Health facilities are under pressure in Thailand, where 98 per cent of new cases are from a more infectious strain of the pathogen, while some island nations in the Pacific Ocean are facing their first Covid waves.

Although nowhere close to India’s population or flare-up in scope, the reported spikes in these handful of nations have been far steeper, signalling the potential dangers of an uncontrolled spread. The resurgence – and first-time outbreaks in some places that largely avoided the scourge last year – heightens the urgency of delivering vaccine supplies to poorer, less influential countries and averting a protracted pandemic.

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“It’s very important to realise that the situation in India can happen anywhere,” said Hans Kluge, the regional director at the World Health Organization for Europe, during a briefing last week. “This is still a huge challenge.”

Ranked by the change in newly recorded infections in the past month over the previous month, Laos came first with a 22,000 per cent increase, followed by Nepal and Thailand, both of which saw fresh caseload skyrocketing more than 1,000 per cent on a month-over-month basis.

Also on top of the list are Bhutan, Trinidad and Tobago, Suriname, Cambodia and Fiji, as they reported the epidemic erupting at a high triple-digit pace.

“All countries are at risk,” said David Heymann, a professor of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine. “The disease appears to be becoming endemic and will therefore likely remain a risk to all countries for the foreseeable future.”

The abrupt outbreak in Laos – a place that only recorded 60 cases since the start of the pandemic through April 20 and no death to date – shows the challenges facing some of the landlocked nations. Porous borders make it harder to clamp down on illegal crossings though entry is technically banned.

Laos has ordered lockdowns in its capital Vientiane and banned travel between the capital and provinces. The health minister contacted neighbours such as Vietnam for assistance on life-saving resources. Nepal and Bhutan have seen cases erupt, in part due to returning nationals. Nepal, which has identified cases of the new Indian variant, has limited resources to combat the virus.

The situation is “very serious”, according to Ali Mokdad, chief strategy officer for population health at the University of Washington. “New variants will require a new vaccine and a booster for those already vaccinated – they will delay the control of the pandemic.”

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Mokdad said the economic hardship of poorer countries makes the battle even tougher.

Thailand, which had been seeking to revive its ailing tourism industry, just reintroduced a two-week mandatory quarantine for all visitors. A government forecast for 2021 tourism revenue was cut to 170 billion baht (US$5.4 billion), from January’s expectations for 260 billion baht. With the country’s public health system under pressure, authorities are trying to set up field hospitals to accommodate a flood of patients.

About 98 per cent of cases in Thailand are of the variant first identified in the UK, based on a sample of 500 people, according to Yong Poovorawan, chief of the Center of Excellence in Clinical Virology at Chulalongkorn University.

About 2 million students in the Vietnamese capital will switch from classroom studying to virtual learning after 34 cases of community transmission were confirmed nationwide since Thursday.

On Friday, Hanoi’s bars, karaoke parlours, clubs and internet gaming rooms were also ordered to close.

Vietnam has confirmed community transmissions of Covid-19 in the major cities of Hanoi and Ho Chi Minh City, along with the northern provinces of Ha Nam, Vinh Phuc, Yen Bai and Hung Yen.

These latter four provinces, along with the coastal city of Da Nang and Quang Nam province, home to the tourist hotspot of Hoi An, have also closed schools.

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The cases are linked to a 27-year-old man who returned to Vietnam from Japan on April 7 and a Chinese expert entering the nation for work, both of whom tested positive after finishing a mandatory two-week quarantine.

The new cases emerged shortly before a three-day public holiday in Vietnam when many families travel across the country, raising the risk of a wider outbreak.

In Cambodia, since the beginning of the current outbreak, more than 10,000 locally acquired cases have been detected in more than 20 provinces. The Cambodian capital Phnom Penh is now a “red zone”, or a high-risk outbreak area, although the government on Tuesday said its restrictions would be eased on Thursday.

In Sri Lanka, authorities have isolated areas, banned weddings and meetings and closed cinemas and pubs to cap a record spike following last month’s local New Year festivities. The government says the situation is under control.

After staying relatively Covid-free thanks to strict border controls, some of the Pacific island nations are now enduring their first wave. Cities in the tourist hotspot of Fiji have gone into lockdown after the wider community contracted the virus from the military.

“The recent rise in recorded cases throughout the Pacific reveals how critical it is to not just rely on strong borders but to actually get vaccines into these countries,” said Jonathan Pryke, who heads research on the Pacific region for the Lowy Institute, a Sydney-based think tank. “India is a shocking warning to this part of the world about how quickly this pandemic can spiral out of control.”

There’s a duty for developed countries, recovering from the pandemic thanks to rapid inoculations, to contribute to a more equitable global distribution of vaccines, diagnostic tests and therapeutic agents including oxygen, according to Heymann, the professor at the London School of Hygiene & Tropical Medicine.

“The developed world can and should contribute funding and at the same time share with other countries any excess vaccines they may have in stock,” he said.

Meanwhile, North Korea’s official newspaper on Tuesday warned of a struggle against the pandemic, insisting vaccines will not deliver an ultimate solution, after a UN-backed roll-out was delayed.

The Covax programme to distribute vaccines around the world had planned to ship 1.9 million doses in the first half of this year. However, India’s surge in cases has resulted in global shortages.

“The situations in many countries prove that vaccines are far from a panacea,” the Rodong Sinmun newspaper said. “Some vaccines, which had been considered highly effective, caused severe side effects, including even death, leading many countries to stop their use.”

North Korea claims to have no cases of Covid-19 but experts remain sceptical, given the country’s poor health infrastructure and porous border with China. It has restricted cross-border traffic, banned tourists, ejected diplomats and mobilised health workers.

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In South Korea, about 3.5 million people have received at least their first vaccine shots after country began vaccinations on February 26. It plans to vaccinate 12 million people by the end of June in a bid to achieve herd immunity by November.

However, a group of South Korean experts warned the virus is likely to remain in circulation as vaccines will not completely prevent transmission.

“[Covid-19] is likely to be a new normal,” said Oh Myoung-don, head of the country’s central clinical committee for emerging disease control. “We will have to live with Covid-19, like getting vaccinated against the seasonal flu.”

Additional reporting by dpa