Nearly two weeks into Thailand's official reopening during the Covid-19 pandemic, it is time to evaluate the country's vaccine management plan, economic costs and prospects of recovery. While the reopening is worth the attendant risks, Thailand is paying a disproportionately high price for earlier mistakes and the government's mismanagement. As the reopening phase builds up, the Thai economy is likely to see a weak and tentative recovery trajectory with medium-term challenges and question marks.
As all countries have had to grapple with the pandemic in different ways, mistakes are unavoidable, and much learning by doing is involved. A year ago, many countries in Asia were in good shape with relatively low caseloads compared to those in North America and Europe. Towards the end of this year, much of Asia is shaking off virus surges, racing for vaccinations and herd immunity. From the bottom of world rankings, countries in Southeast Asia are now ranked near the top for infections and death counts.
Concurrently, virus numbers in the United States now appear to be under control, thanks to its three main vaccines that are easily accessible from Pfizer, Moderna and Janssen. China was the first-in and first-out of the Covid ward last year but has had to keep its borders closed by imposing strict quarantine rules to suppress virus surges. Generally, the Western world offers a mixed picture, as infections have persisted. While effective vaccines are widely available in the most developed economies, a significant number of people there have refused to be jabbed. Most people in Asia want to get their hands on the best-perceived vaccines but these are not always easy to come by.
Amid these fluid virus and vaccine dynamics, Thailand's early mistakes and mismanagement are impeding its way forward. During the second half of last year, Thailand thrived at home by shutting out visitors from abroad. A "zero Covid" mindset set in, and with it a sense of complacency. When it came time to order vaccines, Thai authorities were slow to queue up, while banking on an exclusive licensed manufacturing deal between AstraZeneca and Siam Bioscience.
It did not seem illogical at the time because infection numbers were low and under control. But when caseloads shot up early this year, gravely exacerbated by the Delta variant and new virus waves from April, the situation spiralled. The local production of the AstraZeneca vaccine was delayed and short of target. As the more popular US jabs had not been procured, Thailand had to import more and more Sinovac, a Chinese product with a reputation and efficacy that have been in doubt despite its endorsement by the World Health Organization. Anyone around here presented with a choice between Pfizer or Sinovac would invariably choose the former.
To date, more than 25 million Sinovac doses have been administered locally. Out of the blue last May, Chulabhorn Royal Academy decided overnight to purchase China's Sinopharm vaccine, and has registered for more than 13 million shots so far. Together, the Sinovac and Sinopharm vaccines add up to more than the 36 million AstraZeneca jabs.
As a vaccine hierarchy set in, with popular preference for AstraZeneca and Pfizer/Moderna, the pandemic situation became more complicated by unequal pricing. Some doses were charged for, some were not. This led to other challenges. For example, when Poland wanted to donate 3 million Moderna doses to Thailand via Thammasat University, the deal stumbled because of Thailand's pricing discrepancy. The condition with the Moderna donation was that it had to be free of charge but the local handler needed to cover logistical costs. As the government was not smart enough to offset admin costs on behalf of Thammasat, nothing has come through.
The policy mistakes of not procuring enough and diverse vaccine types were one thing. It should have led to the transfer and demotion of elected officials and public health bureaucrats involved but so far there has been no accountability. Our public health and well-being are still being supervised and overseen by the same officials and bureaucrats who made blunders earlier that likely cost lives.
Even more unforgivable was the potential vested interests involved. As media news and analyses have pointed out repeatedly, the Sinovac procurement seemed fishy. Thailand reportedly paid a higher price for this Chinese vaccine than other countries. When its efficacy was questioned, the government, instead of going for better vaccines, still kept ordering it. The public suspicion is that there may have been commissions and unscrupulous dealings involved.
The only way to find out is to set up a public inquiry but there is none so far. Instead, the government wants to issue an amnesty decree absolving public health officials from any wrongdoing on vaccine procurement and pandemic management.
The Sinovac vaccine then caused an adverse chain reaction. Some Thais are being given a third "booster" shot of AstraZeneca or Pfizer because their first two shots were Sinovac, known to have a shorter immunity period. In addition, health authorities have had to mandate and market the cross-vaccination approach by pairing Sinovac with AstraZeneca as being more efficacious. The long-term effects of mixing vaccines are still being studied. A viral-vector vaccine like AstraZeneca and Janssen mixed with mRNA peers, such as Pfizer and Moderna, has received favourable reports in early studies. But what is known about the Sinovac or Sinopharm mix with AstraZeneca or mRNA vaccines is scant.
The mix-and-match approach is being undertaken out of sheer necessity because Thailand has to use up the Sinovac jabs that have been bought and because reaching 70% complete vaccinations is imperative for a full and sustained reopening. To date, full two-dose vaccinations represent just 51% of the 70-million population, whereas the first dose coverage is 64%. The third-dose boosters, at 4% of the population, should be given to recipients of the first dose but this can't be done because of the Sinovac baggage.
This means the reopening is a big bet on public health. As the 70% complete-vaccination target for the end of this year falls short, Thailand will be forced to take its chances. The economy contracted 6.1% last year, with a 1% expansion projected or even flat growth this year. A full recovery to pre-pandemic numbers is unlikely until 2023-25.
Getting rid of long quarantines for one-day "test and go" requirement has not brought back tourist numbers as much as anticipated. Overall, the reopening is a worthwhile gamble but Thailand is paying for its past mistakes and mismanagement that will keep recovery slow and tentative.
It is understandable to think short term about reviving tourism and boosting growth. But this is also the time to convert crisis into opportunity by thinking longer term about higher-end tourism, strategic immigration for high income and foreign talent, systemic education overhaul, and a more open and equipped environment for innovation and new tech-heavy industries.