Millions of people in China are under lockdown. Hong Kong morgues are overwhelmed. And South Korea is reporting the most cases per capita worldwide.
For much of the pandemic, these places were held up as Covid-19 success stories, as stringent border rules helped them avoid high cases and deaths – even as the pandemic took hold around the world.
Now, they’re among a number of places across Asia Pacific battling unprecedented outbreaks.
While the surge in cases can partly be explained by the highly contagious Omicron variant breaking through the region’s defenses, that’s not the whole story.
In some places, rising case numbers are a symptom of living with Covid as governments accept that trying to eradicate the virus is an unrealistic pursuit. In other places, skyrocketing cases are being blamed on a lack of planning by authorities caught off guard, despite two years of warning.
Asia’s highest ever peak
Many of the places reporting the most cases per capita in the Asia-Pacific region – which spans eastern and southern Asia and Oceania – were previously seen as success stories.
Those include South Korea, New Zealand, Vietnam, Australia, Hong Kong and Singapore.
Of those, two countries that have both been easing restrictions are driving the Asian case numbers – South Korea and Vietnam.
Vietnam fully reopened to international tourists earlier this month – even as cases surged.
Meanwhile, in South Korea, the presidential election earlier this month may have played a role in its spike. Woo Joo Kim, a professor of infectious diseases at Korea University Guro Hospital, said the government eased restrictions in the weeks before the election to address the economic losses suffered by small business owners.
“(The Korean government) relaxed the current measures and social distancing even though the number of Covid cases were getting higher and higher,” he said.
Abhishek Rimal, the regional emergency health coordinator for the International Federation of Red Cross and Red Crescent Societies (IFRC), said Lunar New Year, which was celebrated at the start of the year in both countries, could have also contributed to the outbreaks.
Another factor, he said, was that both Vietnam and South Korea also have large testing capacities, which could also explain why they are finding more cases than other countries.
“They are testing, that is why they are getting it,” he said.
The countries now experiencing large numbers of cases all closed their borders at the start of the pandemic, leaving them largely shut off from the world. When Covid broke through, they used tracing, tracking and social distancing measures to bring outbreaks under control.
In the past few months, most have begun to shift toward a new approach: living with the virus.
After years of banning most foreign nationals, all of the places – apart from Hong Kong – eased border restrictions and relaxed rules for citizens.
The reasons behind that differ from place to place.
Singapore led the way in June when it announced it was a breaking with the zero-Covid club and charting a way to living with the virus. Other countries followed – though not all by choice. Australia and South Korea moved to a similar model only after failing to stamp out local outbreaks.
“We are more than two years into the pandemic … and people are really looking at going back to their normal life,” Rimal said.
But people in Hong Kong and China are still waiting to move forward with their lives. In both places, governments have maintained strict border rules – and people still live with social distancing measures and the threat of snap Covid lockdowns.
Vaccines are key
Even with soaring cases, some authorities across Asia Pacific don’t seem rattled for a simple reason: vaccines.
Besides the tiny Pacific island countries Tonga and the Cook Islands, New Zealand and South Korea are reporting the highest cases per capita in the region – but their death tolls remain relatively low.
“The sacrifices and hard work has brought us here today, and now with more tools and with one of the most highly vaccinated populations in the world, we are able to keep moving forward safely,” New Zealand Prime Minister Jacinda Ardern said last week. “Covid is here to stay.”
South Korean authorities have pushed the same message.
“The number of confirmed cases continues to increase significantly, but the severity and fatality rate, and the medical system’s responsiveness, are considered manageable,” said health official Son Young-rae in a briefing on March 23. “(We) believe that once the peak of this Omicron wave passes, we’ll be able to convert to a system that is closer to a normal life.”
Both South Korea and New Zealand have high vaccine rates – but crucially, they have vaccinated their elderly, who are most vulnerable to severe illness and death from the virus.
And so far, that’s meant that while these countries have seen an increase in fatalities as their cases rise, they’ve still been able to keep death rates relatively low.
Although funeral homes are struggling to keep up with a spike in Covid deaths in South Korea, the country’s fatality rate was 0.13%, lower than the United Kingdom’s 0.18%, the US’ 1.2%, or France’s 0.59%, health official Lee Ki-il said Friday, citing World Health Organization (WHO) statistics.
It’s a similar situation in New Zealand – while the country had one of the highest reported Covid cases per capita over the past week, when it comes to deaths per capita for the past week, it doesn’t even make the top 20 worldwide.
Again, the region’s outlier is Hong Kong.
Hong Kong, with a population of 7.4 million, has reported more than 7,300 Covid deaths since the end of December. The city’s death rate per capita has been the highest in Asia and Oceania every day since February 28.
In Hong Kong, 84.5% of the population age 12 or over have been vaccinated with two shots, but – crucially – just 60% of people age 70 or over have had two doses.
The virus was able to rip through elderly homes, where vaccination rates were low.
The question over whether stringent measures are worth it is also playing out in mainland China, which is facing is biggest outbreak since the one recorded in Wuhan at the start of the pandemic.
And like Hong Kong, vaccinations among the elderly are lagging, raising concerns the city’s deadly outbreak may foreshadow a deadly wave across the border.
About 40 million Chinese over the age of 60 have yet to receive a vaccine, according to data from China’s National Health Commission (NHC). Only about half of those age 80 and over are fully vaccinated, the NHC said in its most recent breakdown on March 18. Of those over 80, less than 20% have received a booster shot, despite WHO saying last year that all elderly people taking China’s inactivated vaccines needed three shots to be fully protected.
For now, it looks as if China is sticking with its zero-Covid strategy – and relying on strict lockdowns to get its spiking cases under control.
CNN’s Yoonjung Seo and Simone McCarthy contributed to this report.