Background Thailand was firstly imported SARS-CoV-2 from Travelers from China in January 2020. As COVID-19 has transmitted globally as pandemic to cause more than 500 million cases and 6 million deaths in last 2 years. Emergency disaster measure has been enforced which has impacted to social-economic crisis in most of the countries. Thus, every country redirect effort to modify its disease prevention and control measures to compensate for social and economic downturn. Purposes In the first year of pandemic, surveillance of COVID-19 in Thailand has been constrained by focusing to mobility populations at the screening immigration ports for imported travelers and tested by RT-PCR technic. The surveillance information has been daily reported for public. Thus, the disease control managers at local level would never have sufficient intelligence for planning and adjust intervention measures to facilitate their own community socio-economic resilience. The study aims to modify tests from medical laboratory as biomarkers for monitor rapid genomic variation of SARS-CoV-2; Immunological status of population from both natural infection and variation type of vaccination; as well as effectiveness of each social and public health measures applied to each community. Such intelligence should be strong basis for planning at national as well as local level. Methodology Community from Thungyangdaeng District and Yarang District, Pattani Province has been selected to represent an area-based population which were infected and studied since 2020 as longitudinal cohort study of RT-PCR test and Immunity study for 2 years. The study included the preparatory phase of the 2 community hospitals and teams for collecting information and specimens; conveyance of specimens to central laboratory in Bangkok; modification technic of laboratory procedures to fit with the test requirement; and feedback the analysis to depict the existing epidemic situation of COVID-19 in local area. The immunity status of population will be tested by ELISA. The incidence and prevalence of COVID-19 in community has been estimated from the RT-PCR test and immunological study. Specific T cell Immunity and Cytokines reaction in the populations’ specimens has been study in the Central Lab. Throat gargle from the population has been tested through Mass Spectrometry to identify protein of SARS-CoV-2 in the central lab as well. Literature review have been conducted to study the evolution of COVID-19 Surveillance and Monitoring system employed in international recommendation and emerging technology for evaluate the situation of local disease control management. These novel technology and systems might be applied to be recommendation to improve the country’s and local level’s COVID-19 surveillance and monitoring systems in Thailand. Result ELISA based Immunological test, Antigen Test Kit (ATK), RT-PCR can be main tools for monitor of Incidence of infection, and sustainable immunology in individual community and at the country level. Specific T cell Immunity and Cytokine Th1 test requires further modification in transportation to Laboratory and adjustment of Lab technic. These 2 tests would be benefit to justification of the duration of immunity and prediction of severity of infection as well as durable prevention of individual and community Immunity. However, Mass Spectrometry has not been well supported for application in Thailand. Systematic surveillance of SARS-CoV-2 and its variants in wastewater may be trialed for sequencing analysis as environment surveillance. Conclusion Modification of 4 tests have been recommended to be feasible to be applied to COVID-19 Surveillance and Monitoring in Thailand. Environmental surveillance (SARS-CoV-2 variants in Wastewater) may be experimented in high-risk area. Definition of systematic COVID-19 surveillance and its strategy and wholistic scope of monitoring in all related sectors in area-based and National level should be established