Malaysia, Thailand and Vietnam are rolling back their zero-Covid policies, but they are not ready to open up, experts warn

Yanzhong Huang, senior fellow for global health at the US-based Council on Foreign Relations think tank, said if vaccination rates with high-efficacy vaccines are not high enough before restrictions are lifted, health care systems in Southeast Asia can quickly become overwhelmed. Might be possible.

“You’re going to see this spike of severe cases, then it’s going to be overwhelming ICU… beds, ventilators, there will be a challenge of capacity constraints,” he said.

But for most of the public and many leaders across the region, there seem to be few other options. Vaccines are in short supply, and many Southeast Asian countries are unlikely to receive mass vaccinations in the coming months. All the time, as people lose work opportunities and are confined to their homes, families are starving.

Jean Garrito, a diving school operator in Thailand’s Phuket island, said small and medium-sized businesses are desperate to reopen borders. He said he was not sure how long the country’s tourism sector could survive.

“If governments are not able to compensate businesses for their losses in the short and long term, then yes – if they don’t fully reopen, we are all doomed,” Garrito said.

End of ‘Zero Kovid’

From June to August, several Southeast Asian countries imposed strict restrictions in an attempt to control the wave of COVID-19.

Malaysia and Indonesia imposed nationwide lockdowns, while Thailand and Vietnam extended lockdowns in high-risk areas. Under these restrictions, millions were asked to stay at home whenever possible and domestic travel was banned; Schools were closed, public transport was suspended and gatherings were banned.

Since then, daily new cases have decreased across the region, although they remain high. According to data from Johns Hopkins University (JHU), the Philippines is reporting around 20,000 cases a day, with Thailand, Vietnam and Malaysia reporting around 15,000 cases every 24 hours. Indonesia’s infection rate has dropped the most – it is now reporting a few thousand cases a day.

The peak has just barely passed, and vaccination rates are very low in some places – but already, some governments are beginning to reopen.

Vietnam is planning to reopen the resort island of Phu Quoc to foreign tourists from next month. According to Reuters. Officials cited economic pressure for the decision, with the tourism minister saying the pandemic had “severely hurt” the tourism industry. So far, less than 7% of the population has been fully vaccinated, according to CNN’s Global Vaccine Tracker – Nowhere around 70% to 90% cited by experts as the need for herd immunity.
Thailand plan to reopen Its capital, Bangkok, and other major destinations for foreign tourists by October, are expected to revive its booming tourism industry, which accounted for more than 11% of the country’s GDP in 2019, According to Reuters. According to CNN’s Vaccine Tracker, about 21% of the Thai population has been fully vaccinated.
Indonesia, which has vaccinated more than 16% of its population, has also eased its restrictions, allowing public places to reopen and factories to return to full capacity. Until October, foreign tourists may be allowed to visit parts of the country, including the resort island of Bali. Reuters.
Malaysia, which has one of the highest vaccination rates in the region, with over 56% of its population being fully vaccinated, Langkawi reopened – Last week for domestic tourists – Group of 99 islands and the country’s major holiday destination. Several states have begun easing restrictions for people who are vaccinated, including eating out at restaurants and traveling interstate.

In some ways, the region’s rapid reopening reflects the “living with Covid” approach in Western countries such as the United Kingdom and parts of the United States, where daily life has essentially resumed normal. .

Among the Southeast Asian countries, Singapore has “opened up” to move away from the previous “zero-Covid” policy, said Abhishek Rimal, regional emergency health coordinator for the International Federation of Red Cross. And although others have made no such formal announcement, their rapid reopening shows governments are weighing the strategy’s long-term sustainability.

“There has been discussion among scientists around the world – what will be the fate of COVID going forward?” Rimal said. “One possible scenario is that it will be an endemic disease moving forward… We are leaning towards being part and parcel of our lives.”

danger of reopening too soon

However, experts warn that low vaccination rates in parts of Southeast Asia, including the Philippines, Indonesia and Thailand, will make reopening more risky than in the West.

Many Western countries have vaccinated most of their populations – including 65% in the United Kingdom and about 70% in Canada.

And although they are still seeing cases, with many reporting brief spikes after reopening, the number of COVID deaths and hospitalizations in these Western countries has been low, indicating the benefits of the vaccine.

In Southeast Asia, the test positivity rate also remains worryingly high. The World Health Organization has recommended that countries maintain a positivity rate of 5% or less for at least two weeks before reopening – but the figure is 20% to 30% in many Southeast Asian countries, Rimal said. .

“This clearly indicates that what we are seeing is not an accurate representation of COVID cases due to lack of testing and contact tracing,” he said. “The recent surge of COVID-19 has taught us one thing – we cannot afford to let our guard down.”

WHO has set other criteria – for example, the global health body advises governments to reopen only if transmission is under control, and if their health systems are able to detect, test, isolate and treat cases. be sufficiently capable. Rimal said some countries have not been able to meet these reopening benchmarks – meaning there is “every chance we could see a Covid surge.”

But many governments in Southeast Asia may not have much choice. vaccine supply stay low In this sector, increased due to repeated delays and global shortages. Some countries were slow to procure doses, not preparing them when the latest wave hit — and some middle-income countries, including Thailand and Malaysia — are ineligible for discounted rates from COVAX, a worldwide vaccine initiative.

Waiting for global demand to subside and supply to open up is really not an option; People’s lives and livelihoods have been severely disrupted for almost two years, with dire consequences if they are not allowed to start again.

“Millions of people are struggling to meet their daily needs,” Rimal said. “Asia has a huge workforce that is dependent on daily wages, and they are being affected by this economic slowdown.”

Vaccine inequality costs tens of billions in lost production

As the pandemic progresses, with communities re-lifting lockdowns every few months and families starving, people are also experiencing pandemic fatigue. Economic tensions aside, governments also face public pressure to reopen.

Rimal said this is a “big dilemma” facing scientists, policy makers and world leaders in Asia. “We know that vaccines are a major answer,[but]we don’t have access to vaccines while we see people suffering and suffering job losses.”

That’s why humanitarian organizations like the Red Cross are calling on global leaders to provide more vaccine doses to low-income and hard-hit countries in South and Southeast Asia, he said. But in the meantime, if countries are ready to reopen, they can only do one thing: strengthen all other aspects of their pandemic response such as public health measures, testing and contact tracing.

“Unless we do that, we will certainly see an increase in cases in the coming days or weeks,” he said.

Vaccine Blues

There’s another key consideration that could make the region’s transition to living with COVID more difficult: the types of vaccines on offer.

Many countries in Southeast Asia have relied heavily on Chinese-made vaccines, which generally have less efficacy than vaccines made by Western companies.

According to Duke University, Thailand has purchased more than 40 million doses of the Sinovac drug, while the Philippines and Malaysia each have about 20 million. Cambodia has bought another 16 million.

Meanwhile, Indonesia has bought 15 million doses of Sinopharm vaccine, while Malaysia has received another 5 million doses.

While experts generally agree that access to any vaccine Chinese-made drugs have a lower level of efficacy than Western alternatives such as Pfizer or Moderna’s vaccines.
Brazilian tests have shown that Sinovac has approximately a . Is 50% efficacy 100% effectiveness against symptomatic COVID-19, and against critical illness, as per trial data submitted to WHO. Sinoform has about 79% efficacy for symptomatic and hospitalized disease, According to who.
In comparison, vaccines from Pfizer and Moderna were more than 90% effective. China’s Foreign Ministry spokesman Wang Wenbin previously dismissed criticism of the country’s vaccines’ efficacy “Inspired by bias … smudges.”

Huang of the Council on Foreign Relations said that while attempting to reopen less than half the population, using less effective vaccines, a flood of cases could lead to hospitals flooding and even restrictions. can be reapplied.

Although not all countries in Southeast Asia rely on Sinovac or SinoForm – for example, Singapore, which has one of the highest vaccination rates in the world at over 77%, mainly uses Pfizer and Modern.
Vaccine inequality is hurting Asia's poor and the rest of the world
Other countries have moved away from using the Sinovac vaccine amid concerns about its effectiveness. In July, Malaysia said it would stop using Chinese-made shots when its current supply 12 million doses ran out.
Thailand said the same month Cancel your health workers One-time dosing with the Pfizer drug, despite already being fully immunized with Sinovac.

Huang said, “I think if they manage to use highly effective vaccines in the form of booster shots and vaccinate a significant percentage of the population, that’s certainly going to make it more equitable again. “

But for that to change, global demand needs to be pinned on supply, or rich countries with enough supplements need to step in and help – which is not happening quickly enough.

“It is very important that high-income countries share vaccine doses in South Asian and Southeast Asian countries at the earliest so that we can come out of the pandemic and go on with normal life,” Rimal said. “It’s one of the most fundamental answers we have.”

For Garrito, the owner of a diving school in Thailand, the reopening can’t come soon enough. “We all have children and have to feed ourselves,” he said.


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