Naemiratch Bhensri, Schneiders Mira Leonie, Poomchaichote Tassawan, Ruangkajorn Supanat, Osterrieder Anne, Pan-Ngum Wirichada, Cheah Phaik Yeong
Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Nuffield Department of Medicine, Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, United Kingdom.
PLOS Glob Public Health. 2022 Jul 8;2(7):e0000723. doi: 10.1371/journal.pgph.0000723. eCollection 2022.
Following the first Thai COVID-19 case in January 2020, the Thai government introduced several non-pharmaceutical interventions (NPIs) in March 2020 (e.g., contact tracing, travel restrictions, closure of businesses, curfews, stay at home orders) to control COVID-19 transmissions. This study aimed to understand the views and experiences of a small number of Thai residents related to public health measures implemented during the first COVID-19 wave in Thailand. A total of 28 remote in-depth interviews with Thai residents (18-74 years old) were conducted between 8 May and 21 July 2020. Interviews were audio recorded, transcribed, and analysed using thematic analysis based on the Framework Method. Our results describe participants' views, challenges, and coping strategies relating to COVID-19 restrictions. Most participants expressed support for the introduction of strict public health measures, while some criticized lacking enforcement or rational of certain measures. Participants identified four major challenges, namely financial hardship; social isolation and loneliness; stigma and shaming; and fear of COVID-19 infection. Strategies adopted to address these challenges included practical coping strategies (e.g., reducing risks and fear of COVID-19 infection; mitigating financial, social, and mental health impacts), and embedded socio-cultural ways of coping (e.g., turning to religion; practicing acceptance; kindness, generosity and sharing ('Namjai'); 'making merit' ('Tham-bun')). The challenges identified from this study, in particular the role of stigma and discrimination, may be relevant to other infectious disease outbreaks beyond COVID-19. Findings from this study underscore the need for policies and interventions that mitigate the negative impacts of NPIs on the public, particularly on vulnerable groups, and highlight the importance of considering socio-cultural context to support community resilience in times of crisis. Our findings remain relevant in light of low COVID-19 vaccine availability and the potential need to implement further public health restrictions in Thailand and elsewhere against COVID-19 or future infectious disease threats.
自2020年1月泰国出现首例新冠肺炎病例后,泰国政府于2020年3月出台了多项非药物干预措施(如接触者追踪、旅行限制、企业停业、宵禁、居家令)以控制新冠肺炎传播。本研究旨在了解少数泰国居民对泰国第一波新冠肺炎疫情期间实施的公共卫生措施的看法和经历。2020年5月8日至7月21日期间,共对28名泰国居民(年龄在18至74岁之间)进行了远程深度访谈。访谈进行了录音、转录,并采用基于框架法的主题分析进行分析。我们的研究结果描述了参与者对新冠肺炎限制措施的看法、挑战及应对策略。大多数参与者对出台严格的公共卫生措施表示支持,而一些人则批评某些措施缺乏执行力度或合理性。参与者确定了四大挑战,即经济困难;社会隔离与孤独感;污名化与羞辱感;以及对新冠肺炎感染的恐惧。为应对这些挑战而采取的策略包括实际应对策略(如降低感染新冠肺炎的风险和恐惧;减轻经济、社会和心理健康影响),以及内在的社会文化应对方式(如求助于宗教;践行接纳;善良、慷慨与分享(“善念”);“做功德”(“行善”))。本研究确定的挑战,尤其是污名化和歧视的作用,可能与新冠肺炎之外的其他传染病疫情相关。本研究结果强调,需要出台政策和干预措施,以减轻非药物干预措施对公众,特别是弱势群体的负面影响,并突出考虑社会文化背景以支持危机时期社区复原力的重要性。鉴于新冠肺炎疫苗供应不足,以及泰国和其他地方可能需要针对新冠肺炎或未来传染病威胁实施进一步的公共卫生限制措施,我们的研究结果仍然具有现实意义。