TaoNow

32 minutes ago, impulse said:

 

The issue with counting available beds is that the number of tests is being managed in many locations based on bed availability.  They quit testing in some areas when the beds are running short.

 

And now that they've built tens of thousands of new beds, they're testing more people.  Which may be the reason that positive tests are up.  Way up.

 

Impulse: you make a good point.  I was thinking only in terms of Covid cases who were sick enough to require hospitalization.

2 minutes ago, Bkk Brian said:

I do wonder why you differ in your opinion to the many Health Experts nationally that have expressed their concern.

 

Preventative measure are the only way, not monitoring death rates, getting data from death rates is a little late to have avoided them in the first place. Death rate data is great for assessing the impact of the virus but thats all.

 

As WHO says, TEST TEST TEST followed by all the other basic measure that do not need repeating again.

 

My local hospital: Here you can have a few links:

 

https://www.thephuketnews.com/phuket-health-officials-concerned-over-icu-bed-shortage-79903.php

 

https://thethaiger.com/news/phuket/icu-beds-for-covid-19-patients-in-phuket-are-close-to-a-critical-low

 

https://www.thephuketnews.com/phuket-health-officials-concerned-over-icu-bed-shortage-79903.php

 

But that give a very narrow picture of just one province, as I mentioned the national ICU and covid ward availability is normally posted here every two or 3 days direct from the officall CCSA daily briefings.

Thank you Brian.  I love Phuket and lived there during 2008-2011.  Perhaps we crossed paths?

I am as frustrated as you and others about the inconsistency of the government Covid case report data. 

I have been imploring my erstwhile contacts with the MOPH to release the national time series of Covid sentinel surveillance data they presumably have on risk populations.  At least that would give some impartial indication of the levels and trends in spread.

Until then, all we have are the daily, new case reports which seem strangely constant to me too. 

And then you have the sudden data dumps of prisoner Covid, which may have been the result of testing conducted over many weeks.

With all these uncertainties and irregularities in the Thai testing and reporting system, I am appealing to you and others on the forum to focus on trends in Covid mortality and the hospital-bed occupancy rate as more reliable indicators to assess the severity of the epidemic -- even if we are somewhat behind the curve.

And even if we are late in our assessment, it won't change the government's Covid control strategy. 

So what is gained by crying foul?

7 minutes ago, Bkk Brian said:

Looking at mortality rate is a little late in the game to stop the spread and people dying my pal.

 

The hospital or lack or hospital beds in ICU and covid wards is posted at least every other day on these threads, you may want to check yourself, its not pretty reading. As for my local area I already check and last week they were at critical stage for ICU admission because of covid patients.

Brian:  Could you name your local hospital?  That would prevent duplication by other members who want to check their local hospitals.  Plus, if Covid beds and Covid ICU beds are increasing, that would surely have a strong correlation with Covid deaths.  Are you seeing them in the national data?

Also, when Covid kills, it kills fairly rapidly, so I don't think it is "too late in the game" to consider mortality as an indicator.

Surely, you would examine the trend lines in deaths (if you believe the data) if you wanted to assess the severity of the situation.

That would only support your argument of out-of-control spread, wouldn't it?

1 hour ago, ourmanflint said:

Quick question, does the Sars-Cov-2 virus behave differently in Thailand for some unknown reason than it does everywhere else in the world, and if not why are you expecting a different outcome?

Outmanflint:  Thanks for the question. 

That is the issue that many of my colleagues around the world have been discussing. 

Was it the masks in the early stages? 

Was it the international border closures? 

Was it the lock-downs and travel restrictions? 

Was it some pre-existing protection from exposure to other ARI pathogens that has kept Thai mortality low for Covid-19?

The fact is we don't know what explains Thailand's current level of Covid mortality. 

And I have no idea what the outcome will be of the path of this virus (in the absence of widespread vaccine coverage).

That is why I am appealing to posters to refrain from jumping to conclusions (e.g., that the Thai epidemic is out of control, that the government is falsifying case reports, that the data are being suppressed or manipulated).

There is no evidence that the Thai government is falsifying data.  Although there might be some irregularities in case reporting.

I think everyone should remain calm and as open-minded as possible, especially since this is a public forum, viewable by all. 

Until then, we should focus on the most empirical data availble, which is Covid deaths and Covid hospitalizations to assess the seriousness of the Thai Covid situation.

36 minutes ago, Bkk Brian said:

Looking a the charts it looks out of control to me

 

 

Brian, my pal, as I mentioned earlier in this thread, and as Danderman and I have suggested:  Look at the national Covid-29 mortality data over time.

"dinsdale" has already gone to the trouble of checking out his local Thai hospital to see if bed occupancy is reaching capacity.  

That would be the best indicator if the situation is 'out of control.'

Please encourage all your brethren to check their local hospital for bed occupancy and report back.

That is the only empirical evidence we have since very few people on this forum believe the government data.

12 minutes ago, club said:

Your posting is evidence

Sir Club:  I am looking at the daily number of Covid-19 deaths in Thailand. 

If you don't believe those data as reported in the daily briedings, why are you on this thread"

1 minute ago, club said:

This thing in Thailand is getting out of control. If you cant understand that maybe you need to stop posting

Please provide evidence, sir.

55 minutes ago, dinsdale said:

I do not in anyway need to tell my location. I did say that the local hospital is taking overflow from BKK hospitals so that narrows it down a bit i.e. not Chiang Mai LOL. If you think I am lying come straight out and say it. 

No, dinsdale, I think you did a fine job.  Just being prudent since some members here are prone to hyperbole.

5 hours ago, dinsdale said:

Almost full at my local with local cases and spill over from BKK. Apart from that the Permant Secratary for Health has stated that out of 1000 ICU beds there are 100 left which will be taken in the coming wks. I hope this helps my fellow TV members with the severity of the situation. Thanks for the advice.

That's good dinsdale, but you forgot to mention your location so that others can verify. 

Also, others need to be as resourceful as you and check out their local hospital.

That is because one report doth not a disaster make.

Continue to track and report the bed vacancy data, and let's stop this chicken-little nonsense with every day's posting of case numbers.

None of regular miscreants here will ever be satisfied whatever the government announces to the public.

So let's drop it.

10 hours ago, Danderman123 said:

That’s a fairly incredible claim, the MOPH is doing real random sampling, but is keeping it secret.

 

If it’s true, one would surmise that it is secret because the numbers are not good.

One of the reasons for the lack of details may be that the testing has been de-centralized to the provincial level.   

Sentinel surveillance may not be centralized as it was during the HIV epidemic. 

Please keep an open mind on this until we know more.   

I will be happy to share what I learn if members are interested and it is taken in good faith.

19 hours ago, ourmanflint said:

 

You've mentioned the HIV epidemic a few times in relation to this, but even you must realise they are different by several magnitudes. HIV spreads nowhere near as fast as this does so govt has to move at much much faster pace as well. 

They need to be doing far more than 2-3000 tests a day, 10x that would be a good start and that is still nothing like the mass testing we have seen in Europe.

You absolutely cannot wait for the data to point to a cluster before acting, not with these new variants, govt needs to be ahead not constantly chasing behind

Thank you for your reasoned response.

19 hours ago, ourmanflint said:

 

You've mentioned the HIV epidemic a few times in relation to this, but even you must realise they are different by several magnitudes. HIV spreads nowhere near as fast as this does so govt has to move at much much faster pace as well. 

They need to be doing far more than 2-3000 tests a day, 10x that would be a good start and that is still nothing like the mass testing we have seen in Europe.

You absolutely cannot wait for the data to point to a cluster before acting, not with these new variants, govt needs to be ahead not constantly chasing behind

I am not suggesting that Thailand should use the same testing strategy for Covid-19 as they did for HIV.  I am merely trying to make the case that the Ministry of Health has the capacity to conduct the number tests for Covid that they need to do in order to stay ahead of the epidemic.   If they are doing selective surveillance, I think it is too early to say that they weren't doing enough tests or in the wrong populations.  

The jury is still out on this, and I would urge posters to remain open-minded instead of resorting to the easy, knee-jerk condemnation of the Thai government -- especially without the data to prove their case.  

11 hours ago, Danderman123 said:

This is argument for the current sad state of testing in Thailand.

 

At the very least, there should be some random sampling in every province, every day.

 I am surprised at your reaction.  Your other posts on the subject seem to indicate you are a voice of reason.

I have access to information that indicates that the Thai MOPH is indeed conducting random sampling (or sentinel surveillance, if you will) on risk populations for Covid-19. 

The fact that you do no hear about it or what the results are does not indicate that it isn't being done.

I would like the MOPH to take the time to tell everyone about the testing they are doing. 

But it would probably fall on deaf or incomprehending ears as typified by many on this forum (though not you, I might add).

Stay tuned and be open-minded please.

13 minutes ago, Petey11 said:

Only problem with targeted testing is you target an area after you see  a cluster evolve through the number of walk-ins. With mass random testing, if you are returning say 2-3% positive you know the infection is there but not in great numbers. If you start getting returns of 8-10% you know you have a problem of widespread infection. It's all good targeting an area when you know you have a problem, but that cluster area you are targeting has been brewing for 2-4 weeks or more. In that time, those infected can spread it to other areas. It's like fighting bush/forest fires, you find it, put it out but unbeknown it has spread underground or jumped by sparks to another area. Before random testing in the UK , this was the same situation, by the time they realized the Kent variant was a problem in the Kent area it had spread to London, then southeast and so on. Now in the UK anyone can get a test, cross lateral if no symptoms and PCR if symptomatic, all free. The WHO had the mantra of test, test, test, actively seek the infections and isolate those carriers. What is the alternative to stop it, lock down all areas if you don't get in front of the virus. Proactive over reactive. But like you so rightly mentioned on "effective use of resources", it all comes down to how much money you want to throw at it. If resources are the limit to testing, just own up and say we have limited resources/money and cannot do more, but I honestly think it's not about the money in Thailand, it's reluctance to spend it and maybe show up the real scale of the problem, saving face scenario. I also think the free test if positive, charge for if negative ,that I've heard reported (if true) , does not encourage people to come forward, or the prospect of two weeks in a field hospital. There are many factors influencing the situation in Thailand, same as all countries. Political for sure and medical. I'm certain that if the doctors on the CCSA had a totally free reign to do as they wish without any constraints, financial or political, you would see a lot more testing been carried out.

Petey:  You make a lot of good points.  I just wish other posters would be as circumspect as you about the options instead of shouting for mass testing. as the only viable strategy to identify, contain, and control the Covid-19 pandemic. 

For example, if money was the limitation, would the government have gone to the extreme of effectively shutting down international tourism (15% of annual GDP?).  I cannot reconcile that drastic action by the Thai government with those who say the country isn't doing enough.  It vitually torpedoed that major sector of the economy to protect the population.

While those kind of decisions are made by different parts of the government, I think eveyone is aware of the sacrifices being made.

I just am so disappointed by all the negative posts on the Forum about what the Thai government is trying to do to avert a Covid-19 catastrophe.   It is in no one's interest to let that happen, and the government is certainly not incompetent as demonstrated by their incredibly effective response to the HIV epidemic.

21 minutes ago, Petey11 said:

If you have members of the medical community now coming out saying they to speed up and increase testing, where does that put those who say testing is ample?

Petey11, I don't think it is a question of whether the testing is ample or not. 

Instead, the question is how strategic is the testing being done?

I think that all countries around the world agree that it would be counterproductive to conduct mass testing of the population, even if you had the resources to do it.   You would come up with too many negatives and not be able to react quickly to the next outbreak.

Instead, what I think Thailand is doing is to conduct targeted testing of those communities when sample surveillance shows the positivity rate (infections per persons tested) exceeds a certain level.

That seems to me to be the most efficient use of testing resources.

But please feel free to propose an alternative strategy to contain the epidemic, 18 months after its emergence in Thailand.

1 minute ago, ThailandRyan said:

Again your trolling and trying to bait someone on a public form where we discuss our views and opinions as we see them with the numbers published.  No where is their any fear-mongering posted in the post you quoted, but the post simply states what the numbers shown daily show and continue to show as we move forward.  If you think what we discuss is fear mongering well then you can block me as well.  Good night.

I am not trolling.  Brian has not provided any first-hand data that the current situation is a major outbreak.  There are some of you who are irrationally afraid of COVID and may be trying to whip up a frenzy of concern.  The important thing is to be calm and objectively analyze the situation -- which is what I am appealing for.  If you don't like rationale arguments, you can block me.

20 hours ago, AgentSmith said:

Because even people following the rules to the letter can still get infected. And while infection rates are still relatively low here this can easily change. And I have relatives here who are 70+ who I really like to give much needed protection because for them in the long run it's a matter of life and death.

 

I got very worked up over foreigners being cut off from all vaccines and I still am. Vaccination is vital. And sure I can wait a little while longer but if the government closes the door for us falang once again I am definitely reconsidering my future in this country. Being blown off at a public hospital with 2 elderly people by my side after asking if they can please register for a jab is not something I wish to experience again.

 

One thing has changed forever. Diplomacy from my side is over and it won't return. Those smiles are over and done with.

 

AgentSmith:  That is a good response, and one that all of us should consider. 

From an epidemiological standpoint, if you have a closed population (like Thailand is mostly for now) then ALL people at elevated risk of Covid-19 should be vaccinated -- regardless of citizenship, ethnicity, or whatever.   

It only makes sense since that would protect the surrounding Thai community as well.  I think the Thai Ministry of Health recognizes this given their communicable disease control measures in communities of non-Thai migrants in border areas. 

However, if there is the perception among health workers that there won't be enough vaccines to go around, that could be a key obstacle to opening up access to all in need. 

If I were in the government, I would blast the message every day that there will be enough vaccine to go around.  Assuming they can live up to the promise which I think they can.

1 minute ago, Bkk Brian said:

Honestly I'm not going to repeat to you what I've already posted in this thread and yesterdays, if you're so interested in my opinion then you can seek it out. As for my claim on US or UK per capita testing use one of the stats sites. Plenty of them. Our world in data, or worldometers are the two most widely used and if you want proof that much visit them.

 

For the UK in particular just check here for absolute full figures https://coronavirus.data.gov.uk/details/testing

 

There, you've got some homework to do now, good luck

But you still haven't explained India and the value of mass testing.  So, I don't think it is worth going back over your posts.  So long.

4 minutes ago, Bkk Brian said:

That was one claim, there are many, how many more would you like? Have you read my posts on this thread?

So what is your point Brian?  That Thailand is incompetent, under-resourced, or barking up the wrong tree?

I am not a Thai apologist but I think we need to be objective about what or what isn't being done.

I would like to see Thailand do more of the type of surveillance they did with HIV, and I complained to my contacts at the Ministry of Public Health in early 2020.

p.s. Please provide references for your claim about per capita testing levels for Covid-19 in the US and UK vis a vis Thailand

29 minutes ago, Bkk Brian said:

You use India as an example? Its also testing far more than 300-400k a day, thats just the number of positive tests. I thought you worked for the MoPh before?

 

Try the UK or US. For a comparative figure the UK has around the same population.

But your claim was that Thailand didn't have the resources.  So your position has shifted I guess.

7 minutes ago, Bkk Brian said:

You should check the testing rates of other countries before you ask which other ones are testing more of their populations.

And India is testing 300,000 to 400,000 persons a day:  How is that helping them to contain the hot spots?

Which countries are testing at a level you think is appropriate?

18 minutes ago, Bkk Brian said:

Its not about their capability or skills but they have already admitted they can't afford to do enough mass testing.

Mass screening would not be efficient or purposeful.  Besides, what other country has tried to test a large segment of their population for Covid-19?

If they wanted to know the prevalence of Thais who had been exposed to Covid-19, they could do a national point prevalence survey of, say, 5,000 folks.  But there is nothing practical you can do with that information.

Instead, I think the preferred strategy is to ramp up testing in communities where there is a high test-positivity rate to try to corral spread.  Which is what they seem to be doing now.