Postcard from Sri Lanka

25 May 2020

by Omar Khan

Sri Lanka opted to throw nuance to the wind and go for an outright 24/7 multi-month curfew. Announced with mere hours of notice, it threw everyone into desperate pandemonium. Touted originally as a “weekend curfew”, when it was extended and then briefly relaxed it had people desperate to get essentials, with open-air markets here resembling a COVID-19 petri dish.

Then, four days after it was first instituted, it went back on, and has not been fully lifted as of today, May 24th, though it has been relaxed in the last few weeks. Essentially, however, from March 20th the entire economic engine came to a screeching halt, imposing grotesque suffering on the daily wage-earners (roughly 40% of the economy) and the SMEs, except for those who were able to get into the business of delivering essentials, which later came to include Big Macs from McDonalds and birthday cakes, lest the elite be too troubled by any of this.

At the time of the curfew, Lanka had 66 cases of Covid-19, with seven fatalities. One month on, post curfew, there have been 271 cases and… wait for it… seven fatalities! But rather than throwing a success party, the authorities decided to double down, even though it was now clear that the healthcare system wasn’t being overwhelmed and that the fatality needle hadn’t budged. No one is quite sure why the most draconian option was chosen and then manically sustained, except that we all mistakenly thought that this was an “equal opportunity” virus, and it’s not. The fatality numbers testify to that, and some regions are relatively far less scathed than others, which clearly hasn’t always been down to the brilliance of their response. But as per all the model-spinners and prognosticators, it was only a matter of time before things exploded here. As of today, the fatalities are up to nine, and we have been curfewed longer than Wuhan was economically shut down.

A Rough Build-Up

After a 30+ year civil war, which conscripted Buddhism and Hinduism – despite these usually being more pacific faiths, as practised – Sri Lanka had blossomed on the tourism front in particular, being crowned by Lonely Planet as “The World’s Favorite Destination” for 2019. Then came the Easter bombing, from a splinter Muslim group, which tragically hit churches and hotels, killing locals and travellers alike.

Though this decimated the tourism industry for many months, by November/December 2019 and with a great deal of pluck, fortitude, commitment and imagination, the tourist numbers and profits were climbing up once again.

And then came COVID-19.

The Global Contagion of Panic Applied Locally

Despite very modest cases here, nevertheless China’s disastrous surge, the exploding numbers in Italy and Spain, the gathering storm-clouds over the US and UK, various Drs. WHO intoning in sepulchral tones the case for impending cataclysm and the hysterical Imperial College model exploding onto the scene – all helped ignite panic.

While most countries saw a spike in cases and went for “flattening the curve”, paradoxically Lanka had no real curve to flatten and thus was unable to consult any evidence to indicate they could “relax the brakes”. They too, like much of the world, segued to “eradication”, which is implausible if not impossible, particularly as you only have to open your borders to be at least vulnerable to fresh infections.

This misplaced and unfortunate global segue – never debated, never justified – has prolonged the suspension of life as we know it, with catastrophically mounting economic costs, particularly here for a developing economy with high debt even prior to COVID-19.

To get a sense of the Lanka response, keep in mind that the ability to go and buy food, medicine and take brief walks (even if accompanied by the odd drone) were considered around the world as the very minimal liberties that even under a penal concept like lockdown could be considered “unalienable”.

Here in Lanka, despite such tame statistics, you couldn’t do any of the above. Even those who could afford it were largely at the mercy of food delivery (including from fast-food restaurants) and pharmacy deliveries. Others foraged and scavenged and hoped somehow that essentials might reach them. For those millions not equipped to be able to order online or with instruments for payment other than cash, this was a greater terror than the virus.

Even liquor stores were closed and couldn’t deliver, so a robust “home brew” market and a black market for imported booze flourished, further impoverishing an already besieged exchequer.

The monthly revenue from liquor sales in Sri Lanka is roughly USD $8 million. Now, unfortunately, locking people indoors and asking them to drink their despair away may have other health consequences, but perhaps that should argue against curfew not alcohol.

At any rate, it was medical vainglory from a politically-motivated medical trade union put in charge of the medical response (not a virologist or epidemiologist in sight) which tut-tutted the government out of these desperately-needed excise earnings at the very time that at least a $1 billion a week was being lost from a national shutdown.

The extremely well-connected were eventually able to wangle “curfew passes” and then began leading an alternative lifestyle, pontificating about public health during weekends on family estates in the hills, while everyday citizens and workers sweltered in small apartments – if not outright tenements – unable to find food, and going broke.

Nostradamus or Science?

Around the world the infection rates and fatality rates simply don’t merit the mania. However, the mania proliferates faster than the virus, and feeds on itself.

Lanka, I fear, fell afoul of the “sunk costs fallacy”. The thinking is: “We blew up our economy, we don’t have even middling fatalities from this when 12,000 die per month from normally-occurring causes of mortality, but we must at least eradicate this threat – we have to get something from this.” And then, alas, a late-breaking Navy cluster (navy, armed services and their contacts – some 600+ cases!), isolated as it was, threw the optics of eradication out the window. This didn’t help the official narrative, as the armed services – almost uniquely here – were in charge of the management and administration of this curious home-brew curfew.

The South Asia Paradox

The French paradox is often cited in dieting circles. The French consume large amounts of fat, cream, drink wine, still manage to enjoy their croissants and still live longer than their nutritionally-paranoid American counterparts; they are more slender, and infuriatingly haughty about the whole thing. Or so the story goes.

Immunologically, it seems there is a South Asian paradox, but it may extend beyond South Asia, to SE Asia and perhaps even to Africa. When a Nepalese was asked about their seemingly-charmed COVID-19 immunity and what the secret was, the answer was, “Bad hygiene.” There may be something to that.

South Asia has 23% of the world’s population, and roughly 0.5% of the world’s COVID-19 fatalities. More Vitamin D from enriched sunlight may play a part (hence the silliness of locking people away from it), but also, doubtless, immune systems hardened by lack of hygiene and food less-than-ideally stored that brings with them viruses, pathogens and strains of this and that, and more. When the Spanish flu raged, more than 20% of the global fatalities came from India. So, has something shifted? Have parts of the world so infantilized their immune systems?

Again, Sri Lanka, rather than leveraging its membership in these “elite” immunological circles, seemed hell-bent on punishing itself paradoxically for low fatalities by imposing the most punitive restrictions to economic functioning and social wellbeing upon itself. And then, when fatalities didn’t rise, post hoc ergo propter hoc came into full play: they congratulated themselves for their deft handling! If you then point out that countries with far less of a lockdown – or none – have fewer deaths still, including Taiwan and Hong Kong and Vietnam which never had any extended curfews and all with still-functioning economies, then fact-free outrage and sputtering contumely are rarely far behind.

A Smattering of Other Confusions

Writing unremittingly here throughout and seeking to relay the findings from such astute sober expertise as Dr. David Katz, Professor John Ioannidis, Knutt Wittowski (savaged and censored for promoting the “heresy” that sunlight and air might help, and it may be time to end this charade, go outdoors, and let our immune systems do what they are designed to), I found that such prosaic sanity fell flat in face of the torrential media hysteria that has been so forthcoming worldwide.

The same fatuous “economy vs. lives” bosh did the rounds here, until growing economic desperation, mass failures of SMEs, devastating layoffs in the apparel and tourism sectors (the life-blood of this economy) finally brought home the incontestable reality that the economy is lives, and that economic bankruptcy is not a medical strategy.

Confounding communication still held sway, however. The recent relaxing of curfew strictures are a prime example. We were officially told that businesses can be open, but that people should only venture out for work or to buy essentials. So, if you are a customer-facing business outside this “essential” sphere, being “open” means what, precisely?

Hotels had been advised they can “open”, but no restaurants, bars, health clubs, etc. Since no one is travelling in or out, if you could somehow transport yourself to an “open” hotel, what would you do there? Play a round of lawn tennis? No, actually – not yet allowed, either!

Clarity of communication, therefore, is so needed, and has been so globally missing. It was glaringly deficient in the UK Prime Minister’s rather incoherent, generic and inconclusive recent statement. It certainly is in short supply in the rambling pyrotechnics over the many weeks of the “Trump show” masquerading as a briefing. Such clarity becomes crucial in order to stress-test policy, to enroll support and to engage people – rather than to seek to bully and browbeat them, or to “order” them to do what you seemingly cannot persuade, much less inspire them to do.

And then there is Colombo, the capital city, which accounts for roughly 50% of GDP. The argument for keeping it curfewed has been that it was deemed “high risk”. This was not based on the number of actual cases but because of population density.

Tokyo has had roughly 160 deaths among 12 million people, Hong Kong has had 4 deaths among just under 8 million, the province of Sindh (which includes the teeming Pakistani city of Karachi) has about 45 million people and has had about 299 deaths. In New York, it was not Manhattan that was the epicentre of fatalities, but – other than in nursing homes – it was the economically-underprivileged areas of the Bronx and Queens that had the biggest surges. These statistics certainly throw the concept into question; but even beyond that, Colombo has 750,000 people and has only had 155 cases attributed to it (“cases” not “fatalities”). One has to blush to say it’s “high risk”.

Circuit Breaker

Hong Kong and Singapore have used versions of this, so has New Zealand. It is simply the argument for evidence-based thresholds and differing strategies, bowing to that evidence rather than prefabricated ideological fault lines.

So, you track types of cases, number of cases, growth of cases, nature of cases (isolated, local, community, imported) and then determine which strategies of suppression, mitigation, isolation or quarantining apply to each such “level”, how much of the economy and our mobility and personal discretion is temporarily suppressed in each, etc., and then you apply these strategies, based on evidence, to a street, a neighborhood, a city, a district, a region, and – only in exceptional circumstances – to a whole country.

Even the UN clearly stipulated that any such intrusion in our lives should be carefully targeted and for a limited period of time, and should be as minimally invasive as possible. I wonder how many varietals of intervention would pass that test globally.

But such an assessment – such a clearly-stated set of containment and mitigation strategies, triggered by evidentiary thresholds that have been debated and clearly shared – should surely precede even a single day of lockdown being imposed and asserted, otherwise.

In short, evidence-based thresholds, including a review of the types of cases (so you do not treat nursing home outbreaks the same way as widespread community transmission), each triggering distinctive, focused, brief, targeted strategies – and not some shibollethic “five tests” created by dubious witch-doctors – should actually guide policy and decisions.

Lanka, Calibration and Breaking News!

Everyone wants Lanka to win: it is a warm, charming, inviting place with a captivating culture, but there are turbulent, choppy political waters ahead. And there is what this reveals about gullibility and aversion to evidence; but Lanka is not unique on those fronts, just more acutely afflicted given how little the data has merited the over-reaction here.

Sri Lanka’s economic bungee-jump-without-the-bungee is a tale less about COVID-19 and more about how we can undermine our sense of balance and operational sanity, and how we can be seduced by the siren call of herd panic. We, as a human family, have somehow to outgrow our aversion to the inescapable leadership imperative of assessing the cost-benefit implications of our choices, being able to sift the essential from the incidental.

No one would – in that clarifying light – opt to destroy their economy and society over errant speculation, rather than opting for ongoing, careful, fact-based course correction as we march towards some clearly-defined and credible aim.

We have been advised here in Lanka now (and naysayers say this is as much about an upcoming election as COVID-19, but it is economically on the side of the angels nonetheless) that as of May 26th, a night curfew from 10pm to 4am will apply to the whole island. We are “at liberty” otherwise.

We shall continue to whittle away, hoping each day that facts and human values – and not COVID-19 “theology” – can increasingly hold sway.

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