beginning, we needed a testing criterion which was as loose as a courtesan’s morals, but what we actually had was as tight as a miser’s purse strings.

In fact I saw one SL epidemiologist come on TV and repeat in Sinhala the exact same thing the British Health Authorities had said about WHO’S test-test-test, that WHO is the World Health Organization and what it says is meant for the whole world not necessarily what’s best for a particular country. In fact the President of the Ceylon College of Physicians, Dr. Ananda Wijewickrema said recently on Derana that ‘we did the amount of testing we needed at the particular point in time and if we had done more we would have wasted our testing capacity. Now at this point we need more testing so we are increasing capacity — not that we fell short earlier’.

This is the kind of eye wash which derailed our operations. Of course, we fell horribly short of testing and failed to catch some vital parts of the root ball because our testing remained faithfully English. For example the index case of the Bandaranaike Mawatha cluster developed respiratory symptoms 15 days after her return from India. She visited the National Hospital, but instead of testing her they remained English and explained away the respiratory symptoms as her habitual asthma. The rest is history.

The second patient to die, had also visited National Hospital with his symptoms before visiting Nawaloka Negombo and they were blind. they say because testing criteria required suspicious travel or contact history and the patient withheld these. But patients always withhold.

For aggressive detecting, doctors needed very generous testing criteria, which these old codgers with their King’s College qualifications were not giving. Welisara had a positive outcome. The old codgers let go of the jealously guarded testing purse strings. Now the testing will hopefully stop being so English and become more and more East Asian.