Nearly a year into the Covid-19 pandemic, there’s now a huge divergence in how different countries are handling coronavirus.
We’re in a relatively unusual position of having spent significant time in two very different countries during the pandemic. The UK has struggled badly at keeping Covid in check, while Thailand on the whole has kept numbers low. And unsurprisingly, the experience of being in both countries is wildly different, so it’s worth comparing life and approaches between the two.
For many months, most of 2020 in fact, Thailand recorded zero local cases of coronavirus, catching a few travellers every day in quarantine with the virus.
It’s true that Thailand is now in a new ‘wave’ of infections, but to put that in context, the total recorded Covid cases in Thailand are around 12,000 at time of writing. Recently the UK was hitting 80,000 cases per day in a similar population size. The UK has well over 1000x more recorded deaths than Thailand.
Some caveats to what follows. It could transpire that some factor of climate, demography or whatever might account for the gulf in numbers. I’m absolutely no scientist. These are my observations and opinions only based on what we have seen.
Equally, Thailand does not appear to be carrying out mass community testing to the same degree as the UK. But at the same time, less than 3% of Covid test in Thailand are positive. Hospitalisations and deaths are also lower by orders of magnitude. In short, at face value and from all available indicators, Covid-19 hasn’t engulfed Thailand in the anything like the same way as it has the UK (although see the end of this article for an update!).
So what’s different? Some observations:
Border controls and state quarantine
Border controls. The biggest single and most obvious difference. From March until late last year, Thailand has been effectively closed to the outside world, and while tourism is now an option there remain extremely rigorous processes to come in.
It’s the main reason we were in the UK for so long in the first place – between March and July we physically could not get to Thailand. Only repatriation flights were allowed until fairly recently.
Everyone entering Thailand has to quarantine in a state-approved facility for 15 days. For foreigners that means an approved hotel at your expense. Before travelling, you have to show a negative Covid-19 test taken at most 72 hours before departure, plus a laundry list of other documents and approvals. If you test positive in quarantine or on arrival – off to hospital until you test negative. It’s a robust, well-organised system that overall has worked.
We spent two solid weeks in a hotel room with multiple tests before we were allowed back out into the general population. The strategy has been to stop the virus getting into the country, then stamp out local outbreaks, and it seems to have worked on the whole.
Until very recently, in the UK it’s been far more lax. Self-isolation has been a paper requirement for some but not all travellers, but there’s very little evidence of it being enforced. It’s odd that the situation is deemed serious enough to close schools, businesses and facilities for months on end, but at the same time not to require state-governed quarantine or serious checks on all incoming arrivals.
As we’ll see, there’s generally a great deal more freedom in daily life in Bangkok, likely because case numbers are relatively low. The important difference I can see is that the virus is kept out of the general population at the border. Thailand is typically logging between 10-20 cases per day detected in quarantine. This is despite having to test negative for Covid before travel, having to jump through a number of hoops to come in the first place, and having extremely low numbers of visitors anyway.
Looking at some very back of the envelope maths – Thailand was getting around 50,000 arrivals per month in mid-2020 – down 99.5% on last year. The UK in July was hitting 500,000 per week with travel corridors. So in a month that’s 40-50x more visitors, and that could be 500-1000 incoming infections per day from all over the world, likely more given the few restrictions on entry and no need (until now) to provide a negative test. How could you possibly stamp out the virus locally if 1000 infections are being imported every day and allowed to head all over the country, isolation or not?
Looking at other countries who have kept the virus in some sort of check – Vietnam, Australia, New Zealand – incredibly strict border controls all round. It’s baffling that this hasn’t been more widespread and is only being seriously discussed now in the UK.
Masks
Mask wearing is encouraged and widespread in all public areas, especially here in Bangkok. Since the recent outbreak it’s particularly strict and people adhere to it. The other day in Lumpini I saw a man running with a mask, a face shield and another mask on his head.
Basically, if you’re not at home you have a mask on, except when exercising outdoors or when eating or drinking. That does get stretched a little but overall masks in public are very widely used, at least here in Bangkok.
Masks were already common here especially when people felt unwell, so they’re a less novel concept.
In the UK, masks were pretty late to the party. When we were there, there was no guidance or directive on masks and they weren’t widely used. Now they are widespread, but typically indoors eg. shops.
Quite how much of a factor they are, I’m not sure, but in Thailand you certainly have a higher level of compliance and general wearing as standard vs what we saw and have heard since from the UK. In most places in Bangkok you aren’t allowed inside without your mask on and would get some funny looks strolling around outside without one.
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Temperature scanning and tracking
The majority of places you visit in Thailand now have temperature scanning at the door, either by someone with a scanner or by a hand scanner. Often this comes with a side of hand sanitizer and there is a lot of visible cleaning and disinfecting going on generally. One of the guards at a park we go to regularly pretends he has a laser gun and goes ‘pew pew’ when he scans you.
Obviously temperature scanners are never going to pick up asymptomatic carriers but I think they play more of a role in keeping people’s guard up. They’re a visual reminder to be vigilant and they possibly stop people from going out if they feel a bit grim.
Thailand does have a simple QR-based scanning system – Thai Chana – to check in and out of almost all public places, and a further app for track and trace. Usage of the scanning varies from what we’ve seen, plenty of people scan but plenty don’t.
One aspect that was mentioned after I posted this was community healthcare run by local government in partnership with local leaders. Apparently this has been very effective on checking that people who should be self-quarantined (for example after provincial travel) are doing so.
It’s a little more proactive than the UK in general which relies more on tracing, having failed spectacularly to implement a tracking app despite much fanfare. A common theme.
Daily life
When we were in the UK, the rules were a lot stricter than they are now in Bangkok. Between March and July in the UK we only went outside for groceries and exercise maximum once a day. We didn’t see anyone outside our household save for dropping groceries at the door of a relative once a week. Thailand around the same time was under similarly tight restrictions with everything closed, no travel etc.
Whilst the UK was in a true lockdown and is close to it again – only supermarkets and pharmacies were really open, Bangkok today isn’t really in a lockdown at all.
Since we returned in July and until January this year, day to day life was verging on normal in Bangkok, minus the tourists of course. Everything was open as normal until the new outbreak, and subsequently the restrictions are nowhere near as severe as in the UK.
Even now in Bangkok, much is still open albeit on more limited hours – restaurants, shops etc – but places like schools, gyms and exercise facilities have been closed for a couple of weeks before re-opening in the coming days. Alcohol sales in restaurants are currently suspended and bars are closed outright. Inter-provincial travel is not recommended from Bangkok. People are encouraged to work from home, as per the UK, where possible.
But in Bangkok people can go out, people can eat at restaurants, dance in the park at a distance and do things that aren’t possible under the UK restrictions.
So day to day in Bangkok is much more normal than when we were in the UK and the current UK measures. That normal is nowhere near ‘normal’ of course – Thailand’s low numbers have come at the cost of practically mothballing the international tourist industry and the economic impact on Thailand has still been significant despite keeping Covid in check, albeit markedly less than the UK.
Other ‘model’ countries like South Korea have seen a smaller impact economically, but their tourism industry accounts for 5% of GDP. In Thailand tourism typically accounts for 20% of GDP.
Economics aside, looking at the Covid control measures overall, I can’t help but think the border and quarantine strategy is the major driver of difference. Masks, scanning and the like may well play a role, but with similar measures in both countries the quarantine measures stand out as the point of difference. On the day to day differences, the UK was actually quite a lot stricter when we were there and in the latest lockdown.
From what I can see, Thailand and other low-incidence countries have very likely made the correct but difficult move by adopting the quarantine approach, and that it’s made local control of cases much more realistic. It’s also allowed for far fewer restrictions on daily life and the local economy, even if there are a few measures in place which are stronger than the UK.
The UK is now going hard on vaccination which is good to see, while Thailand is looking to start vaccinating in February and will likely need to keep up the vigilant but painful approach a while longer.
As ever – fingers crossed there’s an end in sight to all of this.
What happened next…
What a difference a couple of months makes! Since I wrote the first version of this piece back in January 2021, the story has evolved quite significantly. Now into April, Thailand has seen a marked increase in cases and are currently clocking around 2,000 new infections per day, ironically of the UK variant. At the same time, the vaccine rollout has been frustratingly slow, with little over 1 million of the 65 million people in Thailand receiving at least one vaccine dose.
Contrast to the UK – widespread vaccination has seen a huge decrease in cases and deaths with the country well on the way to opening up, even if that does mean a pint in the pissing rain outside a pub.
Putting the numbers into context, Thailand is still logging fewer cases and deaths today than the UK, but the numbers are now very similar. Whilst it feels like the UK is moving towards re-opening, the latest Thai outbreak and a lack of a strong vaccine programme makes that feel further away here in Bangkok, where new restrictions have come into place on daily life. It’s by no means a lockdown but it feels like progress lost.
For my money, Thailand moved away from the approach that served so well up to now when dealing with the new cases. The government has had less appetite to close down travel, particularly over the Songkran new year period, leading a cluster of cases in Bangkok’s Thonglor district to spread widely. Equally I can see why they were not keen to close down given the extra kick to the economy this would have caused. The worry for Thailand now is that the crucial reopening of borders will be further delayed and we may have had short term gain for long term pain.
Meanwhile the UK looks as though it’s reaching some light at the end of the tunnel. Looking at the past year, you could see an ideal strategy by taking Thailand’s hard approach at the start, and the UK’s hard approach on vaccines. The UK has been through a heck of a lot worse than Thailand, but may well emerge earlier.
As of the start of May, Thailand is on track to get seriously vaccinating within the next month or so. With the UK now the example to follow, here’s hoping many other countries can get vaccines rolled out ASAP and there is an end in sight…
Another marked difference between the UK & Asia is social responsibility. You mention that masks weren’t an alien concept to the Thais before the pandemic, which is the case for many Asian countries (wear a mask to protect others from your germs). I suspect there aren’t as many epidemiologist graduating from Facebook and YouTube University in Thailand either…
An admirable analysis, but whilst comparing LON with BKK, perhaps one should mention that this virus tends to ‘breed’ better in cold weather, London being a rather chilly place and Bangkok one of the world’s hottest cities…
Yes I think this is valid, as I said there could be something on these lines that makes a massive difference. On the other hand Korea has similarly tight restrictions to Thailand and a closer climate to the UK and kept it largely in check.