Southeast Asia Had COVID-19 Under Control. What Went Wrong?

Southeast Asia Had COVID-19 Under Control. What Went Wrong?

As the COVID-19 pandemic wreaked havoc around the world, life in Southeast Asia stayed normal. Worshippers thronged Buddhist temples, taxis and tuk-tuks jostled at traffic lights, and revelers crooned in late-night karaoke bars.

In February, however, disaster struck. Massive outbreaks have forced Thailand, Cambodia, and Laos into ongoing lockdowns.

Given the huge numbers of business and leisure travelers to Southeast Asia, it’s remarkable that the region managed to avoid a mass COVID-19 outbreak for as long as it did. It’s uncertain exactly how. People speculate it was due to swift border closures in early 2020, the hot, humid climate, and the fact that everyone masked up.

But through the cracks, the virus got in. On Feb. 7 in Cambodia, four Chinese nationals arrived in the capital of Phnom Penh from Dubai in a private jet, according to the local press. They went straight to the fancy Sokha Hotel for what were supposed to be 14 days of quarantine. But only a day after their arrival, on Feb. 8, they escaped the hotel by bribing at least one security guard. Two of the Chinese travelers tested positive for COVID-19; one carried the highly contagious British variant of the virus. The foursome partied in luxurious apartments and went clubbing.

Before February, daily new COVID-19 infections in Cambodia rarely surpassed 10 a day. On April 10 alone, the country registered 477 new cases. The government responded with a strict lockdown, including a law punishing violators of coronavirus-related rules with up to 20 years in prison. But given the fact that tens of thousands of a low-paid workers live in tiny apartments and shanties throughout Phnom Penh and other cities, social distancing is impossible. And the millions of people who live hand to mouth can’t afford to stay at home.

Vietnam is an outlier among its neighbors for shunning vaccines from China, likely due to hostility between the two countries.

For Cambodia and much of the region, therefore, the only solution is mass vaccination. Cambodia has been proactive in procuring and administering vaccines. Since the first crates of AstraZeneca’s vaccine arrived on March 2, about 22 percent of Cambodia’s 10 million adults have received at least one dose of vaccine, with 15 percent fully vaccinated, according to one estimate. China has also provided over a million doses of its Sinopharm vaccine. As for the four travelers suspected of starting this outbreak, their location is unknown.

Thailand, Cambodia’s wealthier neighbor, is lagging behind. Only 2 percent of its 69 million people have been fully vaccinated, and confidence in the government has hit rock bottom. “The rollout has been very slow,” said Panchana Vatanasathien, the chairperson of the Khao Yai Tourism Association and founder of Food for Fighters, which has helped Bangkok’s poorest residents through the epidemic. “The government lies [about the vaccine] rollout every day, and people everywhere are asking, ‘Where is my vaccine?’”

Panchana, who oversees about 4,000 food box deliveries a day, said COVID-19 is spreading rapidly in communities where up to nine people share a room. She said there have been “many deaths” in these neighborhoods due to COVID-19 and its complications, including a woman who took her own life after her son died.

Thailand’s own pharmaceutical companies are close to creating a vaccine, and a local company, Siam Bioscience, is manufacturing 200 million doses of AstraZeneca scheduled to begin distribution in July. “Siam Bioscience is one of 25 companies selected by AstraZeneca to license its COVID-19 viral vector vaccine,” Anthony Margetts, a compliance consultant at the Thai software firm Factorytalk, wrote in the Chemical Engineer. He added that Siam Bioscience will supply Thailand, other Southeast Asian countries, and the Maldives with vaccines.

Vitoon Danwiboon, the director of the Government Pharmaceutical Organization, said in a statement that Thailand has also imported 6 million doses of the Sinovac vaccine, with another 3 million expected in June.

Vietnam is an outlier among its neighbors for shunning vaccines from China, likely due to the current hostility between the two countries. Instead, Vietnam has imported about 1 million doses of the AstraZeneca vaccine through COVAX, the international network distributing vaccines to developing countries. Like Thailand, Vietnam is also developing its own vaccine. A clinical study of a promising candidate, Covivac, began on March 15, the local press reported.

As official cases in Thailand tripled through April and May, Laos—which shares a long land border with Thailand—was looking very vulnerable. It only took one small incident with parallels to what happened in Cambodia to seed a new outbreak. It came when two Thai men and a Lao woman illegally crossed the Mekong River marking the border to meet another Lao woman, with whom they attended Lao New Year celebrations. They visited several bars, a nightclub, a temple, and a massage parlor, according to local press. The three travelers from Thailand were treated for COVID-19 after their return and are facing charges. The Lao woman who helped them cross the river also contracted the virus; she was arrested after she recovered.

As the region continues its struggle to contain community transmission, it is now fighting more infectious strains of the virus.

In 2020, Laos recorded only 41 cases, all of whom recovered. Now, the total case count has reached 1,878 as the country enters its fifth week of lockdown. Vaccines are rolling out slowly, including Sinopharm, AstraZeneca, and the Russian Sputnik vaccine. To date, 8 percent of Laos’s 7.3 million people have received their first dose of AstraZeneca or Sinopharm, and another 2 percent have been fully vaccinated, according to a source who wished to remain anonymous because they are not authorized to speak publicly.

A second shipment of AstraZeneca to Laos has been delayed, according to the same source. The reason: India’s Serum Institute, which was tasked with fulfilling the order, is overwhelmed and appears to have deprioritized the shipment. Now Laos is planning to use its remaining AstraZeneca stash to give out second doses, even though the vaccines are set to expire before the recommended 12-week pause between shots.

But it is Myanmar that is most vulnerable among the Southeast Asian nations. The country is churning with violence following the return of the hated military government in a coup on Feb. 1. People are not getting tested or pushing for vaccines because, frankly, they have bigger problems to worry about.

Clashes between the military and protesters continue on a daily basis. “Security forces have killed over 820 people and detained an estimated 4,300 activists, journalists, civil servants, and politicians,” Human Rights Watch said in a May 25 statement. Myanmar was reporting between 300 and 500 new infections per day in January, among a population of 55 million. Since the coup, the data has dried up.

A Burmese journalist, speaking under condition of anonymity, said thousands of health care professionals, including doctors and nurses, stopped working as part of the mass protests. “There haven’t been enough technicians to test for COVID-19, [so] there is no accurate data,” he said.

In addition, trust in the military government is so low that it’s holding back the vaccination campaign. “In March, a van drove around my town announcing that vaccines were available for over 60s,” the journalist said. “But few people went because they have no trust in the government.”

While case numbers are still low compared with those of hot spots like India, Brazil, the United States, and much of Europe, the pandemic is now making inroads in Southeast Asia. As the region continues its struggle to contain community transmission, it is now fighting more infectious strains of the virus. Before, it seemed that the odd infection enabled by a bribed security guard or an illegal river crossing could quickly be contained. But the current, more virulent phase of the pandemic could be much less forgiving.