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During the first wave of the coronavirus disease (COVID-19) epidemic in Thailand, 3 Jan to 22 Jun 2020, there were 3,151 confirmed cases and 58 related deaths. This study aimed to describe epidemiological characteristics of the deaths and explore risk factors using a retrospective cohort study design. A COVID-19 related death was defined as a confirmed COVID-19 case who died from a clinically compatible illness. We collected data from investigation reports and medical records using a semi-structure questionnaire and retrieved secondary data from the Department of Disease Control’s database. Of the 58 deaths, the median age was 58 years (interquartile range (IQR) 50-70), 44 were male, and underlying disease was found in 44, hypertension being the most common. The median time from onset to diagnosis date was 7 days (IQR 5-9) compared to 4 days (IQR 2-7) in recovered cases. Six were nosocomial infections and of the remaining 52, 36 had visited a medical facility at least once before they were hospitalized. Male, elderly, and delayed diagnosis were found to be positively associated with death. Early detection of COVID-19 cases should be strengthened in health care facilities throughout Thailand.

We report the clinical outcomes following implementation of initial COVID-19 treatment guidelines in Thailand. A composite poor outcome was defined as death, ICU admission, requiring intubation, or high-flow oxygen. 744 COVID-19 patients (48.8% male) were included, median (IQR) age was 37 (27-48) years [8.4% >60 years] and 21.4% had pneumonia at admission. Admission

Background/Introduction:Thailand Emergency Medical Team (Thailand EMT) was verified by the WHO in 2019 as a Type 1 fixed EMT. The second wave of COVID-19 hit the country in December 2020. Samut Sakhon province was the center of the spread with many migrant workers infected. Several field hospitals were set up, one being situated in the compound of a Buddhist Temple, Wat Krok Krak. Thailand EMT was tasked in setting up and running the operation here in the initial phase.Objectives:To describe Thailand EMT’s experience in operating a COVID-19 field hospital.Method/Description:On December 30, 2020, 16 members of the Thailand EMT were deployed to the Wat Krok Krak Field Hospital. The team comprised of doctors, nurses, pharmacists, and emergency medical technicians who also functioned as logistic officers. Patients were admitted in groups every day. Physicians communicated with patients by using a telemedicine system to monitor patients clinically.Results/Outcomes:From December 31, 2020 through January 6, 2021, 143 COVID-19 patients were admitted. There were 104 female and 39 male patients. Patients were between 16 and 54 years of age, with a mean of 31.5 years. All were foreigner workers from nearby countries. Three patients had to be referred to a tertiary hospital. The rest of the patients were eventually discharged.Conclusion:Thailand EMT was able to adapt and deployed to operate a COVID-19 field hospital. Collaboration with relevant agencies and local authorities played a key role. This deployment, although within Thailand, was a good learning opportunity for the team to prepare for future operations.Tables and Figures (optional)

The World Health Organization (WHO) emergency medical team (EMT) mentorship and verification process is an important mechanism for providing quality assurance for EMTs that are deployed internationally during medical emergencies. To be recommended for classification, an organization must demonstrate compliance with guiding principles and core standards for international EMTs and all technical standards for their declared type, in accordance with a set of globally agreed minimum standards. A rigorous peer review of a comprehensive documentary evidence package, combined with a 2-day verification site visit by WHO and independent experts, is conducted to assess an EMT's capacity. Key requirements include having sufficient systems, equipment and procedures in place to ensure an EMT can deploy rapidly, providing clinical care according to internationally accepted standards, being able to be fully self-sufficient for a period of 14 days and being able to fully integrate into the emergency response coordination structure and the health system of the country affected during deployment. Through the WHO mentorship programme, each EMT is provided with a mentor team, which guides and supports it during the preparatory process. The process typically takes around 1 to 2 years to complete. The Thailand EMT is the first team from the WHO South-East Asia Region to successfully complete the WHO mentorship and verification process. The experience of this process in Thailand can serve as an example for other countries in the South-East Asia Region and encourage them to strengthen their emergency preparedness and operational readiness by getting their national EMTs verified.

To study the recent trend of health-care associated infections (HAIs) across Thailand.Using the modified international HAI definitions, the investigators conducted a prospective, nationwide, multi-centered survey to determine a 1-day point-prevalence of HAIs among hospitalized patients in the 47 acute care, primary to tertiary hospitals in January 2011.Of total 10,762 patients (female 50.6%, mean age 44.2 +/- 27.3 years) enrolled in the study, 780 had HAIs or the average prevalence of HAIs was 7.3% (range 2.8-8.5%). Highest rates of HAIs were found in other hospitals (other type of tertiary-care facilities), intensive care units and lower respiratory tracts when stratified by type of hospital, unit of service and site of HAIs, respectively. Gram negative bacteria remained predominant among etiologic agents causing HAIs, as in prior studies. Acinetobacter spp., however emerged as the most common organism. At the time of study, 49.3% of all patients received one or more antimicrobial agents. Among the patients with HAIs, cephalosporins were the most commonly used.Recently, no significant change on nationwide prevalence and trend of HAIs in Thailand were demonstrated. Notably, Acinetobacter spp. emerged as the most common etiologic agents of HAIs.