Getting Covid-19 jabs is necessary even though they do not completely prevent the infection, an expert virologist said.
In a Facebook post on Friday, Dr Yong Poovorawan urged everybody to get vaccinated against Covid-19, as vaccines can help ease the severity of the disease and stimulate immunity.
He explained that the immunity offered by the vaccine will help the body create antibodies to fight off the infection. However, he said, this immunity will reduce over time.
With the disease mutating all the time, people will need to keep their immunity high and to do this, everybody should take their booster shots, he said.
He likened getting vaccinated to training conscripts to identify the enemy or virus in this case.
For instance, he said, soldiers will be in reserve when there is no enemy but will be able to jump into action immediately as soon as they see the enemy approaching.
Similarly, he said, a booster dose is like having a reserve battalion ready to attack the approaching enemy.
Yong also said on Thursday that a sixth wave of Covid-19 infections has been sparked in Thailand thanks to the BA.5 subvariant that is fast spreading among students.
He speculated that the actual number of daily new infections will come in at around 10,000, though the number of patients requiring hospitalisation will be around 2,000. The daily death rate will be around 20.
Getting a Covid-19 vaccine booster jab helps increase immunoglobulin G (IgG) antibodies and T-cells which protect vital organs, a virologist said.
In a Facebook post, Dr Anan Jongkaewwattana, director of the National Centre for Genetic Engineering and Biotechnology’s Veterinary Health Innovation and Management Research Group, explained that a vital organ is like a castle surrounded by a wall of mucous membrane and a pool of saliva and phlegm.
He said immunoglobulin A (IgA) is akin to a group of soldiers who defend the castle’s walls, while another group of soldiers – IgG – protect the castle itself. Meanwhile, troops of T-cells assist IgG in protecting the castle.
“Troops of IgA stay on the wall to prevent the enemy from invading,” he went on to explain. “If the enemy breaches the wall, the main body of soldiers is ready to deal with the incursion to protect the whole castle.”
Anan said IgG has high enough ability to beat back the enemy, but the castle could be destroyed if the enemy camouflages itself to escape IgG and T-cells.
“Hence, receiving a Covid-19 booster jab helps increase the number of IgG and T-cells to protect the castle,” he pointed out.
However, he said, a Covid-19 vaccine cannot increase the amount of IgA as this needs to be stimulated by other methods, such as receiving other types of treatment or being infected with the virus itself.
“Each battle” may cause people to develop symptoms, but it will make the so-called troops stronger as well, Anan said.
“Unfortunately, the enemy isn’t weak because it has caused a lot of unexpected trouble in the past three years and we can’t predict how it will act against us in the coming future,” he added.
The World Health Organisation (WHO) announced that Covid-19 subvariants BA.4 and BA.5 are variants of concern and expects these to spread around the world.
Both new variants carry the L452R mutation, the same as Delta, so they can spread easily to the lungs.
“Therefore, these subvariants could cause pneumonia and are unlike BA.1 and BA.2, which spread more easily in the upper respiratory tract,” WHO said.
BA.4 and BA.5 can also evade immunity and resist antibodies, so people can be infected again even if they have got vaccines, the international health body said.
“Omicron is highly transmissible, five times higher than other variants,” WHO reiterated.
People who have been infected will experience symptoms such as fatigue and tiredness, dry cough, fever, runny nose, headache, dizziness, nausea, muscle ache, and liquid stools. Incubation period
Meanwhile, Ramathibodi Hospital vice director Asst prof Dr Kumthorn Malathum said the incubation period of Omicron is around seven days on average, faster than other variants by 12 hours to a full day.
Infected people could spread the disease two days before any symptoms, he said, adding that the most dangerous period to spread it is the first day after symptoms appear.
After experiencing symptoms for five days, the spread will be reduced and will further reduce significantly after 10 days.
When/how to avoid contracting the disease
If you mingle with anyone who has been infected, Kumthorn advised considering how close you came into contact with that person.
If that person has symptoms two days after close contact, there is a chance it could have spread. There would be a moderate risk of the disease spreading if the infected person had symptoms a week after associating with a close contact.
However, if it is more than two weeks, the close contact will be relatively safe, Kumthorn said.
The risky period is two days before getting any symptoms and 10 days after, he said, but added that wearing a mask and chatting without being in close quarters carries no risk.
Kumthorn recommended getting an ATK test two times, on the third and fifth day after contact with an infected person.
How long to isolate
Previously, the isolation period for infected people was two weeks but this was reduced to ten days from the day symptoms appear.
Anti-viral drugs should be given to vulnerable Covid-19 patients as soon as possible to protect them from severe symptoms and death, an expert virologist advised on Monday.
Dr Yong Poovorawan said anti-viral drugs like Remdesivir, Paxlovid and Molnupiravir should be given to vulnerable patients as soon as they test positive or within five days of infection.
Vulnerable patients include the elderly aged 60 and above, pregnant women and people with chronic diseases like cancer and diabetes.
Dr Yong, however, said Molnupiravir should not be prescribed to children and pregnant women as the drug can cause genetic disorders. Paxlovid, meanwhile, can react to other drugs and patients can develop Covid-19 symptoms five days after taking the drug.
“My advice is that patients consult a doctor before taking Covid-19 antiviral drugs,” he said.
He also said that students are most at risk while eating and playing with their classmates, adding that they should return home immediately after school. He advised young people to wear a facemask, wash their hands regularly and maintain social distancing.
He also called on schools to avoid holding activities that will bring too many students together like camping, and instead focus on lessons for the next two or three months.
“Education will create quality workers once students grow up, so we should pay attention to this issue,” he said.
The BA.5 subvariant of Covid-19 is likely to cause more lung damage and spread quicker than the BA.1 and BA.2 subvariants, according to a new Australian study.
The University of New South Wales study was published on Sunday and cited by Chulalongkorn University (CU) medical lecturer Thira Woratanarat in a Facebook post on Monday.
Thira explained the study showed that BA.5 has a different mechanism for entering human cells from BA.1 and BA.1 subvariants.
Like the Delta strain, BA.5 enters cells via the TMPRSS2 pathway and is more likely to infect the lower lung.
This is reflected by the increased rate of Covid-19 hospitalisation in countries where BA.5 is spreading, said the study.
Titled “SARS-CoV-2 Omicron BA.5: Evolving tropism and evasion of potent humoral responses and resistance to clinical immunotherapeutics relative to viral variants of concern”, the study was published on the medRxiv pre-print server and has not yet been peer-reviewed.
Citing its findings, Thira warned that Covid-19 was still a more serious disease than flu and advised people not to let their guard down against the virus. He said that while vaccines gave some protection, they do not prevent severe symptoms or death in all cases. Moreover, the health risks of long Covid are well-documented, he added.
He said it was still important to take daily precautions such as mask-wearing so people’s lives and livelihoods were not disrupted by catching Covid.
People should receive two Covid-19 vaccine shots per year in the current situation, Chulabhorn Royal Academy said.
Academy secretary-general Dr Nithi Mahanonda made the statement in a Facebook post on Thursday after being asked by “a lot of people”.
He explained that at first Covid-19 had spread heavily and the situation could not be predicted. However, people now know more about the disease and the rate at which it would spread.
In cold countries Covid infections escalate during winter, he pointed out, while in Thailand it spreads largely between the rainy and cool/cold seasons.
Covid could also spread for the second time in a year, which is likely after schools reopen for a new semester, Nithi noted.
He said everyone needs to receive vaccine doses at regular intervals to effectively combat severity of the disease and death.
Therefore, he suggested, people should go in for two vaccine doses per year at six-month intervals. This could be reduced to once per year if new vaccines prove to be more effective and mutations slow down.
The first dose should preferably be administered from the middle of July to mid-September and the second from the middle of January to mid-March, Nithi recommended.
People who have been recently infected can wait 1-2 months before getting a vaccine dose, he added.
With two types of similar-sounding antiviral medication used to treat Covid-19 – Favipiravir and Molnupiravir – you may wonder what the difference is between the two and which is more suitable for certain symptoms.
Here the Medical Services Department explains:
Favipiravir
This was the first Covid-19 drug in Thailand. It selectively inhibits viral RNA-dependent RNA polymerase.
According to the latest information, patients who have taken this antiviral medication get better when compared to those who did not. Precisely 86.9 per cent of those given the drug got better after 14 days.
It can be given to children or adult patients who have mild or moderate symptoms. People in risk groups such as those with obesity or underlying diseases, or pregnant women during a certain period can take the drug.
Adults need to take 1,600 milligrammes and reduce this to 600mg on the second to fifth day.
The price of each treatment is 800 baht.
Molnupiravir
Molnupiravir has a similar mechanism to Favipiravir and was approved by the Emergency Operations Centre, Public Health Ministry and the Centre for Covid-19 Situation Administration.
This medication should be given to patients with risk factors with mild or moderate symptoms.
Adult patients should consume 800mg capsules – four every 12 hours for five days.
Each treatment costs 10,000 baht.
According to the guidelines, patients are given different medication depending on the severity of the disease and risk factors.
Patients with no symptoms
They are treated as outpatients or at home. The doctor will not provide any antiviral medicine as these patients can recover without the drugs over time.
Patients with mild symptoms without pneumonia or risk factors
This group might be given Favipiravir if Covid is found quickly.
Those who have been infected for more than five days and have mild or no symptoms might not need to get this antiviral medication.
Patients with mild symptoms but have risk factors or mild to moderate pneumonia
The risk factors are:
60 years or older
Chronic obstructive pulmonary disease (Grade 2 or higher), including other chronic lung diseases
Chronic kidney disease (stage 3 or later)
Cardiovascular diseases (NYHA functional class 2 or higher) or Congenital Heart Disease
Stroke
Uncontrolled diabetes
Obesity (90kg or higher / BMI 230kg/m2)
Cirrhosis (Child-Pugh class B or higher)
Immunosuppression (receiving chemotherapy, immunosuppressants or corticosteroid equivalent to prednisolone of less than 15mg/day for more than 15 days)
HIV patients who have a CD4 cell count of fewer than 200 cells/mm3.
Patients should be given one type of medication within five days after being infected for better recovery.
Meanwhile, patients with no risk factors can be given Favipiravir. But if they have one of the factors mentioned above, they should be administered Favipiravir, Remdesivir or Molnupiravir or Nirmatrelvir/Ritonavir.
Patients who have more than two risk factors must be given Remdesivir, Molnupiravir, or Nirmatrelvir/Ritonavir.
Patients with severe pneumonia (resting O, saturation < 94%)
They must be given Remdesivir for five to ten days according to their symptoms.
Covid-19 cases in Thailand have risen due to the faster-spreading Omicron BA.5 subvariant and the lifting of the face mask requirement in public, Chalermchai Boonyaleephan, Public Health Commission vice-chairman, said on Wednesday.
He said Covid-19 patients who developed lung inflammation and used respirators have increased to 727 and 318, respectively, up 20.7 per cent and 13.5 per cent compared to 602 and 280 on June 23 after Thailand lifted the face mask requirement.
He added that daily Covid fatalities have increased from 18 to 22, up 22 per cent.
Covid-19 restrictions should be eased to stimulate the economy and enable people to live as normal a life as possible, but the face mask mandate and booster vaccination drive should be retained to prevent an impact on economy and society, Chalermchai advised.
He said Omicron BA.5 is now the world’s dominant strain, which is spreading 35 per cent faster than BA.2.
Chalermchai pointed out that many countries are at risk of Covid-19 spreading due to an easing in restrictions, including doing away with the face mask mandate in public.
“In fact, economy and society can move on even with the face mask requirement,” he added.
Laboratory tests on 13 people suspected to have monkeypox show none are infected, while there are three people who have come into contact with patients, the Department of Disease Control said on Wednesday.
“The three who came into contact with monkeypox patients have not developed any symptoms,” department director-general Opas Karnkawinpong said.
“Meanwhile, laboratory tests on 13 suspected patients indicate they don’t have monkeypox but have the herpes simplex virus,” he said.
Opas said 6,178 monkey pox patients have been found in 56 countries as of Sunday (July 3). He added that the top five countries with highest number of monkeypox patients are Spain (1,196), Britain (1,185), Germany (1,054), France (498) and the US (459).
“More than 99 per cent of monkeypox patients are men,” he said.
Opas said the severity of the virus in Europe is low as only 10 per cent of patients were hospitalised. He also pointed out that monkeypox can be transmitted among humans by coming into close contact.
“Monkeypox patients will develop a fever, headache, muscle pain, back pain, swollen lymph nodes and fatigue,” he explained.
Patients develop a rash on their arms and legs 1-3 days after being infected, which will form blisters and then crusts.
“Patients will have symptoms for about 2-4 weeks,” he said, adding that most recover on their own.
Opas advised people to avoid crowded places, regularly clean surfaces and objects that are frequently touched, wear face masks, wash one’s hands regularly, avoid sharing personal belongings and consume only cooked food.
“Anyone who develops monkeypox symptoms can take a test at a hospital closest to their home,” he suggested.
The Public Health Ministry is ready to tackle monkeypox as the Department of Medical Sciences can conduct a RT-PCR test for the disease and get a result in 24 hours, he added.
For more information, contact the Department of Disease Control via hotline 1422.
Students will become Covid-19 spreaders after the opening of the new semester, causing the disease to spread further, expert virologist Dr Yong Poovorawan said on Wednesday.
He said even though infected students develop mild symptoms, they can spread the virus to other students, as well as family members and the elderly.
“Similar to other respiratory diseases such as flu, Covid-19 will spread quickly during the opening of the new semester or rainy season, causing more students to be infected and spread the virus,” he predicted.
The mortality rate among healthy students aged 3 or above is 1 in 10,000 and most fatalities have underlying diseases, Yong said, adding that children aged 2 or below are vulnerable to Covid-19.
He pointed out that Covid prevention measures are important to contain the spread of the virus in schools, such as washing one’s hands regularly, avoiding eating with others, wearing face masks and maintaining a social distance.
Yong said Singapore had placed priority on education as no schools were closed, while students were allowed to attend classes after recovering from Covid-19. Everyone in Singapore strictly adheres to Covid prevention measures, he added.
“Everyone must accept the truth and promote education to move on,” Yong advised.
He asked related agencies to focus on improving prevention measures in schools rather than closing them.
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