COVID-19 Situation Update 14
Date: 1 November 1st 2021

Background

The current wave of COVID-19 in Tak Province of Thailand, bordering Burma, has been ongoing for over four months, starting with large outbreaks detected in factories in the area. Although there are some signs of improvement, resulting in the Thai government easing up on some COVID-19 restrictions nationwide, Tak Province remains one of the 7 maximum control zones, the highest level, among Thailand’s 77 provinces as a result of ongoing community transmission.

The biggest city in the province, Mae Sot (home to the clinic), along with its neighboring districts, continues to average over 100 new infections per day in the past week, resulting in a steady, severe strain on the local medical system. There are 2,892 patients currently receiving care for COVID-19 in Tak Province and 21,762 patients have been diagnosed since April 1st of this year alone, an increase of 1,050 patients from the last weekly update on October 25th. On Sunday, October 31th, 121 new cases were diagnosed in Tak, with 77 of those in Mae Sot, home to the clinic, and the nearby districts of Phop Phra, Mae Ramat, and Tha Song Yang. (Tak Provincial Public Relations Office Page)

Since June 28th, at the start of the current wave of the pandemic, the Mae Tao Clinic has operated as an official field hospital for the Mae Sot public health system, providing care for infected individuals deemed low risk for developing complications or severe disease. While MTC staff members are responsible for providing daily care, they work in partnership with medical staff of the Mae Sot Hospital and other Thai public health entities, closely monitoring patients for evidence of clinical deterioration and facilitating timely referrals if necessary. There are 22 people infected with COVID-19 who are currently under MTC’s supervision, an increase of 2 since the last weekly update. Since the start of the current wave, MTC has treated a total of 714 COVID-19 patients, all of whom have either been referred from the Thai health system, are staff from MTC and partner organizations or are residents of the surrounding communities.

Starting from today, the Thai government will further ease up on some COVID-19 restrictions, including relaxations of quarantine measures for fully vaccinated international arrivals from lower incidence countries (63 countries, including Myanmar). Meanwhile, the nationwide vaccination rollout rate has been steadily gathering pace and about 46.44% of the population is fully vaccinated as of October 31th. However, there is considerable heterogeneity in vaccination rates and the corresponding rate for Tak Province is well below the national average. Meanwhile, transmissions in the Mae Sot area continue, adding ongoing strains on the local health system. In order to help alleviate this pressure the MTC partnered with the Mae Sot Hospital in August to form a local COVID-19 control committee. The committee worked to establish alternate isolation systems for mildly ill patients or those without symptoms, thereby freeing up health facilities and personnel to care for those more severely ill, while also closely monitoring patients and facilitating timely referrals, if needed. These measures also helped provide another source for isolation and quarantine services to help control community spread. Home isolation guidelines were also developed and disseminated to those being isolated and treated at home, in factories and in the community. The MTC, working closely with other members of the committee, began providing services for patients undergoing these alternative isolation procedures in the Tha Sai Luat District, just west of Mae Sot city, bordering Burma. These include not only providing monitoring and assessments, along with referrals, for patients, many of whom live in remote areas, but also testing services for COVID-19, medical waste management, and food support.

Figure 1 Reproductive Health Outpatient Health Worker Recording Patient’s Information in a Medical Chart, RHOPD, MTC

The spread of COVID-19 has also added other, severe, indirect strains on the health system. With health facilities forced to close or curtail their services to address the epidemic, including the MTC early during the current wave of the crisis, those still operational have faced additional demands for non-COVID-19-related services. In recognition of this, and the dangers of deferring or avoiding care, the MTC prioritized resuming services catering to the most vulnerable members of the migrant community as soon as it was possible to safely do so. On the 17th of August antenatal care services were resumed, followed by immunization services for essential child preventive health care on August 30th, outpatient reproductive health services on September 6th,and adult outpatient services on September 22nd. Most recently, all other general services including dental care, eye care, and trauma care resumed on October 4th. All services now operate under new, strict COVID-19 prevention guidelines and protocols, including controls on the number of clients waiting at any given time. As we continue to see community transmission of COVID-19, we will closely monitor patient flows and gradually adjust service provision as the situation requires.

Category	Total Case	New Case	Referred to MSH	Currently under supervision	Recovered/discharged
Clinical staff	67	0	5	0	67
Non-Clinical Staff	100	0	12	0	100
Household Contact	111	0	2	0	111
Surrounding community contact	85	0	5	0	85
Patient	116	2	13	4	112
RH delivery patients and their family	27	12	8	14	9
Field Hospital	208	0	6	4	204
Total	714	14	51	22	688

• Last updated on October 27th, 2021

As of October 27th, 22 people infected with COVID-19 (18 staff members, household contacts, surrounding community members, patients and their household members, and 4 referred from the Mae Sot public health system) are in isolation within the clinic compound. Those who have had close contact with patients confirmed to have COVID-19 are also quarantined. A total of 688 people infected with COVID-19 have recovered and have been discharged after at least 14 days isolation and monitoring. The clinic is currently in the process of screening staff members who have recovered from COVID-19 to assess for potential longer-term impairments which may impact their ability to work prior to their return.

Under the Thai national COVID-19 vaccine rollout plan, frontline health workers, including staff from MTC, have been receiving vaccinations. Currently, 299 MTC staff received either their first or second dose of vaccine. Of these individuals, 267 are now fully vaccinated (with two doses of Sinovac, Sinopharm, Pfizer or AstraZeneca) and 21 staff who have completed the two-dose series of Sinovac earlier on this year received an additional 3rd booster dose of AstraZeneca as per Thai national vaccination policy.

Figure 2 Community Members Waiting for Their Turn to Take COVID-19 Vaccines, MTC

Figure 3 A Community Member Receiving the COVID-19 Vaccine at MTC

MTC has also been designated as a vaccination site for the migrant community in Mae Sot, working as part of the Thailand vaccination rollout plan. As part of this initiative, a total of 678 staff members of MTC and its partner organizations, along with community members on the priority list for exposure to and consequences of COVID-19, have been fully vaccinated (with Sinopharm) by trained health workers of MTC and its partner organizations. MTC is working to ensure that all staff and patients at MTC are as safe and as adequately protected in the compound as possible and thus has been encouraging all MTC staff to be vaccinated by the end of this year. The occupational health and safety policy is currently under review to include a vaccine mandate for all staff members.

MTC, along with its partner CBOs and EHOs, will continue working with international NGOs to advocate for vaccine equity, helping to expand access for vulnerable populations living along the Thai-Burma border. Expanding such measures will not only protect the lives and livelihoods of among the most marginalized populations in Thailand but will also help to address the significant and ongoing health security threat posed by COVID-19 to the country and the region, particularly given widening conflict, human rights abuses, displacement and forced migration in Burma.

Education

Since August 4th, Children’s Development Center has been providing education in a contact-free manner to 429 students that are enrolled in the 2021-2022 academic year. Thai Ministry of Public Health started rolling out COVID-19 vaccination for high school students since October 4th (using Pfizer) as part of the national vaccine rollout plan prior to the planned school opening in November. As part of this initiative, 45 CDC students (=< 18 years old) received their first vaccine dose with Pfizer on October 27th. An additional 50 students who are enrolled in Non-Formal Education program and are aged between 12 and 18 will receive their first dose vaccine soon.

Clinical Services

All OPD services other than physiotherapy and acupuncture have now been resumed in a limited fashion and with advance reservations, while all inpatient services have been fully resumed starting from October 4th. Please refer to the Facebook pages of the Mae Tao Clinic (inEnglishand Burmese), which will frequently be updated to incorporate the most up-to-date information as it becomes available, particularly during the current unpredictable situation.

There have been many inquiries about testing and vaccinations for COVID-19. Unfortunately, the clinic is unable to provide these services at the present time as they are all currently handled through the Thai health system. If you think you have been exposed and would like testing, please contact the Mae Sot Hospital call center Tel. 065-461-1120 or the COVID-19 call center Tel. 1330. To access COVID-19 treatment, you can register in the Thai health system through the call center Tel. 1130, extension number 14, or add the Line account @sabaideebot and follow further instructions. If you have tested positive using a rapid test (antigen test kit), please call migrant home isolation center at Tel. 065-476-9295 or 065-476-6560. Services are available in Burmese and the center will help provide services including monitoring and health assessments, food and medicine support, and transportation support, if necessary.

For the latest vaccine information, please visit the Thai Government Public Relations Department’s officialFacebook page. For those who are in need of assistance in management of non-communicable (chronic)diseases or HIV/AIDS, please contact Ms Sophia Hla (English, Burmese and Karen language), Tel. 081-037-5800 or Ms Sable Moe (Burmese and Karen language), Tel. 06-2945-6208.

Donations/Support

We are deeply thankful for all those that have and continue to support our work and the communities we work with. For those interested in doing so, please understand that as a COVID-19 field hospital in the midst of a serious epidemic, to ensure safety for everyone, we are very limited in what we are able to accept. We are currently not able to accept cooked food or individually purchased medicines. If you would like to donate clothes or bedding, we respectfully request that these are new and in their original packaging. The supplies that we are currently most in need of are listed below.

General Social Support

Dry food (rice; tinned fish; cooking oil; salt; yellow beans; chili powder; seasoning etc.)

Nutritional supplements (milk; milo)

New bedding (mat; pillow; blanket; mosquito net)

Medical Supplies

PPEs (surgical mask for medical use; face shields; medical/ hospital grade gloves; medical coveralls)

N95 face mask

Infrared Thermometers

Pulse oximeters

Surgical Scrubs

Disinfectants

Alcohol 70% + Glycerin 1% or Alcohol Gel

Lab Supplies

COVID-19 Rapid Antigen Testing Kits (approved by Thai FDA)*

Glucose test (50/box)

Hygiene Supplies

Personal Hygiene Kit (soap; shampoo; toothpaste & toothbrush; sanitation pad; toilet paper)

*The list of approved kits can be found on the Thai FDA website, here:https://www.fda.moph.go.th/sites/Medical/SitePages/test_kit_covid19.aspx

Please note that this list is dynamic and, given the rapidly evolving circumstances, will be frequently updated to reflect our changing needs and priorities. For further questions regarding donations, please contact the designated persons listed below.

Contact information

For general inquiries and donations, please contact the following:

• Ms Nwe Ni (English, Burmese and Thai language), Tel. 084-820-3743
• Ms Naw Annie (English, Burmese and Karen language), Tel. 089-916-5855
• Ms Pattinee Suanprasert (English and Thai language), Tel. 087-677-1415

For media inquiries:

• Communication team, fundraising@maetaoclinic.org
• Ms Pattinee Suanprasert (Thai language), Tel. 087-677-1415

For clinical inquiries:

• Ms Sophia Hla (English, Burmese and Karen language), Tel. 081-037-5800
• Ms Wah Kuh Paw (Burmese and Karen language), Tel. 089-961-7316

For those interested in supporting our COVID-19 emergency response efforts directly: this can be done through deposits/wire transfer to the following account:

Account Name: Suwannimit Foundation for Mae Tao Clinic

Account Number: 016-8-83807-7

Bank and Branch: Kasikorn Bank, Mae Sot

SWIFT Code: KASITHBK

Bank Address: 84/9, Prasart Withi Rd., Mae Sot, Tak Province 63110, Thailand

For more donation information, please visit our donation page: https://maetaoclinic.org/how-to-