‡Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out.
An outbreak of coronavirus disease 2019 (COVID-19), part of the 2019–2020 global pandemic, has been ongoing in Thailand since 13 January 2020, when the country made the first confirmation of a case outside China.[2] Surveillance among incoming travellers revealed a small number of cases throughout January, almost all of whom were visitors or residents returning from China. The first reported local transmission was confirmed on 31 January.[3] The number of cases remained low throughout February, with forty confirmed by the end of the month. Cases saw a sharp increase in mid-March, which was attributed to several transmission clusters, the largest of which occurred at a Muay Thai fight at the Lumpinee Boxing Stadium on 6 March.[4] Confirmed cases rose to over a hundred per day over the following week, and public venues and businesses were ordered to close in Bangkok and several other provinces.[5] Prime Minister Prayut Chan-o-cha declared a state of emergency, effective on 26 March[6]. A curfew has been announced, effective since night of 3 April 2020.[7]
The Thai government's response to the outbreak was initially based on surveillance and contact tracing, in accordance with the Department of Disease Control's three-stage response model. Temperature and symptom screening for coronavirus testing was implemented at international airports, as well as at hospitals for patients with travel or contact history.[8] Investigations were performed in response to outbreak clusters. Public education focused on self-monitoring for at-risk groups, practising hygiene (especially hand washing), and avoiding crowds (or wearing masks if not possible).[9] While residents returning from high-risk countries were encouraged to self-quarantine, travel restrictions were not announced until 5 March, when four countries were designated as "disease-infected zones" and travellers subject to quarantine, while those arriving from other high-risk countries are placed under observation.[10] Further restrictions were announced on 19 March, requiring medical certification for international arrivals, and also health insurance for foreigners.[11][12]
The government has been sharply criticized for various aspects of its response to the crisis. In early February, in response to concerns over hoarding and price gouging of face masks, the government issued price controls and intervened in their distribution.[13] The move failed to prevent shortages among hospitals, and became a scandal over perceived corruption and siphoning of supplies.[14][15][16] Criticism was also aimed at the government's inconsistent policy over international travel and quarantine requirements, indecisiveness and slowness to act, and poor communication — many official announcements were made available to the public, only to be quickly retracted or contradicted by other government units, and later changed.[17][18] The abrupt closure of Bangkok businesses prompted tens of thousands of workers to travel to their hometowns, risking further spread and reflecting the failure among agencies to coordinate a unified response.[19]
Timeline
January
On 13 January, the Ministry of Public Health announced the first confirmed case, a 61-year-old Chinese woman who is a resident of Wuhan. She had not visited the Huanan Seafood Wholesale Market, but was noted to have been to other markets. She developed a sore throat, fever, chills and a headache on 5 January, flew directly with her family and a tour group from Wuhan to Suvarnabhumi Airport on 8 January, where she was detected using thermal surveillance and then hospitalised. Four days later she tested positive.[20][21][2]
Thailand's second case occurred in a 74-year-old woman who arrived in Bangkok on a flight from Wuhan on 17 January.[22] On 21 January, Nakornping Hospital reported a suspected case of a 18-year-old male patient who arrived in Chiang Mai from Wuhan with a high fever; his blood samples were sent to King Chulalongkorn Memorial Hospital in Bangkok for further analysis.[23][24] His condition had improved according to an official statement released by Maharaj Nakorn Chiang Mai Hospital on 31 January.[25]
On 22 January, the MOPH announced two additional confirmed cases. The third was a 68-year-old man, a Chinese tourist as in previous cases. The fourth case was the first case for a Thai citizen; a 73-year-old woman hospitalised at Nakhon Pathom Hospital [th] in Nakhon Pathom Province, arriving from Wuhan.[26][27]
The fifth case was confirmed on 24 January involving a 33-year-old Chinese woman arriving from Wuhan with her 7-year-old daughter who was not infected. She admitted herself to Rajvithi Hospital, three days after her arrival in Bangkok on 21 January.[28]
On 25 January, the government of Hua Hin District in Prachuap Khiri Khan Province reported a case for a 73-year-old Chinese woman patient who had arrived from Wuhan since 19 January before entering a private hospital in Hua Hin on 23 January. Initial blood sample analysis tested positive; however, authorities are awaiting results from another lab for confirmation.[needs update][29]
Another six cases were confirmed on 28 January, with five from the same family in Wuhan and another from Chongqing. Thailand began scanning all travellers from China.[31][32]
On 31 January, an additional five cases were reported, bringing the cumulative number of confirmed cases to 19. One was a local taxi driver who had no records of travelling to China and was thus suspected to have been infected by a Chinese tourist he picked up, making this the first case of human-to-human virus transmission within the country. The taxi driver was reported to have come into contact with at least thirteen other individuals, mostly family members, before seeking treatment.[3] The other cases were Chinese nationals.[33][34]
February
On 2 February, doctors from the Rajavithi Hospital in Bangkok announced that they had seen the success in treating severe cases of COVID-19 using a combination of drugs for flu (oseltamivir) and HIV (lopinavir and ritonavir), with initial results showing vast improvement 48 hours after applying the treatment. However, it was still too soon to confirm that this approach can be applied to all cases.[35]
On 4 February, the Thai government dispatched a Thai AirAsia plane to retrieve 138 citizens who were trapped in Wuhan following the lockdown, which landed at U-Tapao International Airport at 7:00 p.m. local time. Among the evacuees, six were hospitalised with high temperatures, with the rest subsequently sent to be quarantined in Sattahip Naval Base for two weeks. Three citizens were not evacuated, which included two students with high fever and another with an overstayed visa.[36] On the same day, Thailand confirmed another six cases, including a Thai couple who had just returned from Japan; it was unclear whether they had contracted the virus while travelling or after returning to Thailand. Two new cases were also reported in drivers who had picked up Chinese passengers.[37]
On 8 February, another six cases were confirmed involving two Chinese, and one passenger on board the evacuation flight from 4 days ago and two other Thais who had exposure to tourists. These six cases brought the total count of confirmed cases to 32.[38]
On 11 February, another new case was confirmed, bringing the total count to 33.[39]
On 15 February, the 35th case was found in a 35-year-old Thai woman who worked in a private hospital, marking the first infection in a health worker. An investigation found that she did not wear a mask and protective suit while treating a patient.[40] Several previous reports erroneously claimed that she worked for Bamrasnaradura Institute, which was later refuted and clarified by the MOPH.[41]
After 8 days with no reported cases, two more cases were confirmed on 24 February, bringing the number to 37.[42] Two days later, the number of confirmed cases went up to 40, two of which were Thai nationals who had recently been to Japan. The elderly couple, who had just returned from Hokkaido, had already spread their virus to their 8-year-old grandson at home before seeking treatment. 101 high-risk individuals whom they came into contact with were tested for the virus, including fellow tour group members, family members, passengers on their returning flight, medical workers and the grandson's classmates; 97 tested negative while 4 are still awaiting confirmation.[43] The grandfather was criticised by Public Health Minister Anutin Charnvirakul for initially refusing to disclose his travel history when interrogated by doctors, as he was at risk of becoming a super-spreader.[44]
On 29 February, a new case was confirmed, bringing the total count to 42. A 21-year-old salesman whose job brought him exposures to foreign travellers tested positive for SARS-CoV-2.[45]
March
On 1 March, MOPH reported the first confirmed death in Thailand, a 35-year-old Thai who was originally diagnosed with dengue fever at a private hospital in late January. He was later transferred to Bamrasnaradura Institute on 5 February after testing positive for COVID-19, where he received treatment and had since fully recovered by 16 February. However, the damage the virus had done to his lungs was beyond recovery and he died from multiple organ failure on 29 February. The ministry is currently carrying out investigations to find out which disease is the main cause of his death.[46] On the same day, King Power issued a statement identifying the man who had died as one of the company's partner-product consultants at their Sivaree branch store. The branch has been closed since the day he tested positive for the virus and all staff examined by health officials.[47]
On March 22, Thailand reported 188 new cases, the largest single-day rise since the virus reached the country. Most of the cases are still under investigation.[48][49] On March 24, three new deaths were announced, all of whom were Thai nationals: a 70-year-old male who had tuberculosis, a 79-year-old male linked to the Lumpinee Boxing Stadium cluster, and a 45-year-old male who had diabetes.[50] 4 medical workers were also announced to have been infected with the virus after coming in contact with patients who refused to reveal their travel history while seeking treatment.[51]
Government response
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Controversies and criticisms
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On 11 February, the Holland America Line-operated MS Westerdam was refused permission to dock at Laem Chabang port by the country's Marine Department.[55] The ship was previously denied entry to the Philippines, Japan, South Korea, and Guam due to similar fears.[56]
On 13 February, two cruise ships, the MV Seabourn Ovation anchored at the Phuket Deep Sea Port and the Quantum of the Seas docked at Phuket's Patong pier. Unlike the MS Westerdam, the two ships were allowed because both had planned to make their first stop in Thailand and would depart to Singapore afterwards. The passengers on board were screened by public health officials before being given permission to step ashore.[57][58]
On 17 February, a meeting between Ministry of Foreign Affairs, Ministry of Public Health, AOT and the Immigration Bureau came to the conclusion to disallow entry of all foreigners from MS Westerdam to the country after an American woman tested positive for COVID-19 in Malaysia. The number of passengers who entered Thailand before the ban was 95, 91 were transferred to connecting flights and had already left the country.[59][60]
On 18 February, the health authorities had extended COVID-19 screening to cover visitors from Japan and Singapore. Passengers from these countries were treated with the same method as passengers on flights from Mainland China. The Ministry of Public Health also raised measures against COVID-19 to level 3 in preparation for a surge in transmission. Every province must have at least one hospital capable of testing for COVID-19. The Department of Medical Sciences is currently developing a virus test kit that will deliver a result in five minutes, which is planned to be available within two months.[61]
On 21 February, the Ministry of Public Health announced a new screening criteria, with additional surveillance for visitors from Hong Kong, Macau, South Korea and Taiwan. People developing pneumonia due to unknown causes and living in eight provinces that were popular among Chinese tourists including Bangkok, Chiang Mai, Chiang Rai, Chon Buri, Krabi, Phuket, Prachuap Khiri Khan and Samut Prakan, would be automatically considered as COVID-19 suspected cases.[62]
On 3 April, the Civil Aviation Authority of Thailand ordered that there would be a ban on all passengers flights landing in Thailand from the morning of 4 April to the evening of the 6 April.[63]
Restrictions on travellers from risk areas
As of 22 March, the Ministry of Public Health defined two types of risk areas:[64]
Dangerous Disease Infected Zones
The Civil Aviation Authority of Thailand (CAAT) is requiring travellers from the following countries to show medical certificates prior to boarding their flights to Thailand and after arriving in Thailand when entering immigration checkpoints or their journey will not be allowed. Also, the traveller must seek quarantine in government-managed places for 14 days with no exception.[65]
People who are arriving in Thailand from the following countries are being asked to go into home-based quarantine for 14 days if they show any symptoms and will be monitored by health officials.
On 4 February, the government announced that four products, namely surgical masks, polypropylene, alcohol-based hand sanitizers and wastepaper, are to be designated as controlled goods under the Price of Goods and Services Act, B.E. 2542 (1999) following a cabinet resolution.[66]
On 6 February, Prime Minister Prayut Chan-o-cha warned that the stockpiling and price gouging of surgical masks and hand sanitizers could lead to legal consequences.[67]
On 12 March, health officials encouraged people to make face masks at home out of cloth, stating that cloth masks can prevent droplets bigger than one micron from spreading.[68]
Bangkok partial lockdown
On 21 March, Bangkok City Hall authorities declared a wide-ranging shutdown of various businesses. Bangkok Governor Aswin Kwanmuang disclosed after the City Hall meeting that the board had passed a resolution to close establishments under Section 35 of the Communicable Diseases Act B.E. 2558 (2015), effective for a period of 22 days from 22 March to 12 April 2020.[69] Only supermarkets, pharmacies, and takeaway restaurants will be allowed to stay open at the malls.[70]
Impact
Economy
Bangkok Airways announced a plan to cut their executives' salaries, reduce the number of flights, and cancel some routes; staff will be on leave without pay for 10–30 days starting from 1 March due to the economic downturn and the outbreak of COVID-19.[71]
Education
On 29 February, The 38th Thailand National Book Fair and 18th Bangkok International Book Fair at Impact, Muang Thong Thani were cancelled.[72]Chulalongkorn and Mahidol Universities, following the confirmation of COVID-19 cases among its staff and student body, began suspending classes on 16 March, while Kasetsart University took the same action as a precautionary measure.[73]
Sports
The "THAI FIGHT" boxing tournament in Chiang Rai has been postponed indefinitely due to concerns of COVID-19.[74]
On 1 March, the Football Association of Thailand decided that all Thai League professional football matches in T1, T2, T3 and T4 between 7 and 31 March will be played behind closed doors as broadcast only events.[75] However, on 4 March, the decision was changed to postpone all matches prior to 18 April indefinitely.[76]
The 2020 MotoGPThailand Grand Prix will be postponed due to the spread of the virus. The event has been put off until the outbreak has abated.[77]
The 41st Bangkok International Motor Show, which was originally scheduled between 7 March to 5 April, has been postponed. The new schedule will be announced later.[78]
Channel 7 Boxing Stadium will continue fights behind closed doors as broadcast only events, according an official statement by the channel.[79]
Tourism
Legend Siam, a theme park in Pattaya, will temporarily close from 3 March because of the lack of tourists during the spread of the virus. The park management promised to hire all staff back when it eventually reopens.[80]
On 16 March, the Ministry of Public Health announced that Songkran holidays and celebrations will be postponed until further notice as the number of cases continued to rise by 33 to 147.[81] The Songkran festival in Khaosan Road, Khon Kaen Province, Pattaya, Bang Saen Beach and Patong will not be held, according to each municipality's announcement. The dates of the holiday are to be postponed as well.[82]Ko Pha-ngan District Chief Somchai Somwong made the decision to suspend a party on Rin Beach to avoid the gathering of tourists, which could pose a risk of virus outbreak. The party had originally been scheduled on the full-moon night of 8 March.[83]
Xenophobia and racism
A restaurant in Chiang Mai displayed a sign which read, "We apologize we are not accepting CHINESE customers. Thank you." after a customer left the restaurant upon noticing a group of Chinese people inside. The police demanded that the sign be taken down, but suggested that it could be rewritten in Chinese as "We ran out of food".[84] A similar sign was seen outside a restaurant in Ao Sane Beach in Phuket.[85]
Graffiti artist Headache Stencil reportedly tweeted, "Hey Chink! Please go back to ur shit-eating country. Our government need ur money to keep their power but you all not welcome for us now. #notwelcometothailand #backtourchinklandpls".[84]
Health minister Anutin Charnvirakul made negative comments about "dirty" Westerners, saying they "never shower" and are more likely to spread the virus than Asians.[86][87] The post attracted negative reaction in Thailand[88] and the UK[89] and was quickly removed. Mr. Charnvirakul claimed he was not responsible for it.[90]
Possible spread to other countries
South Korea –
On 4 February, a South Korean woman, who recently visited Bangkok on a vacation, was tested positive and confirmed as the 16th case of the country[91]
Germany –
On 4 March, Cologne city government announced 5 confirmed cases, including a woman who was previously on vacation in Thailand and is believed to have been infected there.[92]
Australia –
On 5 March, Queensland government confirmed that a 81-year-old man who has recently returned from Thailand tested positive and was admitted to Sunshine Coast University Hospital.[93]
India –
On 6 March, India reported the 31st confirmed case. The patient is Indian who has a travel history from Thailand and Malaysia.[94]
^"ผลตรวจ 101 คน สัมผัส 'ปู่ย่าหลาน' ป่วย 'โควิด-19' ออกแล้ว!" [Lab results of 101 individuals who came into contact with 'grandparents-grandson' infected with 'COVID-19' are out!]. Krungthep Turakij (in Thai). 27 February 2020. Retrieved 27 February 2020.