During much of the first year of COVID-19, Southeast Asia seemed one of the few bright spots in the world. Vietnam, a lower-middle income country that had learned from its experience with SARS, had one of the lowest case and death rates in the world. Thailand, Brunei, Singapore, Malaysia and even poorer countries in the region such as Laos and Cambodia mostly kept the virus at bay, even as wealthier states in Europe, North America and Latin America suffered millions of cases and hundreds of thousands of deaths.

To be sure, Indonesia and the Philippines struggled, but the region’s overall low rates even made some scientists question whether people in mainland Southeast Asia enjoyed some natural immunity to the novel coronavirus.

More recently, many Southeast Asian states have experienced troublingly sharp new surges in cases, and some countries could wind up as COVID-19 disasters nearly on a scale with that of India. Thailand, which at points last year had no domestically transmitted COVID-19 cases, now is averaging around 4,000 new cases a day, and some of its hospitals are running out of ventilators and intensive care unit beds.

Cambodia, which had few cases in 2020, is now averaging around 500 cases a day, while Malaysia is actually averaging as many new cases, per capita, as India, where COVID-19 is killing tens of thousands of people, and is struggling to set up mobile intensive care units.

Cambodian Prime Minister Hun Sen, never one to mince words, told his country that it was “on the brink of death.” Tiny and opaque Laos, where statistics can be unreliable, has reportedly seen caseloads grow substantially in recent weeks. Vietnam, hailed as a global success story and an example for other developing states, has seen a rising caseload as well.

Even well-run Singapore, which had recorded only around 30 deaths in a 12-month period, and where citizens were living fairly normally throughout most of 2020 and 2021, has suffered a sharp rise in COVID-19 cases. Singapore has been forced to close many institutions, including schools and restaurants, and cancel some planned major international conferences supposed to be held in the city-state in the coming months.

Indonesia, the Philippines and Myanmar potentially look even worse, with the possibility of even higher figures in the next month than other Southeast Asian countries.

The reasons for this massive spike vary somewhat among Southeast Asian countries. Myanmar, ruled by a military junta since Feb. 1, has seen a massive internal dislocation of its population, with people fleeing the junta’s repression and other types of violence. This internal migration, combined with the collapse of the health care system since the coup, is almost certainly contributing to rising COVID-19 rates, although it is hard to know the true figures amid Myanmar’s overall state failure. But the continuing unrest in Myanmar, and the likelihood of further internal migration and flight of Myanmar nationals to Thailand and other countries, bodes poorly for controlling the virus.

Cambodia and Laos, as well as many parts of the Philippines and Indonesia, are extremely poor, have high rates of inequality and lack quality public health infrastructure, making it challenging to combat COVID-19. When Cambodia imposed a recent lockdown, the government was unable to provide food aid to parts of Phnom Penh, leaving residents of some areas to fight extreme hunger and complaining that wealthier neighborhoods in the capital were taken care of while the poor suffered.

In the case of Indonesia and the Philippines in particular, densely packed cities and large numbers of people working in the informal sector helps spread disease. Inconsistent COVID-19 policies in Jakarta and Manila, combined with senior officials sometimes dispensing folk wisdom about fighting the pandemic, also have contributed to a rolling crisis.

The Indonesian government recently failed to impose an effective or coordinated policy about traveling within the archipelago for Ramadan, for instance, and that widespread travel will probably increase the spread of the virus.

Setting aside affluent Singapore for a second, there are some common challenges across Southeast Asia that will make it harder for the region to stem this current spike. Few Southeast Asian states other than Singapore have a decent supply of COVID-19 vaccines, and many are relying on vaccines made in China, even though the efficacy of Chinese vaccines has not been proven in transparent trials. (According to wire reports, China’s own top health official admitted in April that Chinese vaccines were not very effective.)

Countries that are getting vaccines from European and North American manufacturers could not get their hands on many doses earlier this year, as much of the original tranches were snapped up by Western states in one of many signs of global vaccine inequality.

Singapore now has fully vaccinated about a quarter of its population, but most other Southeast Asian states have not come anywhere close to this figure. Many have only vaccinated around 1% or 2% of their populations, not nearly enough to have any impact on viral spread. By comparison, nearly 40% of Americans have been fully vaccinated, and around 34% of people in the United Kingdom have been fully vaccinated.

Meanwhile, COVID-19 variants from India, South Africa and other regions are traveling to Southeast Asia, and these are more contagious than earlier strains. In particular, the huge number of cases in India may be having an effect on Southeast Asia, with the disease spreading from South Asia into Myanmar and then beyond to other parts of Southeast Asia. Myanmar, Thailand, Cambodia, Laos and Vietnam in particular have highly porous and long land borders, making it difficult to prevent migration.

To some extent, the region’s good fortune and its effective management of the first COVID-19 wave may also have made health and political authorities overly relaxed that they had the pandemic under control.

Perhaps satisfied that they had managed COVID-19 during the first year of the pandemic, for instance, the Thai government, which does have the finances to purchase a wide array of vaccines, initially relied solely on AstraZeneca’s version, limiting its vaccine options. The government then moved slowly to roll out inoculations, sparking public anger. Today, only around 1% of Thais have been vaccinated, and a country once hailed as a pandemic success story is struggling.

Joshua Kurlantzick is a senior fellow for Southeast Asia at the Council on Foreign Relations.

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