Opinion: Thailand should consider ways for monitored home quarantine or self-isolation for Covid-19 positive patients who are asymptomatic or have very mild symptoms

The following is an opinion editorial by Adam Judd.

As Thailand fights another round of Covid-19, this one appearing to come from entertainment venues and surging quickly, the current policy that all patients, regardless if they are asymptomatic or mild, must stay at a hospital, field hospital, or quarantine hotel turned into a temporary hospital needs to be re-examined.

The policy arguably helped Thailand control prior outbreaks with smaller numbers of people but as the current outbreak is of the B117 variant, which spreads faster and is more contagious according to scientific evidence, and more people are becoming infected, the policy is now facing drawbacks.

Notably, multiple reports have come out this morning from Bangkok area hospitals that they are “overwhelmed” and field hospitals are hurriedly being set up to attempt to assist with the number of patients. It’s worth noting that this is not because the majority of people are very sick or need close serious medical assistance, but due to the aforementioned policy that everyone who tests positive for Covid-19, even completely asymptomatic, must stay in a hospital or comparable center for at least fourteen days.

Additionally, many reports have come out that foreign residents, especially in Phuket, are avoiding taking Covid-19 tests or disguising their timelines, primarily because of this policy. (As well as the fact that foreign nationals will need to pay for the pleasure of being quarantined for two weeks, even if asymptomatic and feeling fine, but that is a completely different topic.)

It’s clear that there are advantages to both systems, but the fact is that as the number of Covid-19 cases increases putting people who have extremely mild symptoms or are completely asymptomatic in a hospital and tying up medical resources that could be used for those with moderate or serious symptoms, as well as other medical issues, needs to be examined.

Thailand has a million-person strong volunteer health worker system that was widely credited to helping keep cases low during the first round of Covid-19 and was closely involved in home to home checks and ensuring new visitors to villages and other areas performed home quarantine. By all accounts, they did very well at this task and could easily be tasked to help assist with self-isolation and check-ins for people who are asymptomatic or self-isolating with mild symptoms.

Thailand also has an extremely large police force who, although many will be busy with Songkran-related traffic measures, can also easily be utilized to check in on people and ensure they are self-isolating.

Home isolation may not work for everyone, especially those with extended families that they could put at risk, live in crowded buildings, or do not have the proper living conditions to facilitate such an agreement and these folks should still have the option to be at a field hospital or similar facility. But if someone lives alone and has the ability to self-isolate and is asymptomatic, should they not be given the option to do so? Especially if it relieves pressure on hospitals and the medical system to help those who truly need it and the fact that there are multiple options for Thai officials to track and ensure those people isolating stay home and do not leave (Even smart bands, for tracing, if needed.)

There are some early reports that the CCSA (Center for Covid-19 Situation Administration) and the Prime Minister are discussing this exact issue as you read this article, but as cases increase and people who are asymptomatic put continual pressure on hospital resources, a decision should be made sooner than later. As stated, such a decision would also encourage foreign nationals who are reluctant to come forward for fear of either a financial burden or being “stuck” in a quarantine center for two weeks if positive to do so and help resolve the current outbreak faster.

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