- Stigma around the quarantine process
- Not the new normal of the first wave
People returning to Colombo for work at the Maradana Railway Station after quarantine curfew was relaxed for the Western Province, 09 November 2020. Photo Lalith Perera[/caption]
Later, towards Wednesday evening, Army Commander Lt. Gen. Shavendra Silva and then Police Spokesperson Deputy Inspector General of Police (DIG) Ajith Rohana issued separate statements on how the travel restriction would come into effect, whilst promising that it is not a quarantine curfew that is imposed, but that they were basically creating a buffer between the provinces that are not considered high-risk zones and the Western Province, so that the spread of the virus would be minimised.
By now, the public is growing quite anxious about what will befall them next, given that a reassuring statement can by evening be changed, halting the day-to-day work that people are asked to get on with under the strict guidelines.
Amidst the second wave of Covid-19, “what is the new normal?” is a question that is not going to have a straightforward answer at this point. Therefore, The Sunday Morning spoke to the healthcare sector to understand where we stand, what needs to be done, and the whole stigma that is built around sending people to quarantine centres by separating family members, placing some of the family members in a vulnerable position.
Most suited preventive measure
Government Medical Officers’ Association (GMOA) Editor Dr. Haritha Aluthge stated: “By now, we have been advised by the World Health Organisation that the entire world will have to learn to live with the virus. They have been issuing health guidelines and have been revising accordingly; some countries can adapt to the said guidelines according to the threat level of the virus. Sri Lanka is still experiencing a cluster of cases which means we are at Level 3 of the threat levels.”
Dr. Aluthge also reiterated that given the nature of this virus and its recent mutation, the so-called herd immunity is not the most effective method to combat this disease.
“The President has stated that this is a healthcare emergency and any decision that is taken by the Government to control the spread of the disease is done after consulting experts in the healthcare field. During the first wave, we had the entire country under lockdown, but later, realising the socioeconomic impact, we have now adapted to isolating/imposing quarantine curfew and restricting travel to control the virus from spreading, whilst keeping the country open for day-to-day activities,” Dr. Aluthge noted.
He added that the public should take responsibility and follow the given health guidelines accordingly and contribute towards minimising the spread of the disease.
Co-ordination needs improvement
Meanwhile, Sri Lanka Medical Association (SLMA) President Prof. Indika Karunathilake, noted that the approach of mass quarantine has created concerns and uncertainty among the general public as well as health workers. “Inter-sectoral co-ordination in the process is seriously lacking. This will negatively affect the trust of the general public and the morale of the health system. Criminalisation of disease leading to a reduction in self-reporting will hamper the preventive process.”
He added that sensationalisation and stigmatisation by the media has worsened the situation. Using fear as a health promotional tool is totally incorrect and unacceptable, as it affects negatively by aggravating stigmatisation, he noted. “The process of quarantining, especially, should never be highlighted as a punishment but rather as a preventive healthcare measure, and in such a situation, it is very important to plan ahead to use our resources to the maximum benefit,” Prof. Karunathilake expressed.
“The most important thing is to prevent infection among healthcare workers while minimising the casualties among Covid-19-infected patients. With the exponential increase in numbers, it is vital to maximally utilise the limited resources available. PCR testing should be focused mainly on the suspected patients and surveillance should be strengthened through testing at outpatient departments and in-ward settings. It is important to take appropriate precautions to safeguard healthcare workers,” Prof. Karunathilake elaborated.
Issues in referring to quarantine facilities In the past, there have been various problems in taking such groups to quarantine. Such problematic situations were reported, especially in the transportation of garment factory workers. Those who voiced and protested against them also had to face the scrutiny of the authorities. However, after that, a family of medical professionals was also affected by the quarantine process, which created a backdrop of open opposition from medical professionals as well. With the increase in the number of patients identified in the country, quarantine has been limited to home quarantine and only infected people are being taken away. Now, patients are identified not only in the garment factories or fish shops. Infections are now being reported in various government and private institutions and among people at various levels of society as well. The problem is now affecting the families of many of those infected in various ways. Public Health Inspectors’ Union Sri Lanka (PHIUSL) Secretary M. Balasooriya, explaining the reason behind having to separate family members when sending them to quarantine centres, said: “Each family member may be placed in a different location depending on their circumstances. This disease is spreading more rapidly in society at this stage than other diseases. This condition can lead to other problems if the patient is left homeless. The surrounding people may accuse a patient of being at home. For such reasons, they have to be taken to a management centre.” Moreover, the public health inspectors have observed that there were many instances where even the closest relatives refuse to care for an infected person. “When an infected person is taken away, there must be a system in place to take care of the rest of the family. Apart from the health officers, there are a number of officers in the area such as a grama niladhari, a samurdhi development officer, or a social service officer. There are religious leaders and various voluntary organisations in social co-operation as well. There should be social discourse on these matters and they should be brought to the notice of higher officials and must be corrected. The main support in controlling such an epidemic is the support of the people and society,” Balasooriya elaborated.