Flu-conscious Thais on high alert

Thai Takes
By Philip Golingai

Thailand’s A (H1N1) casualties are among the highest in Asia. Should Thais be worried?

The bad news is this week alone the number of deaths doubled to 14. In the last five days there were seven reported deaths from the new strain of influenza that claimed the life of its first Thai victim on June 20.

The good news is Thailand is at Level 2 on the World Health Organisation (WHO) alert level (0.1%-0.5% fatality rate of all confirmed cases). Thailand’s rate is at 0.4, or four deaths out of every 1,000 infected patients. As of yesterday, the number of infected cases totalled 2,924, of whom 2,815 have fully recovered.

“There are now 14 A (H1N1)-related deaths in Thailand, should Thais be worried?” I asked Dr Kumnuan Ungchusak, a senior expert in preventive medicine in Thailand’s public health ministry, on Thursday night.

“Yes, the number of deaths is increasing every day, but you have to compare this with how many people are infected with A (H1N1),” Dr Kumnuan explained. “The probability of dying from this new strain of influenza is not significant when compared with the seasonal flu (which has a 0.75%-1% fatality rate).”

Try telling that to Vichuta Prawittkarnh, a 33-year-old digital business development manager. She’s alarmed at the daily reporting of A (H1N1)-related deaths. “I think I have a chance of getting A (H1N1) as it is all around us. I hope if I get it, I will not die,” she said.

Vichuta’s fear is a reflection of the concern Thais – especially those living in the cities – have of this “frightening disease”.

There’s also good news/bad news to their concern over the flu outbreak, which WHO declared a pandemic on June 11.

The good news – Thais are more aware of A (H1N1) and are educating themselves on proactive prevention. For example, Vichuta’s mother would remind her to wash her hands after using public facilities.

The bad news, however, is that some Thais are too concerned.“Healthy people with mild symptoms will rush to hospital for treatment; they overload the health service,” noted Dr Kumnuan.

To counter A (H1N1), the Thai government has adopted two major measures – reduce the mortality rate and slow down the spread of the virus.

"Patients with underlying health issues (such as heart disease, diabetes, obesity and cancer) should seek medical treatment and receive the antiviral drug as soon as they develop flu-like symptoms or have a high fever," said Dr Kumnuan. "Doctors should not wait for lab results to confirm the infection first."

He added that the public health ministry found that of the first 11 Thais who died of A (H1N1) nine had underlying health issues.

On Thursday, the Thai Cabinet ordered private tuition schools across the country to close for 15 days starting on Monday in order to curb the spread of the flu virus.

"The ministry of public health found that these schools - which is usually crammed with students – as a major source for the spread of A(H1N1)," explained Dr Kumnuan, adding that the ministry also found that students were one of the most susceptible groups to the new strain of influenza.

The cabinet also asked owners of net cafes to cooperate with the government by closing their businesses during the same period so as to help curb the virus spreading.

Is the Thai government handling the A (H1N1) competently? No, according to the opposition Puea Thai Party. It has demanded that Public Health Minister Witthaya Kaewparadai resign because he “lacked experience and had failed to deal with the flu outbreak”.

However, according to Dr Samlee Plianbangchang, WHO director for South-East Asia, Thailand’s preventive measures against the spread of A (H1N1) is on the right track.

Dr Samlee, as reported by Thai News Agency, said it was not correct to say that “the spread of the influenza in Thailand was more severe than in other countries although the number of people who succumbed to the new virus strain is higher than in any other country in the region”.

“The number of fatalities vary, depending on the reporting system and how effectively measures are put into practice,” he explained.

“Should the system be efficient, the number of patients and victims might show up as being very high. Conversely, the number of new cases and fatalities is very small in some countries because they may not be monitoring their situation appropriately.”

Looks like Thais have little reason to worry about being misled on the flu statistics.

(Published in The Star on July 11, 2009)

Thaksin mania lives on as Red Shirts go two-up against govt

THAI TAKES
By PHILIP GOLINGAI

THE score so far for Thailand’s recent by-elections is: Thaksin Shinawatra 2; Democrat-led coalition government 0.

Last Sunday, the Puea Thai Party (the successor of Thaksin-backed People’s Power Party and Thai Rak Thai) clobbered Chart Thai Pattana Party, a member of the seven-party ruling coalition, in Si Sa Ket province. A week earlier, Puea Thai thumped Bhum Jai Thai Party, another coalition member, in Sakon Nakhon province.

Two constituencies out of 400, according to Thitinan Pongsudhirak, a political analyst at Bangkok’s Chulalongkorn University, “should speak little”.

“However, in a turbulent and fluid body politic, what happened in Sakon Nakhon and Si Sa Ket bears several immediate repercussions,” Thitinan wrote in the Bangkok Post on Tuesday.

The political analyst argued that “it reaffirms that Thai Rak Thai (TRT) fever, which should have been extinguished when the party was dissolved more than two years ago, is resilient in the face of the military coup of 2006, a coup-induced constitution, party dissolutions and various other coercive side measures to overcome the TRT platform”.

Thitinan also pointed out that if Thai Prime Minister Abhisit Vejjajiva’s Democrat Party’s objective “is to retake power after the next election, its coalition partners’ resounding defeats do not augur well for the ruling party”.

Should the Democrats be worried about these two defeats?

“It is far too early to tell because in the last by-elections at the end of January the coalition won almost all of the seats (which became vacant when the court banned PPP and two other parties). So the public sentiment is continuously changing,” countered Democrat Party spokesman Buranaj Smutharaks.

However, Pitch Pongsawat, a Chulalongkorn University political lecturer, pointed out that Thaksin was not actively involved in January’s by-elections.

By and large, Buranaj added, the results really reflected local sentiment more than approval or disapproval of the Abhisit government because his (Abhisit’s) major economic stimulus packages were only passed last week.

For example, he said, government funds were not yet disbursed to benefit the people, suffering through the political and economic crisis, especially in the impoverished north-east region (which is Thaksin’s stronghold and where Si Sa Ket and Sa Sakon Nakhon are located).

But still, the by-election results show that the self-exiled Thaksin is back, politically.

“You can’t deny the fact that Thaksin is still actively exerting his influence on the course of events in Thailand. For example, during the April riots, he explicitly called for more people to take to the streets while the riots were in full swing,” noted Buranaj.

But why is Thaksin, who was overthrown in a 2006 coup, still popular?

“Well, you can’t underestimate the power money has in determining populist movements in Thailand. We can still see a clear continuation of his political activities through his different vehicles – UDD (United Front for Democracy against Dictatorship, also known as the Red Shirts), Puea Thai and his former political affiliates who are banned from politics,” the spokesman said.

But is Thaksin still popular?

“Oh yes, but I think people are also realising the (shifting) rhetoric of the movement supporting Thaksin. The UDD said it opposed dictatorship and then it said it wanted to bring down the privy councillors (advisers to the Thai king) and then last week it wanted to bring back Thaksin (through a royal pardon signature campaign) so that he doesn’t have to face his trials,” Buranaj said.

“It is really a movement using majoritism (pressure through people power) to overrule the rule of law.”

But isn’t Thaksin just “doing a PAD” (People’s Alliance for Democracy, also known as the Yellow Shirts, which seized two Bangkok airports and the Prime Minister’s office when the PPP-led coalition was in government)?

In reply, the spokesman gave the standard answer: The would be no double standard in the way Abhisit’s government deals with the two colour-coded street movements.

On the constant media reports that Abhisit’s coalition government was unstable, Buranaj said: “Many of these rumours are spread by Puea Thai which still can’t find a party leader.

“In Thailand’s constitutional democracy the leader of the opposition is essentially a prime minister in waiting in case the government (collapses).”

Well, 2-0 is not a bad result for a leaderless party.

(Published in The Star on July 4, 2009)

Absent Thaksin strikes polls blow to ruling coalition

Thai Takes
By PHILIP GOLINGAI

LAST Sunday, Thais in a province about 647km north-east of Bangkok voted in a by-election. And what boomed out of the ballot boxes is that Thaksin Shinawatra, the self-exiled former Thai Prime Minister, is back, politically.

The opposition Puea Thai Party, which is loyal to Thaksin, thumped Bhum Jai Thai Party, a member of the ruling coalition, by 83,348 votes to 47,235 in the Sakon Nakhon by-election that was called after a Supreme Court ruling disqualified the incumbent Puea Thai MP.

The by-election result is a nightmare for the Democrat-led coalition government and the power behind the government, noted Pitch Pongsawat, who teaches political science in Bangkok’s Chulalongkorn University.

“It shows that post-Thaksin politics is still very contingent. I’m not saying that Thaksin has an (absolute) influence on the people,” he opined.

“But it is a nightmare because Thaksin – when he really works on something – is able to get the support of the people.”

The Sakon Nakhon by-election was supposed to be a shoo-in for Bhum Jai Thai Party.

“Bhum Jai Thai appeared to have the advantage in that the party controls local officials who include the tambon (Thai for “subdistrict”) and village headmen through its control of the Interior Ministry,” Veera Prateepchaikul wrote in the Bangkok Post on Monday.

While Bhun Jai Thai has control of the interior ministry, Puea Thai Party has Thaksin, the darling of Thailand’s northeasterners who had benefited from his populist policies when he was in power from 2001 to 2006.

Self-exiled (probably in Dubai), the billionaire politician personally telephoned tambon and village headmen, pleading with them to support his party.

“Thaksin used his charismatic asset (to win over the voters),” said Pitch.

A big message from the by-election, according to the political lecturer, is that the people voted for the opposition.

“In Thailand, we are made to believe that you better vote for the government if you want (your constituency) to receive government projects,” he explains. “So it is a big deal when the people voted for the opposition.

“The voters had enough guts to vote for the opposition because they felt that the Red Shirts and the Isaan people (northeasterners) were unfairly treated during the Bangkok protests in April.”

The Sakon Nakhon by-election was also seen as a Thaksin vs Newin Chidchob fight.

Newin? He is a Thaksin loyalist who betrayed his boss. Newin and about two dozen MPs from People’s Power Party (PPP, the dissolved ruling party which is the predecessor of Puea Thai Party) formed Bhum Jai Thai Party to enable Abhisit Vejjajiva, the Democrat leader, to put together a seven-party coalition government in December last year.

Puea Thai Party distributed leaflets with photographs of Newin hugging Thaksin (taken three years ago when the then prime minister Thaksin announced he was taking a temporary break from politics) as well as Newin hugging Abhisit (taken in December 2008 when they embraced to show that Newin supported Abhisit’s push to be prime minister).

The leaflets carried the headline: “Sakon Nakhon residents: Oppose this disgraceful man (Newin).”

Pitch noted: “This is another version of moral politics in Thailand – the voters gave Newin a lesson – you can’t be disloyal to your patron.”

The Sakon Nakhon result also put a speed bump on Newin’s ambition to replace Thaksin as a major force in the northeast and north of Thailand.

On Tuesday, The Nation wrote: “This result might put a smile on Abhisit’s face, because even though Newin helped him form the government, he and his Bhum Jai Thai have been clashing with the Democrats over some government projects.

“Maybe this time Newin will be less aggressive and tone down his power-bargaining tactics and ambition.”

Pitch thinks otherwise. “I don’t think they want Bhum Jai Thai to lose as when its coalition partner loses, the Democrat Party also loses,” he said, adding that the Democrats hope Newin will extinguish Thaksin’s influence in the northeast.

Now all eyes are on tomorrow’s by-election in Si Sa Ket, a northeast province along the disputed Thai/Cambodian border.

The fight this time is between Puea Thai Party and Chart Thai Pattana Party, a member of the Democrat-led ruling coalition.

Who will win?

“It depends on the Thaksin factor – whether he personally calls the voters,” says Pitch. “And that’s going to be a big challenge to the (political foundation of the coalition government).”

(Published in The Star on June 27, 2009)

All hot and bothered about A(H1N1)

ON TUESDAY afternoon, in a private hospital in Bangkok, I took a pop quiz that I knew I would ace. Nevertheless, I had hoped not to flunk it as I feared I would be quarantined.

“Do you have fever?” the receptionist asked when I told her in a hoarse voice that I wanted to see the doctor.

“Yes,” I said.

“Do you have sore throat?” she said.

“Yes.”

“Runny nose?”

Before I could say “no” my wife, who was also seeing the doctor because she was feeling unwell and suspected our eight-month baby was sick too, said “yes”.

“Did you just come from another country?”

“Yes,” I said, as I had just returned from Malaysia and Singapore.

The receptionist wrote something in Thai on an official-looking paper. And I told myself, now we’ve become suspected A (H1N1) cases.

True enough, a polite Thai nurse led us to a special counter – a desk manned by two nurses wearing face masks. A nurse checked our weight and temperature. Interestingly, she did not pay any medical attention to my baby.

If I had fever I would be dispatched to the emergency room to undergo an 8,000 baht (about RM800) test for A (H1N1). And if I tested positive, I would be quarantined.

My wife and I did not have fever so we were allowed to consult our regular doctor. I was diagnosed with throat infection, my wife with common cold. My baby was given the all clear.

False alarm. I’m free of A (H1N1) which I suspected I had contracted.

My suspicion was justified in view of the alarming spike in reported A (H1N1) cases in Thailand the past week. On Sunday, there were 44 reported infections, bringing the total number of A (H1N1) cases to 150. On Monday the number was 201.

And the figures kept on rising – 310 cases on Tuesday, 405 on Wednesday, 518 on Thursday and 589 yesterday.

On Thursday, curious to know why there was an average of 100 confirmed cases a day in Thailand, I sought out Dr Kumnuan Ungchusak, senior expert in preventive medicine in Thailand’s public health ministry.

The country’s first 20 patients were imported cases of A (H1N1), according to Dr Kumnuan. But Thailand could not contain its spread locally and was now facing an outbreak.

For example, two weeks ago 10 students aged 10 from a Bangkok school were absent in one day. One of them tested positive for A (H1N1). Subsequently, about 100 students from the same school tested positive.

“We really don’t know the starting point (of the cases in that particular school). And we detected the problem a little bit late because those infected were not only in one particular class but spread across many,” said Dr Kumnuan.

He added that a school was a conducive place for flu to spread because of the crowded conditions and because students shared common equipment such as computers and telephones.

“Our hypothesis is someone (a student, a parent or a teacher) arriving from a foreign country could have passed through a thermal scan (in the airport) undetected, having mild symptoms. And this person spread it to a student in this particular school.”

Dr Kumnuan said the Thai media’s coverage of A (H1N1) focused on the rising numbers. “Their reports have alarmed the public. But (the increase) is not the key message,” he said.

The key message is that A (H1N1) is similar to the seasonal flu (Thailand has 900,000 cases annually, where 30,000 patients are hospitalised, and 300 die).

Like the seasonal influenza, a patient with A (H1N1) has a 0.4% probability of fatality. Meaning, out of 1,000 infected patients, four (usually five years old and below, 65 years old and above and those with underlying health problems) might die.

“But people are panicking, as they have this image (coming from Mexico) that A (H1N1) is very dangerous,” he added.

There had been no deaths so far in Thailand. As of Wednesday, 393 of the 405 cases recovered.

I asked Dr Kumnuan why he (like most Bangkokians) did not wear a face mask.

“I had observed you, and if you had a runny nose, and you were sneezing and coughing, I would certainly be careful.”

During the 30-minute interview, I tried my best not to cough.

(Published in The Star on June 20, 2009)