The surge in East Asia and the Pacific

Philip Schellekens  |  
Transmissible variants and policy shifts have left their mark

The recent Omicron/Delta appears to have spared no one, including countries that have previously managed to suppress the spread of the virus well. Of key interest therefore is how the East Asia & Pacific region has been doing. We have recently seen a sharp increase in cases in the region, which reflects its catch-up to the reality of more transmissible variants. But it also reflects a move towards greater acceptance of “living with COVID” and, conversely, away from zero-covid approaches of maximum suppression.


A look at the data

Let’s first review global trends. The charts below show the evolution of newly confirmed cases and deaths per million people (the first chart shows the full pandemic period whereas the second one zooms into the period of the first Omicron surge). This is daily data, but the solid lines reflect the 7-day trailing average day-by-day. The scale of the recent Omicron/Delta wave during the Northern Hemisphere winter of 2021/22 is clear. Cases and deaths fell dramatically afterwards, but this was soon followed by an even greater rise connected to the opening up of China.  

To get a better appreciation of the underlying trends driving the global picture, let’s cut the data first by World Bank income classification. The charts below plot daily new cases relative to population and in absolute terms. As we can see, global developments in reported cases continue to be carried by mainly the high-income countries. This is true both in relative and absolute terms, with exception of the most recent spike late 2022/early 2023 when China saw a rapid rise in cases.

Next, let’s cut the data by World Bank region. The charts below clearly show that most of the action during the first wave was driven by the North America region (NAM) and the Europe & Central Asia region (ECA). ECA also remained key in the second wave (around March-April). Of note, however is the surge of the EAP region during that period. Because EAP is such a large region population-wise, the absolute contribution to the global surge is particularly pronounced. This argument applies even more so with respect to the most recent surge around end 2022 as we can see in the spikes for EAP. 

The scale of the surge

The relative scale of the escalation in the East Asia & Pacific region has been huge. In other words, the recent peaks that we have observed in cases are a large multiple of earlier peaks. That of course is mostly the result of the region’s earlier success in containing the spread during prior waves. EAP stands out especially with respect to cases. On mortality, there are other regions where the escalation has been more severe in relative terms. 

The East Asia & Pacific region has been widely praised for its performance over the course of the pandemic in terms of containing spread and limiting morbidity and mortality. Several countries in the region have effectively relied on large-scale testing and tracing and strict quarantine and isolation policies, which has helped keep cases and fatalities well below those of their peers in other regions. 

The recent Omicron/Delta wave appears to have changed that in certain respects. The region overall continues to perform well relative to other regions, but compared to its own past performance it is clear that the recent wave has posed new challenges. Containment in the face of a highly transmissible variant has become more difficult and the costs associated with it more burdensome, while the benefits amidst more widespread vaccination have also diminished.

Against this backdrop, several countries have relaxed suppression policies and have adopted greater tolerance towards “living with COVID”, offering a welcome reprieve from economic and social points of view. International borders are becoming more fluid and individual freedoms less confined, which should over time all contribute to greater productivity and well-being.  

Finally, the following two charts show the cumulative effects of the surge for both confirmed cases and fatalities. This time the selected countries are sorted by their last observation. As we can see, South Korea had by far the largest surge in cases, whereas Australia registered the biggest increase in fatalities.


Cases have been on a downward trend globally. But recent developments mainly in the EAP region have perturbed that pattern and have contributed to a reversal, which by now has dissipated in several countries.

The growth of cases in EAP reflects the catch-up of the region to a reality that other regions have faced already, namely that of a more transmissible variant that is harder and therefore more costly to suppress.

It also reflects the policy shift of several countries towards greater acceptance of a “living with COVID” approach, which depending on vaccine coverage may offer tangible economic and social benefits.

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