Lessons from Thailand’s COVID conundrum

As the ongoing coronavirus pandemic has wreaked havoc on governments and societies everywhere, national responses to cope with COVID-19 have focused on containing and minimising infections and deaths. While most countries are still trying to come to grips with the pandemic, others are grappling with second waves and sudden spikes. Among the few that have slowed and practically stopped the outbreak is Thailand, which is steadily heading towards 100 days without a local transmission. But Thailand’s seemingly impressive virus-fighting strategy has become a victim of its own success. As recent virus recurrences in Vietnam and New Zealand attest, after more than three months of virus-free conditions, the optimal strategy may be to find a way to live with COVID-19 rather than to keep it out completely. 

Learning to live with and beyond COVID

As widely noted, Thailand has done well by keeping infection numbers steady and below 3,400 with a comparatively low death count of 58, ranking the country impressively around 114^th among 215 states and territories. New daily infections could be counted on a single hand, and all of them have come from returnees and visitors holed up after arrival in a mandatory 14-day state quarantine.

Through its Centre for COVID-19 Situation Administration, the government of Prime Minister Prayut Chan-o-cha has made clear its strategy is to hold out for a vaccine, keeping local infections to a bare minimum. But therein lies the problem. As infections became the focus, a local momentum of single-digit to zero cases built up. Each daily COVID-19 centre briefing became a sort of battle cry and a call for victory, quietly cheered and celebrated with relief and national pride. It promoted an air of triumphalism as if Thailand had somehow conquered the pandemic. 

A moving mix of objectives

But fighting COVID-19 is not a war to be lost and won. It must be a resilient process and sustained effort of management, mitigation, and minimisation, overcoming and outlasting a deadly virus that will be around for a long time. Thailand’s virus numbers will inevitably rise again. The key is to live with and beyond them. The COVID-19 centre has itself to blame for setting the bar so high: it is the outcome of having medical professionals in charge of a policymaking operation. By training, medical doctors are geared to cure diseases and eliminate infections. If the Thai government leaves it solely to the doctors, the aim would be low to nil infections at the expense of all other policy priorities. When the COVID-19 outbreak was at its peak in March-April, Thailand needed its doctors to take charge. But now other experts must be listened to and a more holistic approach should be taken  

What Thailand needs is a new approach in view of a moving mix of objectives. The “zero” mentality is detrimental to the Thai economy and people’s livelihoods. It makes Thais afraid of reopening and taking calculated and inevitable risks in a trade-off between public health safety and economic well-being. The Thai authorities need to come up with a rolling average of Thailand’s healthcare capacity for pandemic management. This would indicate the range of case infections Thailand can put up with in an ongoing fashion, taking into account all available hospital beds, ventilators, doctors and so on. This range can then be worked into a system of testing, tracing and isolating (TTI). As infections can become recoveries through TTI, the rolling healthcare capacity can be adjusted and maintained as needed. 

Reviving the economy

With this number to work with, the Thai government can then look at priority areas in Thailand’s services-dominated economy to resuscitate and revive, with all precautions and hygienic requirements in place. Green lanes and “bubbles” for essential business travel are a priority. While mass tourism of the recent past is now unattractive, niche medical tourism can still work. Foreign talent and direct investment connected to the Eastern Economic Corridor and Thailand 4.0 projects should be at the forefront. 

The alternative is to maintain single-digit or zero infections in a relatively autarkic economy with lost jobs, corporate bankruptcies, non-performing-loans, and diminished and dimming prospects for local livelihoods. These dire prospects already have fed into Thailand’s youth movement that wants to overhaul and remake the country. While taking these chances to reopen will only shore up the Thai economy from what will be a deep economic contraction, it is a start.  

Somehow the extremes of having uncontrollable outbreaks or flattening infections to zero or single-digits may not be a long-term optimal answer. Somewhere in the middle of tolerating infections for economic activity and livelihoods while upholding recoveries and minimising deaths may ultimately prove most effective under fluid virus conditions and shifting priorities. Countries that have lived with the virus more widely and effectively will stand in better stead to move on.