On 23 Mar 2020, the Situation Awareness Team of the Emergency Operations Center, Department of Disease Control, was notified that a 44-year-old Thai male, who was infected with coronavirus disease 2019 (COVID-19), had died in a private hospital in Bangkok, and there was a suspicion that some healthcare workers were infected with SARS-CoV-2 following his death. A descriptive cross-sectional study was conducted. We reviewed medical records of the index case, interviewed relatives of the index case, and performed contact tracing using a standard questionnaire. We could identify 206 high-risk contacts. Twenty out of 206 high-risk contacts were then found to be infected with SARS-CoV-2. Fifteen of them were healthcare workers, two of them were current inpatients, and the other three were household contacts. The likely cause of disease spreading was the missed diagnosis of COVID-19 as the index case did not present with upper respiratory tract symptoms at the first visit to the hospital. Meal sharing among healthcare workers and sharing of a portable chest X-ray machine without proper protective equipment potentially served as other causes of COVID-19 spreading.
On 29 Jan 2020, the Operation team was notified by the Emergency Operation Center that there was a Chinese man infected with SARS-CoV-2 admitted in a private hospital in Bangkok. Division of Epidemiology, Office of Disease Prevention and Control 1, 11, and Institute for Urban Disease Control and Prevention jointly deployed to conduct an investigation. Descriptive study was conducted by interviewing the index case about his symptoms, travel history, and reviewing medical records. Contact tracing was done. Close contacts of the index case were classified to high-risk and low-risk contacts. Laboratory testing for SARS-CoV-2 was done among high-risk contacts and symptomatic low-risk contacts. The index case was a 30-year-old Chinese. He had worked in Guangxi province, China. He spent 2 days in Wuhan city and 2 days in Guangzhou city before traveling to Thailand. He developed fever, cough, and sore throat after being in Thailand for 3 days. According to the median incubation period of COVID-19, he could be infected from China. Since he started traveling from China, he wore a surgical mask all the time. From contact tracing, the high-risk contacts that could be followed, none of them had laboratory test positive. Therefore, this strategy of wearing a face mask should be encouraged nationwide especially in case that physical distancing could not be done.
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