An expert on infectious diseases revealed nine facts about “post-Covid conditions”, or “long Covid”.
In a Facebook post on Wednesday, Dr Thiravat Hemachudha, head of Chulalongkorn University’s Information Centre for Emerging Infectious Diseases, noted that long Covid is a syndrome that occurs after a patient is infected with the virus.
He pointed out nine interesting facts:
1. The severity of long Covid is not related to the severity of the disease when infected.
2. Anyone who has been infected can experience it.
3. The syndrome can affect any part of the body or several organs or systems at the same time.
4. It is a symptom experienced by the body even three months after recovery and could be more severe or bring about new symptoms.
5. Myalgic encephalomyelitis, or chronic fatigue syndrome, has been known for some time now but long Covid is severe and could remain longer in the body than other viruses.
6. Brain and psycho-emotional symptoms are found in 30 per cent or more of patients that have recovered. It could cause “brain fog”, slow thinking, short memory, dementia or mood swings, especially in people who are affected or going to suffer with dementia such as Alzheimer’s disease and Parkinson’s.
7. To treat the syndrome, we must make sure if there is any inflammation in the body or brain. If there is, steps must be taken to stop it while considering the side effects of prescribed medicines. Also, factors that might stimulate inflammation must be strictly avoided.
8. This is a warning that people should not be careless and become infected with Covid-19.
9. The best way to prevent long Covid is to treat yourself as quickly as possible.
Some people who have been infected with Covid-19 can experience effects from their infection, known as post-Covid conditions (PCC) or long Covid. Current evidence suggests approximately 10%-20% of people experience a variety of effects after they recover from their initial illness.
This Q&A will help you understand more about long Covid.
Living wage is necessary in the post-pandemic world to ensure workers in global food supply chains are able to afford a decent and dignified life which in turn will benefit businesses and the overall economy, but more must be done to make it a reality, a panel discussion suggested.
Oxfam International and the CSO Coalition for Ethical and Sustainable Seafood hosted an online panel discussion – ‘Battling Inequality in Food Supply Chains: a post-pandemic talk on living wage’. Representatives from civil societies and leading global companies joined the event to discuss how a living wage is crucial to close the inequality gap for workers, especially in food supply chains.
Covid-19 made it worse
Suthasinee Keawleklai, National Coordinator of Migrant Workers Rights Network (MWRN) works directly with migrant workers in Thailand. She revealed that the low wage crisis persisted long before Covid-19, with the current minimum wage frozen for several years, despite the cost of living increasing annually.
“For example, many seafood factory workers in Thailand only earn a daily rate, so they get paid a maximum of around 26 days in a month, but in reality they don’t eat 26 days a month, they eat 30 days a month. We need a fair wage for them to survive.”
The pandemic made these workers even more vulnerable. Many workers were laid off, suspended from work without getting paid, and forced to cram in small rented rooms to reduce the rent cost which increased the risk of Covid-19 transmission. Workers who got infected with Covid-19 also received inadequate support from their employers.
John Samuel, Regional Director of Oxfam in Asia, echoed the situation and shared that at the global scale, the inequality gap has now reached a shocking proportion because of the pandemic, with women and young workers being hardest hit.
“While the CEO and the big promoters have huge profits and huge bonuses, the workers who are working in the food industry hardly get any money to meet their ends.” Mr. Samuel emphasized that the current system is unjust and exploitative and urged that now is the appropriate time for companies to start working towards a living wage.
More than a minimum wage
Cara Flowers, Senior Food Farming & Fisheries Advisor, Ethical Trade Initiative (ETI), clarified that a living wage is more than minimum wage. Having enough just to survive is not a living wage. A living wage allows workers to be able to afford a decent and dignified life with adequate access to food, health, education, housing, and fair employment.
It’s totally unacceptable that those who supply our food and those who bring it to us are those who are suffering the most in terms of food insecurity, poor nutrition and overall poverty. We don’t tend to stipulate what a living wage is, but it is more than minimum wage, and often discussion can come down to what the bare minimum is to provide to survive. We’re not just talking about survival, but about thriving.
Collective benefits for all
Chok Kittipongtavorn, Vice President of Compensation & Benefit and Performance Management from Charoen Pokphand Foods (CPF), revealed that CPF has committed to pay all workers a living wage by 2023. He believed that providing a living wage to workers would in turn benefit the company as well in terms of reducing turnover rate and recruitment cost.
Rachel Cowburn-Walden, Global Director for Human Rights at Unilever, one of the first leading global companies to pay a living wage to all its workers, shared that the company expanded its living wage commitment from direct employees to everyone who directly provides goods and services to Unilever by 2030.
“There’s a real advantage for businesses for workers to earn a decent wage. Economies cannot survive if income is not fairly distributed and if people are not earning enough, then they simply don’t have enough money to put back into the economy”
Challenges to overcome
Despite some progress and commitments from the private sector, the panelists agreed that making living wage a reality remains challenging. One of the key barriers is the lack of comprehensive data which is prerequisite to create a clear and credible benchmark for determining a proper living wage in different industries and markets.
Suggestions to overcome these challenges were made, including that companies should strongly engage with their workers to collect information, gain a better understanding and build their own pathway to achieving a living wage with clear targets.
For CPF, living wage is a journey which needs time and understanding. It has to be taken step by step, allowing time for adaptation and buy-ins. One of its first steps is to develop a living wage benchmark based on the current legally required minimum wage, then taking into consideration the business’ affordability in order to identify the top up.
Ms. Flowers said “we have a lot of companies with policies at the moment, but let’s put in some time-bound targets and measure ourselves. That means having credible benchmarking, being clear about the methodology and including workers and their unions or representatives in this journey.”
Ms. Keawleklai stressed that it is a positive development that more and more companies commit to provide a living wage especially in countries that do not have a living wage benchmark, including Thailand. She suggested that companies should work with civil society groups and workers in creating the proper benchmark that is fair for all.
“On the other hand, creating a living wage benchmark without credible methodology, transparency and workers’ participation could end up meaningless.”
With Covid-19 cases in Thailand surging again due to the highly infectious Omicron BA.4/5 subvariants, demand for some herbal remedies is rising again.
This latest increase comes after the Centre for Covid-19 Situation Administration (CCSA) removed the facemask mandate for open areas, prompting people to let their guard down.
The jump in Covid-19 cases is also making access to treatment difficult, creating a lack of hospital beds, long queues and issues related to registration for treatment.
Even though the National Health Security Office has confirmed that pharmacies under its jurisdiction are ready to prescribe drugs for Covid-19 patients, it does not mean prescriptions will be given at all pharmacies.
Hence, it is advised that people purchase all necessary remedies in advance.
Adults should consume 60 milligrams of fah talai jone thrice a day for five days as soon as they test positive for Covid-19. The dosage should be reduced to 11mg for children. This traditional herbal medicine has been proved to kill the virus in vitro.
2. Paracetamol
Patients suffering from fever or headache can consume paracetamol every four to six hours.
3. Makham Pom (gooseberry) cough syrup
This syrup can be consumed thrice daily to soothe cough or sore throat.
4. Ginger
This spice can help boost immunity against Covid-19, reduce phlegm, relieve nasal congestion and improve circulation. Patients should consume one to two capsules daily after meals until their symptoms improve.
5. Triphala
This herb helps ease cough and reduces phlegm. Patients can consume up to 600mg of Triphala three or four times daily to ease the cough.
These herbal remedies are only useful for patients with mild symptoms. If they do not ease symptoms, patients are advised to seek medical help.
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.
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