Top Thai doctor, Dr Manoon Leechawengwongs, has lambasted the World Health Organisation over its guidance to the public in relation to face mask coverings and its overall approach to combating the disease and other health threats. He has called for the world health body to be reformed and made more responsive to the needs of the international community at this time.

A Top Thai doctor and expert on infectious respiratory diseases has hit out at the WHO for its shifting and misleading guidance on face masks. Dr Manoon Leechawengwongs is also calling for the Geneva-based health organisation to be reformed in the light of its response to the Covid 19 crisis.

Dr Manoon Leechawengwongs is a respiratory disease expert at Bangkok’s Vichaiyut Hospital. He has taken issue with WHO’s ambiguous and unclear advice on the wearing of face masks which has come to be acknowledged worldwide as a key precaution to curb the spread of this disease in public spaces. The top Thai doctor has also called for the body to be reformed and made more agile.

A top Thai doctor, one of the nation’s acknowledged experts on respiratory diseases or infections, has excoriated the World Health Organisation for its conflicting guidance on the use of face masks.

Dr Manoon Leechawengwongs, of Bangkok’s Vichaiyut Hospital, who made news in late March when he warned that the strain of the virus that had entered Thailand after a disastrous boxing event in Bangkok and in the run-up to the state of emergency, was more potent than the earlier, more prevalent one, now says that the world health body has confused the world on the issue of face masks.

WHO claimed face masks should only be worn by those infected or front line healthy staff

At the outset, the WHO maintained that wearing face masks was only advisable for people suffering from the infection and not for those who were asymptomatic. 

It maintained that the widespread wearing of face coverings would simply put pressure on already dwindling supplies of protective clothing for doctors and nurses in hospitals.

Now accepts that the public can wear face masks as part of a range of measures to curtail the disease

In recent days, the international body based in Geneva has come around and now accepts that the public can wear masks when in public but warns that such masks alone are not adequate protection against the disease.

On the 5th of June, it updated its previous advice from April by saying this: ‘The use of masks is part of a comprehensive package of the prevention and control measures that can limit the spread of certain respiratory viral diseases, including COVID-19.’

Confusing guidance from earlier in the year

Previously, the health body’s advice from early April still observed some benefit from the wearing of face masks but warned of other adverse consequences: ‘The use of medical masks in the community may create a false sense of security, with neglect of other essential measures, such as hand hygiene practices and physical distancing, and may lead to touching the face under the masks and under the eyes, result in unnecessary costs, and take symptoms.’ 

It is clear that the WHO’s overly complex guidance to the public is ambiguous and has contributed to confusion worldwide. 

Some expats here initially refused to wear face masks leading to conflict with the Minister of Public Health

Widely considered one of the critical errors made by western medical experts at the outset of this virus as well as initial guidance that the virus was not airborne, the wearing of face masks also became a vexing political issue in Thailand in the months leading up to the state of emergency when Thailand’s Minister for Health Anutin Charnvirakul lashed out at western expats in early February for refusing to wear the items.

Now mandatory in many western public spaces

Now considered a key tool in suppressing the spread of the infection, face masks have become mandatory in many western countries including for travellers on public transport in the United Kingdom and France.

This is despite a deep cultural abhorrence in the West against wearing such coverings.

Even at the outset of the pandemic, some European countries such as the Czech Republic made the wearing of face masks in public obligatory. 

Since May 25th, however, the official order has been rescinded in the EU state due to its success at fighting the disease.

The country like many who have had success in fighting the Covid 19 threat, adopted its own policies despite the official advice of the WHO.

Senior officials in Thailand at one point agreed with the WHO’s position on wearing face masks

However, for a long period, the World Health Organisation insisted that no evidence existed to show that wearing face masks helped fight the spread of the disease. 

At one point, senior officials in Thailand including the Thai PM and the Minister of Public Health himself endorsed this view although they continued to promote their use and production of the garments.

The general public in Thailand and many local authorities thought otherwise.

Thailand has since advised that people in public should wear a face mask which is obligatory now in many public areas as well as commercial centres.

Thai doctor also critical of WHO advise on the use of disinfectants to combat the Covid 19 virus

Dr Manoon, the top Thai medical expert, has also criticised the World Health Organisation after that body found fault with countries including Thailand, which used disinfectant sprays to fight the virus.

The international health body decried this as injurious to health and the environment.

Such measures have been upheld by the Thai Ministry of Public Health.

Old battle between Dr Manoon and the WHO over sensitivity testing of TB drugs decades ago

This week, Dr Manoon was quoted by The Nation newspaper in Bangkok as he recalled a similar dispute with the WHO going back to 1997 and 1998 over tests on tuberculosis drugs for sensitivity.

Dr Manoon had argued that it was very important to understand the sensitivity of TB patients in Thailand to drug treatments to prevent that disease from becoming stronger.

‘Not knowing the sensitivity to a drug may mean the doctor can’t use it, because otherwise the germ targeted could become more resistant and continue to spread to others. The WHO representative in Thailand at that time said my advice was irresponsible, pulling money from other budgets,’ Dr Manoon explained this week.

This drew him into conflict with the WHO representative in the kingdom at that time who said such an approach was both wasteful and ill considered. 

However, the Thai medical practitioner went ahead and established a fund to research sensitivity to TB drug treatments among Thai patients in public hospitals under the patronage of Princess Galyani Vadhana.

WHO later changed its view and endorsed Thailand’s approach advising other countries to do the same

That was in 2001 and after the success of this programme, the WHO did an about-turn and recommended other countries adopt a similar approach.

According to Dr Manoon, this was acknowledged by an article in the Wall Street Journal in 2012 which criticised the inflexible nature of the WHO on public health policy.

Not the first time that WHO has been found wanting in dealing with a crisis or a pandemic

Even as deaths from the Covid 19 virus are now over 404,000, it is worth remembering that the world had an even larger crisis from 1968 to 1970 when H3N2, a strain of the influenza A virus, spread from Hong Kong and China.

Known as the Hong Kong Flu it killed an estimated 1 million people with some claims of up to 4 million.

That virus saw over 100,000 people die in the US and over 60,000 in Germany as it also swept the western world.

In 2009, another pandemic based on influenza took the lives of 300,000 people.

The H1N1 strain of the flu turned out to be not as dangerous as many had feared yet an international report panned the World Health Organisation’s response to that crisis.

Similar concerns were expressed over its response to the Zika and Ebola health threats in recent years.

Call for reform of the WHO

Dr Manoon is calling for the World Health Organisation to initiate reforms and would like to see a more flexible approach to addressing the world’s health problems which would allow it to become more agile in the future in combating crises such as the one the world is now experiencing.

Part of this might entail looking at the way it interacts with the general public and realising that in this social media and internet age, the public is more aware.

Of course, this crisis also raises disturbing questions about the role of the media and governments in this pandemic and it would be wrong to simply make a scapegoat out of the WHO for what is increasingly seen as a failed response or even a debacle.

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