The Lessons from the COVID-19 Management of Maharat Nakhon Ratchasima Hospital for the Preparedness on Emerging and Re-emerging Infectious Disease Management

Abstract

Background: COVID-19 is an emerging infectious disease that spreads all over the world. In Thailand, there were many waves of the pandemic. The purpose of this research study was to obtain the lessons from the COVID-19 management for the preparedness on emerging and re-emerging infectious disease management.

Methodology: This research study is a participatory action research study. The research period was from 31^st December 2019 – 31^st December 2022. The qualitative and quantitative data were studied in order to obtain the lessons from Maharat Nakhon Ratchasima Hospital’s emergency operations conference (EOC) for handling COVID-19 regarding infections.

Results: In the 3^rd, 4^th, 5^th phase, there are more patients and sick personnel. Vaccination was increased in phases 2^nd and 3^rd, with management changing for each phase of the study. In each pandemic phase, the number of the patients was increased. The number was significantly increased in the 2^nd wave. The number of the inpatients who were treated similarly to the outpatients was increased. In the post-pandemic phase, the number of the patients was decreased. However, the number of the outpatients was still high. Regarding the COVID-19 infections, there were the patients with COVID pneumonia. The percentages of the patients with acute respiratory failures in the 3 – 5 waves in the post-pandemic phase were 11.7 - 37.8 because the inpatients had COVID pneumonia or co-morbid conditions. By opening the field hospitals, the highest numbers of the patients were in the 4^th and 5^th waves. MIS-C/MIS-A was found in 10 patients in the 5^th stage. It was the inflammation in many systems in their bodies. It was a serious complication after the COVID-19 infections. It was life-threatening. The highest percentages of the deaths were 6.8 – 15.3 in the 4^th and 5^th waves in the post-pandemic stage. The highest percentage was in the post-pandemic because the symptoms of the patients were worsened. The Delta variant had the infection rate higher than that of the Alpha variant. The COVID-19 vaccination services started in the 3^rd wave. The number of the vaccinated people and vaccinations were increased. It started from the 608 group, medical workers, people and young people who were younger than 18 years. AEFI was related to the number of serviced doses. The number of the sick workers increased in the 3^rd wave. Most of the infections were not from the workplaces. To work in the COVID-19 situations and apply the principles of preventive medicine, there were measures such as public health measures, social measures, organizational measures, personal measures, cooperative communication measures and vaccination measures.

 Conclusion: The lessons were obtained for the emerging and re-emerging infectious disease management. It is suggested to have the followings: epidemic preparedness and rapid responses, public health infrastructures, risk communications, political commitments and partnership building, as well as research and its utilizations.