The Island newspaper of 15/12/20 carried a front-page news item attributed to Prof. Sriyal Malik Peiris, a Professor of Virology in Hong-kong. He is an internationally recognized professional who is the only Sri Lankan to have obtained the highly prestigious FRS (Fellow of the Royal Society) whose other notable recipients include Sir Issac Newton and Prof. Richard Hawkins. He is the recipient of our own DSC (Doctor of Science) from the University of Peradeniya. He is also credited with the discovery of the SARS virus. Then there was a beautiful piece written by my good friend, Dr Sarath Gamini De Silva, titled “Neglecting the sick and insulting the dead” in The Island newspaper of 17/12/20.
Prof. Peiris has hit the nail on the head when he says that “the transmission of the Coronavirus from burial is extremely unlikely and he is very familiar with the business of burials.” This, too, is the opinion of the World Health Organization.
The risk of transmission of Covid-19 from the feces of an infected person is expected to be low, based on data from previous outbreaks of related coronaviruses, such as SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome). There have been no reports of fecal-oral transmission of Covid-19 to date. Coronaviruses have been reported to die off rapidly in wastewater, with a 99.9% reduction in two to three days.
1 [World Health Organization. Q&A on coronaviruses (COVID-19). March 9, 2020. https://www.who.int/news-room/q-a-detail/q-a-coronaviruses
2. Alley, W.M.,. Gundy, P.M., C.P. Gerba, and I.L. Pepper. 2009. Survival of coronaviruses in water and wastewater. Food Environmental Virology 1: 10–14.
Unlike water and food-borne bacterial illnesses, such as Typhoid and Cholera, which could be carried in stools, Covid-19 is a virus that would not be present in dead cells, so that when the patient is dead the virus also dies. To overcome the remote possibility of contamination, he has suggested burying the dead in an impermeable wrapping, Prof. Peiris also mentions that the viral load of a dead or dying person is very low, and therefore the possible transmission, too, is very insignificant. Of greater importance is the prevention of the spread of the virus. This was achieved to a great extent when the first wave of infection occurred. However, things had gone wrong and the President of the Public Health Inspectors Union has stated that the infection has gone beyond control and, therefore, community transmission has started. Furthermore, it is said that some people do not undergo mandatory PCR testing, and, instead, prefer to die and not undergo cremation. This would greatly hamper control and is, in fact, one of the reasons for outbreaks in densely populated clusters, such as Mahaiyawa, in Kandy.
A very important control measure is the identification of the affected (even more important than the symptomatic cases) by carrying out PCR testing in close contacts. Other well tested measures, such as wearing masks, maintaining social distancing, frequent hand washing and locking down of areas with reported cases, should be adopted. Such measures were carried out highly successfully in countries, such as Australia, where the second wave has been well controlled. The rulers there listened to the experts and the results are excellent. The opposite has happened in the United States of America, which is fast approaching an annual figure of 300,000 deaths by the end of the year. Former President, Donald Trump, should be partly blamed for this for not listening to expert scientists such as Dr. Fauci (Head of Infectious Diseases), but President-elect Joe Biden, has recognized the importance of listening to such people, and tackling the Covid-19 epidemic is one of his first priorities.
Our President has made a good start by recruiting educated people to his staff and Cabinet. It is only hoped that they would not disappoint the President by not contributing to the schemes for the wellbeing of the population
-Dr. UPALI ILLANGASEKEKA-
-Retired Professor in Medicine-
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