Last Wednesday marked the 12th day in a row in which the number of COVID-19 cases in Taiwan was lower than the number the previous week on the same day. The figure for that day was over 19,000 reported cases.
People are now accepting this figure, somewhere between 15,000 and 20,000, as background noise, and the government is contemplating reducing the mask mandate. It appears that we are about to normalize the cost of COVID.
It’s sobering to calculate: at 19,000 cases a day, every 60 days Taiwan experiences over 1.1 million cases, with all the attendant costs. A meta-analysis of studies of long COVID in the Journal of the American Medical Association found that 6.2 percent of COVID suffers will develop at least one of the three major clusters of long COVID symptoms.
Of those, according to that study, in roughly 15 percent, or 1 percent of all COVID cases, symptoms will persist for a year or longer. That means that every 60 days Taiwan will be generating 10,000 cases of long COVID of a year’s duration, which in many cases renders victims unable to work. That’s 60,000 such cases annually.
In a study of US cases, 15 percent of COVID victims developed long COVID (persisting two months after the initial infection), with unvaccinated individuals suffering disproportionately. Recall that low vaccination rates among the elderly in Taiwan remain an issue. In another study of over 3,000 long COVID suffers from 56 countries, the majority reported that symptoms lingered for more than 35 weeks.
Of course, those are majority experiences. The outliers are simply insane. Ed Yong in an article for The Atlantic described a case of brain fog that lasted a terrifying 900 days. The victim once worked in AI, “but now ‘runs into a mental wall’ when faced with tasks as simple as filling out forms.”
It is conventional to calculate the economic losses from deaths, caring for COVID cases, treating long COVID cases and lost work hours. Less obvious to many who have thought about this will be the diversion of investment to socially frivolous purposes, such as “alternative” medicines and their attendant “treatment” infrastructure.
In the first half of the last century there was an extensive sanitorium movement for tuberculosis, which did nothing to cure the disease, but planted sanitoria in all sorts of countryside in the belief that clean dry air was good for the disease. Tuberculosis was the most famous rationale for sanitorium building, but they were also built for a variety of other “ailments,” including “hysteria,” fatigue and masturbation.
It is easy to see how that might play out with long COVID, especially in a society that has a widely accepted existing formal system of traditional Chinese medicine as an alternative to scientific medicine. I look forward to the late-night cable TV and radio ads in rapid-fire Taiwanese extolling the virtues of patent medicines for long COVID issues. This will receive impetus from the common experience of long COVID sufferers: doctors don’t listen to them. Multiply that by the short, peremptory doctor visits that characterize Taiwan’s health system.
As with other long-term diseases, long COVID will also generate a host of social costs. Sufferers will put off marriage and children, and lose not just work time (and their jobs) but also learning and promotion opportunities. In Africa this is a common problem with diseases like malaria, which has easily measurable effects on worker productivity.
In children it will harm school performance. “Brain fog” is reported in many cases of long COVID, nearly 70 percent, with up to 78 percent reporting inability to concentrate, according to one study. The school system here runs on rote memorization, after all.
In Sweden, where the virus was essentially permitted to run rampant, an insurance company survey found that 32 percent of the 18-24 age bracket reported brain fog, affecting their social, work and school lives.
That’s what living with COVID means. That’s what happens when it becomes normalized. Around every four years, at the current pace, we will generate enough cases to infect everyone in Taiwan. Many of those will be reinfections, of course. It goes without saying that studies show reinfections worsen both the chance of getting long COVID and its destructive effects.
Nor does anyone really know what the long term effects of the disease are. It is still too new.
The national health insurance system allocates hospital beds and other medical resources on a geographical basis, with a strict number of beds for a given population. This means that the system has few slack resources, an impediment that has slowed the development of a robust medical tourism system here. COVID cases and long COVID will further strain the system, a strain that will become constant over time.
An excellent 2020 piece by Jane Rickards in AmCham’s TOPICS magazine described some of the trends in hospital administration and health care in Taiwan. Typically, the national health insurance covers 56 percent of health care costs, while the remaining 44 percent (read: future long COVID costs) comes from the patient’s pocket. The elderly constitute 15 percent of the insured population, but almost 40 percent of medical expenses.
One of the experts consulted for the piece noted that Taiwan lags behind South Korea and Japan in care for chronic diseases. With Taiwanese averaging 15 visits a year to local clinics and hospitals, the piece says, Taiwan’s system is geared for quantity, not quality of care, and long-term diseases that require patient monitoring and management, such as diabetes, are less well served by the system. Long COVID is a long-term disease.
The death numbers bounce around, last week falling between roughly 35 and 65 a day. At 40 deaths a day, Taiwan will experience 1,200 a year, comparable to the 1,648 people who lost their lives in scooter-related accidents in the first 10 months of last year. It could well be more.
We have decided, in our weariness with travel restrictions and mask orders, to declare that we are done with COVID, to accept all the lost lives and lost years of work and individual growth as the cost of doing business.
After all, that always happens to other people, right?
Notes from Central Taiwan is a column written by long-term resident Michael Turton, who provides incisive commentary informed by three decades of living in and writing about his adoptive country. The views expressed here are his own.
One of the ways that pro-People’s Republic of China (PRC) peaceniks forward PRC propaganda is by presenting its fabricated history of the Taiwan-China relationship as accepted, mainstream history. Like the faces of astronauts on rocket sleds reshaped by high GEE effects, every conversation about Taiwan is distorted by this stream of effluent. PRC supporters ground their conversations about the PRC in this fake history because it allows them to maintain that the PRC is “reasonable” and is simply deterring Taiwan’s “permanent separation” from “China” rather than bent on annexing an island it has never ruled over. It also recasts the PRC
Private conversations with corporate insiders and ex-government officials that cost upwards of US$10,000 an hour. Coded language and blurred regulatory lines. For hedge funds and other global investors, China’s vast web of “expert networks” has become a key tool for navigating an opaque but potentially lucrative economic powerhouse. For Xi Jinping’s (習近平) Communist Party, the secretive industry represents something far more ominous: a threat to national security that must be reined in. That contradiction is now sending shockwaves through the financial world as China’s government cracks down on the expert networks it had showered in praise less than a decade ago during
When Jerome Eisenberg enrolled his daughter at the Brentwood School in Los Angeles, where Adam Levine met some of his Maroon 5 bandmates, the investment manager says he expected her to get a traditional liberal arts education. But after the murder of George Floyd, the US$50,000-a-year school said it was reimagining its purpose “with an eye toward anti-racism” and diversity, equity and inclusion, or DEI. In Eisenberg’s view, Brentwood was pulling a “bait and switch” on parents. He sued the school last year for breach of contract, civil rights violations and emotional distress. “The curriculum change shifted away from teaching students critical
The 24 bright green baby parrots began chirping and bobbing their heads the second anyone neared the large cages that have been their homes since hatching in March. The Central American natives, seized from a smuggler at Miami International Airport, are being raised by the Rare Species Conservatory Foundation — a round-the-clock effort that includes five hand feedings a day in a room filled with large cages. At just 9 weeks old, these parrots have already survived a harrowing journey after being snatched from their nests in a forest. They are almost fully feathered now and the staff has started transitioning them