Why Prayut’s key advisers are living in fear
Complacency remains the biggest enemy for Thailand's Covid-19 specialists
Professor Dr Prasit Watanapa is intimately involved in the government’s efforts to tackle the Covid-19 crisis.
The 63-year-old dean of the faculty of medicine at Siriraj Hospital, Mahidol University is among many leading doctors in Thailand to have been in discussion with Prime Minister Prayut Chan-o-cha to identify the most effective measures for controlling it.
Those physicians have encouraged the government to implement such measures as cancelling the Songkran holidays and closing entertainment venues to stop the virus from spreading since the the outbreak of the pandemic early this year.
At that time, the government was being urged to find non-politicians to communicate more effectively with the public on the measures being taken, so it swiftly established the Centre for Covid-19 Situation Administration (CCSA), with Dr Taweesin Visanuyothin as its spokesperson.
At the same time, Dr Prasit and other leading doctors have been working in tandem with the government to find solutions and educate people on how they can avoid getting sick.
Dr Prasit gave an exclusive interview to the Bangkok Post to mark its 74th anniversary on Aug 1, to share his insights from being in the team fighting the virus and his views on the "New Normal" that awaits Thailand in the post-Covid-19 era.
He is a prominent public figure in both the Thai and foreign media, having often issued cautionary tales via the Mahidol University’s online television channel since the start of the outbreak.
When the government allowed various types of businesses and activities, especially night-time entertainment establishments, schools and national parks to resume operating on July 1 during the fifth phase of easing the lockdown restrictions, Prof Prasit was predictably outspoken.
He renewed his warning that Thais should not let their guards down and should continue following the advice of medical experts to prevent a second wave of the Covid-19 infections in the Kingdom.
The battle plan
Led by Prof Prasit, Siriraj Hospital’s medical team has issued clear Covid-19 guidance to best preserve public health.
In a nutshell, they want to see Thais maintain the now-familiar habits of social distancing, wearing face masks and using hand sanitisers.
The team has played a significant role in communicating directly with members of the public on disease prevention.
Its members have the happy knack of being able to translate complicated subjects into easy-to-understand language, this has substantially enhanced the public’s understanding.
"We have over a million viewers on these clips and have had great positive feedback," said Prof Prasit, who has frequently updated Covid-19 messages via the university’s Facebook Live channel.
However, he is constantly repeating the key message that people should not allow the country’s impressive statistics make them complacent.
"We can say that we are fulfilling our responsibility to society by letting them know the truth and suggesting how they can best prevent themselves contracting the disease."
His medical team has closely monitored the feedback and comments from viewers and found the results very satisfying. Once people understand the situation clearly, he says, they are more likely to fully cooperate.
For example, the number of people using the Thai Chana track and trace application surged from 21 to 30 million after his medical team explained the importance of using it to check in and out of public venues.
Dr Prasit recalls that when the very first patient tested positive for Covid-19 on Jan 12, there was little public anxiety about it and it was assumed to have a mortality rate of just 0.2-0.5%, which is very close to the avian flu of 2009 (0.1%).
One of the first shocks was his team’s discovery that 80% of infected people were asymptomatic, leading to a far greater challenge in controlling its spread.
That’s why the medical community advised as early as January against all group activities as they began to notice an increasing number of infections.
In mid-March, the number of domestic infections rose to 114 cases in one day and Prof Prasit admits that raised serious doubts among his team as to whether the country was on the right track to curb the new disease.
At that time, he recalls, a medical forecast showed that the number of new infections would have risen to 200 cases per day within just three days had the country failed to take suitable measures to control the situation.
That would effectively have meant the virus was spiralling out of control.
The team suggested that the number of infections would be up to 350,000 within 30 days without any preventive measures.
Discussions with Prime Minister Prayut finally came up with more aggressive action to prevent the disease spreading, including city lockdowns and a ban on all foreign entry. That prompt action caused an immediate slowdown in the rate of infection at a pivotal moment in the crisis.
"We [my team] are afraid about the news of no local transmissions in the country right now because it makes people less concerned about preventing it," he said.
"The virus is still in the country and can spread any time when people are too relaxed or act out of ignorance. Please keep in mind that the disease is still alive even though there are no new local infections."
He warned that even the scientific community does not fully understand the characteristics of the Covid-19 virus.
Some Chinese studies found that it had already mutated to six strains that might all be affected differently by a potential vaccine in the future.
In the end, such a vaccine might not even be able to cure the mutated virus, he warned.
Worryingly, there have been reports recently that immunity from Covid-19 might not be permanent, a sharp contrast with the long-held belief that humans will eventually be protected by lifelong immunity.
The World Health Organisation (WHO) has warned that the worst is still to come, adding that it is not even close to being over.
It pointed to a lack of international cooperation and solidarity, warning that the divided world was actually helping the virus to spread.
More than 10 million people have already infected with the deadly virus since it emerged in China last year.
"There is no reason to relax," the professor repeated.
"We currently have neither medicine to treat the disease nor a vaccine to prevent or cure it. Please keep wearing a mask and practise social distancing to keep us free from infection."
Practising the ‘New Normal’
Dr Prasit, 63, also said the Siriraj Hospital had been already prepared its "New Normal" way of giving medications to patients through the development of telemedicine technology, which allows them to advise people remotely.
This also reduces interpersonal contact, a clearly advisable course of action since it is known that the virus can be spread by asymptomatic people.
"I am confident that the quality of this medical treatment won’t be less than medications prescribed through visiting doctors," he said.
Telemedicine technology, he believes, will help reduce the number of outpatient visits to hospitals and lower the use of surgical masks and other vital equipment.
Furthermore, the hospital is now developing telesurgery with robots to reduce the risk of medical staff becoming infected should patients need to have an operation.
Other telemedicine devices are also being developed, said Prof Prasit, and these would enable more precise examinations to be conducted during the course of the pandemic.
"So we must learn lessons from Covid-19 patients," Dr Prasit concluded.
"The key to survival is getting correct and precise information, analysing it, making a decision about which action to take and evaluating the results.
"Adapting too slowly to the information is a sure way to fail."