COVID World Status Report: 6 – The Rest of Asia

Deaths per million (darker is higher)

This is the sixth in a series of status reports on the COVID situation as at May 23^rd, 2022. This report covers those parts of Asia, which were not already included under the heading of Middle East. The countries are divided into four groups. North-East Asia covers a swathe from Georgia to Mongolia (Russia being counted as part of Europe for my purposes). South Asia consists of India and neighbouring countries. East Asia covers China, Japan and neighbours. South-East Asia covers from Bangladesh to Indonesia, Brunei and Timor.

Vaccinations

Here’s the list of percentages of the population fully vaccinated:

These countries are generally comparable in vaccination levels with the Americas (excluding Haiti).

Lockdowns

Here are the graphs of lockdown stringencies over the course of the epidemic, and the current lockdown status, in each of the four groups of countries:

The lockdowns in North-East Asia remained high until a few months ago, but are now generally lower than in many other parts of the world.

In contrast, China and Hong Kong have some of the harshest lockdowns in the world at the moment. China’s actual lockdown levels may be overstated, because it is a large country divided into many sub-regions; but Hong Kong’s are not. The Philippines and Japan are still locked down quite heavily, but the other countries’ stringencies – including, strangely, Macao – are comparable with those in North-East Asia. It seems that those countries, which did best against the virus early in the epidemic, are now reaping the dubious reward of being behind the rest of the world in the race towards herd immunity.

Having for the most part unlocked by March 2021, these countries all locked down harshly for most of the following year. It is only recently that lockdown stringencies in this area have been reduced, and they are now comparable with the middle countries in the lockdown league in East Asia.

Lockdowns have remained stringent in many of these countries throughout the epidemic, and are still high compared with neighbouring regions, except in Cambodia, Vietnam and Timor.

Here is the ordered list of current stringencies, in terms of my “harshness” metric, which only includes mandates, and aims to assess lockdown levels in terms of their impact on the population:

Here are the lockdown mandates for the bottom six above:

Country	Measures
Tajikistan	International: Screening
Mongolia, Georgia	International: Screening, Face covering: Required in some places
Uzbekistan	Events: Mandatory cancelled, International: Screening, Face covering: Recommended
Japan	Gatherings: Up to >1000, International: Ban all arrivals/border closure, Face covering: Recommended; virtually everything else is recommended closed
Philippines	Workplaces: Some closed (Regional), Gatherings: Up to <=10 (Regional), International: Ban all arrivals/border closure, Face covering: Required outside the home; most other things are recommended closed

In terms of stringency, Japan and the Philippines are much harder locked down than the North-East Asian countries.

At the other end of the scale, here are the lockdown mandates for the top four:

Country	Measures
Hong Kong	Schools: Some closed, Workplaces: Some closed, Events: Mandatory cancelled, Gatherings: Up to <=10, International: Ban some arrivals, Face covering: Required when with others
China	Schools: Mandatory closed (Regional), Workplaces: Mandatory closed (Regional), Events: Mandatory cancelled (Regional), Gatherings: Up to <=10 (Regional), Public transport: Mandatory closed (Regional), Stay at home: Required, minimal exceptions (Regional), Travel: Mandatory restrictions (Regional), International: Quarantine high-risk, Face covering: Required outside the home (Regional)
Malaysia	Schools: Some closed (Regional), Workplaces: Some closed (Regional), Events: Mandatory cancelled (Regional), Gatherings: Up to <=10 (Regional), Travel: Mandatory restrictions (Regional), International: Quarantine high-risk, Face covering: Required when with others
Myanmar	Gatherings: Up to 101-1000, Stay at home: Required with exceptions (Regional), Travel: Mandatory restrictions, International: Ban all arrivals/border closure, Face covering: Required outside the home

None of these countries seems likely to unlock substantially any time soon!

For comparison, here are the mandates for Macao, Hong Kong’s rather similar neighbour: International: Ban some arrivals, Face covering: Required in some places. There are also several recommendations for closures.

Cases

Here is the ordered list of cases per million:

The top five in this region have case counts comparable with those in Europe or the Americas. In complete contrast, there are 15 countries at the bottom with less than 3.5% of the population having been reported as cases. Herd immunity is probably a long way away in this part of the world!

Here is a map of cases per million:

Cases per million (darker is higher)

Some of the countries with significant cases (Maldives, Hong Kong, Singapore) are too small to show on the map. As in the Americas, countries with better connections to the rest of the world tend to find more cases per million than those with less good connections.

There is also evidence of what might be a “latitude effect.” The virus has spread easily not just in Japan and South Korea, but also in Mongolia and Kazakhstan (despite their low population densities) and in Georgia. Prompting the thought, if it wasn’t for the high lockdowns, how quickly would the virus be spreading in China, particularly in the northern and central provinces?

Here are the daily cases per million spaghetti graphs:

This is a pattern I’ve seen before in other parts of the world. A build-up to significant peaks in early 2022, representing the arrival of omicron. Followed by a drop almost to zero, and most recently a small bump, which may be BA.2. It’s not yet clear where this is going.

Hong Kong and South Korea have had big peaks in new cases since the new year. Hong Kong’s have since gone down almost to zero. Taiwan’s cases have recently taken off; it looks as if it took an unusually long time for the omicron variant to arrive there. Also, the Taiwanese have recently adopted a “new Taiwan model” policy, described as “gradually easing restrictions and letting the island live with the virus.”

Meanwhile, Japanese cases are bumbling along, with a very slow decline from a small late January peak. It looks to me as if the Japanese have kept their lockdown level too high.

The Maldives and Bhutan have just got over big peaks of new cases. Taking out these two outliers gives:

Now, that is very interesting. India and Nepal have just got over major cases peaks, probably caused by the omicron variant. And their cases are now low. Sri Lanka must have had another variant, likely delta, which peaked in August 2021. And they’ve just surmounted another, smaller peak. Omicron certainly arrived there in December, so could that small peak in February be the omicron peak? That would be very good news, if so.

Let’s take out Brunei:

This time, it is Singapore whose cases seem to be going through the roof. A bit concerning, since they have already had the omicron variant for months. But the raw data for Singapore is showing eight whole days, from May 15^th to 22^nd, with no new cases at all, followed by an enormous number of new cases reported on May 23^rd. An alternative data source (Worldometers) is showing a small peak of new cases in Singapore around that time, which had already been surmounted by early June. So, it looks as though this is may be the handiwork of a known variant, either BA.2 or BA.5. And the strange trajectory of the case counts is probably just an artefact of the way in which the particular data file I took had been updated.

All the other countries, though, seem to have got over their omicron peaks. Even Indonesia and Bangladesh. That’s very good news.

Hospital and ICU Occupancy

In this region, the countries reporting hospital occupancy data are Malaysia and Japan. Both have less than 1% of their available hospital beds occupied by COVID patients. For ICUs, the countries reporting are South Korea (just over 6% full) and Japan (just under 3% full). Neither of these is concerning.

Deaths

Here is the ordered list of deaths per million:

Georgia is now seventh in the world in deaths per million. The rest are all below most European levels.

Here’s the data on a map, normalizing the colours relative to Hong Kong rather than Georgia:

Deaths per million (darker is higher)

Four things stand out here.

The first is the great big white area that is China. Why so few deaths per million? High lockdowns? Or faked data? Or could it be, perhaps, that Chinese ancestry may confer on those who have it advantages against a virus of this kind?

The second is the “arc of hell,” which curves west from Japan to Kazakhstan, passing roughly over Beijing as it does so; and continues, via Turkmenistan which is not reporting any COVID data, into Azerbaijan and Georgia. If you continue this arc across the Black Sea, you come to Bulgaria, the hardest hit country in Europe in terms of deaths per million. And then on to North Macedonia, Montenegro and Bosnia, not to mention Hungary a little to the north. And further west, to Italy and Spain.

And across the Atlantic to… the USA. Which also has done very much worse against the virus than you would expect from its economic and technological status. The “latitude effect,” as I call it, has to be real. Though I have not checked it on the west side of the pond. For which, I would need to look at US figures broken down by state.

The third is the swathe of relatively lightly affected countries to the south of China. Could it be that it is not just Chinese genes, but also regular contact and trade with the Chinese over centuries, which might produce a lower susceptibility to such a virus?

The fourth is Malaysia. Why has it done so badly in deaths per million, compared to its neighbours? Although it has been quite heavily locked down for much of the epidemic? And has more than 80% of its people fully vaccinated? They seem to have had a pretty poor time of it against the virus. To be fair, Malaysian politics doesn’t seem to have helped. For they have a political and constitutional crisis, whose start coincided with the beginning of the epidemic, and which is still on-going.

Next, here is the ordered list of deaths per case:

Here is the corresponding map:

Deaths per case (darker is higher)

Myanmar has a very poor health care infrastructure, which probably accounts for their failure on this metric. They have also had a coup d’état during the epidemic. Japan’s and South Korea’s successes may be because of their relatively good health care systems.

As for the rest, I would guess they have succeeded because they have previous experience of such viruses, through having traded with (or in places like Singapore, lived with) the Chinese over time. Countries further away, like Cambodia and Indonesia, have not done as well on the deaths per case metric.

Now let’s look at average excess mortality over the course of the epidemic. Surprisingly many countries are reporting this metric in the region. Here’s the ordered list:

The countries west of China, particularly the “stans” and Georgia, have not done well on this metric. This suggests that they may have missed identifying some of their deaths during the epidemic as being due to COVID. But every country from Macao downwards has done well, with average excess mortality under 10%. The Maldives, the Philippines and Uzbekistan have average excess mortalities comparable with European ones.

I decided not to bother to make a map of this distribution, since the paragraph above says just about everything the map would show.

It seems rather odd to see Malaysia so low in average excess mortality, given its deaths per million. It looks as if this may be because they stopped reporting this metric in September 2021, after the first mortality peak. Yet another country that stops reporting when the going gets tough!

To sum up

Despite low cases per million and strange numbers in some places, many countries seem to have passed their omicron variant peaks. Even India, Bangladesh, Indonesia, and maybe Sri Lanka. Absent a new variant, they’re on the home stretch.

But Asia in general is lagging Europe, the Americas, the Middle East and Africa in the race to get shot of the virus. This seems to be because countries, that through high lockdowns did well against the virus initially, are at a disadvantage now. South Korea and recently Taiwan have recognized this, and begun to change strategy. But China and, so far, Japan have not. Unlocks are required, in these two countries in particular!

There is what I describe as a “latitude effect” or an “arc of hell,” whereby in a band of latitude between roughly 30 and 40 degrees north, the virus tends to do well, both in spread and in lethality. This band covers most of northern and central China, including Beijing. Places further from oceans are harder hit. But the effect is visible in both Asia and Europe, and maybe (I haven’t checked) might also help to explain the USA’s poor performance against the virus.

People in countries close to China seem to do better against the virus than those further away. This might be due to genetic or trade links giving them a degree of immunity against viruses like this one.

Most of all, bad politics tends to produce bad performance against the virus. This is shown by Myanmar and Malaysia. It is surely why war zones like Syria, Yemen and Sudan, not to mention Ukraine, aren’t doing well. And, likely, may have something to do with why the Nordic countries – where governments are, by and large, trusted more than in most other places in the world, certainly than in the Anglosphere – have done, relatively, so well against the virus.