Bubble and seal approach: from disease prevention and control policy to lessons for the health security of Thailand

Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic in Thailand has occurred since January 2020. The pandemic causes the outbreaks within all business sectors, where both Thai and migrant labors are employed. The important factors contributing to the outbreaks are general safety standards of individual industries that do not comply with the regulations of Ministry of Industry and Ministry of Labor, as well as the lack of fundamental knowledge about personal health prevention practices. As a result, the Ministry of Public Health has proposed the Bubble and seal measure in order to reduce the burden on the public health system by enhancing the collaboration in disease prevention and control among business and government sectors. This Bubble and seal measure is a novel approach that was introduced and implemented during the COVID-19 pandemic. This research aims to study the development process of the Bubble and seal measure and to analyze the experience of the Bubble and seal measure implementation through the perspective of policy stakeholders, as well as to provide the policy recommendation for the Bubble and seal measure development in the future. This research compared the implementation of Bubble and seal measure in two different geographical locations, namely Bangkok and Tak province (located on Thailand-Myanmar border). It adopts two qualitative methods, which are documentary review and in-depth interviews with 31 stakeholders from July-October 2021. The results have indicated that the operation of Bubble and seal measure enabled business sectors to continue with its normal operations. This measure has reduced the risk of outbreaks in the factories, labor camps and mitigated the risk of COVID-19 spreading to the local community. This measure separates the labors into sub-groups so as to avoid a large gathering of workers, limit the movement activities and travelling. The success of implementation of this measure depends on the understanding of all stakeholders, the readiness of business owners especially in financial supports, a good collaboration among policy stakeholders, support from the local community and adaptive capacities to respond to evolving COVID-19 situations from all stakeholders. Findings from this study suggested that the urban area like Bangkok faced more challenges in implementing the measure when compared to the border areas due primarily to a lack of quarantine areas and facilities. In the meantime, the border provinces faced a lack of understanding about the measure, thus leading to conflict with a local community. In addition, the implementation of Bubble and seal measure in border provinces is also impeded by a lack of collaboration among the implementers and a lack of resources. The lessons learned from this study are the needs for the government to 1) strengthen the collaboration among relevant stakeholders, 2) establish the public health emergency plan that covers the financial support, specific locations of quarantine areas, and communications plan, 3) collect data of all Thai and migrant workers regardless of their legal status, 4) provide additional support measures for the business sectors, 5) ensure the accessibility to the health services and the labor welfare for all workers, and 6) enhance health literacy for all in the business sectors to prepare for future pandemics.