Thailand’s hospitals under pressure as Covid crisis deepens

Doctors forced to treat patients in car parks while others turned away as no beds available

Thailand’s worsening Covid outbreak is placing intense pressure on hospitals, forcing doctors to treat patients in parking lots and turn away people who are severely ill.

The country was widely praised for its Covid response last year, when it maintained one of the lowest caseloads in the world. However, there is growing public anger over the government’s recent handling of the pandemic, including its slow and chaotic vaccination campaign.

A third wave began in April, when infections began to spread in Bangkok nightlife venues, including clubs popular among wealthy businessmen. Since then, cases have spread across prisons, factories, construction sites and densely populated areas of the capital.

In about four months, the country’s total fatalities have grown from fewer than 100 to 4,146. Some have died in their homes because no hospital beds were available, according to medical volunteers. Others have died on the streets of Bangkok, including one person whose body was left on the pavement for hours last week, provoking public outrage.

Guardian graphic

“The government is still walking behind the Covid,” said Ekapob Laungprasert, who runs a volunteer group, Sai Mai Tongrot (Sai Mai Must Survive), which assists people who have the virus. “They took action after the problems happened. They need to change their strategy and think further ahead. They need to search for quality vaccines and quickly provide them to everybody.

“Thai people are struggling to get vaccines while other countries do a lottery to encourage people to get a vaccine.”

The government has been criticised for not introducing a lockdown months ago, when case numbers were lower. Various restrictions have been introduced in stages, with stricter measures, including a 9pm curfew, imposed on 12 July across high-risk areas such as Bangkok.

Prof Anucha Apisarnthanarak, chief of the infectious diseases division at Thammasat University, said it was unclear when daily cases would start to fall. On Tuesday, 14,150 cases and 118 deaths were announced.

The real number of cases is difficult to assess because many patients, unable to access testing, are forced to stay at home, said Anucha. “A lot of cases have no appropriate place to shelter them: we don’t have beds in hospital, we don’t have beds in the field hospital. They have to be at home or some other place,” he said.

Infections are now spreading among family members in the home, he added: “Transmission in this situation, where [the] vaccine has not been widely disseminated, can be very alarming and exponential.”

A government rule that hospitals must admit patients who test positive has resulted in facilities capping their daily PCR tests, making them harder for patients to access. Though a home isolation policy has been adopted, hospitals are still required to monitor such patients when resources are already stretched.

On social media, long lines of people can be seen queueing in car parks and tented areas at Bangkok’s testing sites. At a drive-through testing centre in Nakhon Pathom, a city in central Thailand, lines of cars stretched for 1km beyond the hospital, according to reports by Matichon newspaper.

Sai Mai Must Survive has seen a sharp rise in requests for help. Early in June the group would receive about 30 calls each day, but this has now risen to 200. The group provides medical supplies to people in their homes, such as oxygen monitors and tanks.

Patients with severe illness are taken to hospital, Ekapob said, but some are refused admission. “Maybe there are two out of 10 cases that the hospital could not take them in because of no bed available and they died at home,” he said.

Images on social media show the pressure facing medical staff. On Monday, Rachapiphat hospital in Bangkok posted a photo on Facebook of its car park, where beds had been set up for patients from its emergency department. Last week, similar images were shared of Saraburi hospital, where patients were waiting on beds in an outdoor parking area.

The worsening outbreak has heightened anger over the country’s vaccine rollout. On Monday, hundreds of academics and media workers issued a joint statement calling for greater transparency regarding vaccine contracts – including details of who was receiving which jabs, and when doses were to be delivered to the country.

About 5% of the Thai population is fully vaccinated, while 17% have received one dose according to Our World in Data.

The statement follows a leaked letter by AstraZeneca, which said it would supply about 6m doses a month to Thailand. This appeared to contradict a claim by the government that it was due to receive 10m doses.

Thailand is a regional hub for production for the AstraZeneca vaccine. However, production by the Royal-owned company BioScience, which has not previously produced vaccines, has suffered delays.

Contributor

Rebecca Ratcliffe and Navaon Siradapuvadol in Bangkok

The GuardianTramp

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