Quite a lot of mileage is being gained in the Western press with reports of a COVID-19 “spike” in Taiwan over the past few days. None of these outlets seem to think it worthwhile to reflect on the data in any detail. When we do that, things look a lot more reasonable and controllable.
There is certainly no need for citizens or the government to panic; Taiwan’s COVID-19 data, however measured, are the best in the world for a nation of its population size and its manufacturing, trading and income level.
Since the beginning of COVID-19’s presence in Taiwan (20 cases as of Feb. 16 last year) to the present (1,193 cases as of May 8), things have been low and mild.
However, a faster rate of cases is evident from Tuesday last week, from a total of 1,210 with 12 deaths to 2,260 cases with 14 deaths on Tuesday.
This compares with figures since the beginning of the pandemic for South Korea with 133,471 cases and 1,912 deaths, or even Singapore with its much smaller population of 5.9 million, but with 61,689 COVID-19 cases and 31 deaths. In other words, even within low-COVID-19 East Asia, Taiwan remains the tall one standing.
A possible worry is the low level of vaccinations and the possible rapid rise in new cases over the next few days. The latter has occurred in most instances of a spike in countries across the world, although larger case numbers do not necessarily spell a proportional increase in mortality.
Indeed, Taiwan’s record and its excellent medical services infrastructure, together with the characteristic civil obedience of its society, suggest that the mortality rate would not rise to the same growth rate as total cases over the next few weeks.
However, there might be some real worries. The first is the low level of vaccinations in East Asia. While nations such as Serbia or Uruguay have at least 25 percent of their populations fully vaccinated, East Asia has lagged, probably because of the much smaller levels of COVID-19 there, and now because of the greater scarcity of global vaccines flowing in an eastward direction.
Vaccines shown to have worked well are increasingly locked into Europe, the US and outlier high-income nations, who have had reason to be fearful of COVID-19, with much higher levels of the disease generally than in East Asia.
Using figures up to Monday, cumulative vaccinations as a percentage of total populations (receiving at least one dose) amount to a world average of 20 percent, an EU average of 46 percent, an Asian average (this is probably of lesser reliability) of 17 percent and an African average of just 2 percent.
In East Asia, the cumulative averages recorded in descending order are Singapore with 58 percent, China 30 percent, Hong Kong 27 percent, South Korea 10 percent, Japan 6 percent and Taiwan with 1 percent.
Given that vaccinations not only safeguard the vaccinated but also slow the spread of the virus more generally, this lack of vaccination might become the most serious component of the coming Taiwanese experience.
The second problem is the relatively high number of older people in Taiwan than in other late-spike nations such as Brazil, India or South Asia generally. In Taiwan, the percentage of people older than 65 is 16 percent, whereas it is only 7 percent in India and 9 percent in Brazil.
As the virus in its several forms so far is known to be much more severe in its attack on the elderly, this demographic factor is a real worry for Taiwan.
At the same time, the Taiwanese population under 20 years old is 18 percent, 35 percent in India and 28 percent in Brazil. Once again, Taiwan is potentially in crisis, as the virus tends not to attack the young.
With a comparatively large number of old people and a relatively small number of young people, an attack of this particular virus is likely to cause greater damage in Taiwan than in most other recent high-spike nations. No policy can alter demography overnight.
The third clear danger is the partial knowledge of what composes the new spike in Taiwan, especially the virulence of the type of virus. It appears (this is still tentative) that the so-called “Indian variant” is more contagious than that which devastated Europe and the US a year ago.
It might follow the same age preference of earlier variations; it might well yet be beaten back by existing vaccines. We need to know more and quickly.
The real point is that such lacunae in the evidence create room for doubt and confusion, both in the minds of the public and in the government’s plans. Of course, Taiwan has already banned arrivals from India, but the exact variant distribution within the new spike remains to be verified.
Even if there is little in the way of the Indian variant in Taiwan, it is another worry for government policymakers over the next few days. Given that the new variant has been found on all continents, but especially in Asia, it is at least possible that it would be found to cause problems for Taiwan.
This is the area of greatest ignorance today. The UK has the most recorded cases of the Indian variant, and in East Asia, Singapore by far has most, with Japan and China behind it. This estimate is based on the number of recorded sequenced cases. So much depends on how accurate Taiwanese sequencing and counting has been. Many cases globally are not sequenced.
What might we derive in terms of policy measures? The first is to keep things calm and properly “civil”; this is hardly a spike at all in global terms. Taiwan’s strength throughout the long COVID-19 months has been its ability to keep government policies and civil society within a sort of harmony or equilibrium. Other nations have repeatedly failed in this direction, leading to terrible results, even in nations where policies were quite sensible.
Lockdowns might not be useful, although Singapore is certainly trying this tactic. Continuing with Taiwan’s established strategy of closing down areas, quick detection, immediate isolation and so on would probably serve the nation well.
However, there can be little denying the potential importance of vaccinations, whether using shots produced in Taiwan, constructed from Taiwanese and foreign supplies or purchased directly from reliable foreign sources, focusing on known efficient products.
In the Taipei Times and elsewhere, I have repeatedly called for an East Asian project for vaccine production, selection and distribution in the hope that it could extend to the poorer nations of South Asia and elsewhere.
Clearly, this is still valid. A massive project of production would be well within the funding capabilities of East Asia, even excluding China, and would not only partially meet the challenge of the new spike in cases, but would also be seen in Taiwan as good, direct action, and in other places as exemplary of delivering practical help to poorer Asian nations.
High-tech nations such as Taiwan, in partnership with proven vaccine producers such as India and China, could make a global difference.
Ian Inkster is a professorial research associate at the Centre of Taiwan Studies at SOAS University of London; a senior fellow in the Taiwan Studies Programme and China Policy Institute at the University of Nottingham; and a historian and political economist who has taught and researched at universities in Taiwan, Australia, Britain and Japan.
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