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Thailand vs. COVID-19: Early Detection and Treatment, Assertive Approach and National Preparedness

            As the on-going battle against the Novel Coronavirus 2019 or ‘COVID-19’ continues to expand globally, Thailand is standing strong and prepared, in face of this new adversary.  

            Thailand’s experience in handling epidemic situations ranging from Avian Flu to SARS and MERS-CoV has strengthened our ability to manage epidemic situations. Thailand’s readiness to work closely with WHO, paired with development of national preparedness at all fronts, has placed Thailand as the 6th most prepared country in the world for an epidemic or a pandemicin the Johns Hopkins University’s 2019 Global Health Security Index.

            Therefore, when the authorities in Wuhan confirmed on 31 December 2019 that numerous pneumonia cases of an unknown cause had occurred, Thailand was already on alert. The Thai Ministry of Public Health (MOPH) immediately set up a surveillance protocol since 3 January 2020, and activated the Emergency Operations Centre (EOC) on 4 January. This was why, on 8 January, Thailand became the first country to detect a COVID-19 case outside of China, an imported case from Wuhan City, even before the virus was made known to the world.

            At that time, a medical team at the Thai Red Cross Emerging Infectious Diseases Health Science Centre, Faculty of Medicine at Chulalongkorn University was able to detect the virus, and initially identify it as an unknown coronavirus. They kept it isolated, and as soon as China shared the genome of COVID-19 on 11 January, they were able to confirm a match and disclose this information on 12 January.

            To contain the spread of the virus, Bamrasnaradura Infectious Diseases Institute (BIDI), a renowned institute in epidemiology under the supervision of the Department for Disease Control, MOPH, was tasked to spearhead patient treatment and conduct research on COVID-19.

            In early February, the team of physicians at Rajavithi Hospital, under the supervision of the Department of Medical Services, MOPH,took an assertive approach in COVID-19 treatment. The combination of an anti-influenza (Oseltamivir) and anti-HIV medications (Lopinavir and Rotonavir), successfully treated severe COVID-19 cases, within 48 hours. Although the treatment was done on a trial-basis, this finding has helped pave the way for future research on antiviral medication to treat COVID-19 patientsand was noted world-wide.

            The capacity to confirm infected cases on a timely basis is also crucial. Thailand can have diagnostic laboratory examinations for suspected cases done within 24 hours. Testing is available at 13 medical science centers across the country, including Siriraj Hospital, Ramathibodi Hospital, Chulalongkorn University, Prince of Songkhla University, Rajavithi Hospital, Bamrungraj Hospital, and Bamrasnaradura Infectious Diseases Institute. Treatment of patients is effective, with a high recovery rate. Presently, two thirds of infected patients have fully recovered. One death has been recorded.

            MOPH has kept the public, WHO, ASEAN member states and other partner countries informed early in the stages of the COVID-19 situation. The public have access to information on personal hygiene, preventive measures, as well as situation reports and measures through press briefings twice a day. A dedicated MOPH website, Facebook and twitter accounts disseminate the information simultaneously. There is a telephone hotline to respond to public queries.

            The abovementioned  efforts have enabled Thailand to gradually move down the list of countries with highest numbers of infected persons outside China. We are working relentlessly to maintain our current status, where all cases of infections can be accounted for and traceable to imported cases or tourists.

 

Effective System

          While screening measures have been put in place at all ports of entry, the MOPH has pushed forward with the implementation of a contact tracing system ever since the first infection was detected, on suspected individuals and people they have come into close contact. This has enabled authorities to identify virus carriers even before symptoms appear and prevent them from unknowingly spreading the virus.

          Since the beginning of February, MOPH has stepped up measures to ensure that there are no gaps in our surveillance system. On 17 February 2020, the MOPH upgraded screening on patients with pneumonia from unknown causes in eight popular tourist destinations (Chiang Mai, Chiang Rai, Krabi, Phuket, Prachuap Khiri Khan, Bangkok, Samut Prakan and Chon Buri), as well as people who had close contact with travelers from COVID-19 outbreak areas. Such cases will be automatically referred to as Patients under Investigation (PUI). Following the introduction of the elevated screening, PUI cases increased significantly, which has raised the level of confidence that Thailand is indeed leaving no carpets unturned.

          Thailand’s effective system encompasses early detection, comprehensive patient treatment, and assertive action coupled by the transparent nature of our approach. All efforts are made to ensure that this effective system continues with no obstacles.

 

Latest measures

          As the COVID-19 situation continues to spread globally, we need to be prepared for the likelihood of an epidemic phase in Thailand. On 24 February 2020, Thailand’s National Committee on Communicable Diseases declared the COVID-19 a dangerous communicable disease to enable health authorities to respond more quickly and effectively, step up precautionary measures, and enforce tougher rules to contain the situation when necessary. Thailand will continue to maintain open communication with the public in full confidence and transparency.  Through close cooperation with WHO and partners in the region, through vigilance and preparedness, we are confident that we will overcome the disease together.

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