Every day, tens of thousands of new COVID-19 cases are reported in Japan, South Korea and Singapore, and their health systems are not in danger of collapse. It is a very different story in Hong Kong, which is facing a public health disaster.
The difference between these places is directly linked to the guidelines the respective governments are giving to their healthcare systems.
In the event that there are a large number of new cases, those with few or no risk factors and mild symptoms should be able to isolate at home and observe their condition, and if they have any questions, they should seek medical advice from a local clinic, while hospitals should only be responsible for the small number of those with medium to serious symptoms.
In this way, medical treatment in major hospitals can be reserved for those who really need it, so that the collapse of the healthcare system can be avoided and the mortality rate kept to a minimum.
The lesson of what has happened in Hong Kong is right in front of Taiwanese, and yet in the daily news conferences of epidemic command centers across Taiwan, as well as in local government briefings held by mayors or county commissioners, confirmed cases are still treated as something to panic about and to avoid at all costs, and medical staff who might have come into contact with confirmed cases are themselves being treated with care.
Taiwan is fine at the moment, as it is keeping new daily cases to about 500.
However, if the number of daily cases suddenly jumped to 3,000 or 20,000, and medical professionals had to tell the public and clinics that there is no need to worry about the case count — that Taiwan would have to deal with those who are not at risk and those who only have mild symptoms, and coexist with the virus — it would be too much of a change for the public to cope with.
It makes more sense to make hay while the sun shines, and for the government to provide reasonable explanations, educate the public and clearly specify the measures Taiwan would need to take. Then it would be able to control the shock and the uncertainty for when cases suddenly soar.
The question is whether Taiwan is prepared to deal with an onslaught by the Omicron variant of SARS-CoV-2 that is potentially just around the corner.
Clinics should be equipped with COVID-19 pandemic prevention equipment such as N95 masks and rapid home tests, as well as the ability to provide convenient virtual assessments and to allow people to collect medication on behalf of infected family members who isolate at home.
At present, Taiwan’s biggest problem is that the COVID-19 vaccination booster rate among older people is too low, far below other states, such as the UK, where the rate is 96 percent.
In Taiwan, 23 percent of people aged 75 or older have yet to have their first jab. This is potentially the greatest danger, and it could lead to the collapse of the health system.
Taiwan could make good use of the family doctor system, in which physicians familiar with people and their whole family can treat asymptomatic cases, and if there are no high-risk members in their household, they can just advise them to rest at home.
If the blood oxygen levels of such cases fall, they get a fever that will not abate or their condition deteriorates — for example, they have trouble breathing, their blood pressure falls, or they feel drowsy and find it difficult to concentrate — they could ask for a virtual checkup, or call a hospital and be transferred there if needed.
Hopefully, Taiwan will learn from what is happening in South Korea, where there are currently more than 300,000 daily cases, with about one death for every 1,000 cases, but where the health system continues to operate properly.
If large numbers of people contract the virus, so long as they have had their third inoculation, and there is a degree of herd immunity in the community, then it is still possible to see a return to the pre-pandemic economic activity levels and to normal life.
The arrival of the pandemic in our communities is imminent. Older residents should be encouraged to have their third vaccination.
Moreover, the government should assign the task to local clinics to act as the first point of contact. It should drive home the important concept that if there are any unvaccinated high-risk individuals in the family of cases with mild or no symptoms, if they eat together or share washing facilities, then the cases should quarantine in dedicated facilities — which the government should set up immediately, looking to Singapore for how best to do it.
If people have reason to believe that they are infected, such facilities should help them avoid passing the virus on to vulnerable and unvaccinated family members. This would reduce the loss of life and allow hospitals to only treat seriously ill patients.
Even though there are a few cases of young children becoming seriously ill from COVID-19, if there is a child of 12 years or younger, who is unable to be vaccinated, in the family, then people need to be away from danger.
During the extended Tomb Sweeping Day weekend, Taiwanese have been traveling throughout the country and hotels have been packed.
Now that the holiday is over, the nation can hopefully move on to a new, Taiwan-style pandemic response model, as the government is planning for.
Wang Fong-yu is chairman of the Kaohsiung County Medical Association.
Translated by Paul Cooper
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