Covid success coming at a heavy price
It was a matter of time before the government of Prime Minister Prayut Chan-o-cha became a victim of its own misguided success in handling the coronavirus pandemic. By presiding over a public mindset of "zero" local virus infections, the government raised unrealistic expectations at a high price. The fiasco that transpired in Rayong last week, when an infected Egyptian air force official was allowed to roam in a shopping mall and thereby fuelled fears of "second wave" infections, should serve as a wake-up call for an overdue change in virus-fighting strategy.
To be sure, the persistence and potency of the global coronavirus pandemic necessitate tough and proactive measures. Latest figures indicate that the total number of cases is approaching 14 million with a death toll soon to reach 600,000. In the worst-hit countries, particularly the United States, Brazil and India with their relatively large populations, case infections are most alarming and show no signs as yet of abatement and containment.
As widely noted, Thailand has done well in keeping infection numbers below 3,300 with comparatively few deaths at 58, ranking the country impressively at around 100th among 215 states and territories. When the virus-afflicted Egyptian case popped up in Rayong, in addition to a similarly infected Sudanese child and diplomatic dependant in Bangkok, Thailand had not had a local Covid-19 case in more than 40 days. New daily infections could be counted on the fingers of one hand, all deriving from outside the country and discovered during state-mandated quarantines.
Therein lies the problem. As infections became the focus, local momentum of single-digit to zero cases built up. Each daily media briefing by Dr Taweesilp Visanuyothin, the spokesperson for the Centre for Covid-19 Situation Administration (CCSA), became a kind of battle cry and call for victory, quietly cheered and celebrated with relief, undergirded with national pride. It promoted an air of triumphalism as if Thailand had somehow conquered the pandemic.
But it was a false war of the Covid centre's own making. Fighting Covid-19 is not a war to be lost and won. It is more a process of resilience and a sustained effort of management, mitigation and minimisation, overcoming and outlasting a deadly virus that will be around for a long time. Thailand's virus numbers will inevitably rise again. The key is to live with and beyond them.
Local outrage at the Egyptian and Sudanese infections and potential spread also stem from the price of quarantine. As foreigners and Thai citizens travelling to Thailand from abroad faced compulsory 14-day confinement at designated state quarantine facilities, many resent the double standards in the face of exemptions and violations of strict isolation rules. The same applied earlier to the visiting United States army chief of staff but much of his official visit took place without public contact, including an immediate coronavirus swab test on arrival, and therefore went off without incident.
The downstream impact in Rayong was severe. Vendors at its downtown market complained of markedly lower sales as the province got a bad rap from the Egyptian infection. Local hotels saw sudden cancellations ahead of the upcoming four-day long weekend. One Rayong hotel staff member lamented that "just when guests were beginning to come back, they got scared again."
The Covid centre has itself to blame for setting the bar so high. This is what happens when medical professionals are put in charge of policymaking. By training, medical doctors are geared to cure diseases and eliminate infections. If the government leaves it to the doctors, we would have low to nil infections at the expense of all other policy priorities. When the Covid-19 outbreak was virulent in March-April, we needed the doctors to take charge. But now we need other experts as well. Over recent months, some of the medical authorities may also have grown too accustomed to having power and being in charge in the limelight to see other, broader objectives the country needs to consider.
What Thailand needs is a new approach in view of a moving mix of objectives. The "zero" mentality is detrimental to the Thai economy and people's livelihoods. It makes Thais afraid of reopening and taking calculated and inevitable risks in a trade-off between public health safety and economic well-being. In fact, Dr Taweesilp has admitted after the Egyptian case that we must not be glued to the zero benchmark and that infections will go up again. The next policy question is how much should infections go up by and under what conditions.
As a result, the authorities need to come up with a rolling average of Thailand's healthcare capacity for pandemic management. How many infections can Thailand put up with in an ongoing fashion? Taking into account all available hospital beds, ventilators, doctors and so on, there is an infections range that Thailand is capable of handling. This range can then be worked into a system of test, trace and isolate (TTI). As infections can become recoveries through TTI, the rolling healthcare capacity can be adjusted and maintained as needed.
With this number to work with, the government can then look at priority areas in Thailand's services-dominated economy to resuscitate and revive, with all precautions and hygienic requirements in place. Green lanes and "bubbles" for essential business travel are a priority. While mass tourism of the recent past is now unattractive, niche medical tourism can still work. Foreign talent and direct investment connected to the Eastern Economic Corridor and Thailand 4.0 projects should be at the forefront.
The alternative is to maintain single-digit or zero infections in a relatively autarkic economy with lost jobs, corporate bankruptcies, non-performing-loans, and diminished and dimming prospects for local livelihoods. While taking these chances to reopen will only shore up the Thai economy from what will be a deep economic contraction, it is a start. It would restore a semblance of public confidence in economic prospects. It would also enable Thailand to leverage its public health prowess for economic gains. The onus for Covid-19 strategy and policy is on the prime minister who, despite making himself with a military career into the head of national economic management, must know how to spot talent, how and when to delegate, and whom to listen to in the face of fluid virus conditions and shifting priorities with immense ramifications for Thailand and all who inhabit it.
An associate professor at Chulalongkorn University
An associate professor and director of the Institute of Security and International Studies at Chulalongkorn University’s Faculty of Political Science, with more than 25 years of university service. He earned his MA from The Johns Hopkins School of Advanced International Studies and PhD from the London School of Economics where he was awarded the UK’s top dissertation prize in 2002.