Why Asia, the pandemic champion, remains miles away from the finish line

In simple terms, people are fed up, asking: Why are we behind, and when, for the love of all things good and great, will the pandemic routine finally come to an end?

“If we’re not stuck, it’s like we’re waiting in the glue or mud,” said Terry Nolan, head of the Vaccine and Immunization Research Group at the Doherty Institute in Melbourne, Australia, a city of 5 million that is just emerging from its latest lockdown. “Everyone’s trying to get out, to find a sense of urgency.”

While the languishing varies from country to country, it generally stems from a shortfall in vaccines.

In some places, like Vietnam, Taiwan and Thailand, vaccination campaigns are barely underway. Others, like China, Japan, South Korea and Australia, have seen a sharp rise in inoculations in recent weeks, while remaining far from offering vaccines to all who want one.

But nearly everywhere in the region, the trend lines point to a reversal of fortune. While Americans celebrate what feels like a new dawn, for many of Asia’s 4.6 billion people, the rest of this year will look a lot like the last, with extreme suffering for some and others left in a limbo of subdued normalcy.

Or there could be more volatility. Worldwide, businesses are watching whether the new outbreak in southern China will affect busy port terminals there. Across Asia, faltering vaccine rollouts could also open the door to spiraling variant-fueled lockdowns that inflict new damage on economies, push out political leaders and alter power dynamics between nations.

The risks are rooted in decisions made months ago, before the pandemic had inflicted the worst of its carnage.

Starting in the spring of last year, the United States and several countries in Europe bet big on vaccines, fast-tracking approval and spending billions to secure the first batches. The need was urgent. In the United States alone, at the peak of its outbreak, thousands of people were dying every day as the country’s management of the epidemic failed catastrophically.

But in places like Australia, Japan, South Korea and Taiwan, infection rates and deaths were kept relatively low with border restrictions, public compliance with antivirus measures, and widespread testing and contact tracing. With the virus situation largely under control, and with limited ability to develop vaccines domestically, there was less urgency to place huge orders, or believe in then-unproven solutions.

“The perceived threat for the public was low,” said Dr. C. Jason Wang, an associate professor at Stanford University School of Medicine who has studied COVID-19 policies. “And governments responded to the public’s perception of the threat.”

As a virus-quashing strategy, border controls — a preferred method throughout Asia — go only so far, Wang added: “To end the pandemic, you need both defensive and offensive strategies. The offensive strategy is vaccines.”

Their rollout in Asia has been defined by humanitarian logic (which nations needed vaccines the most), local complacency and raw power over pharmaceutical production and export.

Earlier this year, contract announcements with the companies and countries that control the vaccines seemed more common than actual deliveries. In March, Italy blocked the export of 250,000 doses of the AstraZeneca vaccine meant for Australia to control its own raging outbreak. Other shipments were delayed because of manufacturing issues.

“The supplies of purchased vaccine actually landing on docks — it’s fair to say they are not anywhere near the purchase commitments,” said Richard Maude, a senior fellow at the Asia Society Policy Institute in Australia.

Peter Collignon, a physician and professor of microbiology at the Australian National University who has worked for the World Health Organization, put it more simply: “The reality is that the places that are making vaccines are keeping them for themselves.”

Responding to that reality, and the rare blood-clot complications that emerged with the AstraZeneca vaccine, many politicians in the Asia-Pacific region tried early on to emphasize that there was little need to rush.

The result now is a wide gulf with the United States and Europe.

In Asia, about 20% of people have received at least one dose of a vaccine, with Japan, for example, at just 14%. By contrast, the figure is nearly 45% in France, more than 50% in the United States and more than 60% in Britain.

Instagram, where Americans once scolded Hollywood stars for enjoying mask-free life in zero-COVID Australia, is now studded with images of grinning New Yorkers hugging just-vaccinated friends. While snapshots from Paris show smiling diners at cafes that are wooing summer tourists, in Seoul, people are obsessively refreshing apps that locate leftover doses, usually finding nothing.

“Does the leftover vaccine exist?” one Twitter user recently asked. “Or has it disappeared in 0.001 seconds because it is like a ticket for the front-row seat of a K-pop idol concert?”

The demand has increased as some of the supply shortages have started to ease.

China, which has struggled with hesitancy over its own vaccines after controlling the virus for months, administered 22 million shots on June 2, a record for the country. In all, China has reported administering nearly 900 million doses, in a country of 1.4 billion people.

Japan has ramped up its effort, too, easing rules that had allowed only select medical workers to administer vaccinations. The Japanese authorities opened large vaccination centers in Tokyo and Osaka and expanded vaccine programs to workplaces and colleges. Prime Minister Yoshihide Suga now says all adults will have access to a vaccine by November.

In Taiwan, too, the inoculation effort recently got a boost, as the Japanese government donated roughly 1.2 million doses of the AstraZeneca vaccine.

But all told, Taiwan’s experience is somewhat typical: It has still received only enough doses to immunize less than 10% of its 23.5 million residents. A Buddhist association recently offered to buy COVID-19 vaccines to accelerate the island’s anemic inoculation effort, but was told only governments can make such purchases.

And as vaccinations lag across Asia, so too will any robust international reopening. Australia has signaled that it will keep its borders closed for another year. Japan is barring almost all nonresidents from entering the country, and intense scrutiny of overseas arrivals in China has left multinational businesses without key workers.

The immediate future for many places in Asia seems likely to be defined by frantic optimization.

China’s response to the outbreak this month in Guangzhou — testing millions of people in days, shutting down entire neighborhoods — is a rapid-fire version of how it has handled previous flare-ups. Few inside the country expect this approach to change anytime soon, especially as the Delta variant, which has devastated India, is now beginning to circulate.

At the same time, vaccine holdouts are facing increased pressure to get inoculated before the available doses expire, and not just in mainland China.

Indonesia has threatened residents with fines of around $450 for refusing vaccines. Vietnam has responded to its recent spike in infections by asking the public for donations to a COVID-19 vaccine fund. And in Hong Kong, officials and business leaders are offering a range of inducements to ease severe vaccine hesitancy.

Nonetheless, the prognosis for much of Asia this year is billboard obvious: The disease is not defeated, and won’t be anytime soon. Even those lucky enough to get a vaccine often leave with mixed emotions.

“This is the way out of the pandemic,” said Kate Tebbutt, 41, a lawyer who last week had just received her first shot of the Pfizer vaccine at the Royal Exhibition Building near Melbourne’s central business district. “I think we should be further ahead than where we are.”