Asia suffers outbreaks where COVID-19 had seemed beaten

Taiwan, which last year had a stretch of more than eight months without any locally transmitted cases, set a single-day record with 333 of them on Monday. Vietnam, which had also squashed the curve, reported its highest case count a day earlier. Singapore banned dining-in at restaurants, closed schools and put limits on social gatherings after reporting double-digit increases in domestic cases for several days. Rapid transmission in Thailand’s prisons led to a record 9,600 new cases on Monday—surpassing the total number reported in 2020.

The new waves are nowhere near as devastating as India’s fierce outbreak or as past deadly surges in the West. But occurring in places that appeared to have beaten the virus, they show how difficult it is to keep Covid-19 suppressed while infections swell elsewhere in the world, more-transmissible variants take hold and vaccine rollouts fail to gather pace outside a clutch of wealthy nations.

Apart from Singapore, where more than a fifth of the population is fully vaccinated, inoculation levels across much of Southeast Asia are in the low single digits. Taiwan has administered shots to only about 220,000 of its nearly 24 million people, and on Saturday it suspended self-paid vaccinations—which were available to people who needed to travel abroad for work, education or medical treatment—to give priority to front-line workers.

“In places with vaccines, like the United States and the U.K., you have falling cases. But pretty much everywhere else, even in countries that previously had done a great job, you have rising cases,” said Todd Pollack, an infectious-diseases specialist at Harvard Medical School who runs a health program in Vietnam. “It’s a likely occurrence and will continue to happen until vaccines can be rolled out.”

In many of the countries with strong track records in fighting Covid-19, recent cases emerged at airports, quarantine centers or hospitals as the virus broke through their defenses.

In Vietnam, new chains of transmission were traced to people who arrived from outside the country and tested positive after being released from 14-day mandatory quarantines in designated facilities. In Singapore, where travel curbs have cut air-passenger traffic to less than 3% of pre-pandemic volumes, a cluster nevertheless emerged at the airport and included workers in a zone that received travelers from higher-risk areas such as South Asia. Taiwan’s string of cases started in late April when infections were discovered at a flagship airline and its quarantine hotel.

Health officials and scientists say two coronavirus variants caused infections to multiply quickly in many instances. In Singapore, the variant B.1.617.2—first detected in India—has been found in many clusters, and at least four of 21 local cases recorded Monday belong to it. Thailand’s spread is driven by B.1.1.7, first detected in the U.K., its government says.

If outbreaks aren’t brought under control, the virus could evolve further, raising the possibility of still newer variants with mutations that could make vaccines less effective, said Dr. Yong Poovorawan, who heads the Center of Excellence in Clinical Virology at Thailand’s Chulalongkorn University.

In Cambodia, which reported very few Covid-19 cases last year, the B.1.1.7 variant spread quickly in recent months. Contact tracing was unable to get ahead of the outbreak, and tracers found worrisome trends: More close contacts of infected individuals were catching the virus than before, and contacts considered low-risk—with relatively limited exposure to infected individuals—were also testing positive.

“We’re seeing infections in settings that we had not seen last year,” said Dr. Michael Kinzer, Global Health Protection Program director for the U.S. Centers for Disease Control and Prevention in Cambodia.

In neighboring Vietnam, among the region’s success stories with around 4,500 cases and 37 deaths among its population of more than 96 million, the recent outbreak is more complex than previous ones. Infections are scattered across dozens of cities and provinces and in locations from hospitals to industrial zones. Multiple variants are at play and unlike last year, Cambodia and Laos next door are also experiencing substantial jumps in cases, increasing the risk of transmission across the border.

“The current wave is more severe partly because the U.K. and Indian variants spread very fast,” said Tran Dac Phu, senior adviser to the Public Health Emergency Operations Center under the Ministry of Health.

Dr. Pollack, who runs a health program in the country, said that even in places like Vietnam that had honed their systems to effectively fight Covid-19, the more-transmissible variants increase the burden. The variants are better, for instance, at exploiting deficiencies in infection-control measures in quarantine centers, he said.

“It puts more strain on the system because you have to do more tracing, more quarantining,” he said. “You have to move faster to prevent it from getting too big too quickly.”

Nightclubs, bars and karaoke parlors in major Vietnamese cities are now shut. Vietnam hasn’t imposed a nationwide lockdown but is closing off apartments, streets, hospitals, villages and districts where outbreaks are located.

Although Singapore’s recent outbreak is far smaller than the one it experienced last year, when Covid-19 ripped through crowded dormitories that house foreign workers, it has nevertheless returned the city-state to a partial lockdown. Case clusters have been detected at sites including the airport, a major hospital and a prison complex.

At least 87 people are linked to a cluster centered at Singapore Changi Airport, according to the Health Ministry. The first to be detected was of a fully vaccinated 88-year-old man who worked as a cleaner at a terminal. After he tested positive on May 5, other cases were found including a security officer, a private-hire driver, a sales associate at a retail store and others who had visited the terminal.

“We have cast a wide net and taken swift actions to detect, isolate, and ringfence any possible emerging transmissions,” Gan Kim Yong, co-chair of the government’s Covid-19 task force, said on Friday. “We are in a state of heightened alert.” BIGNEWZ