Challenges

Key challenges

Challenges associated with Thailand’s COVID-19 response include the following:

COVID-19 misinformation proliferated.

Although Thai officials leveraged high levels of public trust to promote pandemic awareness and encourage good public health behaviors via online and other risk communication messaging, misinformation and “fake news” also proliferated.¹ A Ministry of Public Health (MOPH) survey found that between May and July 2020, more than 85% of respondents—from every gender, age group, and part of the country—had seen at least one piece of misinformation or disinformation about the COVID-19 virus. Much of this unreliable information came from Facebook, which more than half (55.8%) of respondents reported was their primary source of news about the pandemic.¹

Personal protective equipment shortages strained health workers early in the pandemic.

In Thailand, as in other countries around the world, public demand for personal protective equipment (PPE) rose sharply in March 2020. This caused critical shortages in health facilities, which made it difficult for health workers to do their jobs safely and without fear of contracting the COVID-19 virus from patients or colleagues.²

Surveillance reporting infrastructure is incomplete, and data gaps limited timely decision-making.

Thailand’s reporting infrastructure for pandemic surveillance was new and evolving. In the early months of 2020, a mix of paper-, email-, and spreadsheet-based formats was used for laboratory results and epidemiologic data reporting. The MOPH eventually developed separate online laboratory and epidemiology databases, but these new systems required health workers and laboratory staff to adjust to changing surveillance reporting procedures ad hoc during the pandemic emergency. Moreover, some laboratory results reporting to local authorities were still done manually in certain areas.³

The national database did not include polymerase chain reaction (PCR) results for some people, including walk-in clients who paid for their own tests and clients who were tested in private laboratories. If these individuals tested negative, private laboratories did not submit their results to the MOPH. Health officials also did not track widespread use of rapid antigen tests, including over-the-counter kits, which has made it difficult to accurately monitor the epidemiological situation.³

Vaccine shortages and manufacturing issues caused early delays.

Before Thailand’s mass vaccination campaign began in June 2021, it emerged that local producers of the AstraZeneca vaccine could not deliver the millions of doses they had promised for each month. At the same time, increased COVID-19 burden led to increases in demand for COVID-19 vaccination, heightening the urgency for health officials to deliver as many vaccines as quickly as possible.⁴   The resulting vaccine shortages caused hospitals nationwide to postpone inoculation appointments.^5,6   (The production delays also impacted the planned exportation of Thai-manufactured vaccines.) With the cooperation of the private sector, officials secured alternative vaccines, such as Sinovac, and borrowed AstraZeneca doses from other countries, such as Bhutan, Singapore, and South Korea.^7,8

Digital health technology is not equally available to all.

For some, digital health services may improve access to essential health care. Digital health technology enables participation in health consultations from remote locations for those with physical disabilities, older people who have limited mobility or are housebound and cannot travel easily, and those who may fear discrimination in clinical spaces, such as migrant groups or lesbian, gay, bisexual, transgender, queer/questioning, and other people. It may also allow patients to access specialist services not usually available in their area. These technologies may exacerbate disparities, however, for those without access to digital technologies or for patients with low digital literacy.⁹

According to the World Bank, 78% of people in Thailand used the internet in 2020—more than in many other Association of Southeast Asian Nations countries.¹⁰ However, the digital divide remained a challenge. Lower-income and older people were especially unlikely to have reliable access to the internet. Even if they had access to a computer or mobile phone, people living in overcrowded spaces might have lacked private space to participate in virtual consultations, people with disabilities might have lacked adaptive equipment, and the absence of virtual translation services might have been a barrier for migrant populations.