Thailand’s proposed October reopening needs clarity

In mid-June, Prime Minister Prayut Chan-o-cha gave a speech on national television broadcasting the government’s goal of reopening Thailand within 120 days.

The reopening, needless to say, is a highly desirable goal. Take the Phuket Sandbox, which launched with great fanfare and is heralded as a small but significant first step in reopening Thailand to the outside world. As reporter Matt Hunt wrote, despite deep skepticism elsewhere, Phuket residents and entrepreneurs are optimistic and happy to help make it work. It represents a lifeline after more than a year of darkness: an opportunity to bring back income and work.

Yet the Phuket Sandbox is one thing. Reopening the entire country is quite another. Almost a month has now passed since this ambition was declared. Instead of rejecting this commitment, it is time to take a closer look. Promoting the prospect of bringing tourism back to a tourism-starved nation raises the hopes of many. But can it happen, responsibly?

To begin with, for the avoidance of doubt, let’s clarify the prime minister’s definition of “reopening”. There are two elements to Prayut’s goal. The first is to allow international arrivals without quarantine for those who are fully vaccinated. The second is the reopening of unrestricted businesses at the provincial level which will cause economic problems, except in dire circumstances.

Let’s tackle the latter objective first, as it is more direct. With the current level of infections and the low level of vaccinations, if the situation does not improve significantly by October, it is highly doubtful that a full reopening of the company can take place.

Thailand was able to loosen restrictions when it essentially eliminated the coronavirus from its borders last year. Repeating this feat seems out of the question now, given the government’s reluctance to impose prolonged restrictions and new, more rapidly spreading variants. But the bare minimum would still be to reduce infections to a level that our public health system can address. (Dr. Udom Kachintorn, a consultant to the CCSA, recently said 500-1,000 infections per day would be manageable. Again, we need to consider whether a complete lack of restrictions will simply lead to new waves, taking into account the vaccination rate of the population.)

The other goal of reopening to the outside world is a much more challenging issue.

Get vaccinations. The thesis that in order for the reopening to take place safely a substantial part of the majority should be vaccinated is not controversial. Prayut has set a goal for 50 million people to have received at least their first dose by October, to ease the road to reopening. This immediately raises the question of whether this criterion is robust enough or not: the jury is still out of scrutiny of the effectiveness of two (not one!) Doses of Sinovac against the Delta variant and, according to Public Health England, one dose of AstraZeneca. offers only 30% protection for this variant.

But significantly exceeding this target by October would require titanic efforts. At the time of writing, nearly 13% of the population has received the first dose and nearly 5% are fully vaccinated. On June 8, Thailand delivered just over 470,000 shots, but since then, due to supply problems, vaccinations per day have not been as high. According to the Covidvax tracker on the Ministry of Higher Education website, Thailand currently averages around 240,000 doses per day. At this rate, a further 356 days would be required to fully vaccinate 70% of the population.

The only way to solve this problem would be to find a way to increase the supply of vaccines in Thailand. On this, Thailand faces problems in all directions. Instead of the 10 million doses of AstraZeneca per month predicted by Siam Bioscience, Thailand can now only expect 5-6 million due to export obligations. Pfizer, Moderna and Johnson & Johnson are unlikely to make it through the fourth quarter (and a contract has only been signed for Pfizer). Thailand’s national vaccines won’t be ready until 2022.

At this point, including Japan’s donation of 1 million doses, Thailand could only expect less than 20 million doses of AstraZeneca in the next three months. The government’s solution appears to be to make up for the shortage by importing more Sinovac and Sinopharm vaccines in the hope of providing at least some level of protection to a population that would otherwise be left completely vulnerable.

And while this strategy is preferable to alternates

ming more and more evident that third doses will be needed to offer the best levels of protection. Yet if significant numbers of mRNA vaccines are not due to arrive until late this year, where will the booster shots come from?

The bottom line is this: unless the vaccination situation changes dramatically and unexpectedly within the next three months, a large portion of Thailand’s population will remain exposed to the disease in October.

We can also look at the other side of the equation. Prayut did note that his goal di lui is to reopen to vaccinated tourists, and in theory this should reduce the likelihood of bringing more infections back to Thailand (at least for some vaccines). But what kind of vaccines will Thailand accept? And will Thailand allow tourists in from anywhere in the world?

To be clear, reopening is not an all or nothing scenario. Thailand can choose to have reopening unfold in stages. Singapore, for example, currently allows 14-day quarantine to be waived for travelers from two countries that have largely eliminated community transmission, China and New Zealand, who test negative after spending a day or two in isolation. Beginning by allowing quarantine-free arrivals for fully vaccinated tourists who test negative from countries that have controlled infections may be a possible first step to revive the economy. Would a scheme like this satisfy Prayut’s vision for reopening, however?

In short, only three months away from Thailand’s proposed return to relative normalcy, much is still up in the air. After day after day of record high number of infections, we still don’t know whether we will be able to control the pandemic within our own borders. Given the vaccination situation, we are still unsure of whether we will be able to reopen those borders to others. And if we do, we still do not have answers about the criteria that will be used to determine to whom the border does reopen in October. These are all matters that the government must tackle.

Perhaps it is with a degree of discord that we discuss reopening at all when the prime minister is gearing for more closures, when the public health system is buckling under the weight of uncontrollable community transmission, when the vaccination program continues to lag. But it is necessary to have this conversation now. We must define the parameters of what constitutes acceptable conditions for Thailand’s reopening now, rather than scramble to figure something out just before October. There must be a robust debate about whether the government’s criteria for reopening are sufficient to keep Thais safe. That is the only way we can decide whether a responsible reopening is possible.