The centres have been set up in each of Phuket’s districts: Kathu, Thalang and Muang. The best known example is the conversion of the old prison in Phuket Town to accommodate some 500 people as COVID inmates.
Previously, asymptomatic were asked to observe home quarantine, but now they are going into confinement – despite officials not publicly recognising how many infections have been traced to asymptomtic carriers. Doing so would be a good idea just so the people understand what is going on.
Any doubt as to whether asymptomatic carriers can transmit the SARS-CoV-2 virus has been laid to rest. Not by the World Health Organization (WHO), which refuses to do so as it has taken the position that it is too difficult to report accurately due to the spread by symptom-free carriers varying too greatly among different communities and populations. Instead, the US Centers for Disease Control (US CDC), which has more than enough data points to rely on, in March reported that an estimated 24% of infections happen through asymptomatic patients.
The report noted that 30% of people infected with COVID-19 stay symptom-free, down from the CDC’s previous estimate of 40%. Symptom-free people are less infectious than people with symptoms, but people without symptoms are 75% as infectious as those with symptoms, the CDC report estimated.
In short, there is very much good cause for concern of asymptomatic transmission in Phuket, but the list of problems with the move to detain people only on the basis of an “antigen test kit” result is very long.
First, even to aid their own efforts to contain the spread of infections, local officials are not reporting how many of the latest confirmed infected are Delta variant and not reporting how many of those testing positive have been vaccinated in what are now being called “breakthrough transmissions”. Strike one.
Worse is the reliance to detain people on the basis of testing positive only by an antigen test kit, which officials are calling ATKs in short. In the past month they have stopped referring to such tests as “rapid antigen tests”, as if no longer using the word “rapid” makes the tests more reliable. That does not embolden trust. Strike two.
Phuket officials have confirmed that any of the “care center” detainees are to be tested by RT-PCR method to confirm whether the person is actually infected, but are not reporting how many of the ATK detainees have tested positive, hence they are not revealing to the public how effective the ATKs are in identifying people who are actually infected. Strike three.
In the same vein, the official Phuket COVID situation daily report now includes how many are detained each day on the basis of testing positive by ATK, but does not mark how many people are released after testing negative by RT-PCR method. Strike four.
The daily report marks each day how many people in total remain detained after an ATK test, including the number of new ATK confirmations for that day. This gives the impression that the difference between the total number reported each day might be the number of ATK detainees that have been allowed to go home each day, but in reality the oblique numbers presented fail to confirm how many of those being detained later tested positive by RT-PCR and were transferred to a medical facility, even if asymptomatic, or left at the care centre because they are asymptomatic, or have gone home. We just have no idea. Strike five.
What can be understood by comparing even just the first two reports to include ATK figures is that not one person held for testing positive by ATK was a false positive, and not one detainee started to develop signs of infection. If the ATKs are in any way accurate, they should have identified at least one genuinely infected person. After all, that is what they are being used for. Unless of course not one person being held in confinement with hundreds of other people believed to be infected had an RT-PCR test result back. That beggars belief. Strike six.
Of note, the first daily report by the Phuket Provincial Public Health Office (PPHO) to include any ATK detainee figures featured a zero for how many of the COVID incarcerated had been released to return home. The next day the report did not even include the section. Do Phuket health officials not want to report how many people they are detaining without cause? Strike seven.
The answer to that might be hidden behind one comment this week by PPHO Chief Dr Kusak Kukkiattikoon that “most” of the detainees at the “care centers” are likely to be Myanmar migrant workers.
Phuket’s migrant worker camps have repeatedly been cited by local officials as prime sites for COVID transmissions due to the living conditions at such camps, with no attempt to enforce better living conditions, as if living in poverty were the migrant workers’ fault.
We have seen this type of thinking before. Think America in the 1960s. Residential segregation has long been recognised as a primary cause of not just racism and limited employment opportunities, but also great disparities in health between the segregated community and the greater population as a whole.
As simply as it could be put, D.R. Williams and C. Collins titled their paper published by the US National Institutes of Health in 2001, ‘Racial residential segregation: a fundamental cause of racial disparities in health’.
“Segregation also creates conditions inimical to health in the social and physical environment. The authors conclude that effective efforts to eliminate racial disparities in health must seriously confront segregation and its pervasive consequences,” they wrote.
That was 20 years ago, already decades late for the average American to realise. Failure to recognise this in Thailand in 2021 only lends to the understanding of institutionalised racism in the Kingdom. Migrant workers should be afforded the same level of care and treatment in a pandemic as anyone else, not penned in a prison where any non-infected person is forced to share confined living space with those waiting to be confirmed as infected by a test that now looks like will be days coming.
The US , currently happy to promote its vaccine donations to Thailand, only a handful of years ago was happy to threaten economic sanctions over Thailand’s human trafficking record. Perhaps they might want to start looking at who they are getting into bed with when it comes to civil rights abuses enforced through a perpetually extended emergency decree.