The Economist - UK (2022-04-09)

TheEconomistApril9th 2022

Graphic detail Covid-19 in Asia

81

A tale of

two surges

D

uringthefirsttwoyearsoftheco­

vid­19  pandemic,  rich  Asian  countries

had lower case rates than almost anywhere

else.  But  like  a  dam  holding  back  a  flood,

the longer a region’s defences hold up, the

worse the resulting disaster once they fail.

The Omicron variant has swept remark­

ably fast through places with little past ex­

posure to covid. As a share of population,

South Korea has logged more cases in 2022

than  America  has  during  the  entire  pan­

demic.  Hong  Kong’s  surge  has  been  even

more abrupt. Until this February, it barely

had any positive tests. Its cumulative case­

load per person now matches Finland’s.

In  Europe  Omicron  has  caused  greater

increases in cases than in hospitalisations

or  deaths.  Two  factors  have  combined  to

yield  such  mild  disease:  strong  immunity

levels  and  Omicron’s  low  severity  when

compared with Delta. Untilrecently,it was

unclear  which  mattered  more.  But  the

Asian data show that immunity is crucial,

and that Omicron is still deadly for unvac­

cinated people who have not yet had covid.

Hong  Kong  and  South  Korea  provide  a

natural experiment. Both were mostly co­

vid­free  before  2022,  and  had  little  infec­

tion­induced  immunity.  But  South  Korea

has had a strong vaccine roll­out, whereas

Hong Kong has had one of the rich world’s

worst. Its messaging was decidedly mixed,

giving  equal  weight  to  arguments  for  and

against  vaccination,  and  telling  people

with  chronic  diseases  to  consult  doctors

before  getting  jabs.  Its  nurses  worried

about personal liability for mishaps.

Hong  Kong  also  made  heavy  use  of  Si­

novac, a Chinese vaccine that is less effec­

tive than Western shots. According to Ming

Pao,  a  newspaper,  of  Hong  Kongers  who

died in the recent wave, 71% were unvacci­

nated and another 25% had received Sino­

vac. Just 4% got Western vaccines.

Unfortunately,  Hong  Kong’s  elderly

were  unusually  hesitant.  In  South  Korea

take­up of booster shots, which are needed

to  protect  against  Omicron,  is  greatest

among the old. In Hong Kong, in contrast,

thosemostlikelytogetboostedaremid­

dle­aged.  Just  37%  of  its  septuagenarians

and 14% of those 80 or older, the most vul­

nerable groups, are boosted—similar to the

shares among people aged 20­39 and teen­

agers,  respectively.  When  Omicron  first

struck, these rates were even lower.

This discrepancy has had a big impact.

During the Omicron wave, Hong Kong’s of­

ficial  covid  mortality  rate  has  been  five

times higher than South Korea’s. These fig­

ures can be biased by differences in testing

rates  and  judgments  on  causes  of  death.

But fair comparisons can be made with ex­

cess mortality—the gap between the num­

ber of deaths from all causes and the num­

ber expected under normal conditions.

Although  recent  total­mortality  num­

bers have not been published, our best es­

timate suggests that since February 1st 2.4

times as many people have died because of

the pandemic in Hong Kong as in South Ko­

rea.  At  the  peak  of  Hong  Kong’s  surge  in

early March, its daily excess­death rate was

between  those  registered  in  London  (1.8

per  100,000  people)  and  New  York  (5.1)

when  covid  first  struck—a  period  withno

vaccines, little testing and an incorrectun­

derstanding of how the virus spreads.n

Raging outbreaks show that Omicron is

deadly in unvaccinated people

0

1

2

3

4

5

Johnson&Johnson 1

AstraZeneca Moderna

Pfizer-BioNTech 58 21 19

Pfizer-BioNTech2 Sinovac 38

Hong

Kong HongKong

Japan

New

Zealand

South

Korea

SouthKoreapassedtheUnitedStatesin

cumulativediagnosedcaserateonMarch28th

South Korea

50%confidence interval

Britain

NewYork

London

UnitedStates

Vietnam

HongKong

SouthKorea* SouthKorea

0

10k

5k

20k

15k

25k

30k

2020 21 22 2020 21 22

HongKong

Finland

→ Parts of Asia have amassed a full pandemic’s worth of cases in weeks. Death rates have depended on vaccination levels

Cumulativeconfirmedcovid-19casesper100,000people

Shareofvaccinesadministeredbymanufacturer,January19th2022,% Shareofpopulationvaccinatedbyagegroup, April th 2022, %

Estimated daily excess deaths per 100,000 people

*Doesnotaddupto100%duetorounding Sources:OurWorldinData;PublicHealthEngland; CDC;

KoreaDiseaseControlandPreventionAgency;HongKongDepartmentofHealth;The Economist

1



0 30 40 50 60 70 80+ 1



0 30 40 50 60 70 80+

Doses 1 2 3 Doses 2 1 3

100

75

50

25

0