TallGuyJohninBKK

Once again, it looks like there's no forum news story update on Sunday regarding today's COVID update. So I'll post it here, same as last Sunday: Newly reported official COVID cases declined for a second consecutive day on Sunday, which is not uncommon for weekend periods, while serious COVID cases in hospital and patients requiring intubation to breathe again both rose slightly to set new record highs for the year. Official COVID deaths dropped from 68 on Saturday to 66 on Sunday. Despite 60+ new official COVID deaths occurring daily, the count of total serious COVID cases in hospital has risen every day for at least the past six days, and the count of intubated COVID patients has risen for five of the past six days. https://ddc.moph.go.th/covid19-dashboard/?dashboard=main For added context, during the peak of the Delta wave last fall, Thailand's daily COVID case count topped out at 23,418, but the numbers of serious hospital cases and intubated patients peaked above 5,600 and 1,100 respectively, and daily deaths topped 300 for a brief period.

The same researchers who have predicted that world COVID-related deaths likely are about THREE times higher than the officially reported numbers for 2020 and 2021 seem to have been ahead of the game regarding Massachusetts. In their study published earlier this month, despite the UNDERcounting on a global basis, they actually predicted that Massachusetts was one jurisdiction that may have OVERcounted their COVID deaths -- an exception to the overall reality. And their estimates for a lower total (15,000 instead of 20,000 by the end of 2021) look to be pretty darn close to the reduction announced by the state. None of that, of course, changes the broader COVID deaths picture on a global basis. http://www.thelancet-press.com/embargo/COVIDexcessmortality.pdf "Findings Although reported COVID-19 deaths between Jan 1, 2020, and Dec 31, 2021, totalled 5·94 million worldwide, we estimate that 18·2 million (95% uncertainty interval 17·1–19·6) people died worldwide because of the COVID-19 pandemic (as measured by excess mortality) over that period." ... "The full impact of the pandemic has been much greater than what is indicated by reported deaths due to COVID-19 alone. Strengthening death registration systems around the world, long understood to be crucial to global public health strategy, is necessary for improved monitoring of this pandemic and future pandemics."

Yes, we do know....to some extent... the basis of the COVID deaths UNDERcounting.... The estimates done by The Economist and IHME are based on "excess deaths" -- which looks at how much higher the overall death rates are for the COVID years vs. the typical years that preceded them. Then they take various other factors into consideration to develop their estimates on how much higher the COVID death numbers likely are vs. the officially reported stats.

The Economist has periodically been updating their COVID death estimates both globally and by country, including in current time into 2022. They estimate Thailand has had 59,540 COVID deaths since April 1, 2020 -- almost three times the officially reported number. Worldwide, they're estimating that global COVID deaths are just about three times the official tally of about 6 million. It's a matter of UNDER counting COVID deaths, not overcounting them. https://www.economist.com/graphic-detail/coronavirus-excess-deaths-estimates

There's been a deliberate and extensive misinformation campaign by COVID-skeptic and anti-vax groups to misrepresent the entire issue of how COVID deaths are counted, dealing with the "of" vs "with" issue. But in fact, globally, several independent research groups have estimated that actual COVID deaths are probably three times or so higher than the official counts. The details of the short answer and truth of this are -- people who die of COVID don't generally die of the virus itself alone, but rather, they die of various effects the virus causes in the body such as respiratory failure, pneumonia, heart, liver, kidney failure, strokes and on and on. So invariably, when COVID has set in motion the process of killing someone, there are almost always other parallel conditions (so-called comorbidities) that end up getting listed on the death certificate. In the case of COVID deaths, those other conditions either wouldn't have occurred at all, or might have been pre-existing but wouldn't have been acutely fatal, were it not for COVID. The presence of those other comorbidities doesn't mean it wasn't COVID that actually triggered the decline in health that led to the fatality.

"Bennett thus risks lending legitimacy to Putin while harming Israel’s status and interests in the eyes of its free world allies. He seems to be placing Israel not firmly in the camp of the free world, the Ukraine-supporting world, the sanctions-backing world, in the standoff against a rapacious, mass-murdering autocrat, but somewhere troublingly, uniquely, in-between. Quite apart from the moral intolerability of this position, and the dangerous daylight it places between Israel and its core allies, most especially the United States, this undermines Israel’s own vital need: that the international community, standing together with Ukraine in resisting a warmongering regional power’s devastating agenda, will do precisely the same for Israel when it comes to Iran." https://www.timesofisrael.com/bennetts-attempts-at-neutrality-on-russia-ukraine-spell-trouble-for-israel-on-iran/

So how's it really going out there on Thailand's supposed road to COVID endemic status? Every now and again, despite the stance of officialdom, glimmers of truth unintentionally shine thru, like when the government has to explain why things aren't working well: "NHSO Secretary-General Dr. Jadet Thammathat-Aree explained yesterday (Thursday) that the main reason that this group of patients have been unable to get help from the NHSO so far is because its 1330 hotline system has been so overwhelmed with calls from patients that they cannot get through, and existing isolation facilities are full, causing another problem, which is a backlog of waiting patients who have already registered for isolation facilities. After being made to wait for help for several days, he said that many registered patients have tried to contact the NHSO again via the hotlines and other channels, further overwhelming the system." https://aseannow.com/topic/1253118-thailand-to-expedite-mailing-of-favipiravir-to-covid-19-patients/

What the article reference above fails to reflect is that the numbers being cited only reflect Thailand's official count of COVID deaths. And other, outside sources (IHME and The Economist) say that Thailand's official COVID deaths count is really a substantial undercount of all the actual deaths caused by COVID. Thailand says 23,643 deaths since the beginning of the pandemic. Researchers at IHME say the true number is more than 35,000. And The Economist estimates the actual number at more than 59,000. So let's keep our eyes on the real ball here. "Findings: Although reported COVID-19 deaths between Jan 1, 2020, and Dec 31, 2021, totalled 5·94 million worldwide, we estimate that 18·2 million (95% uncertainty interval 17·1–19·6) people died worldwide because of the COVID-19 pandemic (as measured by excess mortality) over that period." http://www.thelancet-press.com/embargo/COVIDexcessmortality.pdf

New official COVID cases reported Saturday declined slightly to 24,592, but COVID patients hospitalized in serious condition (1,312) and patients requiring intubation to breathe (435) both rose again to set new record highs for the year. The government also reported 68 new COVID deaths. https://ddc.moph.go.th/covid19-dashboard/?dashboard=main For added context, during the peak of the Delta wave last fall, Thailand's daily COVID case count topped out at 23,418, but the numbers of serious hospital cases and intubated patients peaked above 5,600 and 1,100 respectively, and daily deaths topped 300 for a brief period.

MoPH on Friday also released the follow trends chart for the period Feb. 26 to March 11 showing, in order on the chart from left to right: --serious COVID cases in hospital by day --hospitalized COVID patients requiring intubation by day --new COVID deaths by day, and --the 14-day average of new official COVID cases by day https://www.facebook.com/informationcovid19/photos/a.106455480972785/519888416296154/?type=3

For starters, Thailand has a total population of more than 70 million, so the monthly case numbers you're citing for a few months are relatively small in comparison. Then, you're not recognizing that Omicron cases in Thailand are a relatively recent arrival, Omicron is better at evading prior infections than Delta was, the immunity from past infections only has a limited duration, and may or may not even protect against the newer BA2 variant that's now overtaking the original BA1 Omicron variant. Infection doesn’t provide good immunity against Omicron "According to a December 2021 South African study, the risk of reinfection from the Omicron coronavirus variant is 3 times higher than it is for previous strains of the virus. ... Omicron variant is associated with substantial ability to evade immunity from prior infection." AND "Dr. William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center, said it’s not known exactly how long the protection after natural infection will last and how durable that protection will be against a variety of different variants." https://www.healthline.com/health-news/how-long-does-immunity-last-after-covid-19-what-we-know

MOPH released this chart today ranking the numbers of serious COVID cases with pneumonia by province, with Bangkok, the most populous single province, having the most with 182 as of March 10. The far right column indicates the bed occupancy rate of Level 2 and 3 hospitals beds for COVID patient care in those various provinces. The red / yellow / green colors indicate whether the case numbers in that province are rising, remaining flat or declining. The individual province numbers below should be out of a total of 1,238 total serious COVID cases with pneumonia in hospitals reported nationwide as of yesterday among 77 provinces. https://www.facebook.com/informationcovid19/photos/a.106455480972785/519888636296132/?type=3

Not a very large share... since Omicron only replaced Delta as the predominant variant in Thailand toward the beginning of 2022. And, the so-called "natural immunity" you refer to isn't permanent, but is only temporary, post infection. And, there's no guarantee that having had a previous COVID infection is necessarily going to protect you against a different variant in the future.

MoPH breakdown of the 63 new COVID deaths reported today: 37 males, 26 females 61 Thais, 1 American, 1 unknown Median age of 69, with age range from 28 to 93 --49 or78% were age 60 and older --11 or 17% were under age 60 with chronic conditions --3 or 5% were under age 60 with no chronic conditions Heart disease (15) and kidney disease and bedridden (9 each) were the most common chronic conditions reported among the deaths. Bangkok had the most deaths among individual provinces with 7. No mention of the vaccination status for these deaths. https://www.facebook.com/informationcovid19/photos/a.106455480972785/519888449629484/?type=3

The latest vaccination updates reported today: Only 31% of Thailand's overall population, and the same rate for the age 60 and older more vulnerable group, have thus far received the third shot booster dose that medical experts say is required to protect against the Omicron COVID variant. https://www.facebook.com/informationcovid19/photos/a.106455480972785/519888706296125/?type=3 https://www.facebook.com/informationcovid19/photos/a.106455480972785/519888716296124/?type=3

The authors of the above study also noted that their estimate for Worldwide 2020-2021 COVID deaths was very close to a separate analysis done of the same by The Economist. The Economist, though, has periodically been updating their estimates, including in current time into 2022. They have a considerably higher excess deaths estimate for Thailand (59,540), notwithstanding the fact their estimate covers two additional months into 2022. https://www.economist.com/graphic-detail/coronavirus-excess-deaths-estimates

The study you cited above basically concludes that Worldwide COVID deaths during 2020 and 2021 were triple the officially reported figures -- 18 million in reality vs the nearly 6 million officially reported. "Findings: Although reported COVID-19 deaths between Jan 1, 2020, and Dec 31, 2021, totalled 5·94 million worldwide, we estimate that 18·2 million (95% uncertainty interval 17·1–19·6) people died worldwide because of the COVID-19 pandemic (as measured by excess mortality) over that period. ... At the country level, the highest numbers of cumulative excess deaths due to COVID-19 were estimated in India (4·07 million [3·71–4·36]), the USA (1·13 million [1·08–1·18]), Russia (1·07 million [1·06–1·08]), Mexico (798 000 [7 41 000–867 000]), Brazil (792 000 [730 000–847 000]), Indonesia (736 000 [594 000–955 000]), and P-akistan (664 000 [498 000–847 000])." As for Thailand, the study says the country had more than 35,000 COVID deaths for the two-year period, 62% higher than the 21,700 officially reported:

Apparently you missed the news this week that researchers have found that even MILD cases of COVID can cause people's brains to shrink/age up to 10 years worth of living. Deaths matter, of course, but they're not the only important indicator relating to COVID. https://www.bloomberg.com/news/articles/2022-03-07/brain-shrinkage-cognitive-decline-found-months-after-mild-covid

And two shots only is only minimally effective against the current Omicron variant, so that's not saying much. And the two-shot percentage nationwide is only 72%. But a more telling indicator is that 69% of Thailand's population thus far has NOT received the third shot booster dose that the medical experts say provides the best protection against Omicron. And that includes a similar share of the age 60 and older population that's the most vulnerable.

Thailand's COVID update on Friday offered a mixed bag of results, as officially reported cases reached their highest level of the past week at 24,792 and serious hospitalizations set another record high for the year at 1,255, but new daily deaths declined to 63. The drop in daily COVID deaths, from the prior day's yearly high of 74, came as Ministry of Public Health officials began talking about narrowing their definition of when to attribute a death to COVID. But it's unknown whether that plan influenced Friday's reporting. Among other updates, the numbers of unofficial COVID cases (21,626) based on positive ATK tests and thus combined official and unofficial cases (46,418) both declined from yearly record high levels set the day before. The total number of COVID patients under care increased for the day to 222,998, as did the number of COVID patients being treated in regular hospitals, which rose to 63,553. But both figures remained well below their respective record highs for the year. In one good indicator, the number of COVID patients in hospitals requiring ventilators to breathe dropped for the first time in the past week to 415, down from the prior day's yearly high of 420. https://ddc.moph.go.th/covid19-dashboard/?dashboard=main For added context, during the peak of the Delta wave last fall, Thailand's daily COVID case count topped out at 23,418, but the numbers of serious hospital cases and intubated patients peaked above 5,600 and 1,100 respectively, and daily deaths topped 300 for a brief period.

More countering Russian propaganda: https://www.newsweek.com/us-biological-weapons-ukraine-labs-germ-warfare-1685956 "As part of its latest attempts to justify its invasion of Ukraine, Russian officials are once again pushing a false narrative that the Eastern European country is developing biological weapons with the assistance of the U.S. ... In April 2020, the U.S. Embassy in Ukraine also issued a statement ... The statement explained that the U.S. and Ukraine have had a partnership since 2005 to prevent the threat of outbreaks of infectious diseases, as well as allowing for peaceful research and vaccine development." ... Filippa Lentzos, a bioweapons researcher and faculty member at King's College of London, also told the Agency France-Presse news agency that there are no indications that these labs in Ukraine are being used to develop biological weapons and actually aim to prevent preventing disease outbreaks."

From what I'm reading on a quick look, while respiratory distress is a common, perhaps the most common symptom of serious COVID, it's not the only COVID symptom that ends up killing people. Add in heart failure, kidney failure, liver damage, strokes, etc... So it would seem that a Thailand policy decision to only count a COVID death as a COVID death when it involves respiratory distress is not in keeping with the medical realities of COVID. But, it would be one way to attempt to lower the country's COVID death statistics, now at their highest levels of the year, at a time when they're trying to head toward declaring COVID as "endemic" in status. Non-respiratory presentations of COVID-19, a clinical review "While the most fatal complications of COVID-19 include ARDS, heart failure, renal failure, liver injury, and multiple organ dysfunction syndrome (MODS), GI symptoms can contribute significantly to morbidity in infected patients [48]." ... "SARS-CoV-2 can have a profound impact on the renal system. Early research has determined that COVID-19 can directly infect kidney tubules and cause acute tubular damage and subsequent renal failure." ... "A large retrospective study of 221 patients with COVID-19 at the Union hospital in Wuhan found that 5% of patients presented with acute ischemic stroke, one patient developed cerebral venous sinus thrombosis (CVST), and one had cerebral hemorrhage [127,128]." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7513760/

That's not the way I'm reading the report above. Rather, they seem to be saying they're now going to require evidence of pneumonia type lung inflammation or breathing problems as a requirement for classifying a death as COVID. I'd have to look and check as to whether that alone is a medically appropriate criteria for classifying a COVID death. "Anutin said the meeting discussed that when patients died while they were on a ventilator and died of lung inflammation caused by Covid-19 virus, they could be classified as Covid-19 deaths. .... There should be a clear-cut figure as to how many had died because of respiratory system failure or lung inflammations." https://www.nationthailand.com/in-focus/40013255

"Paxlovid (nirmatrelvir and ritonavir) and molnupiravir are two oral antiviral treatments that are authorized to treat mild to moderate COVID-19. These COVID-19 pills are only recommended for people with a high risk of developing severe illness. ... They should both be started within five days of first feeling symptoms. Studies suggest that Paxlovid can lower the risk of severe COVID-19 for high-risk people by almost 90%. Studies suggest molnupiravir can lower this risk by about 30%." https://www.goodrx.com/conditions/covid-19/covid-19-pill-paxlovid-molnupiravir As for Paxlovid: "The co-packaged medication is indicated for the treatment of mild-to-moderate COVID-19 in people aged twelve years of age and older weighing at least 40 kilograms (88 lb) with positive results of direct SARS-CoV-2 testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death.[5][6] If administered within five days of symptom onset, the efficacy of the co-packaged medication against hospitalization or death in adults is about 88% (95% CI, 75–94%).[7] ... The co-packaged medication is not authorized for the pre-exposure or post-exposure prevention of COVID-19 or for initiation of treatment in those requiring hospitalization due to severe or critical COVID-19." https://en.wikipedia.org/wiki/Nirmatrelvir/ritonavir

"...the Public Health Ministry has ordered Covid-19 drugs from abroad. He said the first lot of Molnupiravir had arrived and officials are putting labels on the drug packages to be used for elderly or people with eight comorbidities in various hospitals. He said the ministry has yet to draft and sign a contract to buy Paxlovid drug, which is expected to be done next month." https://www.nationthailand.com/in-focus/40013255 Well, at least they're finally getting around to ordering something from abroad that's been proven to work as a treatment in at least a share of COVID cases -- as opposed to their current medicines that, AFAIK, haven't been proven by credible research to do anything for COVID. And you have to wonder, why are they getting the least effective imported treatment FIRST (Molnupiravir-Merck), and lagging behind on the more effective imported treatment (Paxlovid-Pfizer)? See the widely different COVID efficacy rates for Paxlovid vs Molnupiravir in the next post below... ------------------------- "Molnupiravir... In December 2021, the U.S. Food and Drug Administration (FDA) granted an emergency use authorization (EUA) to molnupiravir for use in certain populations where other treatments are not feasible.[7] The emergency use authorization was only narrowly approved (13-10) because of questions regarding efficacy and concerns that molnupiravir's mutagenic effects could create new variants that evade immunity and prolong the COVID-19 pandemic." https://en.wikipedia.org/wiki/Molnupiravir