Data insight

The surge in East Asia & Pacific

Transmissible variants and policy shifts have made their mark

The recent Omicron/Delta appears to have spared noone, 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 chart below shows the evolution of newly confirmed cases (and also deaths) per million people over the full course of the pandemic. 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 is clear as is the subsequent downward trend in both cases and deaths. The chart below shows the more recent period, where the shaded area reflects the first Omicron/Delta wave followed by a second one that started early March 2022 and has subsequently dissipated. 

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.

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.

Key contributors in EAP
The two charts below show the latest data and identify which countries in EAP currently have the highest case rates and contribute the largest absolute number of cases to the global total. The charts show the global Top 50 for each variable and group the data by World Bank region. As it turns out, several EAP countries currently feature in the global Top 50 for both variables. They are highlighted in gold. 
A huge relative escalation
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. 
The chart immediately below shows the ratio of the recent peak to the all-time peak for weekly cases. 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 chart further below focuses just on cases and shows the countries where the escalation of case rates has been the greatest in relative terms.

Policy shifts 

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.  

Hong Kong SAR

For any “living with COVID” strategy to be feasible and desirable, it is important to have an effective vaccine line of defense in place. The hyper-contagious nature of Omicron means that it will eventually find a way to the most vulnerable, as the recent experience of Hong Kong SAR has illustrated.

The charts below show how Hong Kong SAR stands out on mortality in this comparison with high-income countries with a population over 1 million. The experience of Hong Kong SAR goes to show that Omicron is dangerous and that this pandemic is not over.
Note that the deterioration in Hong Kong SAR is recent. During earlier waves, Hong Kong’s zero covid approach has managed to keep variants at bay. To underscore that point (and not to diminish the tragedy of the current deterioration), the second chart shows the cumulative picture. 

In conclusion

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.

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.