5 min read.Updated: 14 Sep 2021, 07:31 PM ISTDasl Yoon, The Wall Street Journal
As vaccination rates climb, countries such as Singapore and South Korea consider how fast to ease strategies that have minimized infections and deaths
Earlier this month, Singapore reached a Covid-19 milestone: The fully vaccinated portion of the population crossed 80%. But instead of moving ahead with a planned reopening pegged to the achievement, the government put on the brakes.
That is because cases were rising to several hundred each day after an earlier relaxing of some restrictions, raising fears of a hospital-bed shortage.
“We believe it is more prudent to take a pause now, do our best to slow down the spread where we can," said Lawrence Wong, co-chairman of Singapore’s Covid-19 task force, at a Friday briefing.
Widespread vaccination was meant to usher in a long-awaited march back to normal. But for Asia-Pacific countries that tamed Covid-19 by enforcing tight controls, entering a post-vaccination world is complicated.
The success suppressing major outbreaks in places like Japan, South Korea and Australia conditioned officials and citizens to low numbers of infections and deaths. The relatively clean records encouraged people to comply with restrictions through the long wait for the countries’ vaccine shipments to arrive.
Now the vaccines are there. Singapore leads the region in administering shots, but Japan, South Korea and Australia aren’t far behind—on track to be 70% to 80% vaccinated by November, approaching or even surpassing levels in the U.S., U.K. and parts of Western Europe.
In recent days, Japan and Australia’s most-populous state released road maps for relaxing restrictions as more people get fully vaccinated. South Korean officials have increasingly talked about shifting to a policy of living with the virus.
The wealthy Asia-Pacific countries’ phased approach back to normal contrasts with the U.S.’s more aggressive reopening. It more closely resembles approaches taken across much of Europe. Face masks will remain. Gatherings will remain capped, even among the fully vaccinated. Social distancing won’t go away.
Where Asia-Pacific nations differ is in sensitivity to even modest upticks in infections, a side effect of their earlier relative success.
The U.S. has cumulatively reported about 122,000 cases per million people, the U.K. 105,000 and Europe 82,000, according to Our World in Data, a project based at Oxford University. In contrast, Australia, Japan, Singapore and South Korea collectively reported 32,000 cases per million.
The death rates in those four countries are roughly one-tenth of what the U.S. or U.K. has faced. Some contrasts are even more dramatic. Singapore and Minnesota are home to about the same number of people, but the former has reported 58 Covid-19 deaths, the latter nearly 7,900.
Fully vaccinated people are far less likely to be hospitalized or die from Covid-19 than unvaccinated people with similar risk factors. But that realization may face challenges in Asia-Pacific countries accustomed to minimal numbers, health experts say.
“If you open too early, you end up in a stop-start situation," said Alexandra Martiniuk, a professor of epidemiology at the University of Sydney School of Public Health. “Consistency often works well."
Officials in Singapore said they would put reopening plans on hold for at least a few weeks to monitor trends and compare data with countries like the U.K. and Israel, where infections rose sharply after restrictions were loosened. The officials’ aim is to keep severe illness and death rates low and avoid a return to more lockdown-like measures.
Meanwhile, Singapore’s testing protocols have been enhanced and rigid isolation requirements eased in medical facilities to free up hospital capacity as cases surge. Singapore is now detecting hundreds of cases daily and expects numbers to rise over the next two weeks. As of Monday, 57 Covid-19 patients required supplemental oxygen and eight were in critical condition.
Japan’s road map, to be tested as soon as next month, calls for allowing restaurants to open for longer hours and serve alcohol, and baseball stadiums to admit more spectators. Vaccinated people will be allowed to travel, dine in larger groups and visit relatives in nursing homes—activities that are discouraged or prohibited now.
But if infections rise, the public is likely to get nervous. In late August, following a stretch when daily infections soared to around 25,000—three times the earlier peak—some 61% of respondents to a Fuji News Network poll said they wanted to extend nationwide the state of emergency in effect in hot spots such as Tokyo. Three of four said Japan should be prepared to introduce European-style lockdowns with mandatory restrictions on movement if the need arose.
New South Wales, Australia’s most populous state, unveiled a “road map to freedom" last week. Stay-at-home orders for fully vaccinated people will be lifted the Monday after the vaccinated portion of the population surpasses 70%. Up to five vaccinated people will be allowed to gather in private, and domestic travel will be permitted again. Stores, hair salons and gyms will be able to open, with social distancing.
But authorities said large outbreaks could change the map. “We can’t pretend that we will have zero cases around Australia with Delta," said Gladys Berejiklian, the state’s premier.
Australian Prime Minister Scott Morrison last month reaffirmed a gradual strategy under which restrictions would be eased when 70% of Australians 16 and older were vaccinated. When the figure hits 80%, lockdowns would become rarer, and there would be a gradual reopening of some domestic and international travel.
“We’ve learned from watching countries that have removed all restrictions that there is no ‘freedom day,’ " said the Doherty Institute, whose Covid-19 modeling informed the national government’s planning.
In South Korea, most of whose 52 million citizens have received at least one shot—and where officials expect 70% to have received two by next month—stringent restrictions in the Seoul metropolitan area have been extended.
“Even if we attain higher vaccination rates, if we cannot keep up prevention, a return to regular life will be delayed," South Korea’s prime minister said on Friday. But recently the cap on group gatherings was expanded to six people from four, if some are vaccinated.
Asian countries should be able to control outbreaks and suppress variants as vaccinations ramp up, even if they experience some infection waves, said Yik-Ying Teo, dean of Singapore’s Saw Swee Hock School of Public Health.
“Until countries collectively reach high vaccination rates, the world will continue to require some safe management like mask wearing and social distancing," he said.
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