Grave concerns of the medical professional organizations on the Current Situation of COVID-19 Sri Lanka. All medical professional organizations in Sri Lanka (the Sri Lanka Medical Association – SLMA, Sri Lanka Medical Association Inter-Collegiate Committee – SMIC, Association of Medical Specialists – AMS & Government Medical Officers Association – GMOA) have prepared a letter jointly by a on the current COVID19 situation in the country and sent the letter to the President Gotabaya Rajapaksa.

We, the Sri Lanka Medical Association (SLMA), the Government Medical Officers Association (GMOA), the Association of Medical Specialists (AMS), together with the SLMA Intercollegiate Committee (SMIC), consisting of all establishments of medical professionals in Sri Lanka, wish to inform you in unison, that we are very deeply concerned of the currently prevalent crisis situation of the COVID-19 outbreak in Sri Lanka.

Sri Lanka might soon face a COVID disaster of unprecedented major proportions where we will even have to be selective as to whom we treand whom we are compelled to succumb to the disease.

We are quite sure that Your Excellency would agree with us that the number of cases diagnosed and the deaths related to COVID19 are rapidly escalating and the knowledge of the likely presence of at least thrice the diagnosed cases in the community is intensely worrying. We wish to emphasise that all healthcaresources are being overwhelmed, as indicated by the rapid increase in utilization of all health sector beds and healthcare facilities by COVID-19 patients. The number requiring oxygen is very quickly and exponentially rising while waiting for Intensive Care Unit (ICU) and hospital beds, is also occurring. We might soon face a COVID disaster of unprecedented major proportions where we will even have to be selective as to whom we treand whom we are compelled to succumb to the disease.

Since early April, requests for PCR to laboratories are exponentially increasing. All laboratories are working twice or so love their capacity that could be safely accommodated. However, despite being stretched to their maximum capacity, there is a backlog in all hospital laboratories Island wide. There is rapid utilization of existing supplies of consumables and reagents as a result of the tremendous pressures imposed on these laboratories. In such a scenario of inundation of the laboratory facilities, we may even be compelled to make decisions as to confine testing to only selected patients who could be provided in-hospital care.

The facilities for Non-COVID diseases are also being curtailed and even deprived while their management is getting neglected, leading to an unavoidale increase in deaths of patients with Non-COVID diseases.

At the present time, the numbers of patients waiting at home for a bed in an Intermediate COVID-Care centre being made available, are of grave concern. Significant delays in providing beds and in-patient care to those who really deserve has become a frequent occurrence. In such a context, an increase in deaths over the next three weeks or more would be unavoidable.

The healthcare workers are likely to be physically and mentally drained and the fatigue in them, induced by the impending disaster, is going to be considerable and unavoidable. The COVID deaths may reach unprecedented levels and a grave national catastrophe is a real potential threat in the near future.

As such it has become essential to provide relief to overwhelmed hospitals and to do everything possible to buy time until at least 60 per cent of our people are vaccinated.

The medical aspect of the battle against COVID also has its economic implications, and if the spread is not rapidly brought under control, the cost will further escalate exponentially.

In this backdrop, we, as most concerned representatives of the institutions representing all medical professionals in Sri Lanka wish to most earnestly and kindly request Your Excellency to consider implementing the following recommendations as early as possible.

1. Implement strict restrictions of movements of people by very stringent implementation of the Extraordinary Government Gazette notification on controlling COVID-19, published in October 2020.

2. Decide on implementation of selected Lockdown Processes of certain areas, based only on scientific evidence of the density of caseloads. Restriction of inter-district movement of people would also be necessary ifand when indicated.

3. Maintain supplies to and services provided by selected essential service sectors and economic hubs under stringent monitoring for COVID-19 infections and scrupulous attention to preventive strategies.

4. Authorize the isolation of families at homes, along with home management of asymptomatic cases, while being carefully and assiduously monitored by health care professionals. This should be complemented by arrangements being made for early transfer of needy patients with pneumonia, to the closest designated hospitals.

5. Strengthen the curative sector by supplying adequate facilities such as beds, oxygen and ICU facilities.

6. Strengthen the laboratory services Island wide for diagnosis of COVID-19 with PCR testing and also by ensuring steady and uninterrupted supply chain.

7. Implement widespread vaccination in adequate doses at the earliest possible opportunity.

Your Excellency, we hasten to most kindly convey to you that our concerted efforts are always dedicated towards strengthening your hands in gaining control over this nasty virus. We earnestly feel that this is indeed the time to act decisively and expeditiously. If all of us do not put our collective shoulder to the wheel, the authorities may be compelled to implement even stricter lock down control measures as well as even curfews, to try and control the ravages of this pandemic. This contention on the principles on which our recommendations are based would need to be conveyed to the general public too and it should be clearly reiterated that if the government does not act now, it would mean even more severe and sustained hardships for the general populace in the near future.

We remain, Your Excellency, committed as always, towards the welfare of our nation.

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