Domestic travel restrictions enacted as Covid-19 spreads to every Thai province

Island Wrap #37: Health & Tourism edition for April 10-23, 2021

“The virus is out there,” I warned in an article published exactly four weeks ago. At that point, the Samut Sakhon outbreak that began in December appeared to be under control. Reported case numbers in the Bangkok area fell steadily throughout February and March, and most other Thai provinces appeared to be free of the virus. In the capital and elsewhere, life was back to normal.

But some of us remained concerned about sporadic outbreaks — in fresh markets, immigration detention centers and construction sites — which showed that Thailand had not eradicated Covid-19 like after the ‘first wave’ in 2020.

Bars and parties attracted large crowds in areas where the virus never disappeared. Mask wearing continued in public places, but few people bothered to use free hand sanitizer or scan QR codes designed to facilitate contact tracing. The government and private businesses promoted the mid-April Songkran holidays, strongly encouraging domestic travel to go with hundreds of celebratory events.

Again, the virus was still out there. Infections, including of the more transmissible B117 variant, spread swiftly through swanky nightlife venues where social distancing was not enforced. Despite rising case numbers, the government insisted that Songkran must go on. Now, as intensive-care beds become scarce and vaccinations progress erratically, Thailand is paying the price for its recent complacency.

Swings hang empty on Ko Kood, which is closed to tourism until May 1st at the earliest.

The Covid-19 situation

Thailand has reported 19,315 cases, or 1,380 per day on average, over the two weeks since my last Covid-19 report. (Since April 1st, the case number is 21,320.) In another single-day record, 2,062 cases surfaced yesterday.

31 people — including seven on a single day — have sadly died of Covid-19 in the country this month. One was 29 years old. Another, an 85-year-old woman in Bangkok, reportedly died while waiting for an ambulance to arrive.

Including asymptomatic patients, 19,873 people are currently being treated for the virus. Out of those, 91 are on ventilators and 352 have severe pneumonia. One patient is a famous Thai comedian, Kom Chauncheun, who is now fighting for his life with failing kidneys and severe lung inflammation.

A spokesman for the government’s Covid-19 task force said yesterday that 69 of Bangkok’s 262 intensive-care unit (ICU) beds were unoccupied. “If Covid-19 infections continued to rise by 1,500 a day, all ICU beds in Bangkok would be occupied in six to eight days … There are about 1,000 ICU beds nationwide and if infections rose by 1,500 a day, they would all be occupied in 19 days,” according to the statement.

Richard Barrow 🇹🇭🇬🇧 @RichardBarrow

The Thai Red Cross Society has issued an urgent appeal for blood, saying supplies have dropped dramatically since the third wave of the Covid-19 pandemic hit the country bangkokpost.com/thailand/gener… #Thailand

Before we slide too far down the doom tunnel, it’s important to clarify that Thailand’s medical system is largely holding steady, for now. Dr. Somsak Akksilp, director-general of the Medical Services Dept., told Thai PBS that “the number of infections in Thailand is still far too small to disrupt medical services.” Still, if you believe in lucky charms and protective incantations, now is the time to use them.

Over the past two weeks, the virus spread to every one of Thailand’s 77 provinces for the first time since the pandemic began. Bangkok is the hardest hit, reporting 4,223 cases in that span, including a single-day record of 740 yesterday. Add nearby areas and the two-week case count jumps above 6,000 in metro Bangkok.

Chiang Mai province reported 2,810 cases over the last two weeks, while other upcountry provinces like Nakhon Ratchasima and Khon Kaen reported hundreds of cases. Along the coasts, Chonburi (including Pattaya) reported 1,561 cases over the two weeks, followed by Prachuab Khiri Khan (including Hua Hin) with 936. Nakhon Si Thammarat, Narathiwat, Rayong, Songkhla and Surat Thani all reported hundreds of cases as well. Even small and out-of-the-way provinces like Phatthalung — with 67 cases since April 12th — have not been spared.

Readying an ambulance to transport a Covid-19 patient to the ‘field hospital’ on Ko Samui. (Source: Samui Rescue Center / Ko Samui Municipality)

Phuket reported 277 cases since April 10th, making it the hardest hit of Thailand’s islands by a long shot. Since the new outbreak began, Ko Samui has reported 36 cases to go with nine on Ko Phangan and three on Ko Tao, ending coronavirus-free streaks on these islands that previously stretched back to April 2020. At least three people also tested positive on Ko Chang to go with two more on nearby Ko Kood.

Cases are also on the rise in Cambodia, Laos, Malaysia and especially India, generating a sense that much of the region is losing its edge over the pandemic. This is compounded by the violence and instability in Myanmar, where gauging the spread of Covid-19 has become nearly impossible.

There are signs that actual infection numbers are much higher in Thailand. To use April 20th as an example, the fact that only 108 of 1,454 total cases were found through proactive testing is a troubling indication that the situation is out of control. During the Samut Sakhon outbreak, case discovery was heavily tilted towards proactive testing, as opposed to ‘walk-in’ cases found at medical facilities.

The virus appears to have outrun the track-and-trace program that Thailand drew praise for in the early days of the pandemic. As for testing, tens of thousands of PCR and PUI tests, as well as many rapid tests, are being administered daily. The recent positive rate is around 4% according to Dylan Jay’s analysis.

Makeshift field hospitals are accommodating patients in at least a dozen provinces. In one such facility that recently overtook Bangkok Arena, rows of beds made of a sturdy type of cardboard are fitted with thin mattresses, fans and mosquito nets, but no privacy curtains. Covid-19 patients are comfier on Ko Samui, for one, where they’re staying in a ‘field hospital’ that’s actually a beachfront resort.

Ryn J. @Ryn_writes

Bangkok Arena has been converted to a field hospital for asymptotic COVID-19 patients. As of now, Bangkok has 4 field hospitals with around 1,800 beds. This particular one has 400 beds. Today, Bangkok has 347 infection cases and the number keeps rising. Will the beds be enough?

The thought of two weeks in a field hospital may be frightening some people into taking extra precautions against the virus. However, others view the prospect of being forced to stay in a field hospital as a deterrent to voluntary testing. As shown by the experiences of Pontus and Ton, problems may await asymptomatic patients when they return to their residences after being cleared to leave hospitals.

The plan is still to keep everyone who tests positive in medical facilities, but health officials said ‘home recovery’ is possible should beds fill up. Hotels converted into ‘hospitels’ are also in use for patients who luck out, or are willing to pay. At least 74 patients who refused to stay in field hospitals are facing legal action.

In fact, they’re not the only ones facing punishment over the recent outbreak. Criminal charges are being levied against:

• a woman who boarded a plane from Bangkok to Nakhon Si Thammarat after receiving confirmation that she tested positive;

• the managers of three Phuket nightclubs who organized large-scale parties where the virus spread on April 2nd and 3rd;

• the managers of two upscale Bangkok nightclubs that became super-spreader venues, both of whom are serving two-month jail sentences;

• and the organizer of a muay Thai tournament where the virus spread in Songkhla earlier this month, after the outbreak became public knowledge.

Not included among those facing legal action are police who enabled nightclubs to operate without legally mandated social distancing, often while staying open beyond legal operating hours. High-ranking police overseeing the Bangkok nightlife area where the outbreak first erupted were transferred — with full pay — in a sort of ‘slap on the wrist’ that’s common for Thai police misconduct.

By now, the outbreak has outgrown its association with nightlife. While super-spread events and venues are too numerous to name in full, here’s a sample:

• 52 infected police officers in Bangkok forced 961 of their colleagues into quarantine. Cases have also been reported among the police ranks in Pattaya and Phuket.

• More than 140 medical staff from various hospitals are infected.

• More than 30 employees at the Airports of Thailand head office in Don Mueang, north Bangkok, are infected.

• 23 students and at least nine others at a school in Samut Prakan were infected by two foreign English teachers who caught the virus on a trip to Phuket.

• At least 27 cases were linked to a Buddhist meditation center in Chiang Mai.

• At least 17 cases were linked to a shrimp market in Ayutthaya, hinting that Covid-19 transmission originating from the December 2020 outbreak at a shrimp market in Samut Sakhon may have gone overlooked.

• At least one infected person was present at a Covid-19 vaccination venue in Phuket on April 2nd, prompting those who had been there to receive vaccine jabs to enter self-monitored quarantine.

If you’re in Thailand and you think you have Covid-19…

Start by reading this article with details on what to do and who to call if you have symptoms or were in close proximity to someone who tested positive. If you test positive and have health insurance or are willing to pay to avoid a field hospital, try the Line account @sabaideebot for help finding a proper bed.

Just in case you need to prepare for Covid camp. (Source: NBT World News)

Containment measures

Bangkok, Chiang Mai, Chonburi, Rayong, Prachuap Khiri Khan, Phuket, Songkhla and 11 other provinces have been declared “maximum controlled areas” and marked as ‘red zones.’ See this announcement from the TAT for full details on nationwide restrictions — such as no in-person classes and limits on dining out — in both the ‘red zone’ areas and the 59 ‘orange zone’ provinces with milder rules.

Additionally, provincial governors are coming up with restrictions of their own. For one, expect to pay a fine of 20,000 baht (US $636) if caught in public without a mask on your face in any of these 38 provinces. (In case anyone down in the ‘silly islands’ needs to be reminded, Ko Phangan and Ko Tao are part of Surat Thani.)

As for domestic travel restrictions, anyone attempting to enter one of these 49 provinces must show a vaccination certificate or a negative Covid-19 test result from the past 72 hours. Otherwise, expect 14 days of ‘self quarantine.’

Officials on two islands — Phuket and Ko Chang (Trat) — allow incoming travelers to take a rapid Covid-19 test and enter the island if they test negative, despite rapid tests being “unreliable” according to one prominent doctor. Anyone from certain districts needs to submit to a rapid test upon entering Ko Samui, though most travelers are only asked to scan a QR code and get a body temperature check.

As far as I know, Ko Kood is the only Thai island that’s entirely closed to tourists. The community there will reassess the situation on May 1st.

Many tourist attractions are closed throughout the country. If you’re thinking of escaping into the natural world, check this list to see if your national park of choice is closed. The governor of Chonburi backtracked on a decision to close beaches in areas like Bang Saen and Pattaya, but the sand is off limits after dark and alcohol is prohibited. Snorkeling and diving is a no-no around Phuket.

Public transport is still operating, but the frequency of ferries has been reduced at many islands. Bangkok Airways canceled some routes as all domestic airlines grapple with issuing refunds due to canceled trips over Songkran.

To get an idea of what two of Thailand’s once-bustling beach destinations look like these days, see Adam Judd’s photos of Pattaya appearing as an eerie ghost town in The Pattaya News, and an in-depth story on Phuket’s empty spaces by CNN Travel’s Karla Cripps. Across Phang Nga Bay from Phuket in Krabi town, the famous gorilla statues that adorn traffic lights are now wearing masks.

Vaccinations (and other remedies)

Close to a million people have received their first dose of a Covid-19 vaccine in Thailand. After a pause due to the outbreak and supply shortages, vaccination rollouts are resuming in Phuket and other provinces. The public can register for vaccination starting May 1st, but the government has offered no info about foreigner eligibility since saying they would be included in the program back in February.

Saksith Saiyasombut @SaksithCNA

📊Infographic No. 2: According to data by @oc_ccsa and @thaimoph, #Thailand’s vaccination rollout has been wildly inconsistent: Yesterday was a record high with >150k doses, on Apr 14 it was just 773. In total since Feb 28, 964,825 doses were given; 130,743 were 2nd shots.

After much criticism about its vaccination strategy and an embarrassing offer from a certain exiled former prime minister to assist, the government announced that it’s in talks to buy 5 to 10 million doses of both the Pfizer and Sputnik V vaccines.

If obtained, these would add to 2.5 million Sinovac jabs and a crucial 61 million AstraZeneca doses, which are expected to be administered in a mass vaccination program starting in June. If the private sector procures another 10 to 15 million doses, as anticipated, Thailand could meet the government’s new goal of inoculating 50 million people — 75% of the total population — by year’s end.

The extent to which public confidence in the program has been diminished by rare cases of blood clots from the AstraZeneca vaccine and reports of adverse side effects (not to mention a low efficacy rate) from Sinovac is unclear. According to a New York Times report, rejection of the AstraZeneca and Johnson & Johnson varieties by wealthy countries has instilled mistrust of these vital vaccines globally.

Researchers in Thailand continue to develop ‘homegrown’ vaccines while also looking into alternative remedies. One natural option receiving attention is fah talai jone or green chireta, an herb that’s shown promise in combating Covid-19 both in test tubes and patients. “Within three days of using fah talai jone, every patient’s condition improved,” Dr. Kulthanit Wanaratna told Bangkok Post.

Tourists flocked to Cha-am Beach during Songkran, when many avoided nearby Hua Hin due to an outbreak originating from nightlife there. (Source: DMCR)

Effects on tourism

While the outbreak reportedly cut Songkran holiday travel in half, plenty of people went ahead with their trips. Thousands visited Ko Chang (Trat), Ko Larn and Khao Sok National Park, to name a few. Still, vendors in Pattaya lamented earning only around 10% of the income they’d expect from a normal Wan Lai festival full of water splashing and merrymaking prior to the pandemic.

After saying he would lead a meeting about the ‘Phuket Sandbox’ at some point this week, the Tourism Minister has stayed quiet about what might become of the plan. The silence from him and other officials speaks volumes.

I think it’s safe to say that quarantine-free inbound tourism is unlikely to start in Phuket on July 1st as previously proposed, be it due to a need to shift vaccine supply to other provinces or simply because authorities are distracted by the outbreak when they might have been preparing to reopen to inbounds. With the B117 variant now spreading in Thailand, it also seems unlikely that authorities will gamble on other Covid-19 mutations slipping in until mass vaccinations are complete.

If you’re an international traveler who could use a little hope, consider that Thai authorities offered a first glimpse at the country’s new Covid-19 vaccine passport. Also, the TAT announced a new online entry portal for vaccinated foreign travelers looking to visit Thailand. Coronavirus or not, we’ll be waiting for you. 🌴