With doctors and other health care workers already on strike to protest the coup, Myanmar’s health care system may buckle under the outbreak.
Three days before she was arrested by soldiers, Myanmar’s civilian leader, Daw Aung San Suu Kyi, received her first dose of a coronavirus vaccine. Her high-profile inoculation was part of a nationwide campaign to combat the virus through testing, mask-wearing, lockdowns and vaccination.
But like the civilian government that Ms. Aung San Suu Kyi headed, her program to contain Covid-19 was cast aside by the military when it seized power in the Feb. 1 coup.
“There had been a real push toward testing, surveillance and vaccination and all of that just crumbled after the first of February,” said Alessandra Dentice, the head of Myanmar’s UNICEF office.
Now, the country, reeling from a brutal military crackdown and crippled by a monthslong national strike, is paying the price for the junta’s neglect of the pandemic. According to data reported by the regime’s health ministry, the number of daily reported Covid-19 cases has risen sharply, and with limited testing underway, the positivity rate jumped to nearly 22 percent on Thursday. Health experts believe many more cases are going undetected.
Most worrisome are outbreaks in the three largest communities near the border with India, the country where the highly contagious Delta variant was first identified. The variant has been detected among the cases.
As of Thursday, 20 townships in six states and regions have been placed under pandemic-related stay-at-home orders by the military. Outbreaks have also been reported in Yangon, the largest city, and Naypyidaw, the capital. In Mandalay, the second-largest city, all seven townships were placed under stay-at-home orders on Thursday. The six hospitals in the city that accept coronavirus patients have been filled to capacity since last week, according to a local medical charity.
The regime has stopped short of imposing lockdowns or restricting travel from areas with growing outbreaks.
The ousted government in the Southeast Asian nation had acquired 3.5 million vaccines from India before the coup. The junta commandeered most of the shots, but ignored plans to prioritize vaccinations for the elderly. Some shots went to vaccinate soldiers, according to a doctor at a Yangon military hospital. In protest, many doctors refused to get a second dose from the regime.
The military’s unwillingness to provide details about its vaccination program prompted Covax, the global vaccine-sharing program, to delay a shipment of 5.5 million doses in March, said Dr. Stephan Paul Jost, the World Health Organization’s representative for Myanmar. No new shipment has been scheduled.
Myanmar’s health care system may buckle under the outbreak. Doctors and other health care workers have already gone on strike to protest the coup and troops have occupied dozens of medical facilities, prompting many patients to stay away for fear of being detained or shot. Some doctors estimate that hundreds of patients are dying each week because they cannot get the care they need.
“The de facto authorities need to create an environment where people can work without fear and patients can get care without fear,” Dr. Jost said. “It is creating the ultimate dilemma for health workers, whether to serve the country of the future or the patients of the present.”
One community hit hard by the coronavirus is the town of Kalay, 65 miles from the border with India. In April, soldiers firing machine guns and rocket-propelled grenades attacked anti-coup protesters there who had barricaded Kalay’s streets, killing at least 11. Community leaders say the regime is providing little help in combating the outbreak.
Kalay General Hospital, the lone public hospital in the area, has been overwhelmed by the surge in cases. All its beds are occupied by people in critical condition, said Lal Puia, a volunteer leader at the Ate Sut Community Center, which has been converted into a field hospital. More than 250 people who have tested positive are staying there, he said, and many others are staying at home, where they risk infecting family members.
The town has been placed under a stay-at-home order and its streets are empty except for people buying food and medicine or trying to rent oxygen tanks, which are in short supply.
The regime reports that 138 people have died nationwide from Covid-19 in the past two months, including 13 on Thursday. Mr. Lal estimates that nearly 400 people have died in his community alone in that same period, although the number could not be independently confirmed.
“The military government is doing nothing for Covid here so people have to take care of themselves,” Mr. Lal said. “Now, the situation is very bad. Every house has Covid patients because there are not enough places to isolate.”
The situation is so dire in Kalay that a pregnant woman with Covid-19 died last month because she could not get treatment, relatives said.
Bual Cin Par, 37, was struggling to breathe and about to deliver her baby when a soldier turned her away from the understaffed general hospital at gunpoint and threatened to shoot her if she didn’t leave, said a family member who accompanied her. The mother of four was also refused care at the town’s military hospital. She rented an oxygen tank but died shortly after returning home. Her baby also died.
Myanmar had suffered a major outbreak from September to January, with more than 140,000 cases and 3,100 deaths. Ms. Aung San Suu Kyi’s health ministry, which was testing more than 20,000 people a day, had nearly contained the virus by Feb. 1, according to government data.
Some health experts were concerned that the large street demonstrations held against the military would lead to a rise in infections. Most protesters wore face masks, which may have helped keep transmission relatively low, Dr. Jost said. A military-imposed curfew also helped. But when testing plunged after the coup, it became difficult to verify the number of cases in the country.
In recent days, testing has gradually increased to as much as 9,400 a day, according to the health ministry. But the positivity rate has also been rising, more than doubling over the past four weeks, Dr. Jost said. In mid-June, the ministry confirmed the presence of the Delta, Alpha and Kappa variants of the virus.
International health experts had once praised Myanmar’s vaccination program. Ms. Aung San Suu Kyi was quick to secure a promise of 3.5 million vaccines from India, the first batch of which arrived in late January. The government vaccinated 105,000 health care workers — and many top officials — in the days before the coup.
A spokeswoman for the junta’s health ministry, Dr. Khin Khin Gyi, said that all 3.5 million doses have now been administered, and that many of them were made available to the public at vaccination centers across the country. China has since donated half a million doses of its Sinopharm vaccine, with 200,000 earmarked for the military, she said.
Ms. Aung San Suu Kyi, who faces half a dozen criminal charges, received her second vaccine dose in custody. She is being held in isolation and learned this week of the recent coronavirus outbreaks in Myanmar from her attorney, Daw Min Min Soe. “She was very worried,” the lawyer said. “She wants all the people to be aware of Covid and take care.”
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