• Despite there being no threat of Covid, public health officials urge preventive measures

Despite the rise in influenza cases, the Health Ministry last week assured the public that there was no cause for alarm.

While dismissing concerns of a rise in Covid-19 cases across the country, attributing the current hike in flu-like symptoms to a surge in seasonal influenza, Ministry of Health Deputy Director General (Public Health Services – I) Dr. S.M. Arnold stressed that the rising flu-like symptom cases were due to influenza, a common seasonal flu.

He explained that in certain seasons, the number of influenza cases naturally increased, which was not unusual. “In other countries during winter, they give flu vaccines. We don’t have a high number of patients, so we don’t give flu vaccines. But there is a natural increase in certain months,” he added, highlighting that the situation in Sri Lanka did not indicate an abnormal rise.

Dr. Arnold told The Sunday Morning that Covid-19 testing was no longer mandatory and that the World Health Organization (WHO) had declared Covid-19 not a pandemic any longer. 

“We have made Covid-19 testing mandatory in the past, but it is not required now. If a clinician wants to test, they can, but there is no requirement from the Health Ministry,” Dr. Arnold explained.

Contrasting views from GMOA

Dr. Arnold was responding to a statement made by Government Medical Officers’ Association (GMOA) Media Spokesman Dr. Chamil Wijesinghe, who had confirmed a significant surge in influenza cases and noted a slight increase in Covid-19 positive cases, some of which had resulted in deaths, speaking to a local English daily newspaper last week.

In his statement, the GMOA Spokesman had pointed out that most victims of severe Covid-19 cases had been unvaccinated, although some deaths could not be directly linked to Covid-19 despite positive PCR test results. “There is no need for people to panic since Covid cases are not reported at an alarming rate,” Dr. Wijesinghe had stated.

Understanding Influenza

According to the Epidemiology Unit of the Health Ministry, influenza, commonly known as the flu, is a contagious respiratory infection caused by influenza viruses. It primarily affects the nose, throat, and lungs. Symptoms typically appear 1-4 days after infection and include fever, cough, sore throat, and muscle aches. 

While many recover within a week, severe cases can lead to hospitalisation or even be fatal, especially for high-risk groups such as the elderly, young children, pregnant women, and those with chronic conditions or weakened immune systems.

In Sri Lanka, flu cases tend to peak during May to July and November to January. Diagnosis often requires lab tests and treatment varies depending on the severity of the illness. Preventative measures include frequent handwashing, avoiding close contact with infected individuals, and adhering to public health guidelines. Immediate medical attention is recommended for severe symptoms or if symptoms worsen.

PCR testing

In this backdrop, Association of Health Professionals (AHP) President Ravi Kumudesh raised concerns about the availability of PCR test kits in Sri Lanka.

He pointed out that the low demand for Covid-19 testing had led to a decrease in the supply of test kits, making it difficult to determine the true prevalence of the virus. “When doctors are not referring their patients for PCR tests, the need in laboratories for PCR tests does not arise, and, as a result, the labs do not place orders for the test kits. Therefore, there are no test kits available in most labs,” Kumudesh explained.

According to the WHO, the Covid-19 pandemic, caused by SARS-CoV-2, was first identified in China in December 2019 and rapidly spread globally. The WHO declared it a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 and a pandemic on 11 March 2020.

As of 5 May 2023, the WHO determined that Covid-19 no longer met the criteria for a PHEIC. A review committee will focus on long-term management recommendations.

The European region has experienced over two million Covid-19 deaths. On 25 October 2023, WHO/Europe introduced a new Covid-19 Information Hub, replacing the Situation Dashboard, to provide updated health information and datasets. The hub includes the European Respiratory Virus Surveillance Summary (ERVISS), which now integrates data on influenza, Covid-19, and Respiratory Syncytial Virus RSV for the European region and the European Union (EU)/European Economic Area (EEA).

Monitoring the disease pattern

In response to the low number of PCR tests performed in Sri Lanka at present, a senior official at the Health Ministry, who wished to remain anonymous, explained that Sri Lanka had a robust surveillance system to monitor changes in disease patterns and pathogen behaviour.

The official noted that while routine PCR testing for every patient was not performed, surveillance was conducted through 26 systems across the country, particularly focusing on influenza-like illnesses and severe acute respiratory infections. The Medical Research Institute (MRI) plays a key role in this surveillance by collecting and analysing samples from patients with severe respiratory illnesses.

When asked about the status of PCR testing in Sri Lanka, the senior official explained: “PCR is a method used to identify different types of pathogens and we are performing it. There is a surveillance system, but we are not conducting PCR tests on everyone. 

“Covid-19 is now generally recognised as a common disease. We do not perform PCR tests for every patient; there are specific categories for which we conduct surveillance to identify changes in pathogens. If there is a suspected case, we do a test.”

Reiterating that Covid-19 was considered a common disease in Sri Lanka, the official added: “There are different directorates for various diseases, especially communicable diseases, managed by the Epidemiology Unit and a Chief Epidemiologist who collects data every day. In this country, there is a surveillance system to identify changes in disease patterns and pathogen behaviour. Viruses can change their genes every day. We are not conducting tests daily; we are performing surveillance. 

“There are 26 surveillance systems in different parts of the country monitoring influenza-like diseases and severe acute respiratory diseases. For influenza, there are different types of labs, with the main lab at the MRI. We collect samples daily from patients with severe respiratory illnesses, compile ongoing data, and monitor people in various locations.”

Despite there being no Covid-19 threat, public health officials continue to stress the importance of preventive measures such as hand hygiene and avoiding close contact with sick individuals. For those experiencing severe symptoms or at high risk, seeking immediate medical attention is crucial.