Thailand’s secret to exceptional infection prevention

Despite being the main hospital tasked to treat COVID-19 patients, Bamrasnaradura Infectious Diseases Institute in Thailand has no recorded infection among the staff. How do they do this?

From one of the countries with the highest number of COVID-19 cases in March 2020, Thailand has become one of the countries to efficiently curb the spread of the virus. Bamrasnaradura Infectious Diseases Institute (BIDI) is a key part of this commendable response.

As an institute specifically focused on treating infectious diseases in Thailand, BIDI is the main hospital to care for COVID-19 patients, including quarantining them and caring for them. Yet, despite admitting a large volume of patients, there is no recorded infection among BIDI’s staff.

Hospital Insights Asia speaks with Dr Weerawat Manosuthi, Vice Director and Infectious Diseases Specialist at BIDI, on how they are able to implement an effective infection prevention strategy during the pandemic and how technology has played a key role in the institute’s pandemic response.

Coordinated effort

Critical to outbreak management is communication and shared responsibility among the staff. When COVID-19 happened, there was a “fear of the unknown,” says Dr Manosuthi. Medical and non-medical personnel alike were scared of the infection primarily because of the lack of knowledge about the virus, how it spreads, how it affects the body, and how it can be treated.

Dr Weerawat Manosuthi, Vice Director and Infectious Diseases Specialist at BIDI

BIDI acknowledges this fear, hence, the hospital strives to provide sufficient information to the staff to manage their anxiety. Adequate training programs are also implemented including tabletop exercises, annual drills, and even training on how to properly transport infected or suspected patients from one place to another, Dr Manosuthi shares. Not only does this ensure the low possibility of transmission but it also protects the staff from catching the virus.

Furthermore, commendation goes to the national government, local communities, and the private sector, which have all worked together in fighting the virus. The government has implemented a quarantine system headed by the Prime Minister, activated a Situation Analysis Team, and published Clinical Practice Guidelines to support healthcare professionals. Four million village health volunteers are also spread throughout the country to help the medical personnel look after their respective local communities with regard to quarantine guidelines.

A safe environment

The advantage of BIDI as a central organisation at the forefront of the battles against infectious diseases is the easy procurement of personal protective equipment (PPE) for the staff. When the world saw the spread of the virus in mid-December in 2019, BIDI already had a stockpile of PPE in anticipation of the infection reaching Thailand. This proved beneficial especially at the time when supply chains were disrupted.

Apart from ensuring the staff are protected, it is also necessary to maintain a clean physical environment. A basic part of infection control measures, disinfecting the hospital, especially patient rooms, can sometimes be overlooked. But Dr Manosuthi knows better, as his organisation tapped into the use of technology to maintain cleanliness besides using chemical disinfection methods.

Dr Manosuthi believes that physical disinfection using technology is also helpful. This can be properly and efficiently done by using heat, radiation, or chemical vapour to kill germs in affected areas. The most effective method, he says, is radiation disinfection, specifically PX-UV, that is shown to destroy the outer protein coating of the COVID-19 virus. This technology has gained a lot of traction during the pandemic because of its proven capability to disinfect surfaces.

Xenon light is the latest technology which uses PX-UV. Dr Manosuthi emphasises that Xenon is best because it has a broader wavelength and takes the shortest time to kill germs as compared to other kinds of UVC like LED and mercury. Moreover, this technology is mercury-free, therefore, we don’t have to worry about its safety around people, and it has been tested and approved by several clinical studies.

Having these state-of-the-art technologies, a sufficient PPE supply, and partnerships with various sectors will better prepare us to deal with contagious diseases in the future, according to Dr Manosuthi. Of course, we need to make some improvements, especially on the infrastructure and the number of isolation rooms, but securing these fundamentals is equally important.