On Jan 23, as one of the countries most exposed to Covid-19, Thailand reported four infections -- the largest number outside China since the virus outbreak was first reported on Dec 31.
While Covid-19 cases have soared in other countries, the number of confirmed cases in Thailand has remained relatively stable. On Monday, the number of cases here was 50 -- much lower than in many other countries which reported few or even zero cases during the first month of the outbreak.
Why is the number of infections in Thailand so low? Is it possible that there could have been undetected cases?
Those questions have been raised recently abroad and at home. Observers have questioned Thailand's detection, monitoring and surveillance measures -- less in terms of their technical effectiveness but more regarding their comprehensiveness.
It is true that the Thai healthcare system is recognised internationally as robust and capable because of its established infrastructure and the competency of its healthcare professionals. This has resulted in effective implementation of long-established protocols within public health agencies to ensure isolation, tracing, testing and treatment when it comes to dealing with disease outbreaks.
Since the spread of the virus, healthcare professionals have worked day and night to detect cases and contain Covid-19.
But shortfalls and incompetency seem to have emerged from the government through uncoordinated and ineffectual inter-ministerial handling of the situation. Its policies on travel restrictions, monitoring, quarantine and testing have shown plenty of room for complacency.
With no ban imposed on tourists from high-risk countries, especially China, in the early days of the outbreak, authorities mainly conducted thermal scanning on tourists arriving at airports. Given that some infected people can be asymptomatic, the public still doesn't know whether there have been sufficient follow-up checks made on them.
Shengjie Lai, an epidemiologist at the University of Southampton in England estimates that Thailand probably imported 207 cases in the two weeks before travel in and out of Wuhan, China was restricted, according to a report on the website of Nature Research, a research community that publishes significant discoveries. The figure is based on a study of flight data to create models of the virus's possible spread around the world.
The big question remains of whether Thailand has found all the people suspected of having contact with Covid-19 infected patients and proactively carried out testing on them.
At the same time, the government's screening at airports has been criticised as insufficient and lax. The most notable case has been 80 illegal Thai workers returning from South Korea slipping through the net.
The government has also sent mixed and conflicting messages on quarantine measures for passengers from high-risk countries and territories -- South Korea, China, Italy, Iran, Macau and Hong Kong. It has mainly proposed self-quarantine of 14 days with daily reporting required. But the public do not know how strict this measure is and whether those under self-quarantine may have made contact with others without reporting this to authorities.
The government needs to invest more heavily in testing and monitoring suspected cases. We need to understand the big picture of how widespread the infection is before it is too late.