Update on COVID-19 in Thailand: 7 February 2024
We have now entered our 5th year since the first recognition of COVID-19. Overall, to date, 774 million cases and 7 million deaths due to this infection have been reported worldwide. Although we are past the worst phase of the pandemic, COVID-19 has not gone away. Thailand is currently experiencing a significant surge in COVID-related hospital admissions, serious pneumonia cases, individuals needing support from a mechanical ventilator and deaths. There is no evidence that current COVID-19 strains cause higher levels of illness; instead, the upsurge in Thailand is due to higher transmissibility of the virus and lower adherence of people to personal protective measures. In addition, a significant minority of people in Thailand are either unvaccinated or are incompletely vaccinated. 
What is the current situation with COVID-19 variants?
The dominant COVID-19 strain in Thailand and in most other countries is known as JN.1. Based current evidence, tests, treatment, and vaccines all continue to work with this strain, as with previous variants
Are COVID-19 vaccinations effective?
Being immunized with the COVID-19 vaccine lowers the risk of severe illness and death. More than 13 billion doses of COVID-19 Vaccine have been administered globally since 2021, with careful monitoring of side effects. In 2021 alone, COVID-19 vaccines saved an estimated 14.4 million lives.
Do COVID-19 vaccinations have side effects?
COVID-19 vaccines are safe and effective in preventing severe disease and death. No vaccine is free of side effects, but countries, including Thailand, have long-established systems in place as part of their immunization programmes to monitor for adverse events of any vaccine administered in the country. These surveillance systems across the world have shown that severe reactions to COVID-19 vaccines are extremely rare. Data for Thailand can be found at:
https://eventbased-doe.moph.go.th/aefi/
What do we know about post-COVID syndrome?
Some people diagnosed with COVID-19 go on to develop post COVID-19 condition, (also called ‘long COVID’), with lingering symptoms that can include fatigue, breathlessness, and cognitive dysfunction, e.g., ‘brain fog’. Data suggests that about 6% of people with symptomatic COVID-19 infection develop post COVID-19 condition; of these, approximately 15% continue to have symptoms at 12 months, but most people fully recover. The risk of post-COVID syndrome is associated with being female, of older age, being overweight or obese, smoking, pre-existing medical conditions, and having had severe infection that included hospitalization or ICU admission. Although it is less common in children and adolescents, long-term effects after COVID-19 do occur in this age group. Studies have shown that vaccination provides significant protection against post COVID-19 condition 2,3,4 The reason why some people develop post COVID syndrome is not well understood. Several possible mechanisms are being studied, including direct immune effects, neurological effects, modulation of inflammation, impact on the gut microbiome and others. There may be multiple causes, and these may differ from patient to patient. WHO strongly encourages research on this topic and guidance will be updated as we learn more. Although research is ongoing, there is currently no specific drug to treat post COVID-19 condition. However, proper medical management can make a big difference, and there are specific treatments for certain symptoms/subtypes. The management of symptoms, through rehabilitation and in some specific cases through medication, can go a long way in improving quality of life. WHO recommends that patients who have COVID-19 have access to follow-up with multi-disciplinary care if they have persistent, new, or changing symptoms.
What can individuals do to protect infection against COVID-19?
WHO strongly recommends individuals to get vaccinated against COVID-19. Those at high risk of severe COVID-19 need one dose if they have not yet been vaccinated, followed by an additional dose six months to one year later. It is important that people who are in regular contact with other individuals who are vulnerable also get vaccinated and consider the regular use of personal protective measures including masks, cough etiquette and handwashing. If individuals are unsure whether they might need a booster vaccine, they should seek guidance from a health professional
What should I do if I think I might be infected with COVID-19?
Anyone who develops symptoms of COVID-19, especially if they have risk factors of severe illness should get tested to confirm the diagnosis and should seek medical care if the test is positive, so that appropriate decisions can be made about treatment and case management.
Are some countries currently seeing levels of deaths that are higher than levels experienced before the COVID pandemic?
Most countries experienced a rise in deaths above expected (pre-COVID) levels during the COVID pandemic. In some countries, this increased level of deaths (sometimes referred to as excess all-cause mortality) has continued even as the numbers of COVID deaths decreased. These excess deaths are likely to have multiple causes. A proportion of this excess mortality is still due to ongoing COVID-19 infection, but it can also be due to the legacy of interruption to chronic disease detection and management services at a time when healthcare facilities were overwhelmed with COVID infected individuals seeking care. Further analysis of data is needed to fully understand these observations, including why in some counties this excess mortality seems to be much lower, or even non-existent.
Reference:
1: https://ddc.moph.go.th/covid19-dashboard/?dashboard=main
2 https://doi.org/10.1136/bmj-2023-076990