Covid-19 in Thailand, a Mystery

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Something strange is  going on in Thailand.  By all measures, Thailand should have been devastated by the Covid-19 pandemic by now.  In January and early February over 1 million Chinese landed in Thailand.  As of mid-February, over 100,000 Chinese travelers were still in Thailand.  Just walking around Chiang Mai in early 2020 felt like walking around a Chinatown.  Most certainly, the SARS-CoV-2 virus landed in Thailand in late December, or early January.  In fact, the first confirmed case outside of China was found in Thailand on January 13.  

 

Thailand is a densely settled country.  The overall density is 354 people per mi2 but this actually understates the reality in the urban areas; Bangkok has a population density of 13,700/ mi2.   Thai’s love to hang out in large groups.  The more the merry here. 

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Chiang Mai’s walking street in mid-January 2020.  If I were a virus looking for a pandemic, this would be a good place to start.

Thailand would seem to have been fertile ground for a new virus that was seeded here early and often by traveling Chinese.  But it never really took off.  Why?

Today, there have been 2,579 document cases of Covid-19 in Thailand and 40 deaths.  By comparison, New York State with a population less than 1/3 of Thailand has 189,415 cases, and 9,385 deaths.  The disparity is getting larger by the day.  Yes, I know we are probably comparing apples to oranges.  There is a very large discrepancy in the testing rate.  As measured per capita, New York tests 23 times more people than Thailand.  But New York has 73 times more cases, so when corrected for the testing disparity, New York still has 3 times more cases as compared to Thailand.   I would argue that the testing disparity is not that large; both New York and Thailand (at least at the beginning) had similar criteria for doing the tests – basically you had to be sick enough to be at the hospital.  I think a significant part of this testing-disparity is because there were fewer people in Thailand sick with Covid-19. I would further argue that the number of deaths is not nearly as impacted by the testing disparity.  Both New York and Thailand have likely undercounted deaths by counting only hospital fatalities.  The reality is that if Thailand had a similar per capita death rate, there should be nearly 30,000 deaths here!  But there are only 40 deaths in Thailand as of this writing.  This huge difference cannot be caused by lack of testing or any effort at hiding the death toll in Thailand.  

Thailand did not go into lock down until around March 20, and even now, the lockdown is not nearly as complete as in New York or California.  Prior to mid-March that it was pretty much business as usual here.  There was no early and aggressive intervention by the Thai government that kept Covid-19 at bay.

What is it that makes Thailand such infertile ground for the SARS-CoV-2 virus?  Could it be climate?  Perhaps the universal inoculation of the Thai population with the BCG vaccine gave them a large degree of immunity to Cover-19?  Perhaps, it’s the Thai habit of “waiing” instead of shaking hands?  Could it be some quick of genetics?  Something in the food here?  Why is this not big news, and why isn’t this discrepancy being widely studied?  Sorry, I only have questions.