Five things to do to win Covid-19 fight

Thailand has money to fight the Covid-19 pandemic. Yet people are falling like leaves. It’s clear. Cash handouts cannot save lives. Highly effective vaccines can. Rapid mass vaccinations for everyone can. Everyone, Thais and non-Thais. No one is safe from the virus if anyone is left out.

But can these effective Covid-19 solutions happen fast enough to save lives and rescue the national economy?

Amid rising public frustrations with the state’s failure to contain the pandemic, the government must quickly fine-tune the Covid-19 policy. Money is not the problem. The question is how to use it effectively.

Last year, the government secured a loan of one trillion baht to cope with the pandemic. This year, it has secured another 500 billion baht. About 94 billion baht has been allocated for public health measures. Combined with the money from the central budget, the government has at least 134 billion baht for public health measures to contain the coronavirus and return the country to normal.

To date, more than 9,000 people have died – many from lack of vaccinations and hospitalisation. Almost two years into the pandemic, only 8% of the population have been fully vaccinated. Officially, one million people have been infected. In reality, the figures may be much higher.

The economy is collapsing. Stuck in the pandemic, the country loses more than 150 billion baht a month alone from tourism.

We should learn from other countries’ successes. Great Britain, Singapore, and Israel have shown that three things must be achieved before we can open the countries.

Firstly, the majority of the population must receive highly effective vaccines. It is 70% in Great Britain and 80% in Singapore and Israel. Secondly, the spread of the virus must be effectively contained until the ratio between confirmed deaths and confirmed cases (seven-day moving average) drops to 0.1-0.2%. And thirdly, the number of ICU patients (seven-day moving average) should be below nine per one million people.

In Thailand, as of Aug 20, less than 10% of people had been fully vaccinated. The ratio between confirmed deaths and confirmed cases (seven-day moving average) is 1.16%. The number of ICU patients per million (seven-day moving average) is 17.5. And about 25% of people tested are infected.

The government has vowed to open the country this October. That won’t happen. Thailand is far from being ready.

But we have the resources. To turn things around, the government must invest in five public health measures. They are:

HIGHLY EFFECTIVE VACCINES

Thailand must acquire highly effective vaccines immediately for mass vaccinations. The vaccines must be distributed quickly, widely and transparently.

As of Aug 20, 2021, 25.8 million doses of vaccines had been administered, yet the pandemic situation remains critical. This is because the main vaccine Sinovac has a relatively low efficacy rate. Even if half of the population have received Sinovac, it still cannot stop the spread of the coronavirus.

To acquire highly effective vaccines such as Pfizer for 50 million people to be fully vaccinated would cost about 130-165 billion baht. This expense would be covered in a few months when the country can welcome tourists again. Life will return to normal – or nearly – enabling the domestic economy and the export industry to pick up.

In addition, the government must buy more antiviral drugs such as Favipiravir and Remdesivir. Any bureaucratic red tape that delays the use of these medicines must be dismantled.

MASS RAPID TESTING

Investing in mass rapid testing stops the spread of the virus because it expedites isolation and early treatment which saves lives and medical costs.

Singapore conducts about 12,039 RT-PCR tests per one million people a day. In Thailand, it is only about 933 tests per million a day.

Without mass rapid testing, infections will likely rise again after the lockdown which will cost 770 billion baht in damage to private consumption or about 4.8% of gross domestic product, according to SCB Economic Intelligence Centre.

Investing in mass testing for one million people alone could save the country about 5.1 billion baht in medical costs. The mass testing should run until the positive test rate is below 5% which indicates successful virus containment.

Like in Singapore, the government should distribute rapid antigen test kits (ATKs)  and oximeters to every household, especially to the poor and wage earners who face a high infection risk from their work.

A set of home use ATKs, thermometer, and oximeters costs about 1,000 baht. Spending 146.5 million baht for 146,462 urban poor households in Bangkok will save about 3.2 billion baht in hospitalisation costs.

The workers who cannot work remotely should also receive free ATKs. There are 11.9 million of them in the manufacturing, construction, transport, warehouse, hotel and food industries. They produced about 5.8 trillion baht, or 37% of GDP in 2020. They need protection to keep the economy running.

A set of ATK costs about 120 baht. Mass testing twice a month for these workers would cost about 2,856 million baht. Apart from saving lives and the economy, this health measure would save about 66 billion baht in hospitalisation costs.

Importantly, the government should make ATKs affordable through value added tax exemption. A set of ATK now costs about 250-400 baht, well beyond most people’s means.

ISOLATION AND MEDICATION

Speed is the key. Isolation and medication must happen immediately after infection. State agencies need to integrate health services to support home and community isolation, providing the venues as well as food and medical support. This intervention costs much less than the medical costs for critical patients from delayed virus detection and treatment.

According to the Department of Medical Services, taking Favipiravir during the first four days after the symptoms show can prevent critical symptoms and death.

The medical cost for mild Covid-19 patients in a community isolation centre to prevent critical health conditions is about 30,000 baht. The medical cost for moderate and severe Covid-19 patients is about 190,000-360,000 baht.

BETTER PROTECTION FOR FRONTLINERS

Apart from work overload, doctors and health personnel face a high risk of infections. They need highly effective vaccines, more pay, and better protection. Their families also need better protection, particularly the elderly and those with illnesses.

At present, doctors get an extra 1,500 baht per eight-hour shift. Nurses and other health personnel get an extra 1,000 baht. They often work longer hours amid a high risk of infection so they deserve better pay. The government should give them bonuses at year-end to show appreciation for their sacrifice.

HIRE VOLUNTEERS AND STAFF

The government should recruit more volunteers and staff to assist the rising number of people in home and community isolation. They should receive training in Covid-19 care and online case reports for further supervision from health professionals. The volunteers and staff should already be fully vaccinated or be former Covid-19 patients if they have to work in community isolation centres.

State agencies should also collaborate with the various volunteer groups which are now helping Covid-19 patients. Better still, provide funding for them to expand their services. The collaboration will create a better system to help the infected.

Highly effective vaccines, mass rapid testing, isolation and treatment, protection for frontline health personnel, and more volunteers and staff to aid for home and community isolation. Investing in these five public health measures are highly worthwhile economically. More importantly, they would save lives and rescue the economy.

Thailand has the money. The question is whether or not the government has the will and the vision to successfully steer Thailand out of the pandemic.

Saowaruj Rattanakhamfu, PhD, is Research Director for Innovation Policy for Sustainable Development at the Thailand Development Research Institute (TDRI). Policy analyses from TDRI appear in the Bangkok Post on alternate Wednesdays.

First Published: Bangkok Post on August 25, 2021 

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Saowaruj Rattanakhamfu | COVID-19 | vaccines | loan | ATKs | RT-PCR