Take Delta seriously, plead national experts, while giving a systematic course of action

Take Delta seriously, a group of national experts have urged, explaining that Sri Lanka should learn from the experiences of other countries and the evidence of high transmissibility and potential for vaccine escape of this variant.

They have stressed that the country should ensure that vaccines that have proven protection against the Delta variant are selected.

Expressing serious concern over a progressive increase in infection numbers, these experts convened by the World Health Organization (WHO) as the 4th Independent Expert Group Meeting on July 24 have warned that even globally, the number of COVID19 cases and deaths are increasing. This pandemic is nowhere near finished and the worst may be yet to come.

The high rates of positivity in RT-PCR tests that are being done, the death rates and hospital admissions reflect a worsening trend. While all deaths are tested and reported whether they take place at home or hospital, there may be missed COVID-19 deaths with the revised guidelines on home deaths, according to them.

Pointing out that an increasing number of infections from the Delta variant are being reported from several communities, they state that this is of serious concern because it is highly transmissible, has a shorter incubation period and, therefore, spreads much quicker.

While it has already spread before it is detected and before prevention measures are implemented, patients arriving at hospitals are presenting with more severe symptoms, they say.

There has been increased mobility and social mixing in retail, transport, parks and workplaces during the last few weeks (Eg. the ‘Stringency Index’ was 85% in May but was down to 49% last week). There are also weddings, religious events, musicals and other mass gatherings as well as demonstrations which are potential ‘super spreader’ events, being held, disregarding public health guidelines, these experts warn, adding that with the limited testing, the number of cases is likely to be under-reported and does not reflect the real situation at ground level.

Some of the recommendations of these experts include:

Strengthening of data collection at least in hospitals, as the reported cases are underestimated due to limited testing capacity. All suspected cases and patients with symptoms who present to the OPD should be tested for SARS-COV-2. Influenza-like Illness (ILI) and Severe Acute Respiratory Infection (SARI) surveillance data available separately from more than 50 sites can complement and provide a handle on the community burden.

For rational decision making, the current COVID-19 situation needs to be clearly analyzed through a scientific approach; the conduct of a rapid assessment and situational analysis; and the systematic use of proxy indicators such as observed Test Positivity Rate (TPR), trends measured using weekly moving averages and time series analysis, mobility data and effective reproduction rate to interpret the Epi curve.

Strict enforcement of social measures and an immediate halting of specific mass gatherings such as weddings, parties, religious activities in temples, demonstrations, funerals, etc.

Age optimization of vaccines by prioritizing high risk groups and selection of specific vaccines based on the best immunogenic response for a target group. E.g. Sinopharm is less immunogenic in the elderly and may be given to a young population and Pfizer and Moderna to the elderly and those with co-morbidities.

Further expand case management facilities and strengthen support for health staff in hospitals, including the expansion of facilities for home management of asymptomatic patients.