This document summarizes Thailand's response to the COVID-19 pandemic between September 2020 and November 2020. It covers preventing local transmission through measures like health communication, physical distancing, and testing. It also discusses ensuring infrastructure and workforce capacity, providing health services, financing coverage, governance, and multi-sectoral measures. The November 2020 update focuses on gradually lifting restrictions while maintaining preparedness for a potential second wave through ongoing surveillance, prevention, and rapid response systems.

1. COVID-19 Health System
Response Monitor:
Thailand
September 2020
Updated November 2020

2. Authors
International Health Policy Program (IHPP),
Ministry of Public Health, Thailand
 Walaiporn Patcharanaruamol
 Angkana Lekagul
 Chutima Akaleephan
 Kamolphat Markchang
 Mathudara Phaiyarom
 Nattadhanai Rajatanavin
 Nattanicha Pangkariya
 Orana Chandrasiri
 Orratai Waleewong
 Putthipanya Rueangsom
 Ratchaporn Congprasert
 Repeepong Suphanchaimat
 Sataporn Julchoo
International Health Policy Program
(IHPP), Ministry of Public Health,
Thailand
 Somtanuek Chotchoungchatchai
 Titiporn Tuangrattananon
 Thinakorn Noree
 Warisa Panichkriangkrai
 Watinee Kunpuek
 Viroj Tangcharoensathien
Asia Pacific Observatory on Health
Systems and Policies
 Anns Issac
 Nima Asgari‐Jirhandeh
Advisor
 Supakit Sirilak, Ministry of Public Health,
Thailand

3. Presentation outline
 Overview
 Preventing local transmission
 Ensuring sufficient physical infrastructure and workforce
capacity
 Providing health services effectively
 Paying for services
 Governance
 Measures in other sectors
 November 2020 update: Phasing out restrictions – what
interventions are in place

4. Overview: COVID-19 HSRM Series
Health System Response Monitor presents up‐to‐date information on
country responses to the COVID-19 outbreak. HSRM presents
information under six heads:
1. Preventing local transmission: Key public health measures to
prevent the further spread of the disease
2. Ensuring sufficient physical infrastructure and workforce
capacity: Physical infrastructure and health workforce available in
a country. Measures to address any shortages, and other initiatives
to
strengthen capacity
3. Providing health services effectively: Approaches for service
delivery and patient pathways for suspected COVID‐19 cases. Also
describes how countries maintained essential health services
4. Paying for services: Health financing during COVID-19. This
section also describes coverage for COVID-19 testing and
treatment.
5. Governance: Governance response to COVID‐19
6. Measures in other sectors: Responses to COVID-19 by
non‐health sectors

5. Thailand Coronavirus Overview
 First case: 13 January 2020
 Total confirmed cases:169,348
 Total deaths: 1,146
 % of Population Fully Vaccinated 1.60%
Updated 04 June 2021
Source: https://coronavirus.jhu.edu/region/thailand & https://coronavirus.jhu.edu/map.html

6. Preventing local transmission
1.1 Health communication
1.2 Physical distancing
1.3 Isolation and quarantine
1.4 Monitoring and surveillance & 1.5 Testing
1

7. 1.1 Health communication
 Daily briefing on
 Disease overview: epidemic trends | confirmed cases | deaths | tests | global trends
 Preventive measures: Mask wearing, physical distancing, hand hygiene and stay home
measures
 Print, broadcast and social media and website
 Multilingual – Thai, Burmese, Laotian, Khmer and Chinese
 Communication materials and management by multiple departments
 Public communication: Centre for COVID‐19 Situation Administration (CCSA)
 The Department of Disease Control (DDC), Ministry of Public Health (MoPH), via the
Emergency Operations Centre (EOC)
 Impact of communication
 Confidence and trust in interventions
 Public awareness of the seriousness of the situation and awareness of COVID-19
 Thailand’s performance withing global response
 Citizen responsibility and role in pandemic response and containment

8. 1.2 Physical distancing
 March 2020: stay home, stop the virus, for our nation” campaign
 25 March 2020: State of emergency declared
 and restricted both international & internal mobility across provinces
restricted (eased gradually for domestic movement)
 Air & land borders closed
 Lockdown of provinces with clusters of infection
 Active population screening of the entire population in those districts,
testing, treatment and quarantine
 Strict enforcement of test, trace, isolate, treat and quarantine
measures
 Unlocking measures began May 2020

9. 1.3 Isolation and quarantine
 Communicable Diseases Act, B.E. 2558 (2015)
 Measures to test, trace, isolate, treat and quarantine COVID‐19 cases for 14
days
 All confirmed COVID-19 cases treated in hospital
 Three types of quarantine measures irrespective of nationality:
 Home quarantine for low‐risk contacts of cases; daily reporting to health‐care
- 14 days
 Local quarantine, sponsored and managed by the Ministry in collaboration
with the MoPH: all international travelers, irrespective of clinical symptoms
 State quarantine, sponsored and managed by the Ministry of Defense, for
international flight arrivals, irrespective of clinical symptoms
 Self‐funded quarantine in hotels was also available
 Isolation facilities developed at the local and state levels for use with PCR
tests, and monitoring of symptoms.

10. 1.4 Monitoring and surveillance
 WHO case definition of COVID-19 adopted:
“patients with fever, cough, sore throat, dyspnoea, symptoms of pneumonia, and in severe cases develop acute
respiratory distress syndrome, which may result in mortality”
 Extensive monitoring of sites, including long term care homes
 Sentinel surveillance after June 2020 (focus on vulnerable groups)
 Primary care centres, with the support of VHVs, were tasked to perform active
surveillance of patients
1.5 Testing
 Health workforce included field epidemiologists (capacity dev 1980s)
 Laboratory capacity for RT‐PCR was scaled up
 27 July 2020, 10 282 tests per million population were conducted
 Mandatory RT-PCR tests of all international travelers on days 7 and 14
 Test collection strategies: drive‐through & mobile teams in locked‐down districts

11. Ensuring sufficient infrastructure and
workforce capacity
2.1 Physical infrastructure and supplies: shortage and coping mechanisms
2.2 Workforce: mobilizing surge capacity and ensuring occupational safety
2

12. 2.1 Physical infrastructure and supplies:
shortage and coping mechanisms
 Thailand has a robust and adequate health infrastructure
 Challenges in performing RT‐PCR tests in all 77 provinces
 MoPH policy: Establish “at least one RT‐PCR laboratory in each
province”
 April 2020, 80 certified laboratories were available.
 June 2020, an additional 30 laboratories came online
 12 regional laboratory centres of the MoPH provided back‐up testing with a
turnaround time of 24 hours for provinces without RT-PCR
 Adequate stock of medicines were maintained
 Initial shortage of PPE, no shortage of other infrastructure
 Local production of PPEs and donations to address shortfall

13. 2.2 Workforce: mobilizing surge capacity
and ensuring occupational safety
 Existing health workforce: Strong
 37.7 health workers per 10,000 population (lower than WHO benchmark
of 44.5), but strong HWF – number, skill-mix & competencies
 1 million village health volunteers at community level
 Training and redistribution of existing workforce such as nurses taken
to support management
 Additional posts – 40,000 civil servant posts were commissioned
 Support to COVID-19 health workers
 Compensation for health workers who contracted COVID-19
 Safety of health workers ensured via adequate availability of PPEs
 Mental health support provided

14. Providing health services effectively
3.1 Planning services
3.2 Case management
3.3 Maintaining essential health services
3

15. 3.1 Planning services
 MoPH partnered with all non-MoPH public and private hospitals and
established effective referral system to boost capacity
 MoPH recommended postponing all elective procedures during the
peak of the epidemic in April–May 2020
 Outpatient visits for non-urgent & stable chronic care replaced by
telemedicine
 Medicines for chronic conditions delivered by VHVs in some areas
 Field health facilities to manage asymptomatic and mild cases and
minimize the workload of “acute care hospitals” developed
 10% of ICU beds earmarked for COVID-19 patients
 Surveillance of patients by primary care centres, supported by VHVs

16. 3.1 Planning services
 Multiple other efforts to manage at-risk populations:
 Moving homeless people to shelters, with provision of food through food
banks supported by the community, citizens and civil society organizations,
training migrant health volunteers
 Reducing overcrowding in prisons and setting up quarantine zones for new
prisoners

17. 3.2 Case management
 Persons under investigation [PUI]
 Point of initial contact: any public or private health facility, VHVs or public
health officers
 Non‐hospital contact points - advised to go to a hospital or is picked up by
an ambulance, depending on their clinical status
 National policy on COVID‐19 triage launched
 National treatment guideline for COVID‐19 launched by the
Department of Medical Services
 Thai Food and Drug Administration (FDA): Updated evidence, practical
constraints at different hospitals and availability of specific medicines
 Two designated call centres
 DDC call centre with the number 1422
 Emergency Medical Services 1669

18. 3.2 Case management
 Recommendations by the Thai Traditional and Alternative Medicine
(DTAM), for treatment of flu-like symptoms
 National guideline for allocation of critical resources for the
management of COVID‐19 developed by IHPP and Health Intervention
and Technology Assessment Program together

19. 3.3 Maintaining essential health services
 Policies and operational guidelines by each department of the MoPH: to
maintain essential health services and optimize health services
 Dental and surgical services provided to emergency cases only
 Flu vaccination programme was given before it was due and prioritized
for health‐care professionals and the elderly
 Outpatient department visits reduced (telemedicine enhanced)
 Policies for management of NCDs
 Medication for stable NCD cases by post, primary care health workers and
private pharmacies working outside the hospital setting
 Self‐care information for the general population, the elderly and patients
with NCDs: widely disseminated;
 Online self‐care programme for mental health: Department of Mental Health

20. Paying for services
4.1 Health financing: universal health coverage enables access to services by all
4.2 Entitlement and coverage
4

21. 4.1 Health financing: universal health
coverage enables access to services by all
 Universal health coverage (UHC) since 2002, via three public health
insurance schemes
 Civil Servant Medical Benefit Scheme (CSMBS)
 Social Health Insurance (SHI) under the Social Security Scheme (SSS)
 Universal Coverage Scheme (UCS)
 Cost of treatment for COVID-19 was covered under these schemes
 March 2020: Additional budget of THB 6302 million (US$ 203.3 million)
approved for COVID-19
 additional funds THB 1020 million (US$ 32.9 million) to the National
Health Security Office (NHSO) to subsidize COVID‐19‐related services

22. 4.2 Entitlement and coverage
 MoPH directed anyone – irrespective of nationality – residing in
Thailand could access COVID‐19 services free of cost at both public and
private facilities
 Laboratory test for everyone and related PPE for specimen collection
reimbursed by the NHSO
 Admission costs are reimbursed by the respective insurance schemes
 All COVID‐19 services, including diagnostic and intensive care were
given to all regardless of insurance coverage or nationality
 Co‐payment was not required
 Transportation, except ambulatory transport excluded

23. Governance
5

24. Governance response
 Thailand responded to COVID‐19 under the National Strategic Plan for
Emerging Infectious Disease (2017–2021) (NSP‐EID)
 Article 20 of the Communicable Diseases Act, B.E. 2558 (2015), allowed
the establishment of the multisectoral P-CDCC
 Representatives from different sectors and levels were engaged
 Governors entrusted with full power to announce and enforce regulations
within their provincial jurisdiction
 Provincial chief medical officer also convened daily meetings of their own
technical team & ensured liaison with MoPH
 MoPH EOC reports progress and recommends policies and regulations to
the CCSA chaired by the Prime Minister for further action

25. Governance response
 Inter-ministerial efforts were critical to he response.
 Example: Fasttrack of medical devices, diagnostics via the FDA; Ministry of
Finance’s temporary exemption for taxes on pure alcohol used for
manufacturing alcohol-based hand sanitizer

26. Measures in other sectors
6.1 Mobility restrictions
6.2 Economy
6.3 Social and income support
6

27. Measures in other sectors
Intersectoral measures were important to the response
 6.1 Mobility restrictions:
 Mobility restrictions affected businesses, education, entertainment, and
travel were lifted in a phased manner
 6.2 Economy
 Rescue packages to mitigate effects of unemployment and job loss,
particularly in small-to-medium-size enterprises were provided
 6.3 Social and income support
 Social and income support initiatives such as a stimulus package to employ
0.5 million unemployed graduates on community development projects in
rural areas were initiated.

28. November 2020 update
Phasing out restrictions – what interventions are in place
7.1 Situation summary
7.2 Balancing peoples’ health against opening up to international and domestic travel
7.3 Preparedness for the potential second wave of COVID‐19
7.4 Tracking resources and supplies
7.5 Subnational protocols: controlling COVID‐19 at the provincial level
7

29. November 2020: Phasing out restrictions
 7.1 Situation summary: Negative impact on Thai Economy
 7.2 Balancing peoples’ health against opening up to international and
domestic travel
 Need to increase economic activity. Gradual phasing out of restrictions 7.3
Preparedness for the potential second wave of COVID‐19
 Measures to reopen access to medical treatment for foreigners taken.
These include measures like “Alternative Hospital Quarantine” paid for by those
interested in accessing medical care in Thailand
 Special tourist visa scheme (STV scheme): For non-Thai residents for stays
over 90 days
 Boosting domestic travel:
 the government launched the “Rao Tiew Duay Gun” or “trip together”
campaign
 Subsidies on travel

30. November 2020: Phasing out restrictions

31. November 2020: Phasing out restrictions
 7.3 Preparedness for the potential second wave of COVID‐19
 Surveillance and isolation measures
 7.4 Tracking resources and supplies
 7.5 Subnational protocols: controlling COVID‐19 at the
provincial level

32. Thailand COVID-19 Response Plan

33. 7.3 Preparedness for the potential second
wave of COVID‐19
1. Surveillance and isolation measures
 Mandatory quarantine: 14 days at state, local or alternative state
quarantine sites
 mandatory reporting of persons under investigation (PUI) by all public and
private hospitals
 Surveillance of two special population groups:
 PUI patients or patients diagnosed with pneumonia or those with influenza‐like
symptoms
 Specific populations such as new prison inmates, international migrants and
Thai football league players
 Community‐based monitoring such as thermo‐scan and mask wearing for :
community and tourist attractions and other high‐risk venues

34. 7.3 Preparedness for the potential second
wave of COVID‐19
2. Prevention measures
 health and non‐health measures to prevent transmission of cases
 establish a “new‐normal” lifestyle: social distancing of 1–2 meters, mask
wearing, hand hygiene, food hygiene and refraining from touching the
mouth, nose or eyes with the hands..
3. Early detection measures
 Testing capacity and focusing on potential groups that can introduce or
sustain transmission in the country.
 Mandatory 14‐day state quarantine for all international travelers and tests
among them according to protocol
4. Early response measures
 1000 surveillance and rapid response teams (SRRTs) for outbreak investigation,
contract tracing and ensuring an immediate response, and for testing, tracing and
supporting quarantine
 1 million village health volunteers

35. 7.3 Preparedness for the potential second
wave of COVID‐19
5. Social measures include physical distancing
 location‐specific standards for all public venues
 routine monitoring of all public settings on adherence to these measures
Other
 7.4 Tracking resources and supplies weekly dashboard, the EOC
monitors the availability of PPE and medicines
 7.5 Subnational protocols: Provincial governors, as chairs of the
Provincial Communicable Diseases Control Committee, are required by
CCSA to control the COVID‐19 outbreak within 4 weeks and ensure that
the case fatality ratio is less than 1.4%

36. Thank you
Find us at: https://apo.who.int/