Questions/Answers

The emergence and rapid spread of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is instantly leading to public health crises worldwide. The origin of SARS-CoV-2 infection was first reported in Wuhan City, China in December 2019. On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown etiology detected in Wuhan City. As of 3 January 2020, the patients with pneumonia of unknown etiology have been reported to WHO by the national authorities in China. Ministry of Public Health, Thailand officially assigned the health control officers at points of entry to apply the authority for investigation of the passengers’ conditions before allowing the cruise to dock since 3 January 2020. The National Institute of Health (NIH), a part of the Department of Medical Sciences enhances capacity for early detection of newly emerging virus of unknown origins using high-tech laboratory. As with the control of outbreaks and pandemics, controlling the COVID-19 pandemic rests on the detection and containment of clusters of infection and the interruption of community transmission to mitigate the impact on human health and strengthen the stability of the country in terms of public health and economy.

The COVID-19 outbreak is a strong driver of creativity and innovation. This achievement focuses on innovation in development of diagnostic tool and statewide laboratory networks in the context of the COVID-19 pandemic, aiming to mitigate and control the spread of the COVID-19 by using molecular technology in the detection of COVID-19 pathogens. The control of the virus in the early stage has a critical role in preventing and managing the further outbreak. Beyond testing, such as emergency response, communications and laboratory-based surveillance can only be accomplished by a network that includes public health and other agency laboratories and clinical laboratories.

"Promoting the well-being of the people". During the COVID-19 pandemic, it is well-recognized that laboratories play an important role in preventing, detecting and responding to the outbreak of novel pathogens. Department of Medical Sciences has the guidance for businesses and employers responding to COVID-19, for example manpower, personal protective equipment, diagnostic tool and etc. COVID-19 testing laboratories shall be organized to provide safe, quality and effective and efficient services. The role of the laboratory in support of public health response has expanded beyond testing to include a number of other core functions, such as emergency response, communications, laboratory-based surveillance, and laboratory data management. The laboratory networks were established to provide accurate and timely laboratory confirmation of infections, an essential component of disease surveillance systems. The laboratory networks provide high-quality surveillance data to help guide disease eradication, elimination and control programmes.

1. DMSc collaborated with Siam Biosciences, a Thai-born company, to successfully develop COVID-19 diagnostic test kits using technology developed by DMSc together with Siam Biosciences. This test has high sensitivity, specificity and accurate. Thai people have greater access to lower-cost testing. 2. Recognizing that the demand for laboratory services would increase drastically, the Ministry of Public Health began preparing surge capacity for COVID-19 diagnostic capabilities. In late February, DMSc announced the policy to establish one lab in every province to report results within 24 hours. Eventually the laboratory network for COVID-19, including government and private sectors, had been established.

In late February, DMSc announced the policy to establish one lab in every province to report results within 24 hours. The laboratory networks were established to provide accurate and timely laboratory confirmation of infections, an essential component of disease surveillance systems. The laboratory networks provide high-quality surveillance data to help guide disease eradication, elimination and control programmes. Eventually the laboratory network for COVID-19, including government and private sectors, had been established. As of 11 Nov 2021, 450 COVID-19 laboratories were established: 165 laboratories (59 government and 106 private labs) in Bangkok and 285 laboratories (206 government and 79 private labs) across the country. In total, 15,573,509. In responding to the COVID-19 pandemic, Thailand’s laboratory system successfully demonstrated adequate diagnostic security and the ability to manage diagnostic capacity. It is clearly evident that pandemic preparedness, leadership, networking and multi-sectoral collaboration are key to success in managing COVID-19 situation in Thailand. Controlling the COVID-19 pandemic rests on the detection and containment of clusters of infection and the interruption of community transmission to mitigate the impact on human health and strengthen the stability of the country in terms of public health and economy.

The economic shocks of COVID-19 have significantly increased the risks of violent, exploitation, and abuse as individuals. The establishment of COVID-19 laboratories support the controlling of the COVID-19 pandemic through the detection and containment of clusters of infection and the interruption of community transmission. This lead to mitigate the impact on human health and strengthen the stability of the country in terms of public health and economy.

In responding to the COVID-19 pandemic, Thailand’s laboratory system successfully demonstrated adequate diagnostic security and the ability to manage diagnostic capacity. Even though the global situation was unfavourable and stressful, the system was able to endure a lack of reagents and supplies resulting from high global demand and lockdowns in many countries. It is clearly evident that pandemic preparedness, leadership, networking and multi-sectoral collaboration are key to success in managing COVID-19 situation in Thailand. Controlling the COVID-19 pandemic rests on the detection and containment of clusters of infection and the interruption of community transmission to mitigate the impact on human health and strengthen the stability of the country in terms of public health and economy. Target group, including Department of Disease control, private and goverment laboratories

1. The whole genome sequence was shared via the Global Initiative on Sharing All Influenza Data (GISAID). Within six days, the conventional RT-PCR assay was developed and was changed to Real-time RT-PCR five days later. As a consequence, in-house diagnostic testing for COVID-19 was available in Thailand while the commercial kit was not yet accessible. 2. In late February 2020, DMSc announced the policy to establish one lab in every province to report results within 24 hours. The laboratory networks were established to provide accurate and timely laboratory confirmation of infections, an essential component of disease surveillance systems. 3. By February 2020, commercial kits were gradually released into the market. Due to the limitation of knowledge on the virus as well as limited numbers of patient specimens, there were concerns on the quality of the diagnostic kits, most of which were classified as Research Use Only (RUO) while the fully validated kits were In Vitro Diagnostics (IVD). DMSc and FDA worked together in ensuring the standard and quality of diagnostic kits used in the service system during the emergency throughout the validation and authorisation process. If the validation results were sufficient, the test kits would be permitted for import.

Laboratory licensing is essential in dealing with pandemic threats and public health emergencies at all steps from preparedness, detect and respond. Legislative framework is required for the management of work processes, diagnostic capacity, quality, timeliness and sharing of laboratory information. During this crisis, the authority of the CCSA, led by the Prime Minister, has been used to establish a governance mechanism. However, if the emergency status is abolished, an authority will still be required to maintain system integrity. To overcome this problem, DMSc appointed a laboratory expert committee to provide consultations for future decisions.

1. Knowledge innovation : As Thailand was the second country. The whole genome sequence of the virus was revealed by Next-generation sequencing and shared via the Global Initiative on Sharing All Influenza Data (GISAID). 2. Product innovation : Diagnostic testing for SARS-CoV-2 is a critical component to the overall prevention and control strategy for COVID-19. To manage the risk of shortage of diagnostic kit, the DMSc collaborated with Siam Biosciences, a Thai-born company, to successfully develop COVID-19 diagnostic test kits. An in-house diagnostic testing for COVID-19 was available in Thailand while the commercial kit was not yet accessible. 3. Service innovation : DMSc announced the policy to establish one lab in every province to report results within 24 hours. The laboratory networks were established to provide accurate and timely laboratory confirmation of infections, an essential component of disease surveillance systems.

Thai National Influenza Center (NIC) under the DMSc was formally recognized by World Health Organization (WHO) as a national influenza laboratory in 1972 and WHO Regional Influenza Reference Laboratory for the South-East Asia Region : WHO RIRL on June 22nd, 2010. The main responsibility of the Thai NIC is to surveillance emerging influenza viruses and to regularly share newly isolated strains with WHO. High-throughput genome sequencing and bioinformatics are enhancing the ability to investigate and control outbreaks, detect emerging infectious diseases, develop vaccines, and combat antimicrobial resistance, all with increased accuracy, timeliness, and efficiency. The Advanced technology has allowed the NIC to provide leadership and coordination in integrating new technologies into routine practice.

High-throughput genome sequencing and bioinformatics are enhancing the ability to investigate and control outbreaks, detect emerging infectious diseases, develop vaccines, and combat antimicrobial resistance, all with increased accuracy, timeliness, and efficiency. DMSc revealed the virus genome using the Next-generation sequencing. The whole genome sequence was shared via the GISAID. Within six days, the conventional RT-PCR assay was developed and was changed to Real-time RT-PCR five days later. As a consequence, in-house diagnostic testing for COVID-19 was available in Thailand while the commercial kit was not yet accessible.

1. DMSc COVID-19 Real-time RT-PCR Kit : 1.1 Knowledge sharing on laboratory testing among ASEAN countries 1.2 Support for laboratory testing to ASEAN countries 2. Laboratory networks : 2.1 Knowledge sharing on Proficiency testing among ASEAN countries

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Diagnostic testing for SARS-CoV-2 is a critical component to the overall prevention and control strategy for COVID- 19. A national testing strategy in place with clear objectives that can be adapted according to changes in the epidemiological situation, available resources and tools, and country specific context are important. It is critical that all SARS-CoV-2 testing is appropriate and support to carry out contact tracing to break chains of transmission. To achieve the goal, it’s required 1. financial 2. human resource (expertise) 3. equipment

1. It is clearly evident that leadership, networking and multi-sectoral collaboration are key to success in managing COVID-19 situation in Thailand. On the aspect of the laboratory system, networking and synergizing expertise of laboratories resulted in rapid detection of SARS-CoV-2 (the causative agent of COVID-19). Participation of both of the government and private sector resulted in rapid expansion of the COVID-19 laboratory network under the policy “One Lab One Province, 24-hour Results”. 2. Diagnostic testing for SARS-CoV-2 is a critical component to the overall prevention and control strategy for COVID- 19. To manage this risk, the DMSc collaborated with Siam Biosciences, a Thai-born company, to successfully develop COVID-19 diagnostic test kits using technology developed by DMSc together with Siam Biosciences. Aiming towards self-sustainability, this platform intended to expand further to other molecular diagnostics in the future.

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1. Public Sector Excellence Awards 2021 ประเภทยกระดับบริการที่ตอบสนองต่อสถานการณ์โควิด 19 2. Silver Award (Thailand Research Expo 2020)

1. Public Sector Excellence Awards 2021 ประเภทยกระดับบริการที่ตอบสนองต่อสถานการณ์โควิด 19 ---Document review and site visit 2. Silver Award (Thailand Research Expo 2020) ---Document review and Booth visit

1. Thailand’s laboratory system successfully demonstrated adequate diagnostic security and the ability to manage diagnostic capacity. 2. The laboratory network for COVID-19, including government and private sectors, had been established. As of 11 Nov 2021, 450 COVID-19 laboratories were established: 165 laboratories (59 government and 106 private labs) in Bangkok and 285 laboratories (206 government and 79 private labs) across the country. 3. It is clearly evident that pandemic preparedness, leadership, networking and multi-sectoral collaboration are key to success in managing COVID-19 situation in Thailand. Controlling the COVID-19 pandemic rests on the detection and containment of clusters of infection and the interruption of community transmission to mitigate the impact on human health and strengthen the stability of the country in terms of public health and economy.

Participation of both of the government and private sector resulted in rapid expansion of the COVID-19 laboratory network under the policy “One Lab One Province, 24-hour Results”. DMSc : 1. Set guidelines for laboratory networking. 2. Support experts in the assessment area at the actual laboratory 3. Support academic professionals To continuously monitor and maintain the service quality of the laboratory network. 4. Establish a working group to consider the preparation of a network assessment checklist. 5. Provide samples for laboratory proficiency testing. 6. Support the Corona Virus 2019 Test Reagent Kit University : 7. Join the working group to consider making a checklist to assess the network. 8. Support academic professionals To continuously monitor and maintain the service quality of the laboratory network.

Engage and promote multisectoral involvement from the public and private sectors. Clear collaboration includes the joint preparation of the criteria for Real-time PCR Interpretation, which is a key guideline for laboratories across the country. Exchange of knowledge with the laboratory network to continuously monitor and maintain the quality of the laboratory network. To strengthen and sustain the country's laboratory testing system by implementing a laboratory proficiency test program. Building cooperation, integration, coordination and equality among all these sectors. It will be a tool to ensure operations are in line with the 2030 Agenda for Sustainable Development.

1. The pandemic preparedness, leadership, networking and multi-sectoral collaboration are key to success in managing COVID-19 situation in Thailand. 2. Integrated public and private laboratories allow people across the country to have access to efficient services 3. Strengthen the capacity of manpower through training, mentorship, etc. is the necessary protocol to maintain the good laboratory network. 4. Strengthening of information systems is important tool to create the sustainability of the country's health information system.