Lao PDR: Containing COVID-19 Outbreaks but Alert for Virus Spikes

Article

During the COVID-19 outbreak in 2020, Lao PDR was among the Southeast Asian countries which managed to contain the pandemic quite successfully. More than one year later, the virus remains a challenge: in communicating with people via social media, integrating workers returning from neighboring countries, and vaccinating the population. A continuing commitment to care from the government to the whole population will help the country manage the ongoing COVID-19 situation.

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Patuxay, the Victory Monument in Vientiane at night time during COVID-19 lockdown.

Due to strict measures in Lao PDR in 2020 including early lockdown, with only a few cases reported, lots of public health campaigns and tracing case by case, COVID-19 in the country was relatively contained. The first outbreak in Lao PDR brought 19 confirmed cases, no deaths and afterwards, mainly imported cases throughout the year. The small country of 7.3 million people completed their lockdown in less than a month in 2020 – people enjoyed traveling in the country to help boost the economy and continued to live as per normal.

However, the COVID-19 second wave began to surge in April 2021, with the emergence of community transmission throughout the country. The Lao National Taskforce Committee for Covid-19 Prevention and Control announced two females confirmed as the country’s 59th and 60th cases with COVID-19. Case #59 involved illegal entrants from Thailand and they travelled to places including nightclubs, karaoke venues and restaurants in the capital Vientiane. The outbreak happened when Lao communities celebrated the Lao new year in mid-April as well. The number of cases in the country rose from less than 60 to 2,000 in two months and as of July 2021 at the time of writing, there are under 5,000 confirmed cases, although the official number of deaths has remained around 5 nationwide. The country’s lockdown took place from 21 April until 19 July 2021.

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Two Tuk-Tuk drivers are waiting for passengers at Setthathirath street corner which used to be a busy street prior to COVID-19 outbreak, but now is empty of pedestrians.

Due to early implementation of the lockdown, an increase in testing of symptomatic persons and detection of COVID-19, and coordinated tracing and investigating sources of infection with district and village authorities, Lao PDR managed to contain wider community transmission in less than three months. The National Taskforce held a daily press conference to report new cases, the timeline of cases, and the current situation while encouraging people to follow the measures and receive a COVID-19 vaccination through Lao National Television and the Center of Communication and Education for Health Facebook page. The Ministry of Health also developed a number of health education materials to inform the public to avoid crowded areas and parties, wash hands, wear masks and maintain physical distancing. International, local and traditional points of entry into the country remain closed except for some logistics purposes. In fact, the lockdown has eased since the end of June because the number of cases in communities has reduced to a few people. The focus is more on border control as there are more return migrants and this means more imported cases. The small population, young population and population density of 32 people per square kilometer can also help contain the virus.

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COVID-19 Information board at bus stops around Vientiane, requiring people to wear facemasks when going out in public.

Even though Lao PDR has managed to control the wider community outbreak in the middle of July, an outbreak can hit communities anytime. The situation is always critical as its neighbors have a high number of cases daily and the number of imported cases are quite high. Recently, Lao PDR recorded both Alpha and Delta variants from imported cases. The strict hygiene and safety measures and consistent surveillance in the communities and at all entry points need to continue. More importantly, individual accountability to follow the government guidelines and reduce the potential risk of virus transmission is even more crucial to help contain this outbreak.

Once the lockdown began, informal workers including construction workers, street vendors, restaurant staff and massage workers all struggled with earning sufficient income. For many people, losing income for one or two days could impact them a lot and it could mean no food and no money. If there is no food on the plate, people would not just stay at home. Therefore, the impact of the pandemic is not the responsibility of the health sector alone, but multiple sectors need to engage and support the health sector to contain the virus and tackle the impacts of COVID-19.

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COVID-19 information board at Ongtue Temple bus stop, telling people that they are required to check temperature when going to public spaces, observe social distancing, wear facemasks, and wash hands / use hand sanitizers.

The media landscape in Lao PDR during COVID-19

During the COVID-19 pandemic, false information and fake news have become an important issue creating confusion and insecurity among communities. Apart from working hard on virus containment and treatment, the government also needs to monitor social media and manage rumors and fake news through the daily press conference. Sometimes, a higher number of confirmed cases, a specific COVID-19 death case or a particular food to prevent the virus is reported and circulated on social media. Normally, media expression is limited in the country because most media are state-run but, during this time, new so-called ‘media pages’ have been created in the Lao Facebook community.

An interesting example is the story of Case #59 that involved illegal entrants, which was flooded or shared on social media channels, especially Facebook, WhatsApp, Facebook Messenger and TikTok. These media pages and sometimes individual pages revealed Case #59’s personal information and criticized her badly. Many comments expressed hatred, anger and sexually harassed the woman. The COVID-19 lockdown and movement restrictions have pushed more people online and they have turned to media for information. The media plays a huge role in the time of a pandemic.

“In this time, there are more and more online platforms and social media pages in the Lao media landscape and many times, these pages provide rumors, misinformation or even fake news to get more likes and more shares. Many media consumers cannot differentiate between real or fake information. The spread of information through instant messages has created a panic,” said Ms. Souphatsa Singthong, a lecturer in the Department of Mass Communication at the National University of Laos. 

The panic and anxiety could be the main factor for the hatred and angry comments, especially in the new wave of the outbreak. While the unofficial media pages and individual pages displayed their freedom of expression this way, the official media outlets focused on reporting the number of cases, timelines of cases, and distributing information and daily announcements from the National Taskforce and the health communication center. 

“Communicating about COVID-19 is significant to support people to take appropriate actions and consequently prevent the pandemic, but the media should avoid creating panic which can later lead to unkindness to other infected people and prevent people to check for COVID-19. On the other hand, if mass media cannot provide comprehensive information, people may not understand the virus and avoid quarantine,” added Ms. Singthong.

As Lao media workers are government officials, they limit themselves to report other stories related to COVID-19 and rely mainly on the government’s information. Therefore, it is rare to see stories and analysis of the impact of COVID-19 on informal workers who lose their jobs and income due to containing measures, returning migrants and SMEs (small to medium enterprises) on Lao mainstream media.

Friendship bridge
First Lao-Thai Friendship Bridge over the Mekong connecting Vientiane Prefecture in Lao PDR to Nong Khai Province in Thailand. It was funded by Australian Development Aid for Lao PDR and was opened in 1994.

Reintegrating returning migrants from Thailand

Even though community transmission is being managed in July 2021, the increase of imported cases of COVID-19 among returning migrants from neighboring Thailand has become a concern, especially in Champasack and Savannakhet, southern provinces of Lao PDR. The two provinces have seen a spike of imported cases of COVID-19 in the beginning of July. Champasack recently received around 100 returning migrants daily and needs to expand their field hospital. Soldiers and public security patrol the Lao-Thai border on the Mekong River to prevent people entering Lao PDR illegally.

Ms Kam Phoumy, a 33-year-old Lao woman from Pak Ngum district, Vientiane, who worked as an assistant in a salon shop in Bangkok, Thailand, for 10 years recently came back home. Kam returned to Lao after the shop she worked in, like other businesses in Thailand, shut down. Kam had no choice but to return home to be with her 10-year-old son and her family in her village. She knows that she lost good income to support her family but she feels safe to be back with her family at this time of the pandemic.

“I started to open a small salon in my village. I got very little income from this but I don’t have to pay for rent and I work in the rice field to help the family. I am happy to be with my son and my parents again. We have our own rice field for harvesting,” said Kam.

Kham’s husband from the same village still works in a plastic factory in Thailand as the factory is still open and pay him regularly. “I earned THB 15,000 monthly, which is a good income for us. I want to go back once the situation is back to normal but if there is no chance to go back to work in Thailand, I will continue the salon shop in the village and may open a small shop selling consumer goods,” Kam said.

According to the International Organization for Migration (IOM) in Lao PDR, more than 284,000 Lao workers in Thailand returned home and this could be a big challenge for the government. The Lao government has enacted a number of measures to prevent the pandemic but the social protection system covering low-income households and returning migrants is still limited while food prices are rising. Obviously, this pandemic has led to an increase in unemployment, income loss, and loss in remittances. According to the latest edition of the Lao Economic Monitor of the World Bank, about 9% of households in the country receive remittances from abroad and remittances constitute an average 60% of their household income. Kam is lucky that her husband is still working in Thailand and her family can maintain food security from the rice field, but many households of returning migrants are struggling with how they can replace those remittance losses.

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A man waiting to get his second dose of AstraZeneca vaccine at Sisattanak District Hospital.

Vaccination rollouts in the country

Lao PDR has received COVID-19 vaccines through donations from different governments across the world. In fact, Lao PDR received the first shipment of China-supported vaccines at the end of 2020, prioritized for frontline workers, and in 2021 the country has so far received about 1.4 million doses of Sinopharm through a COVID-19 response grant from China. The country has also received vaccines via the COVAX Facility, which is a partnership co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, the World Health Organization (WHO) and UNICEF. The country got Oxford-AstraZeneca and Pfizer-BioNTech vaccines through COVAX Facility, which ensures that the vaccines are prequalified by the World Health Organization.

 “The vaccine donation, whether from COVAX or China, is really important for Lao PDR right now as the vaccine can help prevent severe COVID-19 illness and death. Like other countries, Lao PDR will not be safe from the pandemic so the vaccine is a way to protect people,” said Dr. Latdavanh Kalin, a medical doctor in Sepon district, Savannakhet province.

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Ms. Moukdavanh Loongarloun, a baby caretaker (22) happily showing her vaccination card.

The mass vaccination rollouts in Lao PDR started in early April. All provinces have been allocated doses. According to the Ministry of Health, in the middle of July 2021, more than one million people in Lao PDR had received a first dose of a COVID-19 vaccine, accounting for 14% of the population and around 8% of the population had two doses. Recently, the U.S. government donated over 1 million doses of Janssen (Johnson & Johnson) and as this vaccine requires only a single dose to be effective, this shipment of the vaccine will help another 14% of the population against the virus. Dr. Phonepaseuth Ounnaphom, the Director of the Hygiene and Health Promotion Department, stated in a recent daily press conference that current doses of COVID-19 vaccines in Lao PDR could cover nearly 30% of the total population. The Lao government will receive more vaccine supports and expect that more than 50% of the population will be vaccinated by the end of this year.

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Registering for vaccination for both Lao citizen and foreigner alike at Sisattanak District Hospital.

All of the COVID-19 vaccines including Sinopharm, Oxford-AstraZeneca, Pfizer-BioNTech and Janssen (Johnson & Johnson) administered in Laos have been approved for emergency use by WHO.

“I feel grateful that our country can contain the outbreak quite well so far and now provide some population immunity. Even though we are building our protection against this virus, it is important to continue to wear masks, maintain physical distance, and wash our hands to keep infection levels low,” said Dr. Kalin.

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A facemasked Tuk-Tuk driver is waiting for customers at an empty street in front of Ongtue Temple, Vientiane.

Expanding on care, commitment and support throughout COVID-19

As a developing country, Lao PDR has had a problem with the quality and coverage of health services for many years. But the fact that the community outbreak has been managed so far in the country is more than about good quality health services. It requires full attention and commitment of the government and all sectors involved including media. By working closely with international organizations, the government can also provide free treatment and vaccination for people.

Paying attention to containing measures, close surveillance and vaccine distribution to establish widespread immunity will help Lao PDR manage COVID-19. It also is about understanding this disease and delivering good care to all COVID-19 patients. More importantly, it is about the care, kindness and support each of us can give to each other during this difficult time, especially health care workers, people with low income, migrant workers, and people who lost their jobs. This pandemic tests our resilience, empathy and capacity to respond to public health emergencies.

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Vannaphone Sitthirat is a media and communication consultant based in Vientiane, Lao PDR. She worked as communication consultant for various organizations such as IFC/World Bank, Laos Australia Institute, and FAO in the country. She is also a freelance journalist and was working with the Lao National TV on English News Program. In addition, Vannaphone is a film producer and Co-founder of the Lao New Wave Cinema Productions.

Photos used in this article (except First Lao-Thai Friendship Bridge) are taken by Ms. Phetpakay Bounhaxay, Vientiane-based freelance photographer. All photos are licensed under Creative Commons CC-BY-NC-ND 4.0 / Heinrich-Böll-Stiftung Southeast Asia unless stated otherwise.

The views expressed in this article are not necessarily those of Heinrich Böll Stiftung.