Opinion: Thailand’s proposed October reopening needs clarity

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

Reopening, needless to say, is a highly desirable goal. Take the Phuket Sandbox, which launched to great fanfare and is being heralded as a small but significant first step in Thailand’s reopening to the outside world. As journalist Matt Hunt wrote, despite deep skepticism elsewhere, Phuket’s residents and business owners are optimistic and happy to contribute to make it work. It represents a lifeline after over a year of darkness: an opportunity to bring back income and jobs. 

Yet the Phuket Sandbox is one thing. Reopening the entire country is another entirely. Almost a month has now elapsed since this ambition was declared. Instead of dismissing this pledge, it is time to examine it closely. To promote the prospect of bringing tourism back into a tourism-hungry nation raises the hopes of many. But can it happen, responsibly? 

To begin with, for the avoidance of doubt, let us clarify the prime minister’s definition of ‘re-opening.’ There are two elements to Prayut’s goal. First is permitting quarantine-free international arrivals for those who are fully vaccinated. Second is the reopening of businesses without province-wide restrictions that will cause economic pain, except in dire circumstances. 

Let’s tackle the latter goal first, given that it is more straightforward. With the current level of infections and low level of vaccinations, should the situation not improve significantly by October, it is highly doubtful whether a full reopening of society can happen.

Thailand was able to relax restrictions when it essentially eliminated the coronavirus from within its borders last year. To repeat that feat seems off the table now, given the government’s hesitancy to impose prolonged restrictions and new, faster-spreading variants. But the necessary minimum would still be to reduce infections to a level that our public health system can deal with. (Dr. Udom Kachintorn, a CCSA advisor, recently said that 500-1000 infections per day would be manageable. Even then, we must consider whether a complete dearth of restrictions will simply lead to renewed surges, taking into account population vaccination rate.) 

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

Take vaccinations. The thesis that for reopening to happen safely a sizable portion of the majority should be vaccinated is not controversial. Prayut set a goal for 50 million people to have received at least their first dose by October, to facilitate the way for reopening. This immediately raises the question of whether or not this criterion is sufficiently robust — the jury is still out on how effective two (not one!) doses of Sinovac is against the Delta variant, and according to Public Health England, one dose of AstraZeneca offers only 30% protection for this variant. 

But to significantly overshoot this goal by October would require Herculean efforts. At the time of writing, almost 13% of the population have received their first dose and almost 5% are fully vaccinated. On June 8th, Thailand delivered a little over 470,000 jabs, but owing to supply issues, vaccinations per day have not been nearly as high since. According to the Covidvax tracker on the Ministry of Higher Education’s website, Thailand is currently averaging around 240,000 doses a day. At this rate, to fully vaccinate 70% of the population would require another 356 days.

The only way to fix this issue would be to find a way to increase Thailand’s vaccine supply. On this, Thailand faces problems in all directions. Instead of the 10 million doses of AstraZeneca a month expected from Siam Bioscience, Thailand can now expect only 5-6 million due to export obligations. Pfizer, Moderna and Johnson & Johnson are unlikely to arrive until the fourth quarter (and a contract has only been signed for Pfizer). Thailand’s domestic vaccines will not be ready until 2022. 

At this point, including Japan’s donation of 1 million doses, Thailand would only be able to expect less than 20 million doses of AstraZeneca in the next three months. The government’s solution seems to be to make up for the shortfall by importing more Sinovac and Sinopharm vaccines with 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 the alternative — simply vaccinating less — it leaves one wondering about Thailand’s readiness for reopening. Once again, we still don’t know enough about Sinovac and Sinopharm’s efficacy vis-a-vis Delta. A CNN report recently noted that Mongolia, Chile and Seychelles, which have all inoculated a significant portion of its citizens using Sinovac or Sinopharm, are still experiencing coronavirus surges. Although the vaccines have undoubtedly helped reduce hospitalizations and deaths, it is becoming 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 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. 

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