A zero-sum approach to Covid-19 could have a lasting impact on foreign tourism in Thailand

Island Watch #3

I've been thinking back on that week in mid March, when everything changed. Over the course of a week, the news of borders being shut down to contain the spread of Covid-19 hit like thunder off the Andaman Sea. It was stressful. On March 14th, only a few days before Thailand began to close itself to the world, I tweeted:

It's about time now for expats to choose whether they'll ride out the pandemic in Thailand or back in their home countries. An agonizing decision for many.

At the time, I was grappling with that very choice. The State Dept. soon instructed American citizens abroad to return immediately or prepare to “shelter in place” indefinitely. After talking with family back in Massachusetts, I opted to stay in Thailand, where I have a long-term visa and work permit.

Back then, many people thought the pandemic would hit Thailand harder than the United States. I had no idea what would happen. But I kept faith in Thailand’s public health system, and hoped for the best.

A lone passenger rides Bangkok’s BTS Skytrain during the lockdown on March 30th.

We hunkered down in a small seventh-floor apartment on Bangkok’s far western fringe. From there, I watched as Thailand went from being a high-risk country to a pandemic success story — a transformation that some saw as miraculous. Others still refuse to believe it’s true.

Now, after more than two months without a single known case of local transmission, it’s time to reflect on how the country suppressed Covid-19. Perhaps more importantly, now is also the time to start thinking about how the next chapter of Thailand’s pandemic story might play out. Tourism is at the center of it.

The outbreak

A case of Covid-19 was discovered in Thailand way back on January 13th, the first in the world outside of China. Around two weeks later, a Bangkok taxi driver caught the virus, presumably from one of the thousands of people who had recently flown in from Wuhan. Throughout February, travelers from elsewhere in China continued to enter Thailand without being tested or quarantined.

The Thai government prioritized the economy at first, only placing public health experts in charge of the pandemic response when the virus began to spread more rapidly. In late March and early April, outbreaks hit Bangkok, Phuket, Chonburi and Narathiwat, among others. Nationwide cases spiked above 100 per day in early April. Many of us braced for the situation to spiral out of control.

Instead, daily cases declined into the single digits by the end of April, when skeptics thought the government was fudging the numbers. On May 25th, an asymptomatic woman on Phuket became the last known locally transmitted case of Covid-19 in Thailand to date. For that, I’m proud of this country.

Having followed the situation closely, I was surprised when a recent New York Times article declared that “no one knows what Thailand is doing right.” I'm no public health expert, but several reasons for the country’s success are obvious.

The response

In late March, Bangkok and other cities turned into ghost towns. Nearly everyone wore masks in public — and you couldn't enter a 7-eleven or ride on the metro without one. (In fact, you still can’t.) Most of us barely left our homes. When we had to go out, free hand sanitizer and temperature checks waited around every corner. I can’t recall a single instance of someone not cooperating with these baseline measures.

A stringently enforced curfew kept us indoors all night, every night. Schools closed. Shopping centers shuttered or left only groceries and take-out food available. Though it caused panic buying, a 20-day nationwide ban on alcohol sales drove home the point that gatherings were unacceptable. Many of those who partied anyway — even in small groups — wound up in police stations.

Land borders between dozens of provinces and some districts were closed to normal travel, which would be akin to the counties and towns within an American state sealing themselves off from one another. Only residents were allowed into many provinces; and only if they quarantined. On Phuket, even residents were shut out.

Most airports halted domestic flights, and a ban on international commercial flights was enacted. Nearly all public buses and most trains and ferries stopped running. Many islands — including Ko Phi Phi, Ko Lipe, Ko Yao Noi, Ko Samet, and Ko Chang were essentially sealed off from the outside world.

In Krabi, Phuket and Ko Lanta, among others, the foreign tourists who chose to stay or were stranded by flight cancellations were corralled into specific “quarantine hotels.” Parks and beaches closed. Those who dared to walk on the sand in Pattaya and Phuket were fined by police and shamed by the public.

Meanwhile, a million-strong army of public health volunteers sniffed out anyone displaying symptoms in their communities. Teams of contact tracers tracked down virtually everybody who had been around anyone known to have the virus. A single case was enough to seal off whole residential complexes.

Though overall testing numbers have been low compared to some countries, anyone with symptoms was encouraged to get tested. At first, some hospitals charged high prices for testing. Within weeks, however, the government decreed that hospitals could not charge anyone who came in for a test while showing symptoms.

Importantly, Thailand’s close-to-universal healthcare system enabled even the most impoverished citizens to seek care if they thought they might be infected.

Thailand’s response was not without its hiccups.

In the early stage, the suddenness of travel ban announcements prompted thousands of migrant workers to rush into Bangkok’s bus terminals trying to return to their native provinces and countries before it was too late. Foreigners crowded into immigration offices until the government finally announced a reprieve on overstays and visa expirations on April 9th. It is still in effect today.

In early May, the government’s Covid-19 task force touted a day of zero infections when, in fact, 18 new cases were discovered among Rohingya refugees being detained in Songkhla province near Malaysia. The oversight smacked of “racism,” wrote Bangkok Post, and led some to worry about the types of outbreaks among migrant communities that had already racked Singapore.

Several theories have been floated to explain why Thailand was not ravaged by the virus. One posits that people from the lower Mekong region might have natural immunity woven into their genes. I'm not a geneticist, but this seems to overlook the fact that millions of Thais trace their ancestry to people who arrived from Guangdong and other parts of Eastern China over the last two centuries.

What’s certain is this: Thailand got a lot of things right. For that, its response is now gathering praise — and not only from expats down at the pub.

The World Health Organization has chosen to spotlight Thailand, along with New Zealand, in a forthcoming documentary about countries that handled the pandemic well. And Thailand was moved up to first place out of 184 countries in the Global Covid-19 Index. When it comes to the economy, though, the situation is dire.

In early April, a tuk tuk driver sits across from a closed mall in Bangkok’s normally bustling shopping district. Many drivers, and others whose livelihoods depended largely on tourism, had already left for their native provinces.

The damage

Millions of Thai citizens and foreign residents have lost their jobs due to the pandemic. The tourism sector, which represents roughly 20% of annual G.D.P., is in free fall. President of the Tourism Council of Thailand, Chairat Trirattanajarasporn, recently quantified the damage in terms of business closures:

“The council estimates that in the next three months, up to 30 percent of tourism-related businesses in Thailand are at risk of shutting down permanently.”

Monthly aid payments of 5,000 baht ($160 USD) for those whose livelihoods were slashed by the pandemic are now finished. Many Thais thought this amount was too low to begin with, and many others did not qualify for the aid because they worked in the country’s vast informal jobs sector.

Countless businesses that have not yet gone bankrupt have been forced to furlough staff or cut wages by half. Meanwhile, some of the Thais who are out of work say that no unemployment benefits have reached them. Suicides have increased.

A recent return of domestic tourism, fueled partly by a government stimulus plan to subsidize travel, has helped. Yet compared to the revenue lost from the absence of foreign tourists, domestic travel is but a few drops in the bucket.

A zero-sum game

Economic meltdown or not, Thai public health leaders and many citizens are committed to preventing any return of Covid-19 beyond the quarantine centers. No one knows when tourists from abroad will be allowed to visit Thailand again.

As it stands, only certain categories of foreigners can enter the country — and only after jumping through many hoops and paying a minimum of 30,000 baht ($960 USD) to spend two weeks stuck in a state-approved quarantine facility. The Thai workers now on the front lines of the Covid-19 battle are flight attendants; airport intake staff; bus drivers who cart arrivals to quarantine; nurses who administer tests; and cleaners and receptionists who look after the returnees during their isolation.

So far, this system has been almost air tight. Almost.

Early last month, two Covid-19 infections were reported outside of approved quarantine facilities. Neither was transmitted within the country, but the panicked response displayed how the Thai public remains on edge.

The first was an Egyptian Air Force official who wandered into a shopping center in Rayong while sidestepping the usual 14-day quarantine thanks to an exemption granted by the Thai government. Using U-Tapao Airport as a stopover on a brief trip to China, he left Thailand before authorities realized he was infected.

The other was a nine-year-old daughter of the Sudanese ambassador to Thailand who, after returning from Sudan, was staying in her family's condo on Sukhumvit Soi 26 in Bangkok rather than a state-approved quarantine facility. As with the Egyptian, her family was exempt from stricter quarantine because of their status.

Among the Thai public, panic and fury boiled over fast.

The governor of Rayong was transferred in a move that many viewed as blame deflection by Prime Minister Prayut Chan-ocha. Provincial governors were instructed to “hunt down” anyone who had been to Rayong. Many schools were closed, including one in far-flung Buriram simply because the mother of one student had recently returned from Rayong. The governor of Nakhon Ratchasima caused panic when he said that three residents who had been to Rayong displayed symptoms (they later tested negative). When Prayut visited the hotel where the Egyptian had stayed, two young men were arrested for demonstrating. Tensions ran high.

Many domestic tourists canceled trips to Ko Samet, an island in Rayong province that had recently reopened after months of being closed to non-residents. Some even canceled their trips to Ko Chang, an island located hundreds of km away from Rayong but also on the Eastern Gulf. At least one province, Chiang Rai, instated a 14-day quarantine requirement for any traveler coming from Rayong.

Resorts on Ko Samet were empty in the weeks after the Covid-19 incident in nearby Rayong town.

Attempting to calm the irate public, the government decreed that diplomats and other foreign VIPs would henceforth be placed in state-approved quarantine hotels along with everyone else. All flights from Egypt were temporarily halted.

The hotel, shopping center and condo in question were sealed, their occupants tested and quarantined. More than 7,000 people were tested in Rayong to go with many more in Bangkok and elsewhere. No infections were found.

Still, these incidents sparked a renewed suspicion of foreigners. Nearly 95% of Thai respondents “said foreigners should definitely not be allowed to enter Thailand,” according to one survey conducted the week after the incidents. Claims of restaurants, stores and even marathon organizers denying foreigners have increased.

All of this panic over two infections may seem irrational, especially to people in countries that are enduring far more Covid-19 cases in a single day than Thailand has found in total since the pandemic began. But given how the virus is now spreading for the first time in nearly 100 days in Vietnam, the persistent concern in Thailand is understandable. It might also hint at what the future holds.

Forever abnormal?

Last month’s Covid-19 incidents in Rayong and Bangkok made it clear that Thailand's zero-sum approach is unlikely to ease until a breakthrough — a vaccine for example — squashes the risk of any new outbreaks.

The bad news is that many scientists think it’s doubtful that the vaccines now being developed will end the pandemic once and for all. In a recent story in The Atlantic which quotes a bunch of experts, Sarah Zhang wrote:

“An initial vaccine might limit Covid-19’s severity without entirely stopping its spread. Think flu shot, rather than polio vaccine.”

Meanwhile, “travel corridor” arrangements between Thailand and other countries that have suppressed the virus have been put on ice, and a leading Thai medical professor suggested delaying them for at least six months. Given the panicked response to the Covid-19 incidents in Rayong and Bangkok, it’s safe to say that many Thais would prefer to keep foreign tourists out until they pose no risk at all.

In a zero-sum game where the reward is zero infections, anything more is hard to accept.

If, for example, vaccines end up being only around 75% effective, will Thailand open to tourists from hard-hit countries even if it means that their presence could reintroduce the virus? A recent statement by the government’s Covid-19 task force spokesman, Dr. Taweesilp Visanuyothin, might hold a clue:

“This global situation is cause for concern. We do not expect to permanently maintain zero local infection but hope we can prolong the period of no local infection as long as possible and effectively cope when it does occur.”

Thailand might have little choice but to reopen after going without foreign tourism for so many months, but this is far from assured. And how exactly the tourists might be allowed to return raises a whole other slew of questions.

Will tourists from countries that have also succeeded in controlling the virus get preferential treatment? Will Thai authorities make good on their statements about ending mass tourism and focusing on luxury travelers? If so, will foreign guests be shuttled straight to certain high-end resorts, leaving budget lodgings to fend for themselves? And what will happen to all of the large-scale hotels and other infrastructure that has been built in recent years specifically for mass tourism? Will we end up with a bunch of miniature versions of the Sathorn Unique?

Will travelers from Europe, the Middle East, the U.S. and other hard-hit regions be required to quarantine after arriving, even if they’ve been vaccinated? Will they be confined to a handful of destinations and barred from traveling freely for their first two weeks in the country? Will the government track their every move? Will certain districts or villages ban them indefinitely? If infections slip through, will public panic provoke a shutdown of the provinces where they emerge? If so, might a nationwide ban on foreign tourism be renewed?

As I prepared to publish this article, Tourism Minister Phiphat Ratchakitprakarn offered a clue when describing a new “safe and sealed” proposal:

“We will select only guests from a (foreign) city with a record of no infections for at least 30 days, and they can travel under the sealed conditions provided by tour operators in designated hotels and provinces that agree to welcome those tourists.”

No matter what Phiphat, Taweesilp, Prayut and other officials have said, this is one story that ends with more questions than it started with. For now, the answers are as clear as those dark clouds howling off the Andaman Sea. 🌴