While the COVID-19 pandemic swept across the world in 2020, Taiwanese were adding more healthy years to their lives, Ministry of Health and Welfare data revealed last week.
Disability-adjusted life years (DALY) measure the amount of time lost to severe illness, disability or premature death. As with all good metrics, this one is able to plainly spell out an issue integral to our lived experience, helping society make decisions that could get people through the toughest times in their lives. Hiding behind this dispassionate acronym are years of struggle, costly treatment and impossible decisions about how to receive care and when enough is enough. Even a slight drop in this figure means decades of more time spent with loved ones.
This is why the figure announced by the ministry was so encouraging. The DALY measure during the first year of the pandemic was 8.04, down the equivalent of 5.16 months from 8.47 a year earlier. The average healthy lifespan for 2020 was 73.28 years, the highest since at least 2001 and the greatest annual jump recorded. It rose from 72.39 years in 2019.
The numbers came as a surprise, even to some experts. When the 2019 figures were released last year, Chiu Hung-yi (邱弘毅), professor of public health at Taipei Medical University, predicted that foregoing exercise and medical treatment to stay at home during the pandemic would exacerbate existing conditions and make the population less healthy on average.
On the contrary, people were healthier for longer, likely thanks to COVID-19 preventive measures. Mask wearing and hand washing — even when implemented intermittently before last year’s domestic outbreak — all but eliminated the common cold and the flu season in 2020, which can be deadly to certain people. Experts can now investigate which conditions are exacerbated by which infectious diseases and craft responses that could save lives.
Without clear statistical proof, it would be easy to give in to pessimistic assumptions such as Chiu’s and downplay the good that can come from the bad. Instead, an opportunity to improve lives has been created.
Chen Ying-ren (陳英仁), a geriatric specialist at Linkou Chang Gung Memorial Hospital, said that the other reason for the DALY decline involves changing attitudes toward hospice care and end-of-life treatment. Although a deeply personal decision, even this changing cultural value has been informed by data transparency. Taiwan’s detailed records of medical expenditures and causes of death revealed immense medical futility, at some estimates comprising up to one-third of all healthcare expenses. Medical futility refers to interventions that are unlikely to produce any significant benefit for the patient.
Concern about the burden this places on the National Health Insurance system, paired with the humanitarian desire to allow patients to die with dignity, informed the landmark passage of the Hospice Palliative Care Act (安寧緩和醫療條例) in 2000 and the Patient Right to Autonomy Act (病人自主權利法) in 2016, still the most progressive of their kind in Asia.
Even now, after COVID-19 has finally breached the nation’s defenses, data transparency remains one of the most powerful tools at people’s disposal. Daily tallies showing the number, percentage and background of moderate and severe cases allow the public to cut through the fearmongering and run informed personal risk calculations as the nation moves into the next stage of the pandemic.
Of course, public health is not the only sector improved by reliable statistics. Data-driven governance helps officials and the public alike simplify Taiwan’s massive and multifarious society, enabling everyone to better understand each other and keep improving together.
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