The pandemic's twists and turns

The pandemic's twists and turns

People get a shot of AstraZeneca vaccine at Thamasat University Hospital in Pathum Thani. (Photo: Apichit Jinakul)
People get a shot of AstraZeneca vaccine at Thamasat University Hospital in Pathum Thani. (Photo: Apichit Jinakul)

Health issues dominated the headlines in 2021. Reporter Apinya Wipatayotin revisits the top developments surrounding the Covid-19 crisis, along with other noteworthy events.

Jab challenges

Although the government is set to achieve its target to provide 100 million Covid-19 vaccine doses to people before the end of the year, it faces another challenge: many people still refuse to get vaccinated despite the rising number of Covid-19 infections from the Omicron variant.

Through the year, Public Health Minister and Deputy Prime Minister Anutin Charnvirakul was widely criticised for his management of Covid-19 vaccines despite the government's ability to provide various vaccines, including those from Sinovac, Sinopharm, AstraZeneca, Pfizer and Moderna.

During the third wave of the pandemic, the number of Covid-19 patients and those who died surged. The minister was accused of making the wrong decision for not joining the international vaccine cooperation scheme called Covax, which has 184 member states. His refusal to do so was criticised for reducing Thailand's chances of accessing a variety of jabs, including mRNA vaccines.

Critics also blamed the government for failing to provide the Pfizer vaccine as well as the slow delivery of other vaccines.

A series of campaigns demanding the Pfizer vaccine was conducted by political and social activists. In addition, people were unhappy with the ministry's mixed vaccine formula, citing safety reasons. However, the World Health Organization later published advice on mixing and matching vaccines to ensure safety, efficiency, and the prevention of infections.

Currently, vaccine shortages are not the ministry's main problem. It now must find a way to encourage the unvaccinated to get inoculated against the disease.

An employee of SYH Hospital hands out free antigen test kits at Thanom Nimit market in Bang Khen district. The project is supported by the National Health Security Office and Bangkok's public health office. (Photo: Apichit Jinakul)

Lepu's ATKs

Aiming to mitigate Covid-19 infections, the National Health Security Office (NHSO) asked the Government Pharmaceutical Organization (GPO) to distribute 8.5 million free sets of Antigen Test Kits (ATK) to at-risk people who wanted to have an initial test for the virus.

The GPO conducted the bidding process on behalf of the NHSO because the authority was not allowed to do so under an order by the National Council for Peace and Order.

The bid winner was Ostland Capital, a company that now imports Lepu brand ATKs after saying that each would be sold for 70 baht each. The China-made ATKs promptly sparked quality concerns from the Rural Doctor Society. In May, the product was recalled in the United States due to a high risk of false results, according to the US Food and Drug Administration.

The society later wrote to Prime Minister Prayut Chan-o-cha, demanding he suspend the bidding. The group received a response from the PM, who ordered an investigation. However, the GPO insisted it was following the rules, saying the procurement process was transparent, and the product was in line with standards set by the Thai Food and Drug Administration (FDA).

The FDA also insisted that Lepu's ATK met its standards. The GPO finally agreed to receive 8.5 million ATK sets, which were later distributed to hospitals nationwide.

Meanwhile, the Rural Doctor Society vowed to closely monitor the ATKs' efficiency. It later distributed information on how a southern hospital came across an error while using them.

The NHSO later said the Lepu ATKs were for home use and not professional use.

Omicron looms

This year was the hardest year for controlling Covid-19 outbreaks globally, including in Thailand. The virus has mutated from the original Alpha strain in Wuhan, China, to other variants, including Delta and now, Omicron.

The kingdom's first Alpha cluster was found at a boxing stadium in Bangkok, while a second cluster was found at night entertainment venues in the capital's Thong Lor district.

It was believed that the second cluster started with a rich patient who contracted the disease at a nightclub in Cambodia. The two clusters led to the kingdom's first wave of the Alpha outbreak between January and July. According to the Department of Medical Science, the Alpha variant was already in the country at the time, with over 90% of cases attributed to the variant.

In May, the first case of the Delta variant was detected at a construction site in Bangkok's Lak Si district, where 15 workers were infected. Now, over 90% of cases are the Delta variant.

The infections put a big financial strain on the country's public health services due to over 10,000 cases being detected daily for several months, and more than 20,000 cases were discovered in August.

Luckily, due to mass vaccinations, the infection rate is now in decline with a few thousand being reported daily. However, a new concern arose over the detection of the first Omicron case this month in an American tourist who had arrived from Spain.

Just two weeks after this case was detected, the number of infections has increased, rapidly with the kingdom having recorded over 900 Omicron cases so far. Virus experts believe infections will quickly rise in the coming months, and Omicron will be the dominant variant in the country.

Treatment policy

During the early stage of the Covid-19 outbreak caused by the Alpha variant last year, the Ministry of Public Health required all Covid-19 patients to go to hospital for treatment for 14 days, even if the symptoms were mild.

The third wave of outbreaks caused by the Delta variant was a game-changer. With new infections of over 10,000 cases per day for several months, the country's public health security almost collapsed. The ministry later changed policy by urging people who developed mild symptoms to isolate themselves at home and make telemedicine calls with their hospital.

Meanwhile, patients with moderate symptoms were told to seek treatment at field hospitals and hospitels. The largest field hospital was located at Impact Muang Thong Thani in Nonthaburi province, where medical staff nationwide were relocated for temporary work.

A campaign called "Stay home to help doctors" was launched through mainstream media channels and social media to encourage people to stay home to mitigate disease transmission.

The government also asked people for cooperation on working at home to stop transmissions.

However, due to overcrowded hospitals, many people were found dead at home and on the streets.

Despite the ministry's efforts to transfer patients to hospitals, the plan could not run successfully due to resource problems such as shortages of beds, medical staff and life-support machines. Covid-19 brought a public health tragedy to the country.

Impact Challenger Hall, Muang Thong Thani in Nonthaburi, was converted to be a filed hospital accommodating 1,200 beds.

Health centres

The Ministry of Public Health is now dealing with a dilemma after announcing the transfer of the management of 9,750 tambon health centres to the Interior Ministry's local administrative organisations, including municipalities, tambon administrative organisations and provincial administrative organisations.

The ministry argued that local bodies would be able to develop health centres under local budgets, but progress is slow. So far, only 84 tambon health centres have been transferred to provincial administrative organisations.

Protesters said they were not sure whether local authorities would have enough financial support to provide health services.

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