Thailand tightens containment measures as the Covid-19 crisis deepens

Island Wrap #48: Health & Tourism edition for July 3-16, 2021

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Thailand now finds itself in the throes of a severe Covid-19 crisis. The highly contagious Delta variant is fast replacing the Alpha as the dominant strain of the coronavirus in the country. Many people are unable to get tested or vaccinated. The medical system is buckling under the pressure as an already dire economic situation turns critical for many. The “partial lockdown” came too late.


Covid-19 by the numbers

Thailand reported 110,986 cases, or 7,928 per day on average, since my last Covid-19 update two weeks ago. This means that over the last two weeks, the country recorded nearly 30% of its total confirmed cases for the entire pandemic to date. Yesterday, a new single-day case high of 9,962 was set. According to one expert, the true case numbers are likely to be three to four times higher.

958 deaths related to Covid-19 were also reported in Thailand over the last two weeks, though again, the true number is thought to be higher. A grim single-day high in Covid-19 deaths, 98, was set two days ago.

More than 100,000 patients are now being treated for Covid-19 in various types of hospitals, while many others battle the virus at home. A total of 3,367 patients were being treated in intensive care yesterday, including an all-time high of 847 on ventilators. On some recent days, the number of new patients admitted for care more than doubled the number who were discharged from hospitals.

An expert advisor to the government’s coronavirus task force said that Thailand is now in its fourth wave of Covid-19, due in part to the fact that so many of the infections are now of the Delta variant as opposed to the Alpha strain, which was behind the majority of cases in recent months. In Bangkok, two construction workers were each found to be infected with both of these variants at the same time.

Bangkok’s two-week case total increased to 31,280, including an all-time single-day high of 3,191 on July 10th. Add the five small surrounding provinces and the total for metro Bangkok jumps to 58,746, an increase of more than 20,000 compared to the previous fortnight. The virus also continues to spread in Thai prisons, which collectively reported 2,192 cases over the last two weeks.

The highest case total of any other coastal province was 5,147 in Chonburi, an increase of more than 2,000 over the previous two weeks. Also on the upper Gulf coast, 1,132 cases surfaced in Rayong along with 1,042 in Phetchaburi and 1,021 in Prachuap Khiri Khan. In the deep South, 2,737 cases were found in Pattani over the fortnight, followed by Songkhla with 2,682, Yala with 2,261, and Narathiwat with 1,410.

Setting the low-case bar among coastal provinces were Phang Nga and Phuket, both with 68 confirmed cases over the last two weeks. Next was Trang with 124, followed by Phatthalung with 125, Satun with 138, Chumphon with 160, and Ranong with 172. In the middle stands Trat (262 cases), Chanthaburi (298), Surat Thani (309), Nakhon Si Thammarat (413), and Krabi, where the two-week case count leaped from 79 to 470.

The only coastal provinces that recorded a drop in cases compared to the previous two weeks were Phang Nga and Trang. As for the large islands, other than Phuket, a worrying 31 cases were found in Ko Lanta over the last two weeks, while Ko Chang (Trat) counted seven and one more surfaced on Ko Samui.

Sharp increases in cases were also recorded in upcountry provinces, especially in the Northeast, where Buriram, Surin, Sisaket, Ubon Ratchathani, Maha Sarakham, Udon Thani, Chaiyaphum and Nakhon Ratchasima all reported above or close to 100 cases per day this week. The North is still the least-affected region, but confirmed cases in Chiang Mai did spike above 60 yesterday for the first time in several weeks. Even the backwater province of Nan reported 38 cases on July 12th.

Nikkei Asia’s Covid-19 recovery index ranked Thailand 118th out of 120 countries on July 7th, spotlighting a big tumble from when Thailand’s Covid-19 containment success placed it near the top of similar lists for most of 2020.

Thailand is not alone in Southeast Asia, however. Indonesia, Malaysia, Myanmar and Vietnam are all suffering unprecedented highs in Covid-19 cases and deaths as the Delta variant takes hold in the region. Sluggish vaccination programs and a lack of worldwide vaccine equity are now impairing much of Asia.


A deepening crisis

Many cracks in Thailand’s strained medical system are appearing, especially in metro Bangkok. The country’s largest public hospital, Siriraj, closed its ER services after reaching capacity, while Rajavithi Hospital stopped accepting in-patients and suspended general surgery. Reports abound of hospitals flat-out denying entry to people who have Covid-19 symptoms or already tested positive.

Severe hospital bed shortages are also being reported in the deep South and other parts of the country as case numbers rise in most provinces and Covid-19 patients flee Bangkok in search of medical care elsewhere. The addition of several new field hospitals, including large ones in parts of Bangkok’s Suvarnabhumi and Don Mueang airports, has not been enough to meet the demand.

In Ubon Ratchathani, some patients are reportedly being quarantined in farm huts.

At least 880 healthcare workers have contracted Covid-19, resulting in seven deaths, since the start of the third wave. Oxygen supplies are running low in places. With its morgues filling up, Bangkok’s Thammasat Hospital rented two refrigerated cargo containers to hold the excess bodies. One temple in Nonthaburi is adding a second crematorium due to the unceasing use of the original.

Many heart-wrenching stories are emerging. A 34-year-old who was seven months pregnant died in Prachuap Khiri Khan. In Bangkok, a 50-year-old mother of six died at home after fruitlessly waiting “at least six days” for a hospital bed; an 84-year-old man jumped to his death after his 57-year-old daughter died while awaiting treatment; and an ailing “uncle” is trying to beat the virus at home in Khlong Toei with the help of oxygen arranged by a charity after a hospital denied him care. A “beloved nanny” died at 61 years old after Covid-19 spread through the family she cared for, as explained in a poignant thread by a physician who caught the virus as well.

Some people are finding it difficult, if not impossible, to get tested for Covid-19. Images of crowds queuing for hours and even sleeping on sidewalks to access free testing the next morning appeared in Thai Enquirer, The Nation, Thai PBS and dozens of social media accounts. Authorities finally changed a rule that anyone who tests positive must be immediately placed in care after some hospitals stopped testing entirely, citing a lack of beds to fulfill that obligation. The governor of Samut Sakhon threatened to close all private hospitals over their refusal to test.

Aided by 200 mobile testing squads in Bangkok along with the Thai FDA’s approval of over-the-counter rapid test kits and new testing centers at Rajamangala Stadium and other large-scale sites, the testing shortage eased to some degree this week. Unless, that is, you’re one of the thousands of migrant workers who have been sealed in cramped construction camps in metro Bangkok since last month.

Earlier this week, a leaked letter dated July 5th revealed that officials from the Ministry of Labor opted to stop testing migrant workers due to medical supply shortages in Bangkok. The discrimination came to light a few days after separate claims that “workers in lockdown are not being given food by the government as was promised causing a desperate situation in construction camps,” as reported by Thai Enquirer. In some camps, trapped workers count on volunteers and their employers, some of whom are unreliable or worse, to provide food and supplies.

Sites of recent Covid-19 clusters are too numerous to list in depth, but they include a supermarket in Nonthaburi; an Air Force base in Bangkok; a school in Krabi; a “just got out of jail” party in Nakhon Ratchasima; a temple in Chonburi; a beauty pageant in Samut Sakhon; a quiet fishing village in Narathiwat; and a pineapple canning plant in Hua Hin, which has somehow been able to stay open despite the hundreds of cases that have surfaced among its workers over the past two months.


Containment measures

In what the government called a “partial lockdown,” a curfew from 9:00 PM to 4:00 AM was imposed on metro Bangkok and the deep Southern provinces until July 26th at the earliest. The rules also ban gatherings of more than five people and limit the types of shops that can stay open to sell only “necessary consumer products.” There are rumors that stricter measures are on the way, but no announcements yet.

Governors of provinces that fall outside of the dark-red “maximum and strict control” zones encompassing metro Bangkok and four deep Southern provinces continue to impose rules of their own. One example comes from Rayong, where alcohol sales are now banned after 5:00 PM. Over in nearby Sattahip, all of the beaches controlled by the Royal Thai Navy are closed until further notice.

Interprovincial travel is “strongly discouraged,” especially for anyone coming from metro Bangkok and the deep South. More than 80 checkpoints were set up around Bangkok to make it harder to leave the city, and checkpoints reappeared in parts of Chonburi province as well. Many provincial officials have been restricting entry to travelers from high-risk areas for months, but some, like those in Trang and Trat, tightened up by adding checkpoints at the provincial borders. One man was arrested after trying to use someone else’s vaccine certificate to enter Phuket.

For those who don’t have vehicles, traveling out of the Bangkok area is a challenge due to public transport closures as well as provincial travel restrictions. Government bus routes to all Southern destinations were canceled, and the State Railway canceled or reduced many of its routes. Thai AirAsia canceled all domestic flights until July 31st, while THAI and Bangkok Airways grounded several flights. All domestic flights are currently banned nationwide between 9:00 PM and 4:00 AM.

Some travel restrictions are being pointed back towards Thailand from abroad. The European Union removed Thailand from its list of “safe countries” yesterday, and while entry rules are up to each European country, the move could provoke some of them to start requiring quarantine for travelers from Thailand.


Vaccinations

Just shy of 3.6 million vaccine doses, or an average of nearly 257,000 per day, were administered in Thailand over the past two weeks. 14.94% of Thailand’s total population have received one dose, and 4.87% are fully inoculated.

For the first time, walk-in vaccinations were opened to anyone aged 75 or above at Bangkok’s massive Bang Sue Railway Station. A new round of vaccine registration is opening to foreigners, some of whom are being vaccinated through the embassies of France, Switzerland, Australia, New Zealand, and Canada, as well as the British Chamber of Commerce and the Thailand Board of Investment.

Overall, however, Thailand’s vaccine situation looks messier than ever — or “evidently a complete shambles,” to quote one Bangkok Post opinion writer.

Bad news hit on Thursday when a deputy health minister revealed that AstraZeneca has asked “to extend the timeline for the delivery of 61 million doses of its Covid-19 vaccine by five months,” reported Reuters. This could slash Thailand’s monthly vaccine supply by 4 to 5 million doses for the rest of this year, further jeopardizing the government’s goal of inoculating 50 million people by 2022.

News of the request, which strikes me as more of an admission of imminent delays, broke a day after Thai health officials said they might impose limits on exports of Thai-made AstraZeneca doses to countries that are counting on them, such as Indonesia, Taiwan and the Philippines. At the center of the controversy is Siam Bioscience, a company that many people within Thailand are scared to question due to draconian speech laws relating to its majority owner.

The delay could contradict previous government assurances that AstraZeneca would supply Thailand with 10 million doses per month even if production fell short at Siam Bioscience. As a result, some people who received AstraZeneca as their first dose are now wondering if their second vaccine appointment will be postponed, or if they’ll be told to accept another brand of vaccine for jab number two.

Speaking of which, some people are also uneasy about a new blanket guideline to use the Sinovac vaccine for first doses and the AstraZeneca vaccine as the second jabs for most government-provided vaccinations. The move was walked back for a day after first being announced, causing confusion before it was finally approved. Thailand will be the first country to test this mixed vaccine regimen at scale.

Public trust in Sinovac is low after more than 600 medical workers caught Covid-19 despite having been inoculated with two doses of this inactivated-virus type vaccine. One of them died, and another is in critical condition. A leaked memo suggested that some in the Public Health Ministry did not support giving medical workers a mRNA vaccine booster shot because “it is tantamount to admitting that Sinovac vaccine offers no protection. This will make it harder to defend it.”

The mRNA vaccines discussed in that leaked memo are 1.5 million doses of the Pfizer-BioNTech variety, which the United States is donating to Thailand. After a public outcry, health officials decided to allocate some of those doses towards boosting the immunity of frontline health workers who have already received two shots of Sinovac. The government is also in talks to buy another 20 million doses of the Pfizer-BioNTech vaccine, though no deal has been signed yet.

Those 20 million doses, along with 5 million doses of the Moderna vaccine bound for private hospitals, are not expected to arrive in Thailand until some time during the fourth quarter of this year. The Thai Red Cross is reportedly purchasing another million Moderna doses for high-risk groups, while an institute chaired by Princess Chulabhorn received a million more Sinopharm shots. Japan donated 1.05 million doses of the AstraZeneca vaccine to Thailand as well.

Meanwhile, the Government Pharmaceutical Organization (GPO) filed a defamation suit against a private hospital chairman who questioned why the GPO appears to be selling the 5 million Moderna doses to private healthcare firms at a roughly 30% mark up. This highly effective mRNA vaccine is costing members of the public 1,650 baht per dose. Demand seems to be immense judging by the few seconds that it took for Moderna bookings to sell out through Bumrungrad Hospital and Shopee, even though the actual jabs won’t start until October at the earliest.

The government also ordered 10.5 million more doses of Sinovac despite a chorus of critics who want to know why the authorities are so keen on this expensive, low-efficacy vaccine. One 24-year-old Bangkok resident drew attention to the issue by adding the words, “salesman for Sinovac vaccine,” to the Wikipedia page of Dr. Yong Poovorawan, a well-known Thai virologist “who has fiercely defended Thailand’s reliance on the Chinese-made vaccine,” according to Coconuts Bangkok. The sneaky young man was arrested and charged with defamation.

The sum of the government’s clumsy and not-so-transparent vaccine plan is a great deal of public confusion, frustration and urgent desperation to secure vaccinations. Some are exploiting this sentiment by creating vaccine scams. Others, including a large contingent of Thai doctors, are leveling criticism at the government.


Mounting frustration

Some of the only positive news over the last two weeks is a new government plan to provide limited financial aid to workers and businesses affected by the restrictions. The chairman of the Thai Chamber of Commerce called the package “insufficient,” however, as millions are now living below the poverty line, consumer confidence is at a 23-year low and countless people are relying on food from charities.

The new financial aid measures did not stop a growing torrent of anger and criticism from being aimed at the government. Protesters drove through Bangkok blasting their horns. Opposition politicians passionately called for transparency. Opinion writers and netizens piled on discontent online as calls for class-action lawsuits and inquiries into the “mishandling of the pandemic” mount.

In response, the government sued an opposition figure and added an order to the latest emergency decree that “imposes a two-year jail sentence and/or a fine of up to 40,000 baht for anyone who spreads information or news that causes public fear or affects national security,” reported Prachatai. These penalties could apply to any info that’s interpreted to “cause public fear,” regardless of its truth.

To be honest, I’m more worried about Thailand now than I’d been at any point for many years — certainly since the 2014 coup and perhaps since I first started paying attention nearly two decades ago. Given the Prayut regime’s previous track record of cracking down on freedom of speech and stifling dissent through intimidation tactics like “attitude adjustment camps,” pondering what the former generals might do if they feel like they’ve been backed into a corner makes me shudder.

Well, at least we’ve got a Phuket Sandbox and Samui Plus to follow while waiting for vaccinations and an end to the curfew and travel restrictions, at some point. 🌴


If you’ve been finding these reports useful, please consider making a $5 USD monthly contribution if you’re able. If you’d prefer to make a one-time donation in any amount, you can do so here. For a Thai bank transfer, please get in touch.

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