Asia and Covid-19: Progress Report

Asia Sentinel roundup seeks to sort out the chaff

As the Covid-19 virus makes its ominous way across Asia, countries are in varying stages of readiness to combat it, with Hong Kong, Singapore, Taiwan and South Korea at the forefront, with other countries strung behind them across the pandemic spectrum. 

However, the World Health Organization, like most UN-related bodies, relies largely on governments for data and at this point the data is suspect. The fewer tests, the fewer cases reported. Fewer tests can be the result of shortage or equipment, access to it or lack of trained personnel, as in Indonesia where travelers haven’t been picked up at international airports by thermal scanners. Despite the unreliability of the data, the abovementioned four have been by far the most effective in tracing the infection and then using technology to track those who may have been affected.

It is clear from experiences in Taiwan, Singapore and South Korea that widespread testing and careful tracking of potential cases is essential. However, in some countries, deliberate decisions have been made only to test people already sufficiently sick to be admitted to hospital, which keeps the numbers down and prevents those who are only mildly sick from swamping overcrowded hospitals. 

This link appears to be carrying complete, up-to-date information on the changing situation across more than 160 countries. 

Some decisions appear largely political, for example, US President Donald Trump’s ban on entry from most EU countries but initially excluding the UK although he reversed that later. Trump’s antipathy to the EU and cordial relationship with its anti-EU prime minister Boris Johnson, seem to explain that. 

Meanwhile, the dramatic decline to single digits in China stretches credulity, especially at it followed Xi Jinping’s visit to Wuhan and a declaration of victory. The political nature of the crisis is indicated by voices in China seeking to accuse the US of exporting the virus to China, and others in the United States accusing China of exporting the virus to the US. 

Hong Kong and Taiwan and Singapore, scarred by the 2002- 2003 SARS epidemic which took 299, 75 and 33 lives respectively, acted decisively, restricting travel from the mainland, establishing command centers and clear lines of authority to trace cases. Singapore too has been quite successful without complete lockdowns. Unlike Hong Kong, schools have remained open. As a result, there have been no new deaths in these countries for several days.

South Korea

So far South Korea, with 75 deaths, eight of them new, has tested more than 220,000 people. Naturally, this results in the discovery of more cases than most countries, not least China, where testing has mostly been confined to those already quite sick and their immediate families and associates. 

Italy, with a population of about 20 percent bigger than Korea, has been testing but its numbers so far total only 70,000. One consequence of Korea’s high testing has been that though more cases have been discovered, the death rate at about 1 percent is lower than elsewhere.

Korea’s tracking system may not be possible in less high-tech societies. Also it has involved a degree of invasion of privacy – tracking and publishing movements of identifiable individuals that wouldn’t be tolerated elsewhere and has aroused opposition in Korea itself. Korea has also avoided the blanket quarantines of whole regions, with very strict measures applied to a few hotspots. As a result, normal life has been less dramatically impacted. (continued below)

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The Ineffectiveness of Quarantines

Philip Bowring 

The Korean example of avoiding mass quarantines on grounds of ineffectiveness reminds this writer of the practice of quarantining whole cities two hundred years ago. Then, medical science was primitive by today’s standards, identification of bacteria and viruses unknown but acute human observation and analysis was perhaps more perceptive in some respects than today’s expert science.

In 1838, the British Association of Science published a 45-page entitled Observations on the Oriental plague and on Quarantines as a means of arresting its progress. It was written by John Bowring, a polymath who later became governor of Hong Kong and whose name is better known through the Bowring Treaty, a crucial 1856 deal between Britain and Siam. 

Bowring was no scientist but was an acute observer who made his name as a political economist and literary figure. He wrote it after spending many months in Egypt on a mission to report on that country, then under its noted 19th-century leader Mohamed Ali. The plague paper was a side product.

Plague epidemics occurred sporadically throughout the southern and eastern Mediterranean, and quarantines of whole cities - such as Alexandria in 1834 - were the usual official response. The 1834 epidemic killed some 200,000 (or 5 percent of the population) in Egypt. Movement of goods and people was periodically imposed in an effort to isolate outbreaks. Ships, in particular, were subject to 40-day quarantines (from the French word for 40) while on land people who had been in infected regions were confined to lazarets, hospitals or cordoned areas. The practice was common throughout areas in the Mediterranean occasional hit by plague. 

Quoting doctors resident in Alexandria, the paper argued that mass quarantines were due to 'superstition and ignorance'. Using their observations it concluded that plague was endemic, and epidemics were localised and outbreaks, though unpredictable were closely associated with summer weather patterns. Plague was not contagious, as assumed by quarantine rules. The disease was airborne could be spread by birds and animals, so quarantining humans was pointless. 

Those quarantined in quarantined zones had a far higher fatality rate than those outside. Quarantines of humans were, anyway, almost impossible to enforce effectively due to the needs of people to travel to earn livings, the corruptibility of officials etc. Mortality rates from plague were largely a function of living conditions – high rates resulting in overcrowding and a lack of ventilation. The poor suffered the most. Then as now, travel bans which impeded normal commerce were imposed without any thought to the negative consequence for society as a whole. Quarantines also became diplomatic issues which further obstructed commerce and inter-state relations. In short, the supposed cure was worse than the disease. While countries today struggle to find the best ways of confronting Covid-19, this paper from nearly two hundred years ago at least asks two key questions which are relevant today.

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Philippines

The Philippines, where cases jumped unnervingly overnight by 42 percent to 111 with three new deaths as checking has become widespread, has gone from blaming others to an attempt to lock down Manila with a curfew and entry restrictions. Not only is this even in principle only a half measure, but it will hit the poorest hardest – the vast number of casual laborers, street vendors and other informal sector workers who already live a hand-to-mouth existence.

Duterte used his press conference announcing the “community lockdown,” in which separate communities across the country would act independently on whether to quarantine, mainly to unnecessarily kowtow to China for offering assistance and complimenting Xi Jinping for his concern without mentioning that the virus had originated in China and that authorities had botched the response to it by trying to cover it up and arresting medical personnel who were attempting to spread the word.  

Authorities are advocating 30-day “social distancing measures” that include suspending land, domestic air, and domestic sea travel to and from Metro Manila until April 14 from countries with transmissions. With more than 160 countries now recording transmissions, that means most of them. According to one analysis, Duterte used the event mainly as a political exercise, indirectly promoting his former aide Christopher “Bong” Go, now a senator who is said to be contemplating an attempt to succeed Duterte in 2022 general election. 

Thailand

Tourism represents about 20 percent of Thailand’s national income and has been badly hit by the pandemic, which registered only 82 cases and seven deaths so far – one new although those figures are almost certainly low because of lack of testing. Of nearly 40 million tourists last year, around 30 percent were from China. This has dried up completely leaving many tourist spots like Pattaya almost completely empty. Many Chinese and seafood restaurants that specialized in Chinese clientele have either sent their staff home with pay or closed up. 

Street vendors have also felt the sharp decline in customers and are falling on hard times. Speedboat and other tourist operators are also being forced to scale down or even close. Many are also having difficulty servicing loans. 

Thailand has placed travel restrictions on tourists from infected areas, but last week flip-flopped over cancelling visa on arrival conditions for visitors from 16 countries. The government has cancelled all official celebrations for the coming Songkran water festival. Other public sporting events like running, which attracts more than 500,000 Thais to various venues around the country have all been canceled or postponed. Muay Thai – Thai boxing – has also been cancelled. Financially embattled Thai Airways has cut services to seven international destinations, and along with other local airlines scaled back drastically on domestic services. Airports around the country are very quiet. 

Many hospitals and major clinics around the country don’t have Coronavirus test kits, indicating that the number of actual cases is grossly underestimated. The government last week just introduced a mobile app for tourists and incoming Thais from highly infected areas to register themselves on so authorities can track them for 14 days after arrival. All major shopping centers now are checking temperatures. 

The situation has not been without controversy. The deputy prime minister and health minister Anutin Charnvirakul tweeted that dirty farangs (foreigners) are fleeing Europe and potentially spreading the virus. This is on top of his comments a week earlier where he said farangs who don’t wear facemasks should be kicked out of the country. Asia Sentinel also reported that Thailand’s deputy Agriculture minister Thammanat Prompao is involved in a scheme to hoard 200 million facemasks to profit from the panic. Supplies of facemasks, alcohol, and antiseptic hand-gel are very short around the Bangkok area and been sold for premium prices. 

Malaysia

The issue took a backseat with Malaysia’s political crisis over the last couple of weeks. Now that the crisis has cleared with Muhyiddin Yassin being installed as the new prime minister and appointing a cabinet, focus has been put on the pandemic. Newly appointed religious affairs minister Zulkifli Mohamed, amid criticism, allowed Friday prayers to proceed in Malaysia’s federal territories. But with a number of cases arising from a religious gathering at a mosque that attracted 16,000, Muhyiddin later in the afternoon announced that meetings of more than 50 people were not allowed until further notice. 

Malaysia appears prepared with more than 260 locations within the country with test kits to diagnose the virus. Nearly 240 cases have been detected – 41 overnight -- so far and known cases are being isolated in designated hospitals. Public events like the Sabah harvest festival have been cancelled. The army has been brought in to assist the ministry of health. 

The virus is hitting tourism and travel very hard. Malaysian Airline flights are now at 50 percent capacity. Many staff have been asked to take three months of unpaid leave to keep the airline afloat. There are concerns that regional airlines may face severe financial strain and bankruptcy later on this year, if the situation continues. Malaysia’s economy is heavily dependent on China and is starting to feel the economic slowdown in China. Malaysia’s stock market and currency, the ringgit continue to fall. 

Cases have escalated exponentially since March 2 and signs of panic are beginning to be seen where some hoarding of food from supermarkets has been observed. Visitors from China and Japan are now barred from entry.

Indonesia

Indonesia may be the worst-prepared country in the region, as Asia Sentinel reported on March 12, with Vice-president Ma'ruf Amin and Minister of Health Terawan Agus Putranto, for example, initially saying prayers had kept the virus at bay until it became clear it hadn’t. With Singapore reporting cases that had originated on Batam, an island just 30 km across the strait, plus a case on the tourist island of Bali, the government was finally stung into action, albeit tardily and shambolically.

One of the big casualties appears almost certain to be Garuda International. While all Asian airlines are facing economic catastrophe, Garuda had already lost perhaps 20 percent of its international passengers and some 7 percent of total passengers. Now Saudi Arabia has suspended pilgrimages for Muslims to Jeddah and Medina since February 27. That is expected to cost the airline US$135 million per month at a time when short term debt is estimated at US$1.45 billion and with an outstanding debt of nearly US$500 million coming due in June.  

Corona-positive cases have climbed to 96, up 26 percent overnight. That is almost laughably low, given how far the country is behind the rest of Asia. At least seven cases went through screening at airports without being picked up by thermal scanners, and indication that the country’s equipment may not be up to the task. The government said it would not add to the list of countries whose citizens are restricted from entry including Japan, South Korea, Iran and Italy. China was named earlier. Tourism arrivals fell by 33 percent in February 

Australia

Covid-19 has been the center of media attention for a number of weeks with Australians following the rest of Asia and emptying the shelves of toilet paper, canned goods and long-term foods from supermarkets, causing severe shortages leading to assurances from both government and major supermarket operators that these shortages will be quickly fixed. 

Last week actor Tom Hanks and his wife, on location at the Gold Coast producing a new film, tested positive and went into 14 days quarantine. A couple of days later home affairs minister Peter Dutton also tested positive. This weekend’s opening Formula One race in Melbourne was abruptly cancelled while people were trying to enter the venue, causing anger. Prime Minister Scott Morrison later that day announced that any event more than 500 people must be cancelled, meaning that all winter football events will be played without crowds and televised. 

Australia’s foreign affairs ministry website Smartraveller issued a warning against any unnecessary travel outside the country. With 248 confirmed cases, 49 of them overnight at the time of writing, Attorney-General Christian Parker is contemplating activating Australia’s Biosecurity Laws for population control. Some racist anger at Chinese has forced some Chinese restaurants to close, and there have been racist incidents with people of Asian-decent being refused entry into shopping centers. On Sunday morning, Morrison announced that all arriving travelers must undergo a 14-day compulsory self-quarantine.