BANGKOK: Worldwide, the mortality rate based on those detected with the virus has risen in one month from 3.41% to 4.47% as defined by the World Health Organisation. A senior Bangkok hospital doctor this week has warned that since March 6th, a more deadly and virulent form of the virus has arrived in Thailand brought by a boxing fan returning from Italy who spread it among 5,000 people at a stadium in Bangkok.

Two top Thai doctors have cautioned that Thailand risks becoming another Italy if the current trajectory of the coronavirus is not altered. On Monday, the Dean of the Faculty of Medicine at Siriraj Hospital, Dr Prasit Watanapa, warned of an overwhelmed health service and up to 7,000 deaths if the rise in infections is not halted through the efforts of the public to self isolate. Meanwhile, Dr Manoon Leechawengwong, the head of ICU at Bangkok’s Vichaiyut Hospital has lashed out at authorities for not closing public venues such as the Lumpinee Boxing Stadium in Bangkok where he said a ‘super spreader’ had ignited the current breakout and threat on March 6th last. He also expressed his fear that Thailand is now the subject of a more virulent strain of the virus imported from Italy.

Two top doctors in Bangkok warn of the challenges being faced. Dr Prasit Watanapa of Siriraj Hospital (left) has warned that people must self isolate if a ballooning of infections is to be avoided and up to 7,000 deaths. At Bangkok’s Vichaiyut Hospital the head of ICU, Dr Manoon Leechawengwong (right), has said that he believes a more virulent strain of the coronavirus has been imported into Thailand from Italy linked to the boxing stadium outbreak on March 6th. He attributes this to the far higher mortality rate, currently standing at 9.3% of detected cases, seen in Italy.

One of Thailand’s most respected doctors has come out to warn the population of the gravity of the situation he believes the country is facing.

Speaking on Monday, on an online TV channel with Mahidol University, Dr Prasit Watanapa, the Dean of the Faculty of Medicine at Siriraj Hospital, outlined what the public must do to observe what is being termed ‘social distancing’ but which, so far, has not been clearly explained.

Droplets can be transmitted from human to human at a distance of 1 metre warns top doc at Siriraj Hospital

The key to this, according to Dr Prasit, is that droplets are transmitted when a human being speaks to another person within a distance of 1 metre.

This means that anywhere in public when speaking to another person, you should be wearing a face mask and be 2 metres from the other person.

‘Talking normally to another person produces droplets that travel about one metre. So people must stay at least two metres apart. When you are talking to people, you must wear a mask. Wash your masks daily,’ he explained.

7,000 people could die if urgent changes are not made in personal behaviour by the public

Dr Prasit warns that, based on the current trajectory of infection, Thailand risks becoming another Italy within the next three weeks and has warned that as many as 7,000 people could die if action is not taken.

He explained that the virus infection could be picked up by 350,000 people with 17,000 requiring hospitalisation. This would overwhelm Thailand’s health services.

Current spread of the disease must be slowed

He made his disturbing prediction based on a 33% growth in infection numbers on a day by day basis seen recently and advised that this figure must be limited to 20% in order to contain the virus spread.

On a more optimistic note, he pointed out that if that could be achieved through effective social distancing, then the country could see infection levels drop off within 4 weeks.

122 new cases announced today, a 390% increase in one week with more cases that cannot be tracked

Today, Thailand announced 122 new cases bringing the total number of infections to 721 which represents a 390% increase on the week before.

Of the new cases announced today, over 75% cannot be linked to other infections or specific outbreaks suggesting the disease is now moving to a widespread or uncontrolled epidemic.

However, most of the 92 unaccounted for infections are comprised of younger people who are believed to have contracted the disease in Thailand from social activity.

Ministry of Public Health officials concerned about the spread outside Bangkok and into the provinces

However, Dr Supakit Sirilak, deputy permanent secretary for health cautioned against such an interpretation saying that the increases were the result of more widespread testing. 

The senior public health official did express concern about the increasing number of infections being detected in the provinces. As of yesterday, 40% of cases came from outside Bangkok and that number is rising.

Average age of those infected in Thailand is 38

Of the 721 cases now in Thailand, the youngest is a 6-month-old baby just diagnosed while the oldest is 79 years of age.

The median age is younger at 38 years. This may explain the current death rate which still only stands at 1 person in the kingdom.

67.2% of those infected are male with 32.8% being female. 

52 people have recovered.

Foreigners among the mix of new cases

Among the new cases being detected is a UK national in Hua Hin who flew in recently from Great Britain, a popular French DJ in Phuket as well as a Canadian man and Swiss woman on the resort Island.

On Monday, Dr Prasit of Siriraj Hospital said he feared that the soaring number of cases presaged a situation such as in Italy and Spain where doctors are being forced daily to select those who can be saved with scarce and limited medical resources.

Breakout occurred when disease numbers climbed over 200 in a similar pattern to European countries

The top doctor indicated that the rise in numbers in Thailand last week from 100 to over 200 in 3.5 days was the point when the disease broke out following a similar pattern in European countries.

He fears that officials may no longer be able to control the outbreak.

‘That would be like the situation in Italy. Decisions would then have to be made whether to treat someone or not. I do not want that to happen,’ Dr Prasit made clear. ‘If we do nothing, we will become a country that is unable to control the disease.’

He pointed the finger at entertainment venues such as pubs and especially the two boxing stadiums in Bangkok which has been the impetus for the collapse of Thailand’s containment efforts.

Appeal to keep a distance from each other

He urged the Thai people and everyone in the country to make one supreme effort at social distancing. This means staying at home where possible and only venturing out for limited distances seeking essentials.

New, more deadly strain of the virus has been introduced to Thailand says top Bangkok doctor

Dr Prasit’s warnings about the fate of Italy were amplified by another qualified medical expert on Monday.

Dr Manoon Leechawengwong is Head of ICU with Bangkok’s Vichaiyut Hospital. He is a highly respected respiratory and critical care specialist with experience of viruses.

Dr Manoon warned that Thailand has now been infected with a more deadly strain of the coronavirus which has ravaged Italy.

Mortality rate in Italy may not just be about culture and demographics says Dr Manoon 

His analysis has been questioned by some online.

The doctor claims that the increased mortality rate seen in Italy is not just a question of demographics and Italian cultural preferences.

He believes that the reason is a more severe and virulent strain of the virus.

Chinese scientists announced two strains of the virus on March 4th to the media based on a study

On March 4th, Chinese scientists did reveal that there were two strains of the Covid 19 virus. Type S as the original form of the virus which, according to the Chinese scientists, emerged when spread by animals to a human being.

However, from a sample of 103 viral genomes, they classified 72 as type L and 29 as type S. 2 were unclassified.

The scientists with Shanghai University and Peking University, under the umbrella of the Chinese Academy of Sciences, suggested that type L was a later variation and that it was more virulent.

News of a new strain played down by western media and the World Health Organisation

However, this news has not been covered extensively by western news media and although acknowledged by the World Health Organisation, they suggest that the two types are very similar.

It was reported by the Chinese scientists that type L is more infectious than type S.

Some researchers suggest that this could be extremely important, as a vaccine, if developed, must be able to counteract the effects of both strains of the virus. 

It is also being claimed that the variation of the strains may explain why some individuals throughout the world have managed to be infected twice when normally an infected person would be immune to being infected again, at least by the same strain. 

Other medical experts have compared this to variations of the flu which occur on a seasonal basis.

Bangkok doctor claims ‘super spreader’  launched new virus strain at boxing stadium on March 6th

However, on Monday, Dr Manoon said something far more substantial and ominous.

He warned that an infected person who is part of Thailand’s boxing fraternity had attended a boxing event at Lumpinee Stadium. The individual had just returned from Italy.

This, he claimed, was the ‘super spreader’ who through his relatives and other contacts, has launched a far more virulent and dangerous strain of the coronavirus into Thailand.

This occurred on March 6th when 5,000 people attended the boxing events.

Dr Manoon has claimed that the failure of authorities to shut down entertainment centres and public activities before this new outbreak could be catastrophic for Thailand.

Current death rate in Italy is 9.2% of treated cases in hospital compares to 1.1% in South Korea

Dr Manoon points to the current death rate in Italy compared to Asian countries. In Italy today, there have been 59,138 cases with 5,476 deaths. That’s a death rate of 9.3%.

He has compared this to 1.1% for South Korea with 8,799 cases.

He also counters the argument that the high death rate in Italy was due to demographics and old age by pointing to Japan, with a very aged population, where the death rate is 4.2% based on under 1,000 cases.

These mortality rates are, however, only indicators based on those seeking treatment for the disease or who have been detected.

This week, a Stanford University expert suggested that the real mortality rate based on 100% testing of the population in the United States might be as low as 0.3%.

The worldwide mortality rate is rising

In the last month, the Director-General of the World Health Organisation, Tedros Adhanom, has used the simple methodology of taking the total number of detected cases and correlating them to the number of deaths.

On this basis, taking today’s total number of infections of 339,590 globally and 15,204 deaths, this gives a mortality rate of 4.47%. This figure has risen from 3.41% since last month. 

 Further reading:

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Another record rise in infections on Monday as top virologist predicts widespread transmission in Thailand

Fears that Thailand could be on the verge of a phase 3 breakout with 32 new infections in 1 day

Anutin is proposing to close all bars and music venues including nightclubs and go gos

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Thai Deputy PM Anutin warns the public to be wary of dirty white western tourists who don’t shower