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Universal Health Care Supports Thailand's Coronavirus Strategy


Thailand was the first country outside of China to confirm a case of coronavirus. That was back in January. Since then, while the pandemic has raged in the U.S. and Europe, Thailand has been able to control its epidemic with a caseload among the lowest in the world - just 58 deaths. Thai epidemiologists say the country's universal health care system played a major role. NPR's Malaka Gharib has more.

MALAKA GHARIB, BYLINE: To explain how Thailand's Health System worked to keep the coronavirus under control, let's start with the first Thai citizen to test positive for the virus, a taxi driver. Krit Pongpirul is a professor at Chulalongkorn University Faculty of Medicine. He says the driver's route involved picking up and dropping off Chinese tourists around Bangkok.

KRIT PONGPIRUL: This particular taxi driver - he's 51 years old of age. He had fever. He had coughing.

GHARIB: Pongpirul says the taxi driver went to his primary care doctor at a clinic that is part of the country's universal health care system. For nearly two decades, health care has been free, paid for by the government through taxes.

PONGPIRUL: He got a physical exam and did some testing, including the influenza swab test.

GHARIB: He tested negative, and his doctor sent him home with some meds. Still, his symptoms did not improve. Eventually, he decided to go to the hospital. Health care workers there suspected COVID, and they referred him to an infectious disease institute.

PONGPIRUL: And we performed a COVID-19 specific test.

GHARIB: Now, Thailand takes infectious diseases seriously. It has a communicable disease control unit with more than a thousand teams investigating outbreaks. So when the taxi driver came in for a test, he got not one but two. Both were positive. Once authorities learned of his diagnosis, they tested his family and the health care workers who'd been in contact with him.

Dr. Tanarak Plipat is the deputy chief of Thailand's Department of Disease Control. He says they acted aggressively because they had to. For the size of its population, nearly 70 million, Thailand doesn't have enough medical doctors or hospital beds.

TANARAK PLIPAT: We knew our limitation, and we know that we have to protect those health system as best as we can. We cannot allow an outbreak to happen.

GHARIB: That's where the universal health care came into play. Dr. Pongpirul says the fact that the taxi driver sought medical attention early on, that he wasn't put off by having to pay for something he couldn't have afforded, made a huge difference in helping them control the virus.

PONGPIRUL: That means you get early diagnosis, and that means you get early warning to yourself, to warn yourself not to spread the disease to others.

GHARIB: Boston University sociologist Joseph Harris says much of the country's success with COVID can be chalked up to Thailand's health care system. He wants people to know Thailand's system isn't just good - it's exceptional.

JOSEPH HARRIS: Amartya Sen, a Nobel laureate, has called it a model for the industrialized world, particularly for parts of Asia. You know, it's a model that countries around the world have sought to learn from.

GHARIB: Harris says Thailand has also invested heavily in public health. The country has a network of 1 million community health workers. Tanarak Plipat of Thailand's Department of Disease Control says these volunteers did a lot of the legwork in carrying out its COVID strategy.

PLIPAT: We utilize them well. We use our health workers to be our means for doing quarantine as well as contact tracing.

GHARIB: Dr. Plipat thinks that so far, Thailand has done a, quote, "very good job of controlling the virus." What's next? Plipat says rooting out any last pockets of infection before they become another outbreak.

Malaka Gharib, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

Malaka Gharib is the deputy editor and digital strategist on NPR's global health and development team. She covers topics such as the refugee crisis, gender equality and women's health. Her work as part of NPR's reporting teams has been recognized with two Gracie Awards: in 2019 for How To Raise A Human, a series on global parenting, and in 2015 for #15Girls, a series that profiled teen girls around the world.