Grappling with a Covid-19 outbreak and related restrictions, Thailand awaits vaccines

Island Wrap #39: Health & Tourism edition for April 24 to May 7, 2021

For many people in Thailand, the last couple of weeks have constituted the most trying stretch of the pandemic so far. An unprecedented Covid-19 outbreak grips much of the country. Interprovincial travel is curtailed, and no one is allowed in or out of some areas. Several islands are sealed off from the outside world.

It will be a miracle if inbound tourism to Phuket reopens without quarantine, as still planned, on July 1st. With the economy crippled and mass vaccinations out of reach until next month at the earliest, the hopes of many people are simple: to reopen a business, to get back to school, to go for a jog in the park or have a beer with some mates.

Before life can get back to normal, the people of Thailand will need to overcome numerous obstacles. This article touches on many of them.

(If you’ve had enough pandemic news for the time being, don’t forget about the Travel and Environment edition of the Island Wrap published yesterday.)

By the numbers

Thailand has reported 28,668 cases, or 2,048 per day on average, since my last Covid-19 update two weeks ago. The case number is 49,992 since the current outbreak became apparent on April 1st. Daily case numbers have remained fairly steady over the past two weeks, rarely going far above or below the 2,000 mark nationwide. A full 2/3 of Thailand’s cases since the pandemic started came over the past 37 days.

Bangkok reported 11,402 cases over the two past weeks. Add nearby areas and the number jumps above 17,000 in metro Bangkok. Cases and deaths in the Thai capital are unfortunately trending upwards.

Case numbers are trending downwards in Chiang Mai province, which reported 976 over the past two weeks. Though significant Covid-19 clusters recently hit Sukhothai, Khon Kaen and Nakhon Ratchasima, most of the upcountry provinces reported daily case numbers in the single digits over the past week.

Things are worse in some of the coastal provinces. Chonburi’s case numbers held steady at an average of 104 per day over the fortnight. Others with relatively high two-week case counts include Surat Thani with 725, Songkhla with 432, Nakhon Si Thammarat with 408, Ranong with 295, and Rayong with 281. Krabi, Trang, Phatthalung, Pattani and Chanthaburi all reported 150 to 250 total cases over the two weeks. The same goes for Prachuap Khiri Khan, though its daily numbers dropped to single digits this week after a cluster in Hua Hin fizzled out.

As for the islands, Phuket’s 217 cases were evenly spread throughout the past 14 days. Ko Samui reported 72 cases to go with 17 for Ko Phangan since April 1st, but none were found on either island over the past few days. One island to keep an eye on is Ko Chang (Trat), with 29 cases since its first known local transmission surfaced on April 26th. A resort there is now being utilized as a ‘field hospital.’

Cases have been nonexistent or minimal on all other islands. Ko Tao, Ko Lanta, Ko Samet, Ko Kood and Ko Lipe all had one to five known cases at some point over the last month, but no signs of outbreaks in recent weeks.

A total of 242 people sadly died from Covid-19 over the past two weeks in Thailand. They include dozens below the age of 40 as well as a 92-year-old British man from Hua Hin and the beloved Thai comedian, ‘Uncle Kom’ Chuanchuen. The death rate is trending upwards with 27 yesterday and a record of 31 on May 3rd. In many cases, patients died only one to three days after being admitted for treatment.

The recent death of a 45-year-old man by the name of ‘Ek’ revealed multiple failings in the public health system, as documented in a heartbreaking Bangkok Post article. Difficulty getting tested, poor communication among officials and ineffective emergency response all contributed to this seemingly preventable death.

As seen here on Ko Chang (Trat), Covid-19 tests have been easier to find outside of the big cities.

At the hospital

At least 1,170 Covid-19 patients are in serious condition as of yesterday, including 367 breathing with the help of ventilators. A leading virologist suspects that the B117 variant is behind 98% of all cases during the outbreak.

I’ve heard no recent reports of ICU bed or ventilator shortages in Thailand, but both blood and plasma from recovered Covid-19 patients, which is used in treatment, are running low. Doctors are relying heavily on Favipiravir, an anti-viral drug made in Japan, for treating even the mildest symptoms.

Hundreds of medical workers from at least 17 hospitals in Bangkok tested positive or were forced to quarantine, straining the system. Nine hospitals in other parts of the country — including in Phuket, Ko Samui and Trang — temporarily closed due to staff testing positive and/or needing to isolate. These shortages are forcing remaining professionals to work excruciatingly long hours at some hospitals.

Structures serving as Covid-19 field hospitals range from large arenas in Bangkok to a pavilion with open-air sides in Ranong. Most of them resemble large dorms with basic beds and little else, but at least one is equipped with “ICU facilities.” For patients with the funds, comfier ‘hospitels’ charge up to 12,000 baht a night.

Child patients are controversially being separated from parents at all types of hospitals, even if the parents test positive as well. Photos of a toddler accompanied only by her teddy bear after she said goodbye to her sick father pulled at heartstrings earlier this week. Field hospitals are separated by gender, and one patient complained after a man snuck into a female section to sleep with his girlfriend.

More serious problems have materialized. In Nakhon Si Thammarat, locals threatened to burn down an assembly hall after authorities announced plans to turn it into a field hospital. And police are after three of 13 mandatory drug-rehab inmates who dug their way out of a Covid-19 field hospital in Narathiwat.

Some patients face “community rejection” after being released from hospitals — and it doesn’t always end with death. In Chachoengsao, four temples refused to cremate the body of a Covid-19 victim before the family found a willing funeral venue.

Testing (and sanitizing)

Many first-hand accounts suggest obstacles to getting tested whether symptoms are obvious or not. This is especially true in metro Bangkok, where some privately run hospitals are turning away potential Covid-19 patients and some of the public hospitals lack testing supplies to meet public demand.

Still, the nationwide testing rate recently jumped to around 150,000 per day. The positive rate stands near 4% according to Dylan Jay’s analysis.

Authorities ramped up proactive testing in hard-hit areas like the low-income communities of Khlong Toei in Bangkok, where targeted vaccinations are also being deployed at a rate of 2,000 to 3,000 doses per day over the next two weeks. Containing the spread in cramped quarters like Khlong Toei is considered critical to keeping the outbreak from spiraling further out of control in the city.

The fact that the poor are bearing the brunt of an outbreak which started at high-end venues among the wealthy is not being overlooked. Yiamyut Sutthichaya spotlights inequalities in an excellent article for Prachatai, while Thai Enquirer’s Cod Satrusayang explains the dubious origins of the outbreak in no uncertain terms.

In many parts of the country, proactive testing is happening alongside a track-and-trace program as officials, health workers and volunteers pour immense effort into battling the outbreak. One example comes from Satun province in the far Southwest, where 26 people were tested after being in close proximity to one person who tested positive for the virus in the Thammalung area near Malaysia.

Reporting only nine cases over the past two weeks, Satun joins other provinces with minimal cases — like Chumphon and Phang Nga — that appear to be on the way to fully eradicating the virus if travel restrictions are kept in place. A scenario in which metro Bangkok continues to struggle after less-populated provinces have effectively suppressed the virus seems likely down the road.

Fearing the introduction of Covid-19 variants from neighboring countries like Malaysia and Myanmar, authorities are proactively testing fishers and other workers in border provinces like Narathiwat and Ranong. Patrols are catching unusually high numbers of illegal immigrants, especially near the Myanmar border.

All around the country, authorities are going all in on spraying sanitizer into the air and onto surfaces in public places. This is done at dwellings of people who test positive for Covid-19, but also at random on streets, buildings and beaches. Given the evidence suggesting that the virus is rarely transmitted from surfaces, critics are asking if these dramatic ‘spray downs’ are a waste of resources.

Spraying sanitizer at a resort on Ko Phi Phi Don, where no Covid-19 cases have been reported during the current outbreak. (Source: Phi Phi Tourism Business Community)

Containment measures

The government reordered the 77 Thai provinces into ‘dark red,’ ‘red,’ and ‘orange’ zones based loosely on the severity of outbreaks in each of them. This TAT announcement has details on the rules imposed in each zone.

Provincial governors are adding rules on top of rules. All public parks were closed in Bangkok, leaving some locals wondering why malls can stay open. While Sa Kaeo is the only province with a ban on alcohol sales, anyone caught drinking with anyone else — even in their own home — could face up to two years in prison or a 40,000 baht fine on Ko Samui and other parts of Surat Thani province.

Yala is the only province where a hard curfew is in place from 10:00 PM to 4:00 AM. Governors of 28 other provinces — including Phuket, Surat Thani and Krabi — imposed ‘soft curfews’ to encourage people to stay home. With bars shuttered nationwide and restaurants open only for takeout until 9:00 PM in all dark-red provinces and some in the red zone, there’s not much to do at night.

In-person classes are banned in many provinces, and authorities delayed the start of the coming public school semester to June 1st nationwide. In some areas, there’s a good chance that the start of school will be pushed back even later.

Wearing masks in public is now required in all 77 provinces, even when exercising outside or driving in a car with another person. The maximum fine for not wearing a mask is 20,000 baht, though most offenders are asked to pay considerably less — or perhaps do a few pushups in shame as a penalty. The Prime Minister himself was fined 6,000 baht after he was pictured at a Cabinet meeting sans mask.

Travel restrictions

Starting with international travel, the government backtracked on a decision to reduce quarantine by mandating that all inbound travelers — including those who are vaccinated — must again spend 14 days in a quarantine hotel. In addition, all non-Thai travelers from India, Pakistan and Bangladesh are banned from entering Thailand due to fears over the Covid-19 variants spreading in those countries.

Hard lockdowns (i.e. no one in or out) were imposed on several villages where Covid-19 clusters emerged recently, including two near Ao Nang in Krabi province and others in parts of Nakhon Si Thammarat, Buriram, Nakhon Phanom, Nakhon Sawan and Chiang Dao in Chiang Mai province up north.

No one — including residents — is allowed on or off Ko Phayam until May 11th. Ko Samet is closed until May 10th along with Ko Larn until May 20th and Ko Phi Phi until May 18th. I expect all of these island closures to be extended.

To enter Ko Samui, Ko Phangan and Ko Tao, travelers from the ‘red’ and ‘dark red’ zones, or any province with more than 100 recent cases, must display a vaccination certificate, a negative Covid-19 test from the past 72 hours or a ‘need to travel’ document obtained from authorities in their home district. Once travelers are on these islands, no paperwork is required to catch a ferry from one to the next.

Though residents of Ko Chang (Trat) voted to stay open to tourism and nearby Ko Kood reopened after a brief closure, all travelers must meet the same vaccination or testing criteria mentioned above to visit these islands and Ko Mak. The same goes for Ko Lipe in Satun and all of Trang province’s islands, among others.

Phuket is open, but incoming travelers must pay 500 baht for a rapid test or show proof of vaccination or a prior test result upon arrival. Rapid testing is also an option if traveling to Krabi province, where Ko Lanta is open, but travelers need to take the test at Krabi Hospital rather than at the airport (or bridge) like on Phuket.

More than half of Thailand’s 155 national parks are fully closed, including Mu Ko Lanta, Ao Phang Nga and Hat Noppharat Thara - Mu Ko Phi Phi in the South. Historical parks and many other tourist attractions are closed as well.

The State Railway suspended several trains until May 31st. Many public bus and van services are affected by interprovincial travel restrictions.

Vaccine update

More than 1.2 million people have received a first vaccine shot as of yesterday, and nearly half a million are fully inoculated in Thailand. Bangkok leads with more than 344,000 doses administered, followed by Phuket with nearly 190,000 jabs and Samut Sakhon with close to 180,000. While the vast majority of these have been Sinovac shots, use of the AstraZeneca vaccine is increasing.

More than 1.4 million people have signed up to be vaccinated via the Mor Prom (‘Doctors Ready’) account on the Line mobile platform, including over 400,000 when registration opened on May 1st. (Note that residents of Phuket need to register with a different app.) While the government is pushing the Mor Prom platform, vaccination appointments can also be made directly at hospitals.

AstraZeneca announced that an initial batch of doses (the exact number was not revealed) produced domestically by Siam Bioscience will be delivered on schedule. Officials said the first of these shots will start to be administered on June 7th, though relatively few eligible people have booked appointments so far.

Authorities have done little to quell fear of vaccines among the public, exemplified by the 60 police officers who declined jab opportunities in Samut Songkhram. The Health Minister declared that people will not be allowed to choose their vaccine, and reports of adverse side effects are being widely shared online.

The news that AstraZeneca appears to be on track with its production of 61 million doses is promising, but the rest of Thailand’s vaccine picture remains murky. While the government is reportedly in talks with several producers, no purchase confirmations or shipments have been announced.

Regarding the Prime Minister’s recent promise to help the private sector buy vaccines after months of insisting the government program would suffice, “there has been no change on the ground and private hospitals are still frustrated by the lack of government communication and agency on the matter,” reports Thai Enquirer.

Foreigners included?

The question of whether foreign residents are eligible for vaccination has been mired in mixed messaging from the government, leaving many of us on edge.

Late last month, a Ministry of Foreign Affairs (MFA) spokesman confirmed a February statement that foreigners will indeed be eligible for the public vaccination program. However, a spokesman for the Ministry of Public Health (MOPH) contradicted the MFA on Tuesday by stating that only Thai people could be vaccinated this June and July, regardless of the ages or health conditions of foreigners.

After a front-page headline in the Bangkok Post read “Thais, not expats, get jab priority” the following day, the director-general of the Disease Control Dept., which operates under the MOPH, proclaimed that “vaccines will be provided for anybody living in Thailand, whether they be Thai or foreigners.” In subsequent statements, the TAT and MFA both reiterated that foreigners will receive equal access to vaccines. Phuket officials soon followed suit, announcing that foreigners are now eligible after being left out of the island’s initial vaccine rollout.

But a report published yesterday in Coconuts Bangkok made it clear that — no matter what the government is saying — the staffs at several Bangkok-area hospitals continue to insist that foreigners are not eligible. “A poll of 12 facilities in the capital found none able or willing to register non-citizens, with one insisting it could only do so after 70% of Thai nationals were vaccinated.”

The Bangkok-area hospital that I’ve always used, Saint Louis, had no problem putting myself and two other foreigners on a vaccination wait list over the past two days. Though we only needed to show passports, Bumrungrad Hospital is allowing foreigners with pink ID cards to register. Few foreigners have one of these IDs since obtaining one requires home ownership or permanent residency.

Two long-term foreign residents of Thailand — travel journalist Joe Cummings and comedian Olivia Gilmore — shared their successes registering for vaccination via the Mor Prom platform by inputting a social security or ID card number. Exactly what will happen on the day of their appointments is an open question.

This grassroots organization has been doing loads of good in Bangkok. Click here to see the full-size photos on Twitter, where you’ll also find the group’s contact info if you’re inclined to donate during this time of need.

Help on the way?

A survey by the Bank of Thailand suggests that 47% of hotels may be forced to close, temporarily or otherwise, within three months if the Covid-19 situation doesn’t improve enough for domestic tourism to get cranking again. Containment measures could cost the already struggling restaurant industry another 200,000 jobs. A recent New York Times report spotlights the dire situation on Phuket.

In response, the government is cutting utility bills for two months, albeit in a convoluted way. It also plans to hand out 3,000 baht ($96 USD) per month to 31 million people until December. Aimed at stimulating consumer spending, additional “e-vouchers” worth 7,000 baht are available to four million people “with high purchasing power,” but only if they spend a minimum of 46,000 baht.

While such measures are helpful, millions of people will continue to struggle financially until the outbreak is contained and inbound tourism returns. In the meantime, critical aid is coming from community groups that provide free meals in cities like Bangkok and Pattaya. If you want to help, many of the charities that I featured in an article last year are still assisting the needy. 🌴