A challenging transition: Taiwan’s changing Covid approach

Written by Brian Hioe

Image credit: 總統府, CC BY 2.0 https://creativecommons.org/licenses/by/2.0, via Wikimedia Commons

Taiwan maintained a COVID-zero approach for most of the pandemic to date, although it was not always explicitly named as such, particularly as COVID-zero approaches became associated with the Chinese government.

In particular, Taiwan went COVID-free for most of 2020. However, Taiwan acted quickly to close its borders after early reports of an unknown pneumonia reported in China. Although Taiwan experienced its first major COVID-19 outbreak in May 2020, the widespread use of medical masks, a QR code registration system set up for contact tracing, and limits on indoor and outdoor public gatherings were sufficient to prevent the outbreak. By August, Taiwan reported its first day with zero COVID-19 cases in three months.

Now, Taiwan faces the challenge of transitioning from its COVID-zero approach toward what the Central Epidemic Command Centre (CECC), which coordinates Taiwan’s COVID-19 response, has referred to as a “zero severe COVID” approach. Namely, as Taiwan transitions to a COVID-management strategy, attempts are made to avoid serious cases of COVID-19.

So far, this approach has been successful. According to CECC statistics, over 99.76% of cases to date this year have been light or asymptomatic.

Another challenge the Tsai administration faces is preventing panic from a public accustomed to zero cases or single-digit cases to cases in the tens of thousands. So far, this also seems to have been successful in that while COVID is a major news story, there does not yet appear to be widespread panic or the perception that the outbreak is out of control. This is surprising, given that Taiwan is not accustomed to the waves of COVID-19 that other parts of the world have since become used to over the past few years.

That being said, there continue to be concerns about the possibility of COVID-19 tearing through unvaccinated elders in Taiwan. By early May, only 78.8% of those over 75 had been vaccinated with one dose of vaccine. The first dose vaccination rate has not climbed past 85% for months.

As with other places globally, the elderly have been discouraged from getting vaccinated by fears of vaccine side effects, such as blood clots. The Taiwanese media continually harping on the possibility of side effects from COVID-19 vaccines has been an amplifying factor for such disinformation. On the other hand, elders may be protected by the number of vaccinated young people, with the number of individuals between 18 and 29 with booster shots climbing from 42.4% to 63.9% between March 7th and April 25th. In February, 99.9% of those between 18 and 29 had received at least one dose of the vaccine.

Taiwanese politicians spoke early of the need to transition to “co-existing” with COVID-19 eventually. However, saying this and actually carrying it out prove two matters entirely.

As cases grow, the CECC has moved to reduce the number of days that COVID-19 contacts have to quarantine to three days, followed by four days of self-health management in which contacts

will need to test negative and go outdoors. Positive COVID-19 cases will need to report this to the government, but negative test results do not.

As for confirmed COVID-19 cases themselves, light and asymptomatic cases can quarantine at home, while hospital capacity is reserved for cases of greater severity. This is intended to reduce the stress on Taiwan’s hospital system and avoid overwhelming the medical system.

With a shortage of COVID-19 rapid tests, the government has implemented a rationing system for rapid tests. Each individual is allowed to purchase five rapid tests, as linked to their National Health Insurance card. This is modelled after the method used for distributing medical masks in earlier parts of the pandemic. In addition, a negative rapid test is required for PCR testing to conserve capacity.

Polling from the Taiwan Public Opinion Foundation suggests divided views on transitioning away from a COVID-zero approach. The Tsai administration’s approval rating has also taken a hit as of late, which may be due to shifting away from COVID-zero.

It may not be surprising that this presents an opportunity for the pan-Blue camp to attack the Tsai administration. So, then, has Taipei mayor Ko Wen-je brought up the possibility of Taipei transitioning to a “soft lockdown”. Although criticized by the CECC as overly vague, for Ko, this means a return to the “Level 3” alert status. Indoor dining would be suspended, and there would be a shift to remote work and class.

But Ko may have moved prematurely because he did not have the backing of other pan-Blue mayors. New Taipei mayor Hou You-yi, whose city often sees the most daily cases, has suggested that the central government instead move faster to relax measures. Hou proposed doing away with quarantine altogether and instead shifting to an approach reliant on rapid testing, which the CECC has declined with the view that cases would rapidly increase if it were to drop measures right away.

During the outbreak last May, pan-Blue mayors such as Ko and Hou sought to attack the Tsai administration by striving to be more proactive than the central government in escalating the COVID-19 alert level or accusing the central government of being too hasty to decrease the alert level. This time around, however, Ko and Hou do not seem to be on the same page, which may prevent any proactive challenge to the Tsai administration’s COVID-19 policy.

It may be that looming over Taiwan’s transition away from COVID-19 is the spectre of Hong Kong and China. Both have seen an explosion in COVID-19 cases in an uncontrolled manner in the past months as a result of adhering to the COVID-zero approach.

Namely, COVID-zero has become linked to the political legitimacy of Xi Jinping’s leadership, with the attempt made to link COVID-zero to the governance system of the CCP. Touting the success of COVID-zero is intended to show the superiority of the Chinese system to western countries, as

a result of which, the CCP has refrained from backing away from COVID-zero even when this is not rational, and even when this has led to a sharp uptick in cases.

Ironically enough, having also gone with a COVID-zero approach, showing that COVID-zero is a tactic and is not inherently tied to any form of governance, Taiwan hopes to avoid a similar outcome. Yet, ironically, it may also be that Hong Kong and China present counterexamples for Taiwan. That is, the counterexamples of Hong Kong and China make it politically easier for the Tsai administration to transition away from COVID-zero when they show the outcome of maintaining COVID-zero approaches indefinitely with no plan to accommodate to gradually co-existing with COVID-19.

It is, after all, that transitioning away from COVID-zero and towards co-existing with COVID-19 is not merely a matter of trying to reconnect Taiwan’s economy with the rest of the world. Rather, borders are always porous, even for islands such as Taiwan, and could not be kept out of Taiwan’s borders indefinitely. One notes cases of attempts at undocumented travel to Taiwan on fishing vessels, for example, on which COVID-19 patients were present. And, particularly after developing new and more infectious variants of COVID-19, it would have eventually made its way into Taiwan. But sticking to the landing regarding managing the COVID-19 pandemic may be the greatest challenge to date for the Tsai administration in the pandemic to date.

Brian Hioe was one of the founding editors of New Bloom. He is a freelance writer on social movements and politics, and occasional translator.

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