Move toward 'living with COVID-19' require robust measures, experts say

As more Asian countries look at reopening their borders and economies with a "living with COVID" strategy, experts said governments should remain cautious and prepare plans in case of a rise in infections.

"As we think about opening up, the most important thing to emphasize is that not only should there be a plan for relaxing restrictions, but there should at the same time be a plan for what to do in case restrictions are needed again," said Jerome Kim, director-general of the nonprofit International Vaccine Institute in Seoul. " (Governments) should discuss what the plans are for reinstating requirements."

Kim added that if the hospitalization rate reaches 80 percent of intensive care unit capacity and overwhelms the health system, then measures will need to be taken either locally or nationally.

Across Asia, an increasing number of governments are gradually moving toward coexisting with COVID-19 and reopening their borders for economic recovery.

Malaysia is eyeing a trial border reopening for international tourists next month. Singapore, one of the first countries to declare that it will be "living with COVID-19", is allowing quarantine-free entry for a number of countries and regions, including China. Singapore has fully vaccinated 84 percent of its population and is expected to launch a vaccinated tourist lane with South Korea in mid-November.

Thailand will reopen to vaccinated foreign visitors from 46 countries from Monday, while Vietnam plans to reopen the resort island of Phu Quoc in late November.

Thira Woratanarat, associate professor at the Department of Preventive and Social Medicine at Chulalongkorn University in Bangkok, said Asian countries have learned from the experience of Chile and Denmark, which opened recently after achieving vaccination rates of over 70 percent and saw their daily new infection numbers double in the past three weeks.

Thira said Thailand is in a riskier position than other countries, given that the Southeast Asian nation is reporting high daily infection numbers, and has a limited screening capacity.

"The most worrisome issue is that only 39.9 percent of the population have been fully vaccinated," said Thira, adding that the government needs to enhance its COVID-19 screening capacity and strengthen precautions.

In Indonesia, the resort island of Bali reopened on Oct 14 to fully vaccinated travelers from 19 countries, but they have to test negative and undergo a five-day quarantine in a hotel. As of Wednesday, the vaccination rate in Indonesia was just over 33 percent.

Endemic expected

Noting that Malaysia had vaccinated 94.4 percent of its adult population as of Monday, molecular virus expert Vinod Balasubramaniam from Monash University Malaysia said he agrees with Malaysia reopening its borders and stringent procedures can be put in place to mitigate the risk of importing new infections as it remains cautious about new variants and potential risks.

"Malaysia is on the right track in living with COVID-19," said Balasubramaniam, noting the expectation that COVID-19 will become endemic.

Nikolaus Osterrieder, dean of the Jockey Club College of Veterinary Medicine and Life Sciences at the City University of Hong Kong, said the reopening of borders needs "a mixed approach". Vaccinated travelers can come in, but they still need to be tested and undergo a short quarantine period. Vaccinations will reduce the risk, but health officials also need to keep in mind the number of vulnerable people like the elderly or those who have underlying health conditions when deciding to reopen borders.