By Paris Malik
Despite being geographically close to China, most countries in the Southeast Asian region that have been labelled “high-risk” have yet to show significant spikes in their patient count from the coronavirus outbreak. Additionally, there have been relatively minimal reports or coverage on cases emerging from the area. Should we be relieved? Or should we consider this the calm before the storm – a nightmare reality where the virus is spreading undetected at an unknown rate?
Tracking the outbreak
The coronavirus, officially named COVID-19, originated in Wuhan, China, with the source largely believed to be a ‘wet market’ where the dense amalgamation of human and live animals (being butchered and sold on site) created severe consequences regarding hygiene standards, and therefore heightened risk of zoonotic virus infections. The virus quickly spread, at first across China, then through unknowingly infected persons travelling in and out of the country. Though effective and immediate measures have been taken to contain the virus, its asymptomatic nature has made it difficult to detect, with victims only showing symptoms 14 to 24 days after exposure.
So far more than 90,000 people have been infected in over 75 countries, and experts have predicted the pandemic to peak sometime between late March and late May. The disease has spread globally, with South Korea, Italy and Iran being the hardest hit. Furthermore, the spread shows no signs of stopping, as reports of new cases and deaths in various countries are increasing day by day.
It is an interesting, yet arguably unsurprising, observation that the top ten affected countries are currently in Europe. As of 2019, the continent accounts for 50% of the world’s tourist arrivals, with France, Italy and Spain taking up 55% of EU travelers. A 2019 UNWTO (UN World Tourism Organisation) study has highlighted the continuous growth in international tourism, which correlates to the widespread infection across Europe.
Further inspection down the list shows a surprising lack of cases reported from Southeast Asian countries. What could be the reason for it?
Focusing on Southeast Asia
Currently, Singapore holds the highest number of cases – 110 [then Thailand – 44, Malaysia – 29, Vietnam – 16, Philippines – 3, Indonesia – 2, Cambodia – 1]. The remaining countries (Brunei, East Timor, Laos and Myanmar) have not made any reports nor confirmed any cases.
There is widespread concern within the region regarding state-measures against the epidemic. Southeast Asia is mainly comprised of developing economies, with the leading exception of Singapore (being one of the world’s richest countries). However, most others have poor public health systems and infrastructure; generally Southeast Asian governments do not spend a lot on health expenditure per capita, and they are vastly under-equipped take effective and efficient action against a major disease outbreak. The first reported death from the virus (outside of China) in the Philippines exposed its poor medical facilities and has placed its government under even more scrutiny after learning that the Philippine government slashed $197million from its health budget for 2020 in September 2019. Dr. Tankred Stoebe, an emergency coordinator with Médecins Sans Frontières (Doctors Without Borders), shares his report on patient vulnerability and control measures against COVID-19 in developing economies with growing populations. Particularly in lower-middle income countries such as Laos and Cambodia, their healthcare systems are under-resourced and would struggle to provide services to their populations even without the threat of outbreak.
A recent study published in early February by researchers at Harvard University charted a history of direct flights to and from Wuhan and locations in other countries (including Singapore, Malaysia, Indonesia, Cambodia, Thailand, Vietnam), and have identified “locations which may potentially have under-detected internationally imported cases.” The study deduced that it is statistically implausible that Thailand and Cambodia do not have more cases, and even more so that Indonesia, being the world’s fourth most-populated country, has only reported 2 cases just recently. Moreover, rising concerns on Myanmar and Laos, both bordering China, having zero cases are beginning to circulate. Myanmar shares a 1,400 mile open border with China, and little is known about the spread of the disease within the country due to its autocratic government, who has so far been tight-lipped on the issue.
There is much skepticism and criticism of several Southeast Asian leaders trying to downplay the severity of the outbreak. Back in February, Indonesia’s Minister of law and security, Mohammad Mahfud, MD, has stated in an interview that “the corona virus does not exist in Indonesia”. The statement was made shortly after a Chinese tourist who visited and left Bali was confirmed to have the virus after flying in from Wuhan. It was reported that up until the 5th of February, Indonesia did not have the right testing kit for the coronavirus, heavily relying on airport screening and ‘patients’ self-reporting. Like other Southeast Asian countries, Indonesia is under mounting pressures to improve its virus transmission identification methods. Recently, The Jakarta Post criticized the Indonesian government for worrying more about the mass socio-economic hysteria led on by the outbreak, rather than the outbreak itself.
China’s Impact on Southeast Asian Economies
On the 19th of February, a Special ASEAN-China Foreign Ministers’ meeting was held in Vientiane, Laos, to discuss health inspection measures and border policies within the bloc and with China. The participating countries negotiated ideally keeping their economies open, and coordinating information and standardized health measures with China and the WHO (World Health Organisation).
Whether preserving their relationship with China out of fear, or necessity, many Southeast Asian countries maintain complex networks with the PRC. Trade between the region and China is predicted to skyrocket up to $1trillion in 2020. From 2013-2018, exports to China from: Cambodia grew by 251%, Vietnam grew by 211%, Laos grew by 99%, and Myanmar grew by 82%. The economies of Indonesia, Thailand and Singapore are also dependent on Chinese investors and tourists: mainland Chinese tourist comprise 16% of the total visitors to Singapore in 2019. The plunge in tourism has led to large negative impacts on the GDP growth of these economies.
Having China as its top trade partner, Southeast Asia is very susceptible to the economic fallout of the coronavirus across numerous sectors. The higher the dependency, the more dire the consequences. For example, Vietnam is highly dependent on Chinese supply chains to drive its domestic growth – it is projected to experience the highest net GDP loss, almost 0.8%. Furthermore, the latest S&P 500 index showed the highest decline in Southeast Asian stock prices, falling more than 17% from their high in 2019.
These extensive ties to China further corroborate the issue that the number of cases reported within Southeast Asia do not reflect the real spread of the disease. Sooner or later (hopefully sooner), countries in the region will improve their inspection and treatment measures and obtain full control over the outbreak.