Taipei, Taiwan – After 18 months of keeping COVID-19 on its side, Taiwan is now seeing an increase in cases after a fire was discovered in mid-May.
From just 1,200 cases and a handful of deaths among the island’s 23 million inhabitants, the number of confirmed cases had reached more than 11,000 by Tuesday and the death toll had risen to 308.
The self-governing island was highly praised last year for its effective response to COVID-19, which included strict border controls and contact tracking. Now, when they struggle with closed life for the first time, many in Taiwan are wondering what went wrong.
Six months ago, Al Jazeera interviewed Chen Chien-jen, former vice president of Taiwan and health minister who made his name during SARS [Severe Acute Respiratory Syndrome] broke out almost 20 years ago, about why Taiwan had been so successful in the fight against COVID-19.
This week, we talked back to the epidemiology – above Zoom – of the island’s sudden change of fortune.
Chen says the fire is partly the result of “prevention efforts” as people lower their guard.
Hospitals, which were to be dedicated to COVID-19 and isolation wards, had also begun to be used for other patients and the health system was not prepared for the sudden onset of coronavirus cases, which were tracked by a group of air pilots, he said.
For Chen, the first two weeks of the fire “were a disaster.”
The interview was edited for length and clarity.
The COVID-19 situation in Taiwan has suddenly become very serious. What do you think went wrong?
Given April, we started to have this British variant B117 imported from other countries and as you know B117 is a highly infectious virus. The second important feature is that it causes many asymptotic and mild cases.
He left China Airlines and Novotel employees, then moved to New Taipei City and the Lions Clubs, and then moved to Yilan and finally arrived at Wanhua’s adult entertainment venues, the so-called “tea houses”.
On May 15, before our Central Epidemic Command Center (CECC) announced the Level 3 (semi-block) alert, President Tsai Ing-wen called a meeting and invited me. (I said) thousands and thousands of people will be infected this time.
How do you think current epidemic procedures work?
In the first week of May 15, every day we had about 500 to 600 people infected and my former boss asked me it was pretty good, I said I can’t tell if this is the peak. But fortunately for the first seven days there are 500-600 cases, and the second week is 400 to 500, and then 300 to 400. Now it is 200 to 300.
This means that the epidemic curve has been leveled through Level 3 alert efforts.
So I think that’s a good sign, but (the numbers are) also a bad sign. The disease has become endemic, which means that the virus in Taiwan has a community transmission and it is very, very difficult to eradicate the virus at all now.
Last February, I had some suspicions and unfortunately, my suspicion was that COVID-19 had mutated, and had become grip.
The only way for Taiwan to cope very well in this second phase of the pandemic is to increase the band’s immunity through a national vaccination program and urge the CECC to try to get the vaccine as soon as possible.
What do you think of Taiwan’s response to COVID-19 six months later?
I think that for pandemic prevention, there are two ways to do science. The first is the interruption of virus transmission. That’s what we were doing in 2020 and it seemed to be very successful.
But there is a difficulty of prevention, people get tired of it and loosen their consciousness a bit. So, before November 2020, Taiwan played very well first half of the game, but in the second half we ran out (because) of the vaccine.
I must confess in the first two weeks (of the recent fire) it was really a disaster. Too many people had an infection and too many people rushed to be tested and community stations were not ready at all and neither were the hospitals.
Originally, we asked each hospital to have a designated room or isolation room for COVID-19 patients, but since there were no COVID-19 cases, all hospitals thought they didn’t need it, so they filled it out. many patients in designated isolation rooms.
The situation is quite similar to any country with this wave of patients but fortunately I will say, after two weeks, community based screening stations were set up and then there were more and more isolation rooms available.
If COVID-19 has become more like the flu, what does that mean for Taiwan?
I’d like to share first how we fought the flu by going back to the 2009 H1N1 pandemic.
We did three things: one is a very good contact track and also quarantined in the homes of infected people. For infected people, when they had very severe symptoms they did a quick and immediate test and had to be antiviral, the so-called Tamiflu. They would not have to do any kind of quarantine at home when their viral load has dropped and they have recovered.
At that time, we developed Taiwan’s first domestic flu vaccine and then we used the international and domestic vaccine to immunize people. If COVID-19 is to become more flu-like, in the future, we need a very good and very sensitive specific rapid diagnostic test and an antiviral pill for people who are really infected like the flu.
Taiwan is struggling now to get enough vaccines. Why?
As you know, we ordered 20 million doses of the vaccine: from COVAX about five million, Modern five million and AstraZeneca 10 million. The (national vaccines) Medigen, and United Biomedical, are in clinical phase 2. If their safety and efficacy are good, they could obtain an emergency use authorization.
But as you know, even if we already have the purchase order with COVAX, the delivery is a bit delayed and a bit inadequate. At least we got the donation of 1.25 million (AstraZeneca) from Japan and 0.75 million Modern doses from the United States. We hope that in June we can vaccinate three million people, and if it goes well with international vaccination and domestic efforts, we hope that in July there will be another six million vaccines available, and in August another six million available.
By the end of August, I hope to be able to immunize at least 15 million people in Taiwan with (at least) one dose and at this point the epidemic could be contained much better. With some hope and if that is the case then we will return to a new normal life.
What will solve the current crisis?
The only thing we can do is immunize. We try to make sure everyone is resilient, and more importantly, immunization should be implemented as soon as possible and on the largest possible scale. This is not just for Taiwan, it is for the rest of the world.
There is a kind of competition in time with viruses. If (u) coronavirus continues to mutate like the flu virus, then one day, somehow there will be a new variant that the current vaccine cannot prevent in humans.
What do you think of the COVID-19 theory can be filtered by a laboratory?
According to the recent report there is a piece of human genome in the COVID-19 virus, and it is really strange. It appears to have been genetically modified or inserted by some of the lab and that is why the President of the United States, Joe Biden, has asked his experts to try to find it.
Another reason why people have their suspicions is when the WHO delegation went to the Wuhan laboratory, they did not have much information from their visit. If there are really human genes in the virus, then we need to understand how it could be integrated into the virus gene. This is very strong evidence to indicate that in some laboratories some (researchers) have done a laboratory experiment