Opinion – Thailand must take Long Covid seriously and not leave those suffering behind

In the early days of the pandemic, it was common for people to talk about the day “when Covid-19 is over,” and people were daydreaming of a return to something that resembled 2019 picturing a world where people no longer had to follow any public health measures or wearing mandatory masks and hoping that the mandatory social distancing be banished to history.

As 2022 comes closer to its end, the world is living in those daydreamed hopes — the pandemic, as a social phenomenon, has largely ceased to exist. But of course, the possibility of ever truly being “finished” with the pandemic has eluded us since mid-2020, when several governments around the world gave up on elimination.

Infections, hospitalizations, deaths: all of these continue every day. But under the rationale that vaccines and treatments now exist that make coexisting with Covid possible, governments are getting ready to move on.

Thailand is no exception. Almost all mitigating measures have been dropped. Mask mandates have been eased, although masking remains essentially universal. Now, the government has targeted October as the month where the coronavirus will be declared as endemic; from then, provincial committees will assume responsibility for dealing with the virus.

The government has even mooted ending the quasi-permanent state of emergency, the extension of which has become so routine that few even notice any longer.

“The goal,” Thailand’s Covid center spokesman Dr. Taweesilp Vasanuyothin said, “is for people to be able to coexist safely with Covid-19 and live normal lives.”

It is a logical end-goal, and the government has certainly ensured that in the past several months people return to living normal lives. The initial part of the statement, however, deserves scrutiny: can people truly coexist safely with Covid-19? 

In particular, we need to talk about long Covid: an insidious condition that remains poorly understood but important all the same.

Long Covid refers to instances where people continue experiencing ongoing health problems weeks, months or even years after their initial infection. It is not a particularly rare condition: a study by King’s College London found that 10 percent of those aged 18-49 become ‘long haulers’ after getting Covid.

The symptoms vary: some continue to suffer from headaches and brain fog, others develop shortness of breath and muscle aches, and many do not regain their sense of smell and taste. 

It would be one thing, of course, if long Covid is mild, but far too often it is not.

A recent US study has shown that 4 million Americans are now out of work because of long Covid. Some experts are now calling it a “mass disabling event.” Indeed, we still know too little about truly serious long-term effects; a recent study demonstrated that people who have had Covid are at higher risk of psychosis, seizures and dementia for up to two years, while another pointed out that even mild Covid causes brain shrinkage.

Uncomfortable facts, to be sure, but we must face them. As it lets Covid rip through the population, the government must consider how to mitigate the very real public health effects. 

To its credit, Thai public health agencies have not been idle. Private hospitals like Samitivej have opened long Covid centers and programs, but those are unaffordable to most Thais.

In May, the Bangkok Metropolitan Administration set up 9 long-Covid clinics where patients can check in and receive treatment. The Ministry of Public Health has also provided guidelines for the setting up of nationwide long Covid clinics, while explaining that treatment for long Covid falls under Thailand’s gold card scheme for universal healthcare.

However, the government could certainly be doing more to spread awareness of the fact that long Covid is very real and should be treated. In an interview with Thai PBS World, Dr Thiti Sawaengtham, the deputy director-general of the Department of Thai Traditional and Alternative Medicine, noted that many of the patients that the department had begun treating for long Covid was not even aware that this condition exists.

It could also be more careful with its messaging. Dr. Yong Poovorawan, a famous virologist and a top government adviser, recently wrote on Facebook that long Covid symptoms will ease over time and that people should not panic.

There is no doubt that is true for many, but there are also others who suffer for years. To provide a prominent example, US Senator Tim Kaine has discussed how his long Covid symptoms persist even though he was infected all the way back in March 2020. People shouldn’t panic, but the government should be clear about the potential for long-term effects. 

In addition, building a better understanding of long Covid treatment and its impact on society and the economy should be a key government priority.

Last year, for example, the UK allocated 18.5 million pounds for long Covid research. Has long Covid led to increasing numbers of people unable to work? If so, how many, and how can they be assisted? 

Finally, avoiding preventable infections should remain at the heart of any Covid strategy. Encouraging the adoption of proper ventilation (always remember that Covid is airborne!), rapid testing and masking in crowded areas are still, even as they feel monotonously repetitive at this point, good non-pharmaceutical interventions that will reduce the longer-term public burden of treating long Covid.

We would do well to note that this is not a piece intended to fear-monger. Nor is it a call for a return to the stringent policies of 2020 or to pivot to the zero-Covid policies of China. The die has already been cast: Covid will be considered an endemic disease. 

But having made that choice, the government also bears the responsibility of assisting those who, inevitably but unfortunately, will be suffering as a result. Normalcy comes, in this case, at a cost — and we must not leave those who pay it behind.

A man reacts as he receives a Covid-19 nasal swab test from a health worker in personal protective equipment (PPE) at the Government House in Bangkok

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