Taiwan faces tough choices as infections hit record levels

Taiwan’s health minister last Tuesday said the island could see 1,000 local Covid cases a day by the end of the month. It hit that level just three days later, and must now choose between living with the virus like New Zealand or sticking with elimination strategies like in Hong Kong. 

Local cases hit a new record of 1,390 on Monday and have averaged 1,176 over the past five days. The surge rattled many of the island’s 23 million people, which has seen just 854 Covid deaths from local infection over the entire pandemic.

“The scale of the pandemic right now is very large,” Health Minister Chen Shih-chung said at a briefing Friday, adding Taiwan may one day see tens of thousands—or even millions—of cases. “The point is not about the case counts, but about whether we can prevent a disastrous impact.”

A strategy of border controls, mask mandates and contact tracing stamped out multiple outbreaks, allowing chip factories to drive exports and growth, pushing the jobless rate to a 21-year low. Many residents embraced the safety of the island’s bubble, but businesses want borders to open up. Some 91 percent of American Chamber of Commerce members say it’s “very important” to gradually reopen borders and reduce travel curbs.

“Open borders are still important if Taiwan wants to attract foreign investors, who can contribute more to the economy than tourists,” said Winston Chiao, an economist at Taishin Securities. “To expand or make new investments in Taiwan, they need to be able to come here personally.”

Minister Chen has previously suggested isolation will be required for even triple-vaccinated travelers until 2023, though that was before cases hit four digits. 

Hard decisions

Omicron makes it near-impossible to contain large outbreaks. New Zealand, a Covid Zero hero, ditched the policy after a lockdown failed to halt cases. But its high vaccination rate limited deaths to less than 600, and it’s now benefiting from opening its border and winding back curbs. 

In contrast, China is sticking with Covid Zero and lockdowns, despite public anger and damage to the economy. Hong Kong kept border curbs even as tens of thousands of daily cases overwhelmed its testing, tracing and isolation strategy. 

Taiwan has cut its mandatory quarantine to ten days and has signaled that contact-tracing may no longer be viable in cities with large numbers of cases. Lending weight to a gradual shift to living with Covid is the fact that 99 percent of cases in Taiwan this year have been mild or asymptomatic, according to Taiwan Centers for Disease Control. President Tsai Ing-wen says authorities will balance the needs of the economy with the risk to public health.

Vaccination concern

But a major concern in Taiwan, one of the world’s fastest-ageing populations, is that roughly 16 percent of those aged 12 and above haven’t had a single vaccine against a disease which is most risky for the elderly. Just under 80 percent have received two doses of a coronavirus vaccine.

“The underlying concerns for Taiwan that stop it from reopening are the unvaccinated population and that the effectiveness of the second dose of vaccine is wearing off,” said Chen Hsiu-hsi, a professor of public health at National Taiwan University.

And though a poll has shown residents feel less threatened by the Omicron variant than by Delta, many are nervous about opening up—and they’ll vote in island-wide elections for powerful mayoralties in November. 

“I am fine with the Covid controls,” said Jessica Liao, an auditor who supports the restrictions. “When the vaccination rate is higher, then we can consider living with the virus.”

On the plus side, some 72 percent of those 75 and older are double-vaccinated. That’s better than levels seen during Hong Kong’s outbreak, where most deaths were among unprotected elders. 

Get a shot

The government is pushing vaccines harder, and last week said people in high-contact roles—including teachers and fitness trainers—must have three jabs in order to work from April 22. 

“The public is a little lazy and reluctant to get booster shots—they don’t feel the urgency,” said NTU’S Chen. “That needs to change if Taiwan wants to aim for a win-win: open up borders and ease travel restrictions while being able to contain the pandemic.” Bloomberg News