At Thammasat University Hospital, about 20 miles north of Bangkok, doctors are scrambling to treat COVID-19 patients streaming in. Nearby, extra beds have been crammed in to a student dormitory block, turning it into a field hospital that can accommodate an additional 470 patients.
“We don’t have enough beds, we don’t have enough ventilators,” Anucha Apisarnthanarak, the chief of the infectious diseases division at the hospital, tells TIME. “This is only my hospital, but of course there are a lot more hospitals experiencing the same problem.”
In Jan. 2020, Thailand became the first country outside of China to confirm a case of the disease that became known as COVID-19—but it successfully fought off the pandemic for most of the year, recording less than 5,000 cases in a population of 70 million by mid-December. Now the total has skyrocketed 18-fold to more than 90,000 cases as this onetime COVID success story battles a worrying new surge.
A similar pattern is playing out across Southeast Asia. In 2020, the region moved quickly to implement strong public health measures as early cases began to surface. That allowed it to fare relatively well against the pandemic. But now, many countries are facing exponential increases in case numbers—and the situation may get worse.
Abhishek Rimal, the Asia Pacific emergency health coordinator at the International Federation of Red Cross and Red Crescent Societies (IFRC), tells TIME by phone from Kuala Lumpur there are worrying signs that Southeast Asia is an danger of a devastating second wave like the one killing thousands of people a day across India and South Asia.
“What we are seeing in Southeast Asia are the initial symptoms—that cases are increasing in a similar manner to what we were seeing four weeks ago in South Asia,” he says. “The second wave is really creeping across Asia, spreading from South Asia to Southeast Asia.”
COVID-19 surges across Southeast Asia
Last year, Thailand’s neighbor Cambodia avoided the worst effects of the pandemic, moving quickly to shut down schools and entertainment venues, ban domestic travel and close borders. By mid-February, less than 500 total cases had been reported in a country of 16.5 million people. Now it is recording that many cases each day. For a poor nation with an underfunded health system, this is a potential catastrophe, prompting Prime Minister Hun Sen to warn that the country was “on the brink of death.”
Across the border in Laos, officials have reported less than 1,500 cases, but the case load has increased almost tenfold in the last three weeks—and the landlocked country reported its first COVID-19 related death on May 9. On May 12, Malaysia reported 39 coronavirus-related deaths—the biggest daily tally of fatalities the country has seen since the pandemic began.
Read More: Why the COVID-19 Variants Spreading in India Are a Global Concern
Infections are meanwhile spiking in Vietnam. It has notched just 3,740 cases since the start of the pandemic, but community transmissions began climbing sharply in mid-April and health workers have been told to prepare for 30,000 patients. Prime Minister Pham Minh Chinh said the new outbreak would threaten political stability in the communist-ruled state if not brought under control.
In the wealthy city-state of Singapore, the number of cases of community transmission increased to 71 in the past week, up from 48 the previous week, and the number of cases without a link to known cases has risen to 15 over the past 7 days.
The world’s most populous Muslim-majority nation, Indonesia, is braced for a COVID wave in the wake of the recently concluded Ramadan, which saw authorities struggle to enforce a domestic travel ban. And the Philippines is battling a stubborn coronavirus surge despite having subjected its people to one of the world’s longest and strictest lockdowns.
A Bangkok Metropolitan Administration worker tests a bed for incoming COVID-19 coronavirus patients at a new field hospital in a sports stadium on the outskirts of Bangkok on April 18, 2021.
Lillian Suwarnumpha—AFP/Getty Images
COVID-19 spreading across Southeast Asia’s borders
The causes of the outbreaks across Southeast Asia vary, but Meru Sheel, an infectious disease epidemiologist at Australian National University, says that the devastating surge on the subcontinent may be having knock-on effects. India is recording more than 350,000 official cases a day—a number that experts believe is an undercount.
Already, the country’s COVID-19 crisis has spilled across its northern borders to Nepal, where a catastrophe similar to what is being seen in India is unfolding and where the health system, in the words of a top health official, “has gone down.” India also adjoins Bangladesh, where there has also been an alarming rise in cases, and Myanmar, which in turn borders Laos and Thailand.
Myanmar’s health system—thrown into disarray by the the Feb. 1 military coup and the violent unrest that followed—is cause for particular concern. “The health service across the country is severely disrupted,” says Rimal of the IFRC. “There’s a lack of testing, there’s lack of contact tracing and also there is reduced capacity to treat COVID-19 patients.”