Advocata urges private sector involvement to rapidly expand SL’s COVID-19 testing capacity

In dealing with the COVID-19 crisis, the Government has placed most of Sri Lanka under curfew.  This is to mandate a ‘physical distancing’ strategy to slow the transmission of the novel coronavirus and to reduce the proliferation of new cases. This gives space for the country’s health system to cope with the potential influx of COVID-19 patients.

Curfews cannot go on forever.  In this initial phase, it is essential that the Government uses this period to ramp up the healthcare infrastructure in the country to safely treat both COVID-19 patients and others requiring care. As has been emphasised by medical professionals and the Government Medical Officers’ Association (GMOA), it is particularly important that the government uses this time to increase the country’s testing capacity to effectively test those with symptoms and their close contacts.  

The ‘trace-test-treat’ method has shown to be effective in countries such as South Korea and others which have faced up relatively well to this public health crisis. The Government’s decision on 31 March to expand testing to check for community transmission is a step in the right direction. 

Currently, guidelines for testing (interim case definitions) as directed by the Epidemiology Unit limit testing to individuals with acute respiratory illness who have either had contact with a confirmed COVID-19 patient, or have travelled abroad in the last 14 days. 

Patients with acute pneumonia (not explainable by any other aetiology) and are presenting symptoms, can also get tested, if a doctor sees fit. The definition was expanded to include individuals experiencing fever and respiratory distress, but this definition will need to be broadened, to ensure that individuals with milder symptoms also have access to testing. 

Sri Lanka has currently tested only 2,277 cases, or 87 per million people. Countries such as South Korea have tested 410,564 cases or 7971.04 per million people. The United States, initially lagging and summarily criticised for its COVID-19 response, has dramatically increased testing over the last few weeks with over one million tests being conducted to date and over 100,000 being conducted every day. ‘Trace-test-treat’ is now emerging as a policy consensus to deal effectively with the crisis. 

When looking at current testing capacity, in addition to the Government sector, and universities, the private sector currently has only three laboratories that are equipped to conduct PCR testing. While private sector testing for COVID-19 was initially not allowed, this restriction has now been lifted. 

The Government should work to coordinate with the private sector, and with universities to improve testing capacity, as well as to tap into private sector access to supply chains and technical know-how on new testing options. Given that Sri Lanka has limited fiscal space to face up to the crisis, the Government should prioritise the test and trace in its engagement with donors for funding. 

It is useful to think of the necessary policy responses to the COVID-19 crisis in phases. In this first phase of containment, the focus should be on practicing physical distancing, and expanding the capacity to test. There is an economic trade off that takes place, while the country expands testing capacity. 

This economic burden is not one that will be sustainable for much longer, and the Government has to act swiftly. With adequate testing it is possible for the country to move to the next policy phase, where limited economic activity can be allowed, with strict physical distancing practices and widespread testing continued. 

The Advocata Institute recommends that the Government gives due priority to expanding testing capacity in the country. 

● As an immediate measure, utilise testing capacity that exists in universities and in the private sector.

● Engage with the private sector to identify barriers to the import of rapid testing kits, and facilitate where possible. 

● Update the interim case definition issued by the Epidemiology Unit, to ensure that effective community testing can take place.

(Advocata is an independent policy think tank based in Colombo. It conducts research, provides commentary and holds events to promote sound policy ideas compatible with a free society in Sri Lanka. Visit advocata.org for more information.)