onsdag 7 juli 2021

Domestic COVID-19 cases July 7th. NBT

 

With a surge in infections being reported on Wednesday, driven by the more infectious Delta variant of Covid-19, Dr Taweesilp Visanuyothin, the government spokesman has warned the public that it will have to learn to live with a new level of threat from the disease. Thai Examiner

Top official – fully vaccinated people must wear double face masks against the Delta virus strain
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With a surge in infections being reported on Wednesday, driven by the more infectious Delta variant of Covid-19, Dr Taweesilp Visanuyothin, the government spokesman has warned the public that it will have to learn to live with a new level of threat from the disease. It comes as a top doctor at a Bangkok hospital has come forward to say he is aware of people dying at home who may not be included in the official tallies. There is also an emerging demand for mRNA vaccines among the public and health personnel on the front line. However, the boss of the Government Pharmaceutical Organization (GPO) has warned that the much sought after Moderna vaccine will not be available until early next year.  

The rising threat from the Delta variant of Covid-19 was confirmed by the Centre for Covid-19 Situation Administration (CCSA) on Tuesday when it disclosed that the more infectious strain now accounted for 52% of all infections in Bangkok and had nearly doubled its impact in the provinces. The CCSA spokesman Dr Taweesilp Visanuyothin warned the Thai public that they would have to adjust to the new threat when he suggested that fully vaccinated people should wear two masks while in public. It comes also as there is growing disillusionment over the vaccine rollout while the contents of a leaked government document from a meeting within the Department of Disease Control last week showed public health advisors discussing the efficacy of the Sinovac vaccine from China for frontline health workers and the use of mRNA vaccines as booster shots.

vaccinated-people-must-wear-two -face-masks
The grim outlook facing Thailand as the Delta variant of the virus makes its way through the population with surging infection rates and death tallies has prompted Dr Taweesilp Visanuyothin (centre) to warn even fully vaccinated people to wear two face masks in public. It comes at the Prime Minister, Prayut Chan ocha (right), was, this week, forced to work from home after coming in contact last week with an infected business representative in Phuket while the Minister of Public Health Anutin Charnvirakul (left) confirmed the authenticity of a leaked Department of Disease Control report where key advisers were recorded discussing the efficacy of the Sinovac vaccine for front line medical staff.

Thailand's Centre for Covid-19 Situation Administration (CCSA) confirmed on Tuesday that the latest wave of the virus, which has been causing rising infection rates and deaths, is being driven by the Indian or Delta variant of the disease technically referred to as B1617.

It follows a stark briefing given by the top CCSA spokesman Dr Taweesilp Visanuyothin, on Tuesday, in which he warned the public it would have to adapt to the new variant strain which is about to dominate the country. The public health official confirmed that the new strain is significantly more infectious.

It comes as Prime Minister Prayut Chan ocha has been forced to work from his army compound home in the Bang Khen area of Bangkok after coming in contact with a Chamber of Commerce member at a reception in Phuket last week for the Sandbox initiative who later tested positive for the Covid-19 virus. 

Delta variant is more infectious and is driving daily infection tallies consistently above 5,000 per day

The Delta variant is 50 to 60% more infectious than the UK Alpha variant or B117, which itself, was 50 to 60% more infectious than the initial variant of the virus that dominated the kingdom up to the beginning of April when it launched the 3rd wave.

On Wednesday, the infection numbers surged to 6,514 according to the daily report from the Ministry of Public Health. There were 54 new deaths. 

On Tuesday, the kingdom registered 57 deaths, the worst day since last Friday's tally of 61 which was the highest tally so far with rising daily infection rates with consistent tallies over 5,000.

Delta variant now accounts for 52% of all new cases in Bangkok driving a deadly fourth wave expanding into the provinces where its share doubled in a week

Medical experts point out that it causes a higher infection rate among families with nearly all members of households coming down with this variant of the disease including younger people.

The government spokesman confirmed that it now accounts for 52% of all new cases in Bangkok where the fourth wave of the virus has emerged.

It also appears to be gaining ground in the provinces outside the capital with 18% of cases from June 28th to July 2nd coming from the variant compared to the week earlier running from June 21st to June 27th.

It comes as Assistant Professor Dr Smith Srisont, Head of Forensic Medicine  Laboratory at the Department of Pathology Faculty of Medicine Ramathibodi Hospital Mahidol University, on Wednesday came forward to make claims that many deceased older people he has examined and who had died at home, were found to be infected.

On this basis, he feared that the number of deaths reported may be understated and came to this conclusion after examining the bodies of four deceased people from the inner city of Bangkok on Tuesday.

'We have to adjust our lives to cope with it' says top government official at grim daily briefing

'Other regions are following the same pattern as Bangkok,' Dr Taweesilp told the briefing. 'We have to adjust our lives to cope with it.'

Dr Taweesilp later clarified that this means wearing double face masks, even for those who had been fully vaccinated, such is the threat represented by this new wave or variant of the virus.

Delta rising beyond the capital with growing concern for health workers and the need for booster shots

The scale of the threat posed by the Delta variant, not only in Bangkok but now as it spreads beyond the capital, has sparked concern for health workers who were vaccinated from the beginning of March this year in the first phase of inoculation, which except for 117,000 doses of AstraZeneca flown in from South Korea, comprised almost entirely of the Sinovac vaccine.

Turkey, which earlier this year embraced the Chinese vaccine approved by the World Health Organisation for its campaign, has recently announced that it is proceeding with an offer of mRNA booster vaccines to those who have received the inactivated type of vaccine based on older technology.

Sinovac approved for adults under 60 by the WHO but its efficacy for frontline health workers questioned

The WHO approved the Sinovac vaccine for adults aged under 60 but there are question marks over its efficacy in medical environments following a disappointing performance in an initial field test in Brazil in January where the efficacy rate was only 50.4% according to the Butantan Institute in São Paulo, Brazil which also confirmed a 78% efficacy rate at preventing 'mild to severe' Covid-19 infection.

In January, Thailand's respected top virologist, Dr Yong Poovorawan, specifically defended the use of the Sinovac vaccine for hospital staff and the vaccine's efficacy has also been praised in Turkey and Bahrain which has since moved to provide mRNA booster shots for its population.

Top virologist Dr Yong defends the use of the Sinovac vaccine to protect frontline medical staff at high risk

Questions have been raised about the Chinese vaccine following a leaked document from the Ministry of Public Health which this week was confirmed as authentic by Minister of Public Health Anutin Charnvirakul.

Minutes of a meeting at the Department of Disease Control on June 30th last in Bangkok about the use of 1.5 million Pfizer jabs donated by the USA

The document details what appears to be minutes of a meeting among three committees at the Department of Disease Control in Bangkok on June 30th last including an academic committee established under the Communicable Disease Act 2015, an advisory group on antibodies as well as another academic advisory group on the country's ongoing vaccination campaign.

The topic under discussion was the application of mRNA vaccines or specifically doses of the Pfizer vaccine which was approved by the Food and Drug Administration at the end of June.

From the minutes, it is evident that the government is to obtain an early shipment of 1.5 million Pfizer vaccines from the US government promised by US President Joe Biden on the 10th June last when he committed the United States to supplying 500 million doses of American vaccines to countries worldwide with 'no strings attached'.

Meeting told the use of mRNA vaccines as booster shots for healthcare workers would question the efficacy of the Sinovac doses administered

It was already public knowledge that Thailand was due to receive 20 million Pfizer jabs as contracted for between the government and the Manhattan-based US Pharmaceutical giant just the day before and confirmed on June 9th. 

Anutin signs up Pfizer for 20 million doses but warns that Covid-19 may be with us for some time into the future

However, the notes from the meeting including a selection of quotes from the participants, showed that there as a discussion on the use of Pfizer mRNA vaccines.

One proposal was to use them to vaccinate young people aged 12 to 18, the other was to focus on at-risk groups including the elderly, those with chronic underlying conditions and pregnant women while thirdly the prospect of applying the jabs as booster shots to front line medical personnel was discussed.

In response to the latter proposal, however, one meeting participant made a very influential comment. 

'At present, if it (the Pfizer jab) is administered on the third group, it is tantamount to admitting that the Sinovac vaccine offers no protection. This will make it harder to defend it.'

Hundreds of vaccinated doctors, medical personnel infected after being vaccinated, some critical

The comment follows a strong basis for administering booster shots to front line staff as it is reported that hundreds of fully vaccinated doctors and medical staff have become infected after being fully vaccinated with the Sinovac vaccine.

Some are reported to be in a critical condition prompting calls from representative bodies and amongst health professionals for the deployment of mRNA booster shots.

The response to the leaked comments from the Ministry of Public Health was mixed with the Director of the Department of Disease Control, Dr Opas Karnkawinpong, denying that the document had any official standing. 

He was critical of any attention being paid to it.

'Its format is not even a standard meeting agenda. Different opinions are expressed at any meeting and propagating one comment out of its context is not right. It's not fair to other participants,' Dr Opas said while Minister Anutin admitted it was authentic but insisted that no decision had been made at the meeting.

Dissatisfaction with late availability of the Moderna vaccine with massive public demand for the product

There is also increased public dissatisfaction with the inability of private hospitals to gain access to the Moderna mRNA vaccine which along with the Pfizer product, is a favourite option among the Thai public as confirmed in several surveys alongside AstraZeneca. According to the World Health Organisation (WHO), the Moderna vaccine is 94.1% effective.

Reports from hundreds of private hospitals who have been marketing a commercial service offer for the public to pay for their own vaccine package with two Moderna shots for approximately ฿3,700 has generated up to nine million expressions of interest including a large segment of the country's expat community and foreigners who have expressed a preference for this vaccine.

Demand for the shot could be seen this week when, on Monday, Ramathibodi Hospital in Bangkok advertised bookings for Moderna and was inundated with takers so that the offer was sold out within five minutes.

The revelation comes amid a mood of uncertainty and anger towards the government for its perceived mishandling of this latest outbreak and the continued failure of the country's vaccination campaign to achieve its goals.

Delivery of AstraZeneca short of quotas promised says MP with two-thirds being exported from Thailand

These failures are increasingly exemplified by the shortage and undersupply of AstraZeneca vaccines which are manufactured here in Thailand.

The shortage in promised quotas for June has again meant that vaccination appointments have had to be rescheduled.

Wiroj Lakkhanaadisorn, a Move Forward MP, in recent days, pointed out that only 5.37 million doses of the locally produced vaccine were delivered in June compared to 6.3 million doses promised.

He said he obtained his information from the Ministry of Higher Education, Science, Research and Innovation.

He also claimed the Siam Bioscience plant in Pathum Thani was now producing 15 to 17 million doses per month but only one third or 5 to 6 million doses were being delivered to the government for the Thai public.

'There is also a report that from July, AstraZeneca Thailand will export vaccines to other countries, and only one-third of the vaccines produced will be reserved for Thailand,' the MP claimed.

Government Pharmaceutical Organization (GPO) boss says a contract will be signed for Moderna only in August and delivery will be early next year

Dr Vitoon Danwiboon, the Director of the Government Pharmaceutical Organization (GPO) moved to dampen expectations this week by making it clear that the earliest the Moderna vaccine will be available in Thailand is the beginning of 2022.

'The GPO contacted Moderna Inc in the US to buy its vaccines and the company replied that it would deliver the vaccines in the first quarter next year at the earliest,' he said.

The government agency boss dismissed reports from private hospital operators that they can purchase the vaccine directly from Moderna by insisting all orders must be placed through the only authorised agent in Thailand, Zuellig Pharma, to conduct vaccine imports for the private sector.

Money must be paid over first by hospitals

Currently, the Government Pharmaceutical Organization (GPO) has failed to sign a contract with Moderna as it is insisting that all funds required to honour it must, at the outset, be paid over from the private hospital network before it takes such a step.

Mr Vitoon said he expected that a contract will be signed with the US-based firm, one of the first in the world to receive a US government emergency approval for its highly effective mRNA vaccine, in August.



The Chonburi Department of Public Health announced 262 new and confirmed cases of Covid-19 today, as well as three new deaths, July 7th. The Chonburi governor yesterday (July 6th) ordered the temporary closure of a company in Pan Thong. Pattaya News

Chonburi announces 262 new and confirmed cases of Covid-19 with three deaths, a temporary closure of one company

Chonburi-

The Chonburi Department of Public Health announced 262 new and confirmed cases of Covid-19 today, as well as three new deaths, July 7th. The Chonburi governor yesterday (July 6th) ordered the temporary closure of a company in Pan Thong

This makes a total of 10,285 cases of Covid-19 in the current round of infections, with 3,728 still under medical care/supervision, and with a total of 55 recorded deaths in Chonburi since the start of this recent round of infections in early April. Three new deaths were announced this morning, although details were not provided.

Additionally, 6,502 people in total have now been released from medical care and fully recovered since this current wave began. 170 people were released yesterday.

The district-level new cases were as follows today:

Mueang Chonburi 58, Si Racha 38, Banglamung (Pattaya) 90, Panat Nikhom 6, Sattahip 4, Ban Bueang 43, Pan Thong 9, Ko Chan 2, Koh Si Chang 7 and 5 new cases transferred from other provinces for medical care.

The details on the cases are as follows:

  1. Proactive case finding at a worker camp at Syntec Contruction Public Co.,Ltd in Banglamung, 21 cases
  2. Medical staffers, 5 cases
  3. Risky occupation, meets a lot of people, 2 cases
  4. Cluster at Pupan ice factory in Huayyai, Banglamung, 1 case
  5. Contact from previous confirmed case at a party, 1 case
  6. Traveling from high-risk areas, upcountry from Bangkok, 1 case and Nakhon Pathom, 1 case
  7. Contact with previously confirmed patients: in families, 92 cases and in workplaces, 31 cases
  8. Previously confirmed patients (Which is under investigation), 45 cases
  9. Currently investigating, 62 cases

A total of 561 close contact searches were received today with 1,402 initial proactive searches, and more proactive search reports are pending.

Chonburi did not release specific information around how many people are asymptomatic or serious.

Additionally, the Chonburi governor yesterday (July 6th) ordered the temporary closure of the Nutcon Corporation Co.,Ltd in Nong Tamlueng, Pan Thong. The order has been annouced by the Chonburi Public Relations Office this morning (July 7th).

The order concludes that in order to control the spread of the virus, the Chonburi communicable disease committee has ordered the temporary closure of Nutcon Corporation Co., Ltd..

Nobody is allowed to leave the camp and nobody may enter without permission from a Chonburi Public Health Official.

The order is from today (July 7th) until August 3rd.


BREAKING: A fully vaccinated tourist from UAE who came in on the #PhuketSandbox has tested positive for #COVID19.

 

🔴 BREAKING: A fully vaccinated tourist from UAE who came in on the #PhuketSandbox has tested positive for #COVID19. He was immediately transferred to a hospital for treatment. People in his group have been moved to an ALQ hotel where they will do 14-day quarantine at their own expense. Their SHA+ are obliged to give them a full refund #Thailand 

SOURCE: ภูเก็ตแซนด์บล็อกพบต่างชาติติดเชื้อโควิด-19รายแรก - โพสต์ทูเดย์ ข่าวภูมิภาค https://www.posttoday.com/social/local/657366

The Center for COVID-19 Situation Administration (CCSA) has revealed that it has adjusted the strategy to tackle the current COVID-19 outbreak in the country. The adjusted measures are the following. PRD


 

Jomtien bar owners become a coffee and crepe shop to survive Covid-19 crisis. Pattaya News

A popular bar in Jomtien has been turned into a coffee and crepe shop to help their staff survive the current Covid-19 crisis in the Pattaya area, which has seen almost three months of closures of the entertainment industry with no end in sight in a row currently.

Pattaya –

Ms. Tawirada Tanapoomchai, 30 told The Pattaya News, "I am a staff member at the bar. Our bar, 'Country Road' has temporarily closed due to Covid -19 in Jomtien near Dongtan Beach."

Bars and entertainment venues are closed by Thai government orders at a national level notes TPN media and have been for about three months. The Center for Covid-19 Situation Administration, or CCSA, has not given any estimate on when entertainment venues will be allowed to reopen. Venue owners also claim they have been given little to no financial aid from the government for the closures. Although some provinces, like Phuket, have allowed alcohol in restaurants, this is still forbidden in Chonburi.

"Other staffers and I asked the bar owner if we can open a coffee and crepe shop so that we can earn some money for our living. The owner agreed with us, although they don't make a major income from the project. We gained permission from local authorities to do so and are now a coffee shop." Tawirada explained.

"Country Road Café is located on Jomtien beach road near Krung Si Bank which is about 100 meters from the beach. " Tawirada concluded.

TPN notes the "Country Cafe" is open during daylight hours. Alcohol sales, as well as music and entertainment or usage of pool tables or other entertainment features, are forbidden.




Get out and golf with pro Tony Meechai. Led by Thai-American and PGA of America golf professional Tony Meechai, and partners Nesta Thailand, starting on July 16, family-friendly golf and health day camps will be held every third Friday until the end of the year for people who want quality time in the great outdoors learning a new skill and having a lot of fun. Bangkok Post

Get out and golf with pro Tony Meechai
PGA pro Tony Meechai wants to make golf more accessible. photo courtesy of pro golfer Tony Meechai

Covid-19's third wave, the worst so far, has above other heartaches confined families to their living quarters during ongoing lockdown-like restrictions that have played a toll on their mental and physical health.

Computer screen usage is growing by the minute along with, yes, our waistlines due to obvious lack of exercise. Working out at the gym is no longer an option in such precarious times.

Moreover, the list of outdoor activities are also at its minimal but what if there was an activity that is safe, fun and also abides by Covid rules and regulations?

The activity in question is golf. Not playing it, but learning and training.

Led by Thai-American and PGA of America golf professional Tony Meechai, and partners Nesta Thailand, starting on July 16, family-friendly golf and health day camps will be held every third Friday until the end of the year for people who want quality time in the great outdoors learning a new skill and having a lot of fun.

Why join? Simple. Get out and enjoy the fresh air in a safe and controlled environment while learning a game with pro Tony that you can enjoy for life. Advantages are that you get to learn something new with the 2018 Best Professional Coach in Asia at an enjoyable world-class training facility, Lotus Valley Golf Resort, in Chachoengsao.

The training process is based on the Club-Focused Instruction approach which has been proven to work for many decades and is taught against the backdrop of the world-class training facilities at Lotus Valley Golf Resort.

The natural turf driving range is complemented by a very large chipping and putting green and three practice holes that allows golfers to practise real shots and work on the most important part: the short game.

The camp is divided into two parts. The first part consists of a presentation that covers "Golf To Better Your Life And Health" and the second consists of real practice and drills.

Programmes, which are open to all ages, begin at 9am and concludes by noon. Transportation leaving from Sukhumvit 65 at 7am can be provided for those who need it. The formal training kicks off at 10am and is augmented with presentations of "Golf To Better Your Career" and "Golf Fitness And Health". The training concludes at 11am for lunch.

To make it exclusive, the first eight registered sign-ups from Bangkok Post readers for each Friday session receive a special fee of 1,500 baht which includes three hours of training, golf cart and caddie fee. Use Code: BKKPOST.

For more information and registration, call Mild at 02-038-3695086-778-1707 or email info@blackhatgolf.com.








Covid claims snowball in last 45 days Total claims for Covid insurance ballooned to 1.77 billion baht in the first half of the year from 588 million baht as of May 15, says the Office of the Insurance Commission (OIC) secretary-general Suthiphon Thaveechaiyagarn. Bangkok Post



The increase in insurance claims was in line with records for daily new infections and emerging clusters.

The claim loss ratio climbed to 36% of Covid insurance premiums of 4.93 billion baht at the end of June, said the OIC.

Sales of Covid insurance from May 16 to June 30 increased by 962 million baht.

Mr Suthiphon said the insurance industry has enough excess reserves to handle even the direst scenario, in which the pandemic and new variants are not controlled this year, with vaccines successfully developed and distributed in 2022 and 2023, respectively.

"The OIC requested cooperation from non-life insurance companies in being cautious in making dividend payments this year," he said.

This is the second year for such a request.

At the end of March, the capital adequacy ratio (CAR) of the life insurance industry was 329%, similar to its 320% mark at the end of 2020. The CAR of non-life insurance was 320%, down from 324% at the end of last year.

Chayanin Kerdpholngam, assistant secretary-general at OIC, said the stress test took three factors into consideration: macroeconomics, estimated insurance claims, and the financial market.

Ms Chayanin said for the most severe scenario, the GDP is expected to shrink by 1.7% this year and 0.3% next year.

The projection for total claim losses included in the assessment was calculated by insurance companies.

The OIC asked insurance companies to offer the highest figures for total claims from mortality and medical expenses they can handle. The goal is to figure out whether these companies can absorb the risk of even the most severe scenario.

"Considering the latest data regarding the pandemic, the estimated figures are still considerably harsher than the reality," she said.

Regarding financial markets, investors are expected to sell bonds in the severe scenario as they lose confidence when the economy goes down.

The bond selloff would cause the government bond yields to pick up, to the benefit of insurance companies.

Some negative impacts from the pandemic can be offset by the benefits from a rise in bond yields, said Ms Chayanin.

"Without the positive factor of the financial market, in the severe scenario the CAR ratio would slightly decline, but remain double that of the minimum requirement of 200%," she said.

However, the OIC plans to keep a close eye on the pandemic situation, said Ms Chayanin.


😥😥😥😥😥😥 COVID19 UPDATE on WEDNESDAY: 6,519 cases & 54 deaths. ☹️ Over the last seven days, there has been an average of 5,981 cases per day 1 July: 5,533 - 57 dead 2 July: 6,087 - 61 dead 3 July: 6,230 - 41 dead 4 July: 5,916 - 44 dead 5 July: 6,166 - 50 dead 6 July: 5,420 - 57 dead 7 July: 6,519 - 54 dead <— TODAY






Thailand is now entering the fourth wave of the COVID-19 pandemic, with the Delta coronavirus variant expected to become the dominant strain in Thailand and the rest of the world in 1-2 months, said Clinical Professor Emeritus Dr. Udom Kachintorn who is an advisor to the Centre for COVID-19 Situation Administration (CCSA) today (Tuesday). Thai PBS World

Thailand enters 4th COVID-19 wave as more cases are of mutated virus, CCSA advisor says

Thailand is now entering the fourth wave of the COVID-19 pandemic, with the Delta coronavirus variant expected to become the dominant strain in Thailand and the rest of the world in 1-2 months, said  Clinical Professor Emeritus Dr. Udom Kachintorn who is an advisor to the Centre for COVID-19 Situation Administration (CCSA) today (Tuesday).

In his Facebook live message, he said that the Delta variant is spreading fast in Thailand and, for June and July, is accounting for 30% of all new COVID-19 cases, particularly in and around Bangkok where it is around 50%, predicting that it will become the dominant variant in the next 1-2 months due to its fast transmissibility, which is 40% more than the Alpha strain, which represented 85-90% of all cases in Thailand prior to June.

He pointed out that the Delta variant hastens the lung infection, resulting the patients being put on ventilators in just 3-5 days, compared to 7-10 days in the case of Alpha variant. If this situation is allowed to persist, he said that the need for more hospital beds will increase steadily until the entire Thai health system collapses.

Regarding existing vaccines' ability to deal with the Delta variant, Dr. Udom said that the study from Britain shows the efficacy of Pfizer, AstraZeneca and Sinovac has been reduced in dealing with the strain.

He said that Pfizer and Moderna are best at stimulating immunity, followed by AstraZeneca. When used against the Delta variant, efficacy of Pfizer drops from 93% to 88%, while the efficacy of AstraZeneca drops from 66% to 60% percent. For the prevention of severe symptoms, Pfizer has 96% efficacy, compared to 92% for AstraZeneca, he added.

As for the Chinese-made Sinovac, Dr. Udom admitted that there is very little information from the producer about the vaccine's efficacy in protecting against the Delta variant adding, however, that he does not think the vaccine is good enough against it.

Whether a third dose is needed or not, he said studies are underway to try to determine which vaccine is suitable as a booster, with results expected in a month, but he did not recommend mixing vaccines for the first and second jabs.

He said that medical personnel should be the first group to receive the third jab, which should be AstraZeneca or an mRNA vaccine like Pfizer, because most of them were inoculated with Sinovac vaccine originally.

Studies from Oxford University, which is partnered with AstraZeneca in the development of the vaccine, show that, giving the third dose of AstraZeneca six months after the second dose will boost immunity six times and with few undesirable side effects.

Asked when the 4th wave of infections will end, he said Thailand has already imposed a partial lockdown in some provinces, but not maximum measures yet, adding that the CCSA will have to assess the situation in the next two weeks.

He said he would prefer to see new daily infections between 500-1,000 cases, as he urged everyone to cooperate in the fight against the new variant and to report for inoculation, to reach the 70% inoculated population target.



Bangkok Post highlights 7/7

 

Heavy rain triggers flash flooding across Pattaya, authorities provide traffic assistance - Pattaya Mail

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