Lock it down, now

Taiwan is repeating the world’s COVID mistakes, and time is running out

Having lived in a parallel universe where COVID doesn’t exist for all of 2020, Taiwan is now in the bizarre topsy-turvy situation of apparently speedrunning all of the world’s mis-steps regarding the virus.

There’s always been a few lonely voices asking why we didn’t do random community tests just to make sure COVID really isn’t in the community. The answer from Health Minister Chen Shih-Chung was always that false positives would cause unnecessary panic and overextend medical resources. But because we chose to forgo an early warning system, we probably lost a few good weeks. For some reason, we also did not ensure we had adequate testing capacity in the case of a breach. This lead to the phenomenon of “backlogging,” or hundreds of cases being retroactively added to the days’ count days or even weeks after. In short, it made the seriousness of the initial days of the outbreak invisible until much later.

A picture, or gif in this case, says a thousand words:

Chase W. Nelson 倪誠志 @chasewnelson

TODAY’S (6月5日) #COVID19 cases in #Taiwan 🇹🇼 📈511 local (476 today, 35 backlogged) + 0 imported 📉10k tests remain in backlog 📈Increasing trend projected 🧪1.7% test positive rate (only likely cases tested) 🏥38 deaths Analysis below ⬇️ 1/6

Taiwan did not impose Level 3 “soft lockdown” until May 20th, and then only for eight days. It’s since been extended to June 14. With incredible naïveté, netizens declared “watch out, world, Taiwan’s only going to demonstrate how to get out of soft lockdown in two weeks once.” The prevailing sentiment was: we’re Taiwanese. We behave. We’ll be different.

But this is not how the virus works at all.

Level 3 is not good enough

People still went to work, went to school, even indoor dining! Some of those things are now being shut down piecemeal, but people still traveled pretty much unimpeded. People waited in lines for up to an hour at crowded supermarkets to stock up, while grandmas still did their daily shops at traditional markets, which didn’t shut down.

Meanwhile, parks are closed. Nobody seemed to get the memo that outdoor exercising is pretty safe. We had hazmat crews spraying down the streets with disinfectant, doing nothing except giving people a false sense of security since we know COVID is spread through aerosol not fomites.

The CECC soldiered on with its contact tracing scheme, trying to contain each cluster. But with the virus already circulating for so long within the community, this was an approach that failed to scale. I am not an epidemiologist but let me just say the obvious…when you have weeks of hundreds of new cases every day PLUS backlogs of cases that aren’t even sussed out until weeks after the test samples were initially taken, the contact tracing ship has sailed! I’m not a politician either, but I’ll also say something else that hasn’t been said much but seems pretty obvious to me: Taiwan will not go into level 4 hard lockdown until the number of deaths become politically intolerable.

So far, we’ve had 212 deaths in 22 days. 37 alone on June 5th. The way things are going, it’s gonna come. And when it does, people are going to wish we locked down hard the moment we realized we have a problem.

Medical resources are already stretched

North Taiwan, especially the greater Taipei metropolitan area containing Taipei and New Taipei City, are blessed with the nation’s best hospitals and most adequate medical resources. But within two weeks of the outbreak we are already sending COVID patients out of Taipei because we are out of beds here. If we’re sending Taipei patients south, where are we going to send patients when clusters outside of Taipei break? There’s already a serious cluster in Miaoli, spreading quickly amongst the cramped dorms of the migrant workers.

Things are about to get a lot worse

Remember that thing last year where people in the US went home for Thanksgiving despite being told not to and predictably caused a huge spike in dead grandmas? Well we are on track for a replay of that in Taiwan if things don’t turn around very soon.

You see, Dragon Boat festival weekend is next week. That’s when people go home, eat Zhongzhi (glutinous rice dumpling wrapped in bamboo leaves. Very fattening but delicious) and remember their ancestors. Surely, they’ll forego that this year, right?

Not according to this schedule. Tickets down south to Kaohsiung for 6/11 are SOLD OUT for Taiwan rail. They are limiting passengers for social distancing, which cuts down on the number of travelers, but it’s still extremely concerning that people are not choosing to avoid to possibly bring the unwanted gift of COVID to their beloved relatives down south.

Vaccines are not coming soon enough

There’s been a very big and moving to-do about Japan donating 1.24 million doses of AstraZeneca vaccines to Taiwan. That’s fantastic. But you know, Taiwan’s population is 23.5 million.

Domestic vaccines are supposedly coming online in end of July. But we’ve got pretty scant information on the timing of how we’re going to get those shots in arms, never mind whether they’ll be as effective as other vaccines.

I don’t think there’s anyone in Taiwan right now who still thinks we’re on track to COVID zero. But even if the strategy is just to slow-roll this until we get vaccinated, we are still not doing enough. It’s going to be months before every Taiwanese gets two shots in their arms.

We know enough about COVID and how it works to know that it’s going to be too late.

The death rate in Taiwan right now is 2.19 percent, already higher than the global average of 2.15 percent. Now some of it might be inadequate testing and some of it might be our relatively elderly population. But if we let it go exponential and run out of proper care facilities we know that has the potential to go a lot higher.

Whatever it is we are doing is not enough

The CECC and Minister Chen in particular had built up a lot of good-will amongst both the domestic and international community for keeping COVID out of Taiwan for just about all of 2020. But it’s becoming obvious…now that COVID is in, there isn’t an adequate plan.

People are rapidly losing faith in their sluggish approach. This, they said on June 5th, with 511 COVID cases:

William Yang @WilliamYang120

The CECC said they don't encourage the panic-style of testing so asymptomatic cases should be assessed by doctors before they decide whether they need to be tested or not.

Panic-style of testing? No. The proper time of panic has long passed us. Taiwan should be testing, testing, testing because the time for complacency is long over.

The best time for Taiwan to go on a Level 4 lockdown was probably May 10th. The second best time is now.

Will we snatch defeat from the jaws of victory with the finish line already in sight?