Health workers have been staging protests outside hospitals |IMG SOURCE: AFP/Maria Tan

The delta variant is upending every model of success that's emerged in the past 18 months, sending economies once ranked as among the best places to be during Covid tumbling.

With the highly transmissible mutation slipping through strict border curbs in some places and denting the protection provided by vaccination in others, Bloomberg's August Covid Resilience Ranking saw stark shifts. New Zealand, the longest-reigning No. 1 since the ranking debuted last November, plunged 26 spots after the nation's domestic life went from the most relaxed to the strictest, as the government imposed the highest level of lockdown after delta infiltrated its fortress-like defenses.

Vaccination and reopening leaders like the U.S. and Israel—highly ranked in the spring and early summer for their progress in returning to normalcy after rapid inoculation—dropped too as delta drove new infection surges, seeding a concerning number of breakthrough infections while sending unvaccinated people into critical care wards.

In August, European nations were the most resilient with a middle-ground strategy of widespread immunization and reopening based on vaccination status. Nine of the top 10 were from the continent, with Norway holding onto the top spot for the second month running.

The Scandinavian nation has administered enough shots to cover 60% of its population, kept fatalities at a very low level and opened its borders to vaccinated travelers. Low death rates, quick vaccine rollouts and an embrace of travel put the Netherlands and Finland second and third.

Nearly everywhere else, delta's advance has been unprecedented. From Japan and South Korea that relied on social compliance, to mainland China and Vietnam that used strict curbs, every approach that managed to stem the pathogen's spread has been challenged by the variant, dashing hopes that the end of the Covid-19 era was in sight.

READ: Philippines' Health Secretary Chief: Francisco Duque Keeps Dropping The Ball As Health Sector Chief

Covid Resilience Ranking

RANK CHANGE ECONOMY BLOOMBERG RESILIENCE SCORE PEOPLE COVERED BY VACCINES LOCKDOWN SEVERITY FLIGHT CAPACITY VACCINATED TRAVEL ROUTES
1 – Norway 80.1 59.9% 39 -40.1% 381
2 ▲12 Netherlands 75.8 63.1% 36 -32.2% 353.5
3 ▲4 Finland 75 59.3% 40 -69.2% 386.5
4 ▲4 Ireland 74.6 67.1% 45 -55.7% 373
5 ▲1 Austria 74.5 58.3% 56 -38% 379.5
6 ▲4 Belgium 73.5 69.4% 47 -33.8% 303
7 ▲5 Germany 73.4 60.1% 56 -48.4% 387.5
8 ▲3 Singapore 73.3 76.7% 44 -81.8% 152
9 ▼7 Switzerland 73.2 55.1% 44 -40% 387
10 ▲10 Spain 73.2 68.8% 48 -25.4% 381
11 ▲2 Denmark 72.8 72.7% 39 -48.1% 206.5
12 ▼8 France 72.5 65.3% 67 -31.2% 386
13 ▲3 Turkey 72.4 54.3% 50 -14.6% 376.5
14 ▲15 Czech Republic 71.9 52.9% 37 -58.4% 371.5
15 ▲3 U.A.E. 71.9 82.7% 55 -52.1% 375.5
16 ▲11 Italy 71.7 62.8% 50 -25.2% 208.5
17 ▲7 Romania 71.3 25% 38 -12.4% 390
18 ▲12 Hong Kong 71 47.7% 63 -85.5% 253.5
19 ▲3 Saudi Arabia 70.9 51.1% 50 -43% 370.5
20 ▼5 Sweden 70.8 58.8% 37 -54% 206.5
21 – Greece 70.6 52.3% 54 -0.4% 215.5
22 ▲3 U.K. 70.4 67.1% 44 -56.5% 318
23 ▼4 Canada 70.3 70.1% 61 -53.5% 151
24 ▼15 Mainland China 69.5 70.1% 79 -23.8% 140
25 ▼20 U.S. 69.5 56.9% 56 -14.8% 354.5
26 ▼3 South Korea 69.4 37.3% 47 -46.9% 151.5
27 ▲12 Colombia 67.8 33.4% 51 -20.5% 368
28 ▲3 Portugal 67.6 69.1% 58 -28% 204
29 ▼26 New Zealand 67.1 28.9% 96 -38.3% 151.5
30 ▲3 Chile 66.3 73.2% 79 -34.2% 131
31 ▼3 Australia 64.9 34.2% 68 -72.4% 148
32 – Poland 63.9 47.2% 28 -33.7% 190
33 ▼7 Japan 63.6 47.5% 52 -48.9% 149
34 – Russia 62.6 26.5% 43 0.6% 192
35 – Brazil 62.3 43.8% 51 -31.8% 342
36 ▼19 Israel 61.1 71.9% 55 -57.3% 149
37 ▲1 Nigeria 58.6 1% 44 5.5% 255
38 ▲4 Peru 58.2 26.3% 68 -47.3% 364.5
39 ▼2 Egypt 58 3.3% 44 -32.7% 378.5
40 ▼4 Mexico 57.6 31.7% 64 -6.4% 376.5
41 ▼1 Taiwan 57.2 21.7% 56 -87.2% 145
42 ▲2 India 56.3 21.5% 71 -27.1% 105.5
43 ▲2 Pakistan 54.7 12.3% 63 -61.3% 349
44 ▲4 Bangladesh 54.5 7.1% 57 -37.2% 236.5
45 ▼2 Iraq 54.1 3.2% 76 -28.1% 355.5
46 ▲5 South Africa 53.8 11.2% 52 -57.3% 347.5
47 ▲3 Argentina 52.6 44.1% 76 -68% 122.5
48 ▼1 Iran 47.9 11.9% 75 -11.1% 269.5
49 ▼8 Thailand 47.7 19.8% 72 -89% 205.5
50 ▼4 Vietnam 45.9 9% 73 -82.5% 138
51 ▲2 Indonesia 44.6 16.9% 69 -60.7% 129
52 ▼3 Philippines 44.1 14.3% 73 -77.9% 132.5
53 ▼1 Malaysia 42.7 49.4% 81 -90.9% 134.5
Note: Latest data as of Aug. 25, 2pm Hong Kong time. Flight Capacity and Vaccinated Travel Routes metrics were introduced in June 2021. See more here. (SOURCE: BLOOMBERG)

The Covid Resilience Ranking is a monthly snapshot of where the virus is being handled the most effectively with the least social and economic disruption. Tapping 12 data indicators that span Covid containment, the quality of healthcare, vaccination coverage, overall mortality and progress toward restarting travel and easing border curbs, the Ranking reflects the world's biggest 53 economies' performance measured against one another as they all confront the same threat.

While much is still unknown about the damage delta will ultimately do in highly vaccinated places, the Netherlands—which rose 12 spots in August—may provide an optimistic scenario: though case counts surged near record highs, its delta wave has waned with few deaths and without major disruption to reopening efforts.

WRONG DIRECTION

The bottom five in August's Ranking are Southeast Asian economies, a region that's emerged as the new virus epicenter with the world's highest monthly death toll per capita: Thailand at No. 49, Vietnam at No. 50, Indonesia No. 51, the Philippines No. 52 and Malaysia in last place.

READ: Philippines' Health Secretary Chief: Francisco Duque Keeps Dropping The Ball As Health Sector Chief

Despite covering nearly half of the population with vaccines and implementing reopening plans for the inoculated, new cases per 100,000 reported in Malaysia over the past month swelled to one of the highest in the world. The country's central bank has also halved its 2021 economic growth target.

A coffin containing a Covid-19 victim is carried for burial in West Java Indonesia on Aug. 22. Photographer: Timur Matahari/AFP/Getty Images

The lone bright spot in the region is the small city-state of Singapore, which is cautiously reopening as 77% of its population are covered by vaccines—the second-highest among ranked economies.

The bottom 10 continues to be populated by developing economies whose vaccine rollouts are lagging, reflecting how the world's poorest are largely facing delta with no shield of inoculation, a situation that World Health Organization chief Tedros Adhanom Ghebreyesus called "a shame on all humanity" on Aug. 18.

This inequality is likely to only worsen going forward, as rich nations announce plans to administer booster shots for fully vaccinated people, hoovering up even more of the scarce supply.

Will vaccines be able to beat back delta with limited fatalities? Or will the strategy of learning to "live with the virus" extract unexpected costs? That will be the focus of the Ranking as we move into September.

The Two-Track Pandemic

Vaccination is where places like Europe—and until recently, the U.S.—have made up for ground lost in their inability to effectively contain Covid. They moved to the top in the Resilience Ranking as investment in research and a focus on fast rollouts proved pivotal. The U.S.'s Operation Warp Speed saw some $18 billion plowed into developing the first Covid-19 vaccines.

Economies that moved early to secure and administer shots have the advantage of being mostly inoculated with mRNA vaccines, which appear to not just prevent a person from developing Covid, but lowers their chances of contracting and transmitting it as well. With delta denting this, vaccination leaders like Israel have also moved the fastest with doling out booster shots.

In places where the majority are inoculated, the link between infection numbers and deaths appears to be weakening, and policy makers are reframing the way they view Covid-19 cases.

"The vaccines will help us keep the pandemic under control, but we need to continue to live with the virus, just as we live with other infectious diseases," said Minister of Health and Care Services Bent Høie in the top-ranked Norway. "It is impossible to fully eradicate the risk."

But most of the developing world is yet to even start inoculating in a meaningful way, lacking the purchasing power to forge deals that put them at the front of the queue. Covax, the WHO-backed effort to help poorer countries procure doses, only started distributing shots at the end of February and is facing a supply shortfall that's seen many places run out of vaccines entirely.

Just 10 nations have administered 75% of all vaccine supply while low-income countries have vaccinated barely 2% of their people.

"Vaccine injustice is a shame on all humanity and if we don't tackle it together, we will prolong the acute stage of this pandemic for years when it could be over in a matter of months," said WHO chief Tedros in August, calling for a temporary moratorium on booster shots to help shift supply to those places that have not even been able to vaccinate their at-risk communities.

Covid Lessons

While merely a snapshot in time amid a fast-moving crisis, Bloomberg's Covid Resilience Ranking through 10 editions to date has crystallized some lessons on how to best handle the pandemic.

A constant of consistently high-ranked economies has been a widespread degree of trust and societal compliance. New Zealand—a stalwart of the top three before a delta outbreak sent it into the world's strictest lockdown—emphasized communication from the start, with a four-level alert systemthat gives people a clear picture of how and why the government will act as an outbreak evolves.

Investment in public health infrastructure also matters. Undervalued in many places before 2020, systems for contact tracing, effective testing and health education bolstered the places that have performed consistently well in the Ranking, helping socialize hand-washing and the wearing of face masks. This was key to avoiding economically crippling lockdowns in the first year, before vaccines were available.

The arrival of vaccines, including some using the unprecedented mRNA technology, has been a silver lining, and highlighted the importance of funding healthcare research and development.

Bloomberg's Covid Resilience Ranking provides a snapshot of how the pandemic is playing out in 53 major economies right now. By pivoting more toward opening up and the revival of global travel, we also provide a window into how these economies' fortunes may shift in the future as places exit the pandemic at different speeds.

It's not a final verdict—it never could be, given the imperfections in virus and vaccine data and the fast pace of this crisis. Circumstance and pure luck also play a role, but are hard to quantify.

New variants of concern, which will continue to emerge as outbreaks rage in the developing world, are also a threat: scientists fear mutations that can overcome existing vaccination and drive a new phase of the pandemic. The arrival of delta has made part of that concern a reality.

BLOOMBERG NEWS