Always spread your bets around

The Department of Medical Sciences reveals that tests show AstraZeneca vaccine samples produced by Siam Bioscience meet all requirements. Photo courtesy of the Ministry of Public Health

The World Health Organisation had hailed Thailand's handling of the novel coronavirus at its peak early last year, noting that cooperation and health measures are the keys to success. However, the third wave of the viral pandemic has thrown us into chaos. It has raised the number of infections to over 65,000 and deaths to more than 200, stretching the country's public health system to its limit. What can we learn from this?

With the benefit of hindsight, we should diversify options to reduce risk. I think the government is too complacent about its vaccine management. When the latest round of the outbreak hit the country last month, it was unprepared for the UK variant that can transmit faster than the original strain. Currently, we have only two vaccine brands, Sinovac and AstraZeneca, with a total of 2.6 million doses administered. The government distributed about 1.3 million doses between Feb 28-April 28, accounting for only 1.7% of the entire population.

In fact, the government has not paid attention to those who raised red flags. On Jan 18, Thanathorn Juangroongruangkit, the leader of the Progressive Movement, criticised the government's vaccine procurement for being too sluggish and betting on one horse. He questioned why the government didn't take action until the Ministry of Public Health ordered the vaccine from AstraZeneca in November last year although the committee of the National Vaccine Institute approved the blueprint for public access to inoculations many months earlier. He also questioned why Siam Bioscience, founded by the late King Bhumibol Adulyadej, has been chosen to produce the vaccine for AstraZeneca.

In terms of risk management, his foresight had a grain of truth, but it went unheeded and instead saw him get slapped with lese majeste charges.

Actually, bureaucratic arthritis can cripple risk management during a crisis such as this. In early February, Somchai Jitsuchon, research director for inclusive development at the Thailand Development Research Institute, who is involved in vaccine management, said procurement regulation doesn't allow for the pre-ordering of products in the development phase because it is at risk of losing deposits. At the time, nobody knew the vaccine would come to fruition. He suggested that the government amend regulations or bypass them to allow betting on many horses.

It was not until former PM Thaksin Shinawatra took aim at the sluggish vaccine rollout that the government immediately began to secure more jabs from Russia's Sputnik V and America's Pfizer a few days later. Public Health Minister Anutin Charnvirakul insisted that he would amend rules to speed up vaccine procurement in an emergency and promised that the country would obtain 100 million doses for 50 million people to achieve herd immunity by the end of this year.

It is understandable that the government wasn't enthusiastic about vaccines last year because the rate of infections remained low. In fact, local production of vaccine supply is beneficial in the long term because it can help reduce our dependence on foreign manufacturers. Unfortunately, the problem is new variants emerged before our vaccines could be made available in the second half of the year.

The price of betting on only a few horses has left the country with no choice but to use current vaccines amid growing public scepticism about their efficacy and side effects, following the report of medical workers suffering stroke-like symptoms after being given the Chinese jab. Frontline medical personnel are no different from guinea pigs at the moment.

While the vaccination plan moves at a snail's pace, those not inoculated remain at high risk of infection. If they develop severe symptoms, it will further tip the balance because the current caseload is putting our public health system on the verge of collapse. New critical patients may have difficulty receiving proper treatment because hospital beds are full, which will increase the mortality rate.

The government should protect the country from this fiasco. Diversifying vaccine procurement will speed up herd immunity and prepare for new variants. The mass rollout will begin in June until the end of this year with 61 million doses of AstraZeneca. However, it remains to be seen whether it can fight mutations. The viral vector vaccine works by putting a small part of the coronavirus on a harmless carrier and injecting it into the patient. If new strains break out, will this kind of vaccine be effective?

At the same time, the country can follow the United Kingdom by thinking about a booster programme. In December last year, Margaret Keenan, 91, was the first person in the world to receive the Pfizer Covid-19 jab as part of a mass vaccination campaign in the UK. It has now ordered an extra 60 million doses of Pfizer's booster jabs. If we don't learn from the worst, our time and money will go down the drain again.

Thana Boonlert is a feature writer for the Life section of the Bangkok Post.

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