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COVID-19 in Southeast Asia: outbreak delayed but developing

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ASEAN countries start taking measures to mitigate an outbreak as cases begin to surge, despite an initial delay

BY Courtney Weatherby

Considering the geographic and economic closeness between Southeast Asia and China, the coronavirus challenges Southeast Asia both economically and directly as an outbreak. The loss of tourism, supply chain disruptions, and problems posed by ongoing severe drought have already caused many Southeast Asian countries to slash growth expectations for 2020. The outbreak appeared manageable until recently: despite early coronavirus cases, ASEAN countries avoided rapid-spread outbreaks like those seen in South Korea and Italy and only confirmed 755 cases throughout the first two months of the global outbreak. However, a drastic rise in new cases starting in mid-March foreshadows a major challenge in the new form of sustained local transmission.

ASEAN countries reacted quickly to the news of the coronavirus spreading in China, showing that many learned important lessons from the 2003 SARS outbreak. Thailand, Singapore, and many other countries responded swiftly by establishing screening, contact tracing, and quarantine protocols for suspected cases. Vietnam’s government and many individual airlines halted flights from China, but most ASEAN members merely applied screening for travelers.

Thailand illustrates the difficulties with this approach. In October 2019 Thailand was ranked sixth globally in terms of countries best prepared for a major infectious disease outbreak, the only developing country to reach the top ten. Early reports from the WHO indicated that Thailand had strong capacity for case detection and control. Until mid-March, Thailand’s steps appeared to have contained a local outbreak. Although Thailand was the first country to register a COVID-19 case outside of China and recorded local transmission of the coronavirus from Chinese tourists in early January, case numbers inched upwards and remained under 100 for nearly two months. The Thai government did not institute containment measures seen elsewhere.

The situation changed in mid-March. Cases surged from 82 on March 14 to 721 on March 23, raising questions about a new wave of infection. While a few cases were imported, the majority of this surge is confirmed as community spread with many linked to sports events and entertainment venues in downtown Bangkok. The government has reacted by postponing the major Songkran holiday and closing schools, shopping malls, and other public spaces. The central government is now encouraging people not to travel back to their home provinces amid concern that the virus could spread outside of Bangkok.

Thailand is not alone in this resurgence. In Malaysia, large-scale religious gatherings went forward unrestricted and cases surged from 29 on March 1 to more than 1500 on March 23. Despite indications that travelers had brought it into the country and that cases could have been missed in screening, Indonesia did not record any local cases until March 2 and officials actively downplayed the risk. Laos and Myanmar confirmed their first cases on March 24, but many outside analysts question the capacity of their healthcare systems to properly identify and track the coronavirus. Charted out, the rapid rise in cases in Indonesia, Malaysia, the Philippines, and Thailand starting in mid-March indicate a shift in trajectory from a slow and manageable rise in cases towards a more serious outbreak. The delay of widespread local infection reflects the limited success of the region’s initial approach, but Thailand and its ASEAN neighbors are now facing a much more complex challenge as they belatedly endorse social isolation and containment efforts in a bid to slow the spread. Only time will tell if this late response will be enough to flatten the curve and curb a more serious outbreak.