Leading doctor cites Phuket Sandbox as example of what will happen when Bangkok reopens

[webfact]

Picture: Thai Rath

 

Thai Rath reported the comments of leading Chulalongkorn University figure Dr Thira Woratanarat.

 

Dr Thira of the uni's medical science faculty was looking at the worldwide state of the Covid-19 pandemic and Thailand's place.

 

In terms of new infections Thailand was ranking 10th worst in the world at the moment, 7th if ATK data was considered. 

 

This compared unfavorably with ASEAN neighbors Malaysia, Vietnam and the Philippines.

 

He said that the Phuket Sandbox could be seen as a model for what will likely occur in Bangkok when the city is opened up more fully. 

 

He expected more infections in the capital and spoke of the continued need for caution to stop the situation getting out of control.  

 

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[Tropicalevo]

Nothing like stating the bloomin' obvious.

[ThailandRyan]

Well someone has spoken up and exposed the true nature of how the Sandbox has actually failed and created more issues then it solved, but hey many think that the Sandbox has been a true success.  A success for only those with Skin in the game, but not he regular old little folks who rely on tourism. If as he says this could follow on to the other openings here in Thailand then it is not a guess as to why they have pushed the opening dates back.

[richard_smith237]

 

27 minutes ago, ThailandRyan said:

Well someone has spoken up and exposed the true nature of how the Sandbox has actually failed and created more issues then it solved, but hey many think that the Sandbox has been a true success.  A success for only those with Skin in the game, but not he regular old little folks who rely on tourism. If as he says this could follow on to the other openings here in Thailand then it is not a guess as to why they have pushed the opening dates back.

 

The Sandbox... The very name ‘Sandbox’  is a term adopted from computing and means 'a testing environment in a computer system in which new or untested software can be run securely’ - The adoption of the term ’Sandbox' for the Phuket Sandbox simply means that Phuket has been used as a testing environment to see if the incoming international visitors contribute to the spread of Covid-19. 

 

As far as the Sandbox model itself - it has been proven that incoming international arrivals do not contribute to the increase of Covid-19 on the Island of Phuket - The ’test’ itself has established what it needed to.

 

Phuket and other area’s of Thailand have encountered an increase in domestic transmission.

The Sandbox ’test’ has shown that Vaccinated arrivals who have also had a negative Pre-Flight and Arrival Covid-19 RT PCR test do not present an elevated threat to the spread of Covid-19 within Thailand. 

 

From that ’test' perspective the information established from the Phuket Sandbox has been a success. 

 

IF someone was of the opinion that the Phuket Sandbox model was to increase tourism and provide economic stimulus to the Tourism Industry within Phuket, then they have fallen foul to believing the ’theatre’ and misinformation. 

 

 

38 minutes ago, webfact said:

He said that the Phuket Sandbox could be seen as a model for what will likely occur in Bangkok when the city is opened up more fully. 

The increase in case load in Phuket is not related to the increase in vaccinated individuals from overseas. 

The increase in case load in Phuket is related to domestic transmission in areas of high-population density such as slum accommodation and markets. 

Covid-19 is not being spread on the beaches and in restaurants, most of which are virtually empty (in Phuket).

 

 

 

Edited September 23, 2021 by richard_smith237

[MajorTom]

Well, the sandbox did not "open up" anything. It was actually adding more restrictions. So logically you could draw the absolute opposite conclusion.

Domestic arrivals have been severely restricted in Phuket compared to other provinces. Zero effect.

Actually cases are 3 times higher than the national average.

 

Unless he blames the double vaccinated, triple tested international arrivals for the spread?

[lujanit]

But but the covid czar says it is all under control for the country to open in August.  The doctor will be sent to an attitude adjustment camp.  Telling the truth is a crime here.

[smedly]

14 minutes ago, richard_smith237 said:

The Sandbox ’test’ has shown that Vaccinated arrivals who have also had a negative Pre-Flight and Arrival Covid-19 RT PCR test do not present an elevated threat to the spread of Covid-19 within Thailand.

you missed the important bit

 

Foreign tourists run the risk of getting infected through local transmission and as they are the only people actually being targeted with multiple tests and run the risk of finding themselves locked up through no fault of their own.

 

It is pretty obvious as I have said many times over weeks that CV19 is rampant in Phuket (and lets face it all of Thailand) and their vaccine program has failed to surpress it, tourists need to be aware that only they are targets of mass testing and the chance of a few of them failing a test is high if they mix with untested infected locals. Until Thailand gets this virus under control in Thailand I see no good reason why anyone would want to come here for a holiday, how does Thailand get this virus under control - mass vaccination with effective vaccines and mass testing to show how it is working - unfortunately Thailand is seriously lacking in both - in fact they have reduced PCR testing by some 50% in the last 3 weeks and do not do mass random testing 

[ezzra]

You just can't, by any stretch of imagination even begin to compare Bkk to Phuket, a giant metropolis to a relatively small seaside town, having said that, the only way will be to open Bkk and be vigil to any signs of things are going wrong or situation getting out of control and and than either control it or at least learn from it and do it again, this Covid not going away anytime soon no matter what percentage of the populations will be vaxed, so grab this Covid by the horns and deal with it but let people live again and go back to normal life...

[robblok]

29 minutes ago, richard_smith237 said:

 

 

The Sandbox... The very name ‘Sandbox’  is a term adopted from computing and means 'a testing environment in a computer system in which new or untested software can be run securely’ - The adoption of the term ’Sandbox' for the Phuket Sandbox simply means that Phuket has been used as a testing environment to see if the incoming international visitors contribute to the spread of Covid-19. 

 

As far as the Sandbox model itself - it has been proven that incoming international arrivals do not contribute to the increase of Covid-19 on the Island of Phuket - The ’test’ itself has established what it needed to.

 

Phuket and other area’s of Thailand have encountered an increase in domestic transmission.

The Sandbox ’test’ has shown that Vaccinated arrivals who have also had a negative Pre-Flight and Arrival Covid-19 RT PCR test do not present an elevated threat to the spread of Covid-19 within Thailand. 

 

From that ’test' perspective the information established from the Phuket Sandbox has been a success. 

 

IF someone was of the opinion that the Phuket Sandbox model was to increase tourism and provide economic stimulus to the Tourism Industry within Phuket, then they have fallen foul to believing the ’theatre’ and misinformation. 

 

 

The increase in case load in Phuket is not related to the increase in vaccinated individuals from overseas. 

The increase in case load in Phuket is related to domestic transmission in areas of high-population density such as slum accommodation and markets. 

Covid-19 is not being spread on the beaches and in restaurants, most of which are virtually empty (in Phuket).

 

 

 

But Richard, it still means that the sandbox is a huge risk. Not as much from the tourists but from the Thais themselves. It just shows the risks of opening up too many venues.

 

I fully accept that there are risks from opening up, but there should be some hard limits on extra number of peoples in hospitals in a serious condition. Because if lifting of measures means that hospitals can't cope its dangerous for everyone. So they should have something like a limit, if more then so many people go into the hospital and it looks like hospitals cant cope measures will follow. 

 

Living with it and opening up also means you need to have measures in place to close things down if it gets out of hand. So in this way the Phuket sandbox is showing the risks of opening up. These risks don't come from tourists but from the fact that things are opened up.

 

[robblok]

7 minutes ago, smedly said:

you missed the important bit

 

Foreign tourists run the risk of getting infected through local transmission and as they are the only people actually being targeted with multiple tests and run the risk of finding themselves locked up through no fault of their own.

 

It is pretty obvious as I have said many times over weeks that CV19 is rampant in Phuket (and lets face it all of Thailand) and their vaccine program has failed to surpress it, tourists need to be aware that only they are targets of mass testing and the chance of a few of them failing a test is high if they mix with untested infected locals. Until Thailand gets this virus under control in Thailand I see no good reason why anyone would want to come here for a holiday, how does Thailand get this virus under control - mass vaccination with effective vaccines and mass testing to show how it is working - unfortunately Thailand is seriously lacking in both - in fact they have reduced PCR testing by some 50% in the last 3 weeks and do not do mass random testing 

Yes at first i wondered why the numbers dropped so much, but no more mass testing and limiting PCR testing make the numbers now highly suspect. I would say these numbers cant be compared with the numbers of before because if you limit testing you get less positives. So the situation might not have improved much at all. We just dont know it.

[richard_smith237]

10 minutes ago, smedly said:

36 minutes ago, richard_smith237 said:

The Sandbox ’test’ has shown that Vaccinated arrivals who have also had a negative Pre-Flight and Arrival Covid-19 RT PCR test do not present an elevated threat to the spread of Covid-19 within Thailand.

you missed the important bit

 

Foreign tourists run the risk of getting infected through local transmission and as they are the only people actually being targeted with multiple tests and run the risk of finding themselves locked up through no fault of their own.

 

It is pretty obvious as I have said many times over weeks that CV19 is rampant in Phuket (and lets face it all of Thailand) and their vaccine program has failed to surpress it, tourists need to be aware that only they are targets of mass testing and the chance of a few of them failing a test is high if they mix with untested infected locals. Until Thailand gets this virus under control in Thailand I see no good reason why anyone would want to come here for a holiday, how does Thailand get this virus under control - mass vaccination with effective vaccines and mass testing to show how it is working - unfortunately Thailand is seriously lacking in both - in fact they have reduced PCR testing by some 50% in the last 3 weeks and do not do mass random testing 

Agreed, I excited the Sandbox last week. 

 

I was aware of the fact that even while ‘triple vaccinated’ (1x AZ / 2x Pfizer) there was no guarantee that I will not be exposed to the SARS-CoV-2 virus, there was a greater probability that I would not contract Covid-19, but again, no guarantees and the downside of contracting Covid-19 is hospital isolation (even without symptoms) - so caution was the name of the game, but that didn’t stop me going to the beach and restaurants etc. 

 

 

The common sense approach (when vaccinated) is of course to continue with life, but maintain intelligent caution. Its clear a greater proportion of the population needs ‘quality’ vaccination. 

 

 

Once the population has been vaccinated, covid-19 numbers become less relevant and hospitalisations with serious symptoms become the true metric.

 

 

 

 

 

 

 

[smedly]

3 minutes ago, robblok said:

Yes at first i wondered why the numbers dropped so much, but no more mass testing and limiting PCR testing make the numbers now highly suspect. I would say these numbers cant be compared with the numbers of before because if you limit testing you get less positives. So the situation might not have improved much at all. We just dont know it.

exactly but it fits the agenda

 

I would rather know the full extent of virus spread in my locality but that is impossible to know because of very limited targeted testing, if Thailand had a testing program like the UK (1 Million per day) I wonder how that would look - they have no interest in knowing

[brewsterbudgen]

Are they really going to refer to Bangkok as a "sandbox" when it reopens next month?

[ThailandRyan]

1 minute ago, brewsterbudgen said:

Are they really going to refer to Bangkok as a "sandbox" when it reopens next month?

Maybe they could call it the "Sinking City"

[jacko45k]

Just now, ThailandRyan said:

Maybe they could call it the "Sinking City"

Sandbag rather than sandbox?

[richard_smith237]

8 minutes ago, robblok said:

But Richard, it still means that the sandbox is a huge risk. Not as much from the tourists but from the Thais themselves. It just shows the risks of opening up too many venues.

 

I fully accept that there are risks from opening up, but there should be some hard limits on extra number of peoples in hospitals in a serious condition. Because if lifting of measures means that hospitals can't cope its dangerous for everyone. So they should have something like a limit, if more then so many people go into the hospital and it looks like hospitals cant cope measures will follow. 

 

Living with it and opening up also means you need to have measures in place to close things down if it gets out of hand. So in this way the Phuket sandbox is showing the risks of opening up. These risks don't come from tourists but from the fact that things are opened up.

 

Agreed.... The true metric can no longer be Covid-19 cases alone. 

 

A better metric is hospitalisations with symptoms, i.e. those who need to be in hospital. 

 

 

I would just like to clarify: Phuket hasn’t opened up - I was in Rawai and Laguna areas, restaurants were open, but bars a pubs etc remained closed. 

 

The only significant difference between Phuket and Bangkok is the Curfew - that said, in Phuket pretty much everything was dead by 9-10pm anyway. 

 

That said, the outbreaks in Phuket have not been from restaurants, thats not to suggest there are no outbreaks in restaurants (Hua Hin example highlights this), but the greatest risks of outbreaks are clearly in areas of high population and accommodation density, shared dorm accommodation, slums, wet markets etc. 

 

 

Once a ’set’ proportion of the population (i.e. 70% is the figure being used) is vaccinated, I would like to see Thailand fully opened up (to fully vaccinated individuals), then IF ‘necessary’ hospitalisations reach a certain level (i.e. 70% of beds full), healthcare and isolation measures should be but in place. 

 

Another facet of this is the ’type’ of vaccination - its clear Sinopharm and Sinovac are not as effective as AZ or Pfizer. 

 

 

ALL of the comments above have very little to do with the actual thread Subject - Sandbox has little to do with local transmission. 

 

As far as the ‘bigger picture’ Sandbox test is concerned - Infection has not been brought into Thailand by overseas visitors. 

 

 

 

 

 

 

 

 

 

 

 

[fondue zoo]

Bangkok, nothing like the smell of covid in the morning.

[richard_smith237]

7 minutes ago, smedly said:

exactly but it fits the agenda

 

I would rather know the full extent of virus spread in my locality but that is impossible to know because of very limited targeted testing, if Thailand had a testing program like the UK (1 Million per day) I wonder how that would look - they have no interest in knowing

 

There is also another facet to consider with mass testing - that is false positives. 

 

The UK office of national statistics quotes an RT PCR test false positive rate of 0.8 to 4.3% 

 

The Lancet (in an Article published in Sept 2020) quotes  0.8 to 4.0% false positive rate for an RT PCR test. 

 

Thus, out of 1,000,000 Covid-19 RT PCR tests per day - anywhere between 8,000 and 40,000 tests could be a false positive result. 

 

When ‘Mass testing’ the issue is that we (Thailand or any country) could be testing itself into a Panic. 

 

Any positive tests really should be tested again to ensure the accuracy of the false positive result. 

 

 

Additionally: Once we are all vaccinated a positive test result means little in the same manner that testing positive for influenza means little, particularly for those without symptoms - the key metric remains to be ‘how many people are becoming unwell’.... 

 

 

 

 

 

 

[Pravda]

Sandbolloxx

[robblok]

3 minutes ago, richard_smith237 said:

 

There is also another facet to consider with mass testing - that is false positives. 

 

The UK office of national statistics quotes an RT PCR test false positive rate of 0.8 to 4.3% 

 

The Lancet (in an Article published in Sept 2020) quotes  0.8 to 4.0% false positive rate for an RT PCR test. 

 

Thus, out of 1,000,000 Covid-19 RT PCR tests per day - anywhere between 8,000 and 40,000 tests could be a false positive result. 

 

When ‘Mass testing’ the issue is that we (Thailand or any country) could be testing itself into a Panic. 

 

Any positive tests really should be tested again to ensure the accuracy of the false positive result. 

 

 

Additionally: Once we are all vaccinated a positive test result means little in the same manner that testing positive for influenza means little, particularly for those without symptoms - the key metric remains to be ‘how many people are becoming unwell’.... 

 

In Thailand it was already so that 2 tests were needed before it was counted. That was one of the ways to keep the numbers low. Many never had a second test. I know this first hand from when there were cases at my GF her company.

 

Mass testing / active testing is always needed to keep check of things. But now all of a sudden the numbers dropped because they tested less. Why because the goverment was getting more and more flack. 

 

I liked to have keep them testing the way they did before so we had a comparison.

 

Anyway they just manipulate the numbers and that leads to less trust in a government. How do we ever know the situation when this happens.

 

But yea if there are enough people vaccinated then it does not really matter how many people are infected. Only hospital rate is important.

[2 is 1]

1 hour ago, richard_smith237 said:

The increase in case load in Phuket is not related to the increase in vaccinated individuals from overseas. 

The increase in case load in Phuket is related to domestic transmission in areas of high-population density such as slum accommodation and markets. 

Covid-19 is not being spread on the beaches and in restaurants, most of which are virtually empty (in Phuket).

????

[jacko45k]

11 minutes ago, richard_smith237 said:

Any positive tests really should be tested again to ensure the accuracy of the false positive result. 

You seem to have already concluded it is a false positive so why bother?

In reality you  are suggesting retesting all positives... IE double testing.

Are false negatives to be ignored at the same time..... I saw figures of 1.8-58%.!

 

 

 

 

Edited September 23, 2021 by jacko45k

[BestB]

Leading doctor can look at all other countries and see, covid cases not going anywhere. However with vaccinations, people do not end up in ICU or dead.

 

So there are 2 choices, keep country closed, Covid is not going to disappear and totally wipe out the economy or open up, same covid, and learn to live with it while rebuilding the economy

[tingtong]

Not sure slowly starving locked in your room but covid free is the better option vs taking a chance on covid...what the majority survives fine.

[DLock]

Is there any websites that detail how the Bangkok sandbox will work?

 

I understand staying in SHA+ Hotels, but is it like Chiang Mai with restricted travel to limited tourists attractions and no free wandering wherever they want?

 

Or as long as you are fully vaccinated and stay in a SHA+ Hotel, you can go wherever you want in Bangkok?

 

I am not really up to date on the re-openings, so appreciate any better information that I have...

 

[robblok]

32 minutes ago, DLock said:

Is there any websites that detail how the Bangkok sandbox will work?

 

I understand staying in SHA+ Hotels, but is it like Chiang Mai with restricted travel to limited tourists attractions and no free wandering wherever they want?

 

Or as long as you are fully vaccinated and stay in a SHA+ Hotel, you can go wherever you want in Bangkok?

 

I am not really up to date on the re-openings, so appreciate any better information that I have...

 

I think nobody is up to date, as they keep giving dates and changing them. They also never explained what will open up and what wont open up. No details if quarantine is still needed. 

 

I been trying to get info so my parents can visit in future. But with all those U turns and changes I am not going to risk it for them. They are so bad at communications that this puts people off. 

[richard_smith237]

44 minutes ago, jacko45k said:

55 minutes ago, richard_smith237 said:

Any positive tests really should be tested again to ensure the accuracy of the false positive result. 

You seem to have already concluded it is a false positive so why bother?

In reality you  are suggesting retesting all positives... IE double testing.

Are false negatives to be ignored at the same time..... I saw figures of 1.8-58%.!

I haven’t concluded anything....  The Lancet and the UK Office of National Statistics concluded that between 0.8% and 4.0% / 4.3% were false positives. 

 

As Rob mentioned - ’some’ positives were being ‘double tested’ to significantly minimise the statistical probability of a fast positive. 

 

I also read that someone in the Sandbox tested ‘inconclusive’ (also known as reactive) - which isn’t a positive test and was repeat tested without an additional charge. 

 

 

You are correct: I am suggesting all positive tests are re-tested. The financial consequences of false positives are costly - IF in the Sandbox (or ASQ) and I tested positive, I would insist on a second confirmation test. I wouldn’t want to be sent to an isolation facility on the basis of a questionable result. 

 

 

Your comment regarding false negatives is also valid. Perhaps all PCR tests should be taken twice to eradicate error to far smaller statistical margins. 

 

 

I missed the source in my earlier thread: 

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30453-7/fulltext

 

 

 

[richard_smith237]

8 minutes ago, robblok said:

I think nobody is up to date, as they keep giving dates and changing them. They also never explained what will open up and what wont open up. No details if quarantine is still needed. 

 

I been trying to get info so my parents can visit in future. But with all those U turns and changes I am not going to risk it for them. They are so bad at communications that this puts people off. 

I suspect by ‘Opening up’ Bangkok on 1st Nov what they really mean is ‘entry requirements’.

 

i.e. in much the same manner Vaccinated arrivals can enter Phuket with proof of vaccination, CoE, Pre-Flight and Arrival PCR tests, I suspect arrivals to Bangkok will fall under the similar list of requirements... such as: 

- Must be Dual Vaccinated (<12 months, >14 days)

- Enter with CoE

- Pre-flight PCR test

- Arrival PCR test

- Insurance

 

The outstanding issue will be whether arrivals have to stay at an SHA Plus hotel in Bangkok as they have in Phuket. IMO this requirement is utterly ridiculous.

 

 

The term 'Opening up Bangkok’ - may be misconstrued to mean that all restaurants and bars etc will open up without restrictions, but I do not believe this is the intended messages - I ’think’ they mean, open up to international arrivals,. I believe ’social’ restrictions will vary according the situation (case load / hospitalisations).

 

[robblok]

14 minutes ago, richard_smith237 said:

I suspect by ‘Opening up’ Bangkok on 1st Nov what they really mean is ‘entry requirements’.

 

i.e. in much the same manner Vaccinated arrivals can enter Phuket with proof of vaccination, CoE, Pre-Flight and Arrival PCR tests, I suspect arrivals to Bangkok will fall under the similar list of requirements... such as: 

- Must be Dual Vaccinated (<12 months, >14 days)

- Enter with CoE

- Pre-flight PCR test

- Arrival PCR test

- Insurance

 

The outstanding issue will be whether arrivals have to stay at an SHA Plus hotel in Bangkok as they have in Phuket. IMO this requirement is utterly ridiculous.

 

 

The term 'Opening up Bangkok’ - may be misconstrued to mean that all restaurants and bars etc will open up without restrictions, but I do not believe this is the intended messages - I ’think’ they mean, open up to international arrivals,. I believe ’social’ restrictions will vary according the situation (case load / hospitalisations).

 

Richard,

 

But that is just it you suspect, i suspect nobody really knows. I think they don't know themselves and they change their mind so often. Its so dangerous to plan anything when you have a government that works like that.

[GrandPapillon]

it was a trapbox, not a sandbox, so no big loss ????

 

keep Thailand closed, will keep the bargains 'warm' when we can return in 2022