Former vice president Chen Chien-jen (陳建仁), an epidemiologist, earlier this year said that as the highly transmissible but less severe Omicron variant of SARS-CoV-2 became the world’s predominant strain of COVID-19, a “zero COVID” strategy is no longer practical, and people should be prepared to live with the virus. He said the “three treasures” preventing the healthcare system from being overwhelmed by severe cases and death are “vaccines, rapid tests and antiviral drugs.”
Taiwan in the past two years had implemented strict border control measures and domestic restrictions to prevent the spread of the virus in local communities. This helped buy time for the arrival and distribution of vaccines. However, as vaccine uptake slowed and daily cases began to surge, rapid test kits and antiviral drugs took on a more essential role.
The sudden demand last month for rapid tests, which at the time cost about NT$300 each, almost depleted the nation’s stocks. A rationing system was implemented on April 28 and the price was fixed at NT$500 for a pack of five. However, people still need to wait in lines at pharmacies to buy the limited supplies, which often run out before everyone can buy one. Taiwanese questioned whether the Central Epidemic Command Center (CECC) had made adequate preparations for the Omicron wave.
By Monday, the situation seemed to be addressed as single test kits were being sold at eight chain retail stores in northern Taiwan, but lines still formed outside pharmacies, and several industries are still in need of tests for their workers. Adding to the pressure, government-funded polymerase chain reaction (PCR) testing stations and emergency rooms have been crowded by people waiting for hours to be tested.
New Taipei City Mayor Hou You-yi (侯友宜) and Taipei Mayor Ko Wen-je (柯文哲) have repeatedly called for rapid test results to be enough to confirm a case, so that PCR testing would not stress healthcare capacity. Ko also urged for antiviral drugs to be prescribed to people whose rapid test show a positive result. The CECC partly agreed to their request by allowing people in quarantine or isolation to confirm their results with a doctor via a video call as of Thursday.
Minister of Health and Welfare Chen Shih-chung (陳時中), who heads the CECC, on Friday said that there are legal and medical concerns, as rapid tests can produce false positive results. Prescribing antiviral drugs to people who falsely test positive for COVID-19 would be inappropriate and problematic.
Giving doctors the means to prescribe antiviral drugs accurately and efficiently to cases at higher risk of severe COVID-19 illness is a challenge for the government. Taipei has procured 700,000 courses of Paxlovid, the main COVID-19 oral antiviral drug, although fewer than 1,000 courses had been prescribed as of Monday.
The CECC in the past week has simplified prescription procedures and expanded channels for patients to receive Paxlovid faster — it needs to be taken within five days of the onset of symptoms. However, many people are having trouble booking a telemedicine appointment, and some are not meeting the government’s criteria for obtaining the drug.
Local infections are expected to reach their peak around the end of this month. The CECC and local governments must cooperate to improve the efficiency of COVID-19 testing and how Paxlovid gets prescribed. Keeping severe COVID-19 cases and deaths as low as possible is essential to safely riding out this wave of the pandemic.
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