Tue, September 28, 2021

in-focus

Testing and primary care: Two critical elements in fighting the pandemic


From this week, Antigen Rapid Tests, a test kit for professional use, is available at hospitals and clinics across Thailand.

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Individuals will also be able to buy self-test kits at all licensed pharmacies and primary care units.

The Public Health Ministry has authorised widespread use and over-the-counter sale of these medical devices in response to rising Covid-19 cases over the past few weeks.

Despite providing a result in 30 minutes, the rapid test kits were not approved for official use earlier because health experts were concerned about its inaccurate result. Only RT-PCR tests, which must be administered by a health professional and take between 24 and 48 hours to provide a result, were authorised.

Learning about the availability of Antigen Rapid Test kits, the National Health Security Office (NHSO) did not wait to introduce these devices into its coronavirus testing program. These kits will increase our daily testing capacity, especially in the Bangkok metropolitan region, where two-thirds of new confirmed cases are reported, and Covid-19 tests are in high demand.

From July 12, NHSO, in collaboration with the Urban Institute for Disease Prevention and Control, Public Health Ministry's Department of Disease Control, and Mahidol University's Faculty of Medical Technology, set up testing stations in the region.

Their locations include Thupatemi Royal Thai Air Force Sports Stadium in Pathum Thani, Bangkok's Rajamangala National Stadium, and the Government Complex. The total daily testing capacity is between 10,000 and 12,000 tests.

We believe that if we keep testing people like this for at least two weeks, those who test positive will be isolated quickly and can access medicines and treatment. In return, this will reduce the spread of the coronavirus.

We are also placing more emphasis on our Covid-19 treatment program to reduce hospital overcrowding.

Around 80 per cent of people who tested positive were asymptomatic or had mild symptoms. They don't need intensive care at hospitals. They can recover by getting basic treatment in isolation, either at home or in community facilities.

Placing them under care and isolation, we have connected the patients to primary care clinics. In Bangkok, there are 204 clinics partnering with the NHSO. Each can look after 200 patients or 40,000 in total.

These clinics are part of our primary care network, a key asset of the Thai health system that plays a prominent role in fighting the pandemic.

When patients call the NHSO's 1330 hotline to request medical care, our staff will match them with a physician in a clinic near their home address.

The clinic staff will then deliver medical devices such as a thermometer and an oxygen saturation monitor to the patient, who will also be provided medicine and meals. The physician will closely monitor the patient via video call or phone call.

We also support the community isolation program run by local communities in Bangkok metropolitan region.

The program engages community members in turning their communal spaces such as temples and community halls into isolation facilities. They run and manage the facilities and monitor the symptoms of patients who are mainly the community members or their neighbours.

Support by civil society groups, local communities are connected to doctors and medical staff, which assess the patients' health conditions via online communication channels. If their symptoms worsen, hospital staff will send ambulances to pick them up and transfer them to a hospital facility for intensive care.

The NHSO also covers the expenses of medical services and provisions given to the patients in the isolation program – including RT-PCR and Antigen Rapid Test, laboratory service, patient transfer, mobile medical service, meals, medical devices, and personal protective equipment for medical staff.

You can see that many people are involved in this community isolation program, including community leaders and members, non-governmental and governmental organisations, and volunteers who help strengthen primary care.

Without them, it will not be possible to provide quality care to thousands of Covid-19 patients at once.

As it is unlikely the pandemic will end soon, all players in primary care will be even more critical to ensure access to Covid-19 treatment, and reduce the exhaustion of medical staff who should prioritise moderate to acute cases.

The NHSO will continue supporting the primary care network while expanding our daily testing capacity, as we have learned that both are critical elements for us to fight the pandemic.

Published : July 30, 2021

By : Dr Jadej Thammathach-Aree Secretary-General, National Health Security Office (NHSO)