Is Thailand rushing to categorize COVID-19 an endemic disease?

Thailand is preparing to declare COVID-19 an endemic disease this year despite a rising number of infections and warnings from the World Health Organization (WHO).

Dr Opart Karnkawinpong, head of the Disease Control Department, insisted on Friday (Jan 14) that Thailand was not standing in opposition to the world health agency and its advice. The fact was, he continued, that when it came to management of COVID-19, Thailand is merely a step ahead of WHO and many other nations.

“We have been pioneers on this front in many aspects,” said Opart, citing the cross-vaccination program and reopening of the country via the Phuket Sandbox tourism scheme.

“This is because we look ahead,” he explained.

He added that Thailand would not declare COVID-19 an endemic disease right away. But with foresight, the government was working to build public understanding of what an endemic means and how they can transition out of a pandemic that has killed millions and wreaked financial havoc over the past two years.

What is an endemic?

An infection is considered endemic when infections stabilize to a baseline that is always present in a particular population or region without external input.

Mahidol University’s Faculty of Medicine Ramathibodi Hospital explains that infections are only considered to be an outbreak if the number of cases rise unexpectedly. The disease becomes an epidemic when it spreads to wider areas and infections suddenly surge beyond the baseline. When an epidemic rages across the world, it becomes a pandemic.

What if COVID-19 becomes endemic?

At the point that Thailand considers COVID-19 as endemic, the government will lift most – if not all – restrictions. There will likely be no mandatory quarantine or tracking to see how patients were infected. Pubs, bars and the rest of the entertainment industry are expected to be able to operate normally, along with the rest of the economy.

Those who do catch COVID-19 will have to take care of themselves, just like when they catch flu.

In a prelude to this arrangement, the Public Health Ministry has already announced that the main treatment modes of COVID-19 patients will be home isolation or community isolation. Currently, those who come into contact with infected persons only need to self-quarantine and take an antigen test every three days.

Is Thailand ready?

The Public Health Ministry insists there are grounds to re-categorise COVID-19 as an endemic disease. It cites strong evidence that, although the Omicron variant driving the pandemic is highly transmissible, it has a very low fatality rate.

It adds that Thailand has a high vaccination rate and also efficient disease-control management that has prevented large Omicron outbreaks.

Though Thailand has recorded over 7,500 new infections per day since Jan 7, the daily death toll has not exceeded 19 during this period. This is a stark contrast from the middle of last year, when the country was hit by hundreds of COVID fatalities per day.

Concerns linger

Dr Thira Woratanarat, who teaches at the Chulalongkorn University’s Faculty of Medicine, has cautioned authorities against rushing to declare COVID-19 an endemic disease. He underlined that much was still unknown about Omicron, which is triggering tidal waves of COVID-19 around the world.

“We also can’t ignore long COVID,” he said.

According to the lecturer, recent studies by leading universities including Stanford and Yale show survivors of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection frequently experience lingering neurological symptoms, including impaired attention, concentration, speed of information processing and memory. Even mild respiratory SARS-CoV-2 infections can cause multi-lineage cellular dysregulation and myelin loss in the brain.

Thira suggested that the government monitor the situation for another year or two before deciding to downgrade COVID-19 into an endemic disease.

“Wait till we know it well enough first. In the meantime, prepare COVID-19 vaccines for all,” he advised.

Source: Thai Public Broadcasting Service

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