Category: Medicine

BEIJING China began locking down most of its largest city of Shanghai on Monday as a coronavirus outbreak surges and amid questions about the economic toll of the nation’s “zero-COVID” strategy.

Shanghai’s Pudong financial district and nearby areas will be locked down from early Monday to Friday as citywide mass testing gets underway, the local government said. In the second phase of the lockdown, the vast downtown area west of the Huangpu River that divides the city will then start its own five-day lockdown Friday.

Residents will be required to stay home and deliveries will be left at checkpoints to ensure there is no contact with the outside world. Offices and all businesses not considered essential will be closed and public transport suspended.

Already, many communities within the city of 26 million have been locked down, with their residents required to submit to multiple tests for COVID-19. And Shanghai’s Disney theme park is among the businesses that closed earlier.

Shanghai detected another 3,500 cases of infection on Sunday, though all but 50 were people who tested positive but were not showing symptoms of COVID-19. China categorizes such cases separately from “confirmed cases” — those in people who are sick — leading to much lower totals in daily reports.

China has reported more than 56,000 infections nationwide this month, with a surge in the northeastern province of Jilin accounting for most of them.

In response to its biggest outbreak in two years, China has continued to enforce what it calls the “dynamic zero-COVID” approach, calling that the most economical and effective prevention strategy against COVID-19.

That requires lockdowns and mass testing, with close contacts often being quarantined at home or in a central government facility. The strategy focuses on eradicating community transmission of the virus as quickly as possible, sometimes by locking down entire cities.

While officials, including Communist Party leader Xi Jinping have encouraged more targeted measures, local officials tend to take a more extreme approach, concerned with being fired or otherwise punished over accusations of failing to prevent outbreaks.

With China’s economic growth already slowing, the extreme measures are seen as worsening difficulties striking employment, consumption and even global supply chains.

While China’s vaccination rate is around 87%, it is considerably lower among older people.

National data released earlier this month showed that over 52 million people aged 60 and older have yet to be vaccinated with any COVID-19 vaccine. Booster rates are also low, with only 56.4% of people between 60-69 having received a booster shot, and 48.4% of people between 70-79 having received one.

Source: Thai Public Broadcasting Service

This year’s COVID-19 infections in Thailand, diagnosed by means of rapid antigen tests, reached 1,015,583 yesterday (Saturday), according to COVID-19 Information Centre today.

22,476 new COVID-19 positive antigen tests were recorded yesterday and 25,821 cases today. The death toll in the past twenty four hours is 84 and 251,936 people are still being treated, with 1,672 cases of lung inflammation among them.

The hospital bed occupancy rate is 27.6% and 24,066 patients have recovered today. This year’s COVID-19 death toll is now 3,101.

Meanwhile, Dr. Yong Poovorawan, head of the Centre of Excellence in Clinical Virology at the Faculty of Medicine of Chulalongkorn University, offered advice on how to dispose of used test kits properly, noting that they are regarded as contaminated waste, or a bio-hazard, whether they positive or negative.

He pointed out that several hundreds of thousands of rapid antigen test kits are being used each day and they need to be properly disinfected before they are placed into red disposal bags.

Since most people do not have red bags and do not separate bio-hazard waste from normal household rubbish, he said there is a possibility that the virus could spread into the environment, such into as water ways, though improper disposal.

He suggested formaldehyde or concentrated chlorine be dripped into the bag, contacting the used test kits, before the bag is discarded.

Source: Thai Public Broadcasting Service

Thailand’s Livestock Development Department is expected to produce its first lot of inactivated vaccine against Lumpy Skin Disease (LSD) in cattle by May, which will eventually reduce the country’s dependence on imports.

In announcing the successful development of the vaccine, the department’s director-general, Sorravis Thaneto said today (Friday) that the vaccine will be available in water and oil based capsules and will cost about 9 baht per dose.

The Animal and Livestock Biotechnology Office can produce up to 100,000 doses of the vaccine a month. The production process of the vaccine takes about two months.

The first lot of locally manufactured vaccine expected to save an estimated 21 million baht. Imported vaccine of the same volume would cost 27 million baht, but the manufacturing cost of the local version is only about 6 million. Ultimately, local manufacturing aims to save as much as 280 million baht a year.

Clinical trials of the two forms of vaccine show that the oil capsule produces a 100% immune response, against the 80% response produced by the water based capsule. The effects of the oil based capsule last up to seven months.

The first outbreak of LSD in Thailand was reported in March 2021 in Roi Et province. The disease is characterised by pyrexia, nasal discharge, swelling of the superficial lymph nodes, large skin nodules covering the entire body, poor milk production and miscarriages. The morbidity rate varies between 10% and 20%, with low mortality.

The disease has spread to wildlife, with at least nine banteng found to be infected in Huai Kha Khaeng wildlife sanctuary in July last year.

Source: Thai Public Broadcasting Service

The Ministry of Tourism and Sports will propose to the Centre for COVID-19 Situation Administration (CCSA) that the “Thailand Pass” requirement for all international arrivals be revoked and that the RT-PCR COVID-19 tests required upon arrival be replaced with the quicker Rapid Antigen Tests.

According to Tourism and Sports Minister Phiphat Ratchakitprakarn, the replacement of the RT-PCR test on arrival, tentatively set to start on May 1st, with antigen tests conducted by formal medical facilities, would only be possible if COVID-19 infections and deaths during and after the long Songkran long holiday in April remain stable, at between 50,000 and 60,000 cases a day, including those who have only tested positive using antigen tests and daily fatalities do not exceed 100.

The CCSA will also be asked to consider the Ministry of Tourism and Sports’ proposal to revoke the “Thailand Pass”, expected on June 1st, to encourage more tourists to visit Thailand without the need to apply for “Test and Go”, “sandbox” or other quarantine programs.

Thailand Pass was introduced on November 1st last year, when Thailand reopened to international travellers, who had to apply for the pass at least seven days before their departure.

At least seven million tourists are projected to visit Thailand this year, against a projected target of 10 million. Revenues from tourism this year are estimated to be about 30% of those recorded in 2019 and to be on par with 2019 revenues in the next two years.

Source: Thai Public Broadcasting Service

In December and January, Thailand detected 73 cases of suspected “Deltacron”, a broad name describing variants of the COVID-19 virus (SARS-CoV-2) that contain a mixture of mutations found in Delta and Omicron, but all the patients have recovered, said Medical Sciences Department Director-General Dr. Supakit Sirilak today (Wednesday).

He said virologists at the department have decoded the genetic makeup of all the 73 cases and found they could be Deltacron cases, but results of the findings have been sent to GISAID, a global science initiative and primary source headquartered in Germany, for confirmation.

When the 73 suspected Deltacron cases were detected, Dr. Supakit explained that the Delta variant was still being found in small numbers of patients, hence, there were possibilities that Delta could combine with Omicron.

Since Omicron has now become the dominant variant, accounting for 99.95% of all new COVID-19 cases, he said that there is little chance of Deltacron emerging and it will soon disappear, like the Beta variant, if it does not spread quickly.

At this stage, there are no signs that Deltacron will supplant Omicron as the dominant variant, he said, adding that Deltacron is regarded by the World Health Organization as a variant being monitored.

Of the 1,981 COVID-19 cases monitored by the Medical Sciences Department between March 12th and 18th, only one Delta case was found, accounting for 0.05%, while the rest were Omicron cases.

Of all the Omicron cases, he said the BA.2 sub variant accounted for 78.5% of Omicron cases, a steady increase from 51% and 67.6% respectively.

Despite more cases of the BA.2 sub variant, he noted that symptoms are not severe.

Dr. Supakit said that random tests for sub variants of Omicron had been conducted on different groups of people, such as medical personnel, those with low CT (cycle threshold value), clusters, overseas travellers and those with severe symptoms.

The findings show that infection rates of the BA.2 variant do not differ much between groups, which means that BA.2 does not cause more fatalities among the infected.

Source: Thai Public Broadcasting Service

The average number of new laboratory-confirmed (PCR positive) community-acquired COVID-19 cases reported per day increased by only 7% in the past 7 days compared to the previous week. Although the daily reported confirmed case numbers appear to have plateaued somewhat, case numbers remain very high. In addition, not all probable (ATK positive) cases are subsequently confirmed by PCR testing. The average number of probable (ATK positive) cases reported per day over the last 7 days (20,304) has decreased by 14% compared to the week before (23,533), but also remains very high.

Bangkok continues to report the highest daily number of COVID cases. The average number of new COVID-19 cases reported per day for Bangkok in the past week (3,235) is 4% higher than the week prior (3,119).

The average daily number of all currently ‘active’ COVID-19 cases (235,382) over the last seven days increased by 5% compared to the previous week. A greater proportion of patients continue to be monitored in hospitels, community isolation and home isolation. The average number of COVID cases occupying hospital beds per day over the past week (67,278) is 7% higher than the average daily number reported for the week prior (62,928).

An average of 83 daily deaths were reported in the past week, compared to 69 for the previous week. (an increase of 21%)

The average daily number of severe COVID-19 cases over the past seven days (1,440) represents a 9% increase over the average number reported for the previous week (1,324). The average daily number of ventilated COVID-19 cases over the past seven days (522) also represents a 16% increase over the average number reported for the week prior (449).

The recent rise in new COVID-19 case numbers continues to cause a significant increase in the number of severe and ventilated cases in hospitals in Thailand, although the number of seriously ill COVID-19 cases remains much lower than the numbers seen in July and August 2021. There is still currently capacity in the healthcare system to admit patients.

Although Thailand has not experienced a huge upsurge of COVID-19 cases as seen in some other countries, both the policy of not confirming by PCR testing for all probable cases, as well as the widespread use of rapid antigen tests (including those available ‘over the counter’ that may not be reported) continues to make it difficult to accurately monitor the situation.

Rising COVID-19 vaccination rates in Thailand continue to significantly reduce levels of severe illness and deaths caused by circulating COVID-19 strains. High vaccination rates also help to reduce the transmission of COVID-19. However, vaccination rates are still low in some provinces and some important risk groups.

Source: World Health Organization

The Disease Control Department has asked critics not to undervalue the Favipiravir anti-viral medication, as it insists that the drug is efficacious in the treatment of COVID-19.

Dr. Opart Karnkawinpong, the department’s director-general, cited a Thai study on the use of Favipiravir, jointly conducted by the Clinical Research Centre of the Faculty of Medicine at Siriraj hospital, the Bamrasnaradura Institute of Infectious Diseases, the Department of Disease Control and the Medical Sciences Department.

He said today (Saturday) that the study was conducted on two groups of COVID-19 patients. The first 62 patients were administered 1,800 milligrams of Favipiravir twice day a day on the first day, followed by 800 milligrams twice a day for four days. The second group of 31 patients were not given Favipiravir.

The patients were administered the anti-viral medicine an average of 1.7 days after they started falling sick and doctors monitored their condition by measuring the virus load in their nostrils.

After 14-days of monitoring, 79% of the first group showed signs of improvement, compared to 32.2% of the second group. Dr. Opart said that the study shows that Favipiravir has statistically significant efficacy in the treatment of COVID-19.

He recalled that, when the COVID-19 outbreak started more than two years ago, there were no drugs to treat the patients and doctors tried various anti-viral medicines, such as those used in the treatment of AIDS and flu, on the theory that the anti-viral drugs would be able to stop the virus from replicating.

During the trial, Dr. Opart said they concluded from their observations that numerous patients who were given Favipiravir, which is used to treat flu, saw their condition improve.

He said that Favipiravir was effective in treating mild and moderate symptoms and numerous patients, given the medicine, recovered and were discharged from hospitals.

He insisted that the Ministry of Public Health has always placed the safety of patients as its top priority and would not use ineffective or dangerous drugs to treat COVID-19 patients, as alleged by some critics.

He asked critics not to under-value Favipiravir, as he cited the case of the Chinese-made Sinovac vaccine, which was heavily criticised for being substandard, causing many people to reject the vaccine, resulting in some of them from not getting vaccinated and dying from infection by the virus.

A report, published in “Nature” as recently as last month and titled “The efficacy and safety of Favipiravir in treatment of COVID-19: a systematic review and meta-analysis of clinical trials” concluded, however, that “Overall, Favipiravir possibly exerted no significant beneficial effect in the term of mortality in the general group of patients with mild to moderate COVID-19. We should consider that perhaps the use of antivirals once the patient has symptoms is too late and this would explain their low efficacy in the clinical setting. There upon, more clinical trials with a larger sample size are necessary to evaluate the exact efficacy and safety of this intervention.”

Source: Thai Public Broadcasting Service

The Thai Department of Medical Services took delivery of two million capsules, or 50,000 courses, of Molnupiravir anti-viral medicine today (Friday) from Merck and Ridgeback Biotherapeutics, the joint developers and manufacturers of the COVID-19 treatment.

Department Chief Dr. Somsak Akksilp said that the drug will be distributed to hospitals in Bangkok and other provinces, to be used by COVID-19 patients who develop mild or moderate symptoms and elderly COVID-19 patients who have any of the seven underlying diseases and who are not on ventilators.

He added that the drug cannot be used by pregnant women or people who have a low white blood cell count.

One-third of the anti-viral medicine will be distributed next week, to be followed by two other portions on dates yet to be set.

Dr. Somsak said that Bangkok will get a larger share of the medicine than other provinces because it has the most infections, adding that he expects all 50,000 courses to run out within a week if the number of mild and moderate cases keeps on increasing.

Each patient will receive a course of Molnupiravir, four capsules to be taken orally twice a day for five days.

Dr. Somsak said the medicine has been proved to be effective in reducing the risk of death among serious cases, if it is taken within the first five days of developing symptoms.

Thailand today recorded the highest ever confirmed daily infections, at 27,071. The figure is of those who tested positive in RT-PCR tests. However, a sizable group of 23,157 also tested positive using rapid antigen test kits who will need to have their results confirmed by RT-PCT tests.

Source: Thai Public Broadcasting Service

South Korea reported a record 400,741 new daily COVID-19 cases, the Korea Disease Control and Prevention Agency said on Wednesday, as the country seeks to further ease social distancing rules despite a wave of Omicron infections.

South Korea had its deadliest day yet of the pandemic on Tuesday, with 293 deaths reported in the latest 24 hours, as the country grapples with a record surge in coronavirus infections driven by the fast-moving omicron variant.

Health officials said the country’s medical response remains stable following efforts to expand resources, with more than 30% of intensive care units designated for COVID-19 treatment still available. But the strain on the hospital system is expected to increase in coming weeks, considering the time lags between infections, hospitalizations and deaths.

South Korea has reported a daily average of around 337,000 new cases in the past seven days, including 362,283 on Tuesday, representing more than an 80-fold increase from levels seen in mid-January, when omicron emerged as the dominant strain. The country’s caseload is now over 7.2 million, with 6.4 million added since February.

The omicron surge and its growing economic toll will pose an immediate major challenge for conservative South Korean president-elect Yoon Suk Yeol, who will take office in May after narrowly winning last week’s election.

Source: Thai Public Broadcasting Service

The average number of new laboratory-confirmed (PCR positive) community-acquired COVID-19 cases reported per day increased by only 5% in the past 7 days compared to the previous week. Although the daily reported confirmed case numbers appear to have plateaued, case numbers remain very high. In addition, not all probable (ATK positive) cases are subsequently confirmed by PCR testing. The average number of probable (ATK positive) cases reported per day over the last 7 days (23,533) has decreased by 23% compared to the week before (30,564), but also remains very high.

Bangkok continues to report the highest daily number of COVID cases. The average number of new COVID-19 cases reported per day for Bangkok in the past week (3,111) is 12% higher than the week prior (2,766).

The average daily number of all currently ‘active’ COVID-19 cases (223,159) over the last seven days decreased by 2% compared to the previous week. A greater proportion of patients continue to be monitored in hospitals, community isolation and home isolation. The average number of COVID cases occupying hospital beds per day over the past week (62,928) is 13% lower than the average daily number reported for the week prior (72,500). This is also a reflection of the reduced levels of serious illness caused by the omicron strain, i.e. relatively fewer people need hospital admission.

An average of 69 daily deaths were reported in the past week, compared to 60 for the previous week. (an increase of 15%).

The average daily number of severe COVID-19 cases over the past seven days (1,324) represents a 15% increase over the average number reported for the previous week (1,150). The average daily number of ventilated COVID-19 cases over the past seven days (449) also represents a 23% increase over the average number reported for the week prior (366).

The recent rise in new COVID-19 case numbers continues to cause a significant increase in the number of severe and ventilated cases in hospitals in Thailand, although the number of seriously ill COVID-19 cases remains much lower than the numbers seen in July / August 2021. There is still currently capacity in the healthcare system to admit patients.

Although Thailand is not experiencing a huge upsurge of COVID-19 cases as seen in some other countries, both the policy of not confirming by PCR testing all probable cases, as well as the widespread use of rapid antigen tests (including those available ‘over the counter that may not be reported) continues makes it difficult to accurately monitor the situation.

Rising COVID-19 vaccination rates in Thailand continue to significantly reduce levels of severe illness and deaths caused by circulating COVID-19 strains. High vaccination rates also help to reduce the transmission of COVID-19. However, vaccination rates are still low in some provinces and some important risk groups.

Source: World Health Organization