Response to latest COVID-19 outbreak in Thailand

[Danderman123]

5 minutes ago, Jingthing said:

Are you a Thai field hospital administrator?

No. A former hospital biller. I don’t work in field hospitals.

 

I can’t prove a negative, ie that field hospitals don’t bill patients. I do know that billing patients requires codes for reimbursement that can’t be generated in a couple of days, these would have to go on the Thai equivalent of UB-82.

 

I would suggest that we wait for the first instance of a foreigner trapped in a field hospital before talking about this any more.

 

 

Edited April 21, 2021 by Danderman123

[Jingthing]

1 minute ago, Danderman123 said:

No. A former hospital biller. I don’t work in field hospitals.

So you're making stuff up. I find no value in further communication with you. Bye.

[ParkerN]

Just now, Danderman123 said:

Given that the UK variant seems to spread so widely, it appears to be more infectious than the originals. But about the same for lethality. The latter is hard to know, because cures for Covid have just been introduced recently.

Thanks. I am grateful for the critique. And for not being a virologist.

[rabas]

9 hours ago, Danderman123 said:

no.

 

Scientists believe that the human body can only be infected by one coronavirus at a time.

For clarity, yes, a person can have two strains of SARS-2-CoV at the same time.  If one is significantly stronger, that strain can dominate over time, in the same patient.

 

Here is a case of a daughter who got a milder strain from her mother, clade 20A,  then was infected with a second strain from clade 20B. Slowly over time clade 20B won.

 

https://pubmed.ncbi.nlm.nih.gov/33540596/

 

This does not mean that two strains in the same patient are likely to generate mutations.  That is exceedingly rare. After 130,000,000 confirmed cases, there are about 5-6 major variants. From what I read, none are from co-infections. They likely came from severe, long term patients, not the kind of people treated in a field hospital.

[Bkk Brian]

13 minutes ago, rabas said:

For clarity, yes, a person can have two strains of SARS-2-CoV at the same time.  If one is significantly stronger, that strain can dominate over time, in the same patient.

 

Here is a case of a daughter who got a milder strain from her mother, clade 20A,  then was infected with a second strain from clade 20B. Slowly over time clade 20B won.

 

https://pubmed.ncbi.nlm.nih.gov/33540596/

 

This does not mean that two strains in the same patient are likely to generate mutations.  That is exceedingly rare. After 130,000,000 confirmed cases, there are about 5-6 major variants. From what I read, none are from co-infections. They likely came from severe, long term patients, not the kind of people treated in a field hospital.

Good info!

 

Since that is confirmed then lets make a logical assumption that there are currently 2 strains going around in Thailand, one being the UK variant and the one which was prevalent before whichever one that was? Anyway, its perfectly possible in a field hospital for one patient with the old strain, then being infected with the Uk strain as well, so possibly making sicker than he may have been? Its a stretch but possible yes?

[richard_smith237]

9 minutes ago, Bkk Brian said:

Good info!

 

Since that is confirmed then lets make a logical assumption that there are currently 2 strains going around in Thailand, one being the UK variant and the one which was prevalent before whichever one that was? Anyway, its perfectly possible in a field hospital for one patient with the old strain, then being infected with the Uk strain as well, so possibly making sicker than he may have been? Its a stretch but possible yes?

 

This wiki page outlines the main strains... 

 

If the B.1.1.7 entered Thailand, it's maybe a fair assumption that other have. 

 

 

It's interesting to read Rabas’ comment that mutations (antigenic drift) may actually occur in long term (symptomatic?) patients - that would make a lot of sense.

 

It would also suggest that as more and more Thai’s test positive, there will be more symptomatic long term ’sufferers’ of Covid-19 in whom the SARS-CoV-2 virus may mutate, thus presenting the increased potential for Thai variants. 

 

 

Edited April 21, 2021 by richard_smith237

[impulse]

44 minutes ago, Danderman123 said:

I would suggest that we wait for the first instance of a foreigner trapped in a field hospital before talking about this any more.

 

Wow.  The voice of reason.  How refreshing.

 

I haven't read a single case of a foreigner being charged (much less overcharged) for mandatory Covid related treatment.

 

Someone send me a PM if they know of one.  With Covid "coverage" spread out across a few dozen threads, I can't be sure I'm reading them all.

 

[Bkk Brian]

48 minutes ago, Danderman123 said:

 

I would suggest that we wait for the first instance of a foreigner trapped in a field hospital before talking about this any more.

 

 

I do, a few all from the same cluster. At an International school, 3 students, 1 teacher and one parent, all foreign. First they were all admitted to a government hospital for 2 or 3 days, then when it was clear they were all either very mild or without symptoms, they were then transferred to a field hospital within a University. What I don't know is what that Field hospital is like as there are no photos. Its on the third floor of the sports complex building.

 

They should be due out in a few days and I will be able to ask how it was as I know one of the parents.

[blackcab]

On 4/20/2021 at 4:38 PM, snoop1130 said:

Thailand has 270 COVID-19 testing laboratories, with each lab having the capacity to test around 81,000 samples a day.

 

As has been previously mentioned, this equates to about 21 million tests per day. One year ago Taweesilp Wissanuyothin, the  spokesperson for the Ministry of Public Health and the Center for the COVID-19 Situation Administration stated that with a total of 97 laboratories nationwide there was a testing capacity of 20,000 tests per day. That's about 2,000 tests per day, per laboratory.

 

One year later, the average testing capacity of each laboratory is about 78,000 tests per day. Believable or not? You decide.

[ParkerN]

6 hours ago, richard_smith237 said:

 

Are you serious ??... 

 

You believe that only one variant is in circulation in Thailand ????  (or anywhere else) ?

 

IF so, you’ve just removed yourself from sensible debate..... 

 

Not really what he said... and if I can see that, then I'm sure you and others can.

[Danderman123]

1 hour ago, rabas said:

For clarity, yes, a person can have two strains of SARS-2-CoV at the same time.  If one is significantly stronger, that strain can dominate over time, in the same patient.

 

Here is a case of a daughter who got a milder strain from her mother, clade 20A,  then was infected with a second strain from clade 20B. Slowly over time clade 20B won.

 

https://pubmed.ncbi.nlm.nih.gov/33540596/

 

This does not mean that two strains in the same patient are likely to generate mutations.  That is exceedingly rare. After 130,000,000 confirmed cases, there are about 5-6 major variants. From what I read, none are from co-infections. They likely came from severe, long term patients, not the kind of people treated in a field hospital.

That is an interesting data point.

 

There are similar data points for, as an example, a pregnant woman getting pregnant again, ie having two babies a month apart. Rare.

[Danderman123]

1 hour ago, Bkk Brian said:

I do, a few all from the same cluster. At an International school, 3 students, 1 teacher and one parent, all foreign. First they were all admitted to a government hospital for 2 or 3 days, then when it was clear they were all either very mild or without symptoms, they were then transferred to a field hospital within a University. What I don't know is what that Field hospital is like as there are no photos. Its on the third floor of the sports complex building.

 

They should be due out in a few days and I will be able to ask how it was as I know one of the parents.

Great. Let us know how many baht the foreign students were charged for their stay in the field hospital.

[Danderman123]

1 hour ago, impulse said:

 

Wow.  The voice of reason.  How refreshing.

 

I haven't read a single case of a foreigner being charged (much less overcharged) for mandatory Covid related treatment.

 

Someone send me a PM if they know of one.  With Covid "coverage" spread out across a few dozen threads, I can't be sure I'm reading them all.

 

Well, for a foreigner sent to a private hospital, they or their insurance will have to pay. The issue on the table is the cost of non-treatment at a field hospital for asymptomatic foreigners.

[Danderman123]

1 hour ago, Bkk Brian said:

Good info!

 

Since that is confirmed then lets make a logical assumption that there are currently 2 strains going around in Thailand, one being the UK variant and the one which was prevalent before whichever one that was? Anyway, its perfectly possible in a field hospital for one patient with the old strain, then being infected with the Uk strain as well, so possibly making sicker than he may have been? Its a stretch but possible yes?

It is confirmed by a single data point in the entire planet, literally a one in 30 million event. Don’t get too excited.

 

Edited April 21, 2021 by Danderman123

[Bkk Brian]

2 minutes ago, Danderman123 said:

Great. Let us know how many baht the foreign students were charged for their stay in the field hospital.

I don't think they'll be charged, its more to find out about the experience but I will ask

[Danderman123]

Just now, Bkk Brian said:

I don't think they'll be charged, its more to find out about the experience but I will ask

There is little doubt that if the epidemic widens, foreigners will be sent to field hospitals. There won’t be many, because foreigners tend not to be tested unless they are ill, and are rarely caught by contact tracing.

[Bkk Brian]

1 minute ago, Danderman123 said:

It is confirmed a single data point in the entire planet, literally a one in 30 million event. Don’t get too excited.

 

I'm not excited about it, I'm interested to know about the potential for 2 variants to mix in a Field Hospital, thats pretty much it. It seems it is possible no matter how rare it maybe.

[Danderman123]

2 minutes ago, Bkk Brian said:

I'm not excited about it, I'm interested to know about the potential for 2 variants to mix in a Field Hospital, thats pretty much it. It seems it is possible no matter how rare it maybe.

One case involving a long term symptomatic patient.

 

Zero cases involving asymptomatic patients.

[Bkk Brian]

1 minute ago, Danderman123 said:

There won’t be many, because foreigners tend not to be tested unless they are ill, and are rarely caught by contact tracing.

School clusters in International schools have been growing, all teachers  majority of which are foreign get tested along with the pupils. Its stopped now as most are closed if not all.

 

More then 50 teachers tested where my daughter goes to school where one of the clusters occurred.

[Bkk Brian]

Just now, Danderman123 said:

 

 

Zero cases involving asymptomatic patients.

How do you know? Thats a bold statement right there

[impulse]

10 minutes ago, Danderman123 said:

Well, for a foreigner sent to a private hospital, they or their insurance will have to pay. The issue on the table is the cost of non-treatment at a field hospital for asymptomatic foreigners.

 

Before complaining about the deplorable treatment of foreigners, wouldn't it be wise to wait until a foreigner is treated deplorably? 

 

Has anyone posted about being "sent to a private hospital" or being billed for "non-treatment at a field hospital"?

[Bkk Brian]

2 hours ago, rabas said:

For clarity, yes, a person can have two strains of SARS-2-CoV at the same time.  If one is significantly stronger, that strain can dominate over time, in the same patient.

 

Here is a case of a daughter who got a milder strain from her mother, clade 20A,  then was infected with a second strain from clade 20B. Slowly over time clade 20B won.

 

https://pubmed.ncbi.nlm.nih.gov/33540596/

 

This does not mean that two strains in the same patient are likely to generate mutations.  That is exceedingly rare. After 130,000,000 confirmed cases, there are about 5-6 major variants. From what I read, none are from co-infections. They likely came from severe, long term patients, not the kind of people treated in a field hospital.

Here's a few more:

 

Scientists in Brazil recently reported that two people were simultaneously infected with two different variants of SARS-CoV-2, the virus that causes COVID-19.

 

https://theconversation.com/coronavirus-what-happens-when-a-person-is-simultaneously-infected-with-two-variants-154748#:~:text=Scientists in Brazil recently reported,without needing to be hospitalised.

[rabas]

44 minutes ago, Bkk Brian said:

Here's a few more:

 

Scientists in Brazil recently reported that two people were simultaneously infected with two different variants of SARS-CoV-2, the virus that causes COVID-19.

 

https://theconversation.com/coronavirus-what-happens-when-a-person-is-simultaneously-infected-with-two-variants-154748#:~:text=Scientists in Brazil recently reported,without needing to be hospitalised.

Great article, all in one place. 

 

Note the underlined part about very few cases have been reported. This may mean that few cases have been studied. It takes a lot of analytical and sequencing work to do such studies.

 

"The evidence so far does not suggest that infection with more than one variant leads to more severe disease. And although possible, very few cases of co-infection have been reported."

 

 

[Danderman123]

1 hour ago, impulse said:

 

Before complaining about the deplorable treatment of foreigners, wouldn't it be wise to wait until a foreigner is treated deplorably? 

 

Has anyone posted about being "sent to a private hospital" or being billed for "non-treatment at a field hospital"?

There are many, many cases of foreigners testing positive for Covid, and then being hospitalized. But, you have lost the plot. The current discussion is about foreigners being sent to a field hospital and charged big amounts of baht. 

[impulse]

14 minutes ago, Danderman123 said:

There are many, many cases of foreigners testing positive for Covid, and then being hospitalized. But, you have lost the plot. The current discussion is about foreigners being sent to a field hospital and charged big amounts of baht. 

 

Has there been a case where that has happened?  How much was the "big amount of baht"? 

 

Not how much do people think it will be, or how much the experts say it will be.   How much were they actually charged?

[Danderman123]

Just now, impulse said:

 

Has there been a case where that has happened?  How much was the "big amount of baht"? 

 

Not how much do people think it will be, or how much the experts say it will be.   How much were they actually charged?

No one has provided any examples of foreigners being sent to a field hospital and then billed for big money. That's my point, it's a non-issue. 

 

Same with people in field hospitals infecting each other - it's a one in a million possibility of an infected person getting a second infection. Less so when everyone has the same same virus infecting them. 

[daveAustin]

On 4/20/2021 at 12:46 PM, Phuketshrew said:

Can anyone spot the difference?
 

Yes. The first one is a Pink Floyd album and the second is a hospital. 

[richard_smith237]

38 minutes ago, Danderman123 said:

No one has provided any examples of foreigners being sent to a field hospital and then billed for big money. That's my point, it's a non-issue. 

 

Agreed, the likelihood of a foreigner being tested in the first place (without symptoms) is pretty low. IF they were, and tested positive and couldn’t afford a private hospital, did not have insurance etc, I suspect the field hospital would be free - its a pointless debate until we see this happen. 

 

 

38 minutes ago, Danderman123 said:

Same with people in field hospitals infecting each other - it's a one in a million possibility of an infected person getting a second infection. Less so when everyone has the same same virus infecting them. 

 

A one in a million possibility?  you’re not plucking odds out of thin air are you ?

 

What are the odds of a false positive from a Covid-19 RT PCR test ?

 

Lancet medical site quotes 0.08% and 4% false positive estimate for tests carried out in the UK.

 

You seem to like ‘in a million’ stats, so....  anywhere between 8,000 and 40,000 false positives per million.

 

So... I think there is much more than 1 in a million chance of someone contracting Covid-19 in a facility where most people are carrying the SARS-CoV-2 virus, where washing and bathroom facilities are shared. 

 

If using the rapid Antigen test the potential for false positives is much higher.

https://www.fda.gov/medical-devices/letters-health-care-providers/potential-false-positive-results-antigen-tests-rapid-detection-sars-cov-2-letter-clinical-laboratory

 

That said: But, you mentioned second infection...  Can a person present with a more serious symptoms of Covid-19 from contracting a variant of concern (i.e. UK variant B.1.1.7) if they had tested positive for an existing SARS-CoV-2 variant ???? - no one seems sure. 

 

 

 

 

 

 

 

 

 

 

 

[Danderman123]

34 minutes ago, richard_smith237 said:

 

Agreed, the likelihood of a foreigner being tested in the first place (without symptoms) is pretty low. IF they were, and tested positive and couldn’t afford a private hospital, did not have insurance etc, I suspect the field hospital would be free - its a pointless debate until we see this happen. 

 

 

 

A one in a million possibility?  you’re not plucking odds out of thin air are you ?

 

What are the odds of a false positive from a Covid-19 RT PCR test ?

 

Lancet medical site quotes 0.08% and 4% false positive estimate for tests carried out in the UK.

 

You seem to like ‘in a million’ stats, so....  anywhere between 8,000 and 40,000 false positives per million.

 

So... I think there is much more than 1 in a million chance of someone contracting Covid-19 in a facility where most people are carrying the SARS-CoV-2 virus, where washing and bathroom facilities are shared. 

 

If using the rapid Antigen test the potential for false positives is much higher.

https://www.fda.gov/medical-devices/letters-health-care-providers/potential-false-positive-results-antigen-tests-rapid-detection-sars-cov-2-letter-clinical-laboratory

 

That said: But, you mentioned second infection...  Can a person present with a more serious symptoms of Covid-19 from contracting a variant of concern (i.e. UK variant B.1.1.7) if they had tested positive for an existing SARS-CoV-2 variant ???? - no one seems sure. 

 

 

 

 

 

There was a case of that.

[Danderman123]

35 minutes ago, richard_smith237 said:

 

Agreed, the likelihood of a foreigner being tested in the first place (without symptoms) is pretty low. IF they were, and tested positive and couldn’t afford a private hospital, did not have insurance etc, I suspect the field hospital would be free - its a pointless debate until we see this happen. 

 

 

 

A one in a million possibility?  you’re not plucking odds out of thin air are you ?

 

What are the odds of a false positive from a Covid-19 RT PCR test ?

 

Lancet medical site quotes 0.08% and 4% false positive estimate for tests carried out in the UK.

 

You seem to like ‘in a million’ stats, so....  anywhere between 8,000 and 40,000 false positives per million.

 

So... I think there is much more than 1 in a million chance of someone contracting Covid-19 in a facility where most people are carrying the SARS-CoV-2 virus, where washing and bathroom facilities are shared. 

 

If using the rapid Antigen test the potential for false positives is much higher.

https://www.fda.gov/medical-devices/letters-health-care-providers/potential-false-positive-results-antigen-tests-rapid-detection-sars-cov-2-letter-clinical-laboratory

 

That said: But, you mentioned second infection...  Can a person present with a more serious symptoms of Covid-19 from contracting a variant of concern (i.e. UK variant B.1.1.7) if they had tested positive for an existing SARS-CoV-2 variant ???? - no one seems sure. 

 

You are making a point that prior to entering a field hospital, best to get a second test.