Abstract
Southeast Asia (SEA) emerged relatively unscathed from the first year of the global SARS-CoV-2 pandemic, but as of July 2021 the region is experiencing a surge in case numbers primarily driven by Alpha (B.1.1.7) and subsequently the more transmissible Delta (B.1.617.2) variants. While initial disease burden was mitigated by swift government responses, favorable cultural and societal factors, the more recent rise in cases suggests an under-appreciation of prior prevalence and over-appreciation of possible cross-protective immunity from exposure to endemic viruses, and highlights the effects of vaccine rollout at varying tempos and of variable efficacy. This burgeoning crisis is further complicated by co-existence of malaria and dengue in the region, with implications of serological cross-reactivity on interpretation of SARS-CoV-2 assays and competing resource demands impacting efforts to contain both endemic and pandemic disease.
Highlights
Since the emergence of SARS-CoV-2 in Wuhan, China in December 2019, there have been over 200 million cases of COVID-19 worldwide, with over 4 million confirmed deaths by mid-2021 [1]
We provide a perspective of how the Southeast Asia (SEA) experience of SARS-CoV-2 has been molded by the region’s unique infectious disease exposures
Imposition of lockdown measures presumably increased incidence of vector-borne disease due to the efflux of city workers to residential areas with higher levels of transmission, and cessation or modification of typical vector control measures. This phenomenon may have contributed to the historic dengue outbreak in Singapore in 2020 [78, 79], incidence patterns in other countries appeared unaffected by SARS-CoV-2 (Supplementary Figure)
Summary
Since the emergence of SARS-CoV-2 in Wuhan, China in December 2019, there have been over 200 million cases of COVID-19 worldwide, with over 4 million confirmed deaths by mid-2021 [1]. The WHO identified SEA as a neglected hotspot for the emergence of antibiotic resistance in common bacterial pathogens including Staphylococcus aureus, Streptococcus pneumoniae, Neisseria gonorrhoeae, and several gram-negative bacteria [36] This unique milieu of endemic, emerging, and resurgent infections in SEA makes it an ideal model for understanding the interface between tropical diseases and the rising threat of SARS-CoV-2. Imposition of lockdown measures presumably increased incidence of vector-borne disease due to the efflux of city workers to residential areas with higher levels of transmission, and cessation or modification of typical vector control measures This phenomenon may have contributed to the historic dengue outbreak in Singapore in 2020 [78, 79], incidence patterns in other countries appeared unaffected by SARS-CoV-2 (Supplementary Figure). A limitation of this review on the pandemic’s impact on tropical diseases may be that it is too premature, with the true magnitude only assessable many years
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