Time To Rethink Our Covid-19 Testing Strategy

Not the time to play Russian roulette with the country’s health and economy

- Dr Ravi P. Rannan-Eliya

The Minuwangoda incident should come as no surprise. The problems were obvious with the Kandakadu outbreak, but I remained silent in the hope that lessons would be learnt, but it seems that I was wrong.

We must recognise that as long as the global COVID-19 pandemic continues, we can never declare final victory against COVID -19 in Sri Lanka. To do so is to fool ourselves and the public. Wise leaders, like Jacinda Ardern, the New Zealand PM, warned their nations not to let their guard down, even after months of no local cases, because they understood that (a) no set of border controls can be 100% guaranteed to keep the virus out, and (b) it is impossible to know with certainty that there is no COVID-19 virus circulating unseen in the community.

As long as we allow international arrivals, there is a constant risk that the virus will creep in undetected and spark a local outbreak or worse, a second wave. The gold standard for detecting the virus, the PCR swab test, is not 100% perfect. Done properly and at the optimal time, the test still fails to detect the virus 10-20% of the time. Compounding this is that we know now that many people infected by the COVID - 19 viruses never experience any symptoms. This is mostly in the case of younger adults. None of this would matter if those who test negative or have no symptoms are not infectious, but it turns out that they are.

This means that however good our airport quarantine procedures are, it is always possible that a positive case will get through and later cause a hidden outbreak.14 days observation of arrivals during quarantine for any symptoms, plus two PCR tests, plus 14 days home isolation is not 100% guaranteed to pick up all infected cases. This is not an issue of competence. It simply reflects the biology of the virus.