PMC:7796072 / 1677-4325 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7796072","sourcedb":"PMC","sourceid":"7796072","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7796072","text":"The coronavirus pandemic (COVID-19) has to date infected over 60 million people worldwide, causing more than 1.43 million deaths [1]. The latest COVID-19 statistics for the Kingdom of Thailand as of November 25, 2020, were 3942 confirmed cases and 60 deaths in a total population of 66.6 million [2,3]. These numbers translate to 56.25 cases and 0.86 deaths per million inhabitants, respectively, both being puzzlingly low among countries with reliable statistical information [4]. The whole of the Mekong River basin and other Southeast (SE) Asian (SEA) neighbors seems to share Thailand’s low infection and death rates. Myanmar, Laos, Cambodia, and China’s Yunnan province all report similarly minimal infection rates (Table 1, Figures 1, 2) [4,5]. Many attribute this low incidence to Thai social and cultural practices promoting an inherent social distancing. When greeting one another, Thais do not shake hands or hug, but use the “wai”, a prayer-like motion. An outdoor lifestyle combined with mask wearing practices due to pre-existing environmental pollution was already in place before the pandemic [5]. Thailand’s efficient, robust, and responsive grassroots-level universal health care system, directed by able scientists, has greatly impacted preventive and treatment measures [6] even with a rising prevalence of pre-existing comorbidities like obesity, diabetes, and hypertension in the whole of the Mekong river region [7,8]. Others might argue that Thailand’s low testing frequency (19 tests per 1000 people) might underestimate the magnitude of the COVID-19 situation [3]. Here, we need to bear in mind that while all returning residents are tested and quarantined, community testing only occurs when tracing contacts or for symptomatic cases seeking treatment (virtually non-existent in the community). Another way of looking at the extent of testing relative to the scale of the outbreak is to ask: how many tests does a country do to find 1 COVID-19 case? The WHO has suggested around 10–30 tests per confirmed case as a general benchmark of adequate testing, and the Thai average as of November 5, 2020 was 649.7 tests per 1 positive case [9]. With her porous land border crossings, Thailand allows for population movements. Furthermore, COVID-19 infection rates have increased in its western neighbors. Yet Thailand has not seen any increase in the number of local COVID19 cases. After several months without local infections, single-digit indigenous re-emergences have died out spontaneously both in Thailand and Vietnam [10]. Elusive locally-shared, genetic determinants may provide an explanation to the above 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