With Covid-19 infection cases skyrocketing and a rise in fatalities, the government must come to term with reality, making use of all scarce resources wisely, as it races against time in dealing with the new outbreak.
The number of new cases as released yesterday by the Centre for Covid-19 Situation Administration (CCSA) was 1390, which brought the total cases to more than 40,000. Of that number, over 14,870 infections are associated with the Thong Lor cluster involved with several entertainment venues in Bangkok's business district that was detected early this month and has since spread across the country.
The sharp rise in infection cases put great pressure on the country's health care system. Several hospitals are full, and have used up their bed capacity. Those whose medical personnel are infected from the virus have experienced some difficulty.
One policy that needs an immediate review involves isolation for people with mild Covid-symptoms or who are even asymptomatic. Currently, the Health Ministry demands that all those testing positive must enter state quarantine, such as hospitals or field hospitals that are freshly built.
Late last week, Dr Opas Karnkawinpong, director-general of the Disease Control Department, said the infrastructure was sufficient as the government has set up field hospitals and also has persuaded hoteliers to provide so-called "hospitels''. He has ruled out a possibility that those with mild symptoms or no symptoms could practise self-isolation and seek consultation from doctors online or over the telephone. The DG condemned those who refused to enter state quarantine, and threatened to slap them with a lawsuit.
Not every doctor agrees with the ministry or Dr Opas. Instead, quite a few are for self-isolation or home-quarantine, with a support system to allow health personnel to follow up each patient. Home quarantine can help reduce the pressure on resources and manpower, and also the chances of infection spreading when a number of people gather in the same compound.
While Dr Opas said talks about sufficient infrastructure, in fact some responsible for field hospitals have started asking for donations. Thammasat University hospital as well as Siriraj, Chulalongkorn and Ramathibodi are facing a protective equipment shortage. Worse, there are reports that Covid-19 has hit some hospitals hard as a number of medical personnel have been infected.
Such a centralised approach is questioned or even opposed even by fellow doctors. All existing resources should be used for patients with a serious condition. The fact is: a large number of the country's health personnel must be exhausted after battling Covid-19 since the first outbreak. What is needed now is to set priorities and work out a support system, such as quick hospital transfers, online follow-up system or checks over the telephone so personal contact can be reduced.
In most advanced countries, hospitals are only for critical cases, while the others must stay at home in quarantine, with a noteworthy support system.
In fact, the disparity among doctors on this point has created public confusion. There are reports that some policy-makers at the Health Ministry have started eyeing a home quarantine option. But Dr Nattapong Wongwiwat, deputy chief of Medical Department, still insists a centralised system will carry on. The ministry would rather wait until the current system cannot go on. In fact, the country cannot afford such a wait, which would do more harm than good.