PHETCHABUN: A senior official at the Ministry of Public Health, while announcing the latest infections on Wednesday, warned that if the current trend continues then Thailand faces a ‘vast and uncontrollable’ epidemic. It comes as his colleague at the ministry, the chief of the communicable disease division, stated that the best-case scenario, if there is a full-blown outbreak, would be a toll of 400,000 infections which would peak only in January and February 2021. 

A 67-year-old Belgian man is in a critical condition straining to breathe as he fights for his life against the Convid 19 coronavirus in Phetchabun. He arrived in Thailand on March 3rd and holidayed in Pattaya until March 10th when he became sick. His condition was revealed today as Thailand recorded its largest number of infections, so far, although authorities still insist the kingdom is still in a controlled stage of this emergency. However, on Wednesday, the Thai prime minister revealed that if a Phase 3 breakout occurs, which eminent doctors and professional bodies have declared a certainty, then Thailand will go into lockdown mode. This has implications for all foreigners both now living in Thailand and thinking of travelling to the kingdom. 

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Two senior officials at the Ministry of Public Health made striking statements on Wednesday. While announcing the largest rise in infections so far to well over treble the number last week, Dr Suwannachai Watanayingcharoenchai, the Director-General of the Department of Disease Control said that if the current situation continues then Thailand faces a ‘vast and uncontrollable’ epidemic. On Wednesday also, the Thai Prime Minister Prayuth Chan ocha said that a Phase 3 outbreak would see the country placed in lockdown. The situation has implications for all foreigners living in Thailand and those considering travel to the kingdom.

Thailand announced 35 new cases of the coronavirus on Wednesday, a record, bringing the total cases now to 212. That means the figure for those confirmed to have the virus has nearly quadrupled in a week.

On Wednesday also, the Thai Prime Minister Prayuth Chan ocha suggested that urgent preparations had begun to prepare the country for a Phase 3 widespread transmission of the disease which other government agencies have said could see Thailand, in a best-case scenario, suffer 400,000 infections and see this crisis extended until early next year.

Prime Minister confirms that plans for Phase 3 are being put in place to deal with widespread infection

On Wednesday also, General Prayuth confirmed that if a Phase 3 situation is announced, Thailand will be placed in lockdown. On Tuesday night, Taiwan announced that all foreigners would be banned from entering the country.

‘Information must be collected and preparations must be made beforehand, starting today. If the outbreak reaches its third stage, it will be hectic and the country will be locked down,’ the Prime Minister said on Wednesday. He said that no one wants to see such a situation develop but if it was required, then it will happen.

Reports on Wednesday night suggested that Public Health Minster Anutin Charnvirakul was sourcing antiviral drugs from China.

Tourism industry leader calls for lockdown now

The day before, a Thai tourist industry leader called for a lockdown of the kingdom. Chamnan Srisawat, the president of the Thai Federation of Provincial Tourist Associations said such a move may help contain the disease now seen in the capital and some other tourist centres.

Leading virologist and physicians body says it is either inevitable or already happening

We have already heard this week from leading physicians in the Thoracic Society and Dr Yong Poovorawan of Chulalongkorn University. They have said that a Phase 3 breakout is either inevitable and in the case of the respiratory physician’s society, already underway in Thailand.

Foreigners must plan now for the growing eventuality of a lockdown in Thailand with limited movement

This has implications for foreigners living in the kingdom as they consider travel plans. Now, based on logic and probability, it is a reasonable assumption to consider that this will happen.

This will mean flights suspended in and out of Thailand and considerable limitation of movement within the kingdom by necessity.

This may be particularly problematic for foreigners living in Thailand who are most at risk, such as those with underlying conditions or who do not have strong support networks.

Prime Minister says Thailand is still in a state of a limited or controlled virus outbreak but has acknowledged that plans are being made for Phase 3

On Wednesday, Prime Minister Prayuth still insisted that the country remains in a situation where the outbreak was being controlled. 

However, the rise in infections is perplexing.

He revealed that authorities are making preparations to expand the number of beds available for those seeking treatment for the Convid 19 virus.

This may include the use of military hospitals, reorientation of existing facilities or the opening of new ones and perhaps the use of hotels.

Government is guided by projections of a secret report prepared by an emergency response unit at the Ministry of Public Health

The government appears to be following a model for the progression of the disease outlined by the Emergency Operation Centre, a unit of the Department of Disease Control at the Ministry of Public Health.

It is taking the current data available in Thailand and comparing it with international events.

The planners, anticipating a Phase 3 breakout, suggest that 5% of cases may become critical and significantly, that only 45% of those infected will display symptoms and require treatment at all.

The basis of this is data obtained from studying the outbreak aboard the large population of the Diamond Princess cruise ship quarantined in Japan recently.

The government is also preparing for a death rate in the order of 2% of those requiring treatment.

The current world average for those reported as being treated according to the methodology of the World Health Organisation Director-General, Tedros Adhanom, is 4.1%. In Italy, with now over 2,500 deaths, this figure is 7.94%.

Expert panel predicted no Phase 3 outbreak nationwide but a limited outbreak in Bangkok and other tourist provinces

One optimistic point we can grasp is that when viewed by journalists for a Thai news agency at the end of last week, the government’s report did suggest that there would not be a Phase 3 breakout nationwide in Thailand. It predicted a rise of infections in Bangkok and other provinces associated with tourism.

It predicted over 2,200 infections by May in this judgement and analysis.

Most cases on Wednesday still linked with boxing stadium as well as 6 Thai returnees from Cambodia

Dr Suwannachai Watanayingcharoenchai, the director-general of the Department of Disease Control, announced 35 new cases on Wednesday, many of which are linked to a boxing stadium cluster but also including 6 Thai nationals returning from Cambodia and four Thais working closely with foreigners, mainly in the hospitality industry.

The top health official disclosed that there were now two additional critical cases bringing the total to three.

One is a 49-year-old Thai man in Surat Thani who has developed renal complications. He came down with symptoms of the disease on March 8th.

Belgian reported on Tuesday now in critical condition in Phetchabun after being taken ill on March 10th

The third is the foreigner from Belgium who on March 10th called his family in Phetchabun to ask them to collect him after spending a week’s holiday in Pattaya.

The 67-year-old man has a Thai wife in the north-central province who is currently in quarantine with her extended family.

The Belgian has developed acute respiratory distress syndrome (ARDS), one of the most terrifying aspects of this disease as it attacks the lungs and pulmonary system. He is now on a ventilator and in isolation at Phetchabun hospital.

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Ministry official says expanded testing is linked with rising infections in Bangkok linked with boxing

Dr Suwannachai revealed that the recent surge in numbers is linked to moves by health officials to expand testing to groups believed to be at the highest risk from the disease.

He cautioned that those who tested positive for the coronavirus were people who had blatantly ignored government advice, in particular, to stay clear of crowded areas.

The Ministry of Public Health is also asking anyone with symptoms and who visited any Bangkok nightlife venue from March 9th and 10th, to come forward and be tested besides those who attended boxing events staged between March 3rd and March 6th at two venues in the capital.

‘If the current situation continues, the epidemic in this country will be vast and uncontrollable’

However, Dr Suwannachai warned that if the current trend continues then this epidemic will wreak havoc on the kingdom.

‘If this situation continues, the epidemic in this country will be vast and uncontrollable’ the top Ministry of Public Health doctor admitted.

Best case scenario is a widespread outbreak with 400,000 infections and a peak next year

Meanwhile, even the most optimistic forecast presented on Wednesday by Dr Sophon Iamsirithavorn who is the Chief of the Communicable Disease Division at the Ministry of Public Health was quite sobering to contemplate.

He told the media that the best-case scenario for the Thai government in a widespread outbreak of the disease would be 400,000 infections assuming an infection rate of 1.6.

There is no definitive data yet on the infectiousness of the disease which is very much controlled by people’s behaviours and movement. Without such controls, Convid 3 has been shown to have an infectiousness rate of up to 2.4.

Behaviour of the population to control the spread

In the government’s best-case scenario of 1.6, this would leave Thailand facing 400,000 infections

Based on the data relating to the number of infections, this would leave 180,000 people showing symptoms of the disease based on the cruise ship sample, with up to 9,000 of these developing to a critical condition. This could see 3,600 deaths based on a death rate of 2%.

The health experts said that a second estimate is that the country would experience up to 10 million infections.

This large rise comes when the infection rate rises to 1.8. An increase in the infectiousness rate to 2.2 would see over half the population of Thailand becoming infected. 

Worst case scenario of half the population being infected is very unlikely says top ministry official

The doctor indicated that the latter scenario would be extremely unlikely given the rapid changes in the behaviour expected from the population.

The public is becoming aware of the grave nature of this challenge. On the other side of the coin, Dr Sophon says these figures highlight the huge responsibility that is being placed in everybody’s hands to exercise caution at this time.

Dr Sophon estimates that it will take a year for the crisis to reach a peak which will also be disconcerting news to many.

He suggests that this will happen in January and February 2021 when Thailand will again see low temperatures. 

Warm weather so far seems to be a complicating factor – it is not killing the infection as hoped for

This suggests that the hotter weather which the Thai Tourism Minister, Phiphat Ratchakitprakarn, suggested some weeks ago, might wipe out the virus, may only now serve to slow its spread.

Dr Sophon summarised his findings as follows: ‘Going by this forecast, we are confident that the outbreak can be kept under control and medical treatment will be manageable. We don’t expect infections to exceed one million as long as we have close cooperation from the public.’

China after its devastating outbreak suddenly looks hopeful – our world has been turned upside down

The economic and social implications of such a course of events is difficult to imagine at this point. It now brings us to the point of looking at the situation in China as it only begins to recover after two months of devastation, as a source of hope.

Surely this is another wake-up call to suggest that for Thailand and the rest of the world, everything is being turned on its head at this time.

Economic impact of this crisis already building up in the financial system with shocks yet to come

That’s even before we consider the worldwide economic implications of this.

These are currently building up in the financial system from economies everywhere which are shutting down vast segments of activity.

This will be felt in both the short term and long term.

We have already seen some effects such as stock market crashes and layoffs in business both in Thailand and in other countries.

The most significant economic developments have yet to come. Some of them will be shocks. Even if these are managed, others will be felt well after the health crisis has passed.

Further reading:

Bars and massage parlours ordered to close in Bangkok and Pattaya as officials say virus is still local

Another record rise in infections on Monday as top virologist predicts widespread transmission in Thailand

Fears that Thailand could be on the verge of a phase 3 breakout with 32 new infections in 1 day

Anutin is proposing to close all bars and music venues including nightclubs and go gos

Thailand extends quarantine rule for western countries including the US and the UK over virus

Thai Deputy PM Anutin warns the public to be wary of dirty white western tourists who don’t shower