After 15 months leading the world as a case study in epidemic management, Taiwan’s bubble has burst.
In just one week, the case count for Covid-19 infections spiked by more than 40%, and it’s likely that figure will keep climbing in coming days. Compared to India, which reported 311,170 new cases on Sunday alone, Taiwan’s 784 in a week is minuscule. Yet the sudden surge, bringing total cases to 2,017 by Monday, forced authorities to implement unprecedented restrictions and has people wondering what went wrong.
At least some of it can be traced back a month ago to pilots returning from overseas. While Taiwan has imposed a strict 14-day quarantine on arrivals for more than a year, air crews faced just a five-day isolation period. This freedom allowed them to hit the town soon after returning home, as was the case with one pilot who visited bars and a barbeque restaurant six days after a flight from the U.S. He subsequently tested positive. And he wasn’t the first.
A week earlier, on April 23, authorities announced that a China Airlines Ltd. pilot and a colleague were confirmed cases. This was soon followed by positive tests among family members and workers at the airport quarantine hotel where air crews stayed. By May 3, Health Minister Chen Shih-chung was warning that local transmissions were on the brink of spreading beyond the families of what was then just 24 cases.
Yet, for about a week, daily case reports gave the impression that this outbreak was under control. Sporting events went ahead, pubs and clubs stayed open, and night markets remained bustling.
Then another blind spot emerged. On May 11, seven local transmissions were announced, followed by 16 the next day — at the time, a record for Taiwan — and most were linked to a local chapter of Lions Club International. Among them, a past-president in his 60s whose contact-tracing history found him to have spent time at a hostess tea shop in Taipei’s Wanhua district. These are generally venues where older men are intimately served by women of a similar age: Call it sexy tea. As Chen himself joked at a recent press conference, it’s hard to social distance in these kinds of establishments.
Now dubbed the Lion King in local media, that one patient has since been linked to dozens of further cases, including a group trip to visit a games hall, the likes of which are sometimes considered a front for gambling, in Yilan, 50 miles (80 kilometers) away.
When 29 new domestic cases were announced two days later, all but three were aged 50 and above. From there, growth escalated — 180 the next day, 206 on Sunday, 333 on Monday. Over those three days, the female patient count was much higher than men, in a 60-40 split. One case, which tracing data show as two degrees of separation from the Lion King, took a 200-mile train ride to the southern city of Kaohsiung, where she visited the local gym for three nights in a row.
By this time, authorities had no choice but to announce the strict measures everyone was already expecting but hadn’t yet been seen during Covid-19. A Level-Three alert (on a four-tier scale) shut all gyms, bars, clubs and cinemas in Taipei. Gatherings indoors were limited to five people, outdoors to 10, and foreigners were banned from entering without a residency permit until June 18.
Chen, who still enjoys unprecedented popularity, stopped short of a full lockdown by explaining that he must balance strict physical curbs with the need to maintain mental health and avoid the excessive psychological burden that comes with the harshest restrictions, such as preventing people from leaving their homes.
Then came escalated mask mandates. While Taiwanese have generally embraced mask-wearing — even before the pandemic — authorities last year chose to enforce the rule in limited areas such as public transport and convenience stores. Elsewhere, people have been generally compliant even when not compelled.
The exception has been among older citizens, who are often regarded in Taiwan as viewing themselves above the law. This might in part be explained by a cultural respect for elders that means they escape question by younger generations, while many are considered less health conscious.
In elevators, shops and even the nightly trash collection, the non-compliant invariably seem above 60 and carefree. It got so rampant that Taipei City announced over the weekend that it will slap fines of up to NT$15,000 ($530) for anyone not wearing a mask even outdoors — likely mere tokenism, since local police rarely even enforce existing anti-smoking rules against anyone.
With a population of 24 million, similar to Australia’s, Taiwan had been among a handful of places that had kept the virus at bay. Until recently, the vast majority of its cases were imported, detected as arrivals stayed in quarantine at appointed hotels.
Yet success has bred complacency across the board. An initial slow start to getting a supply of vaccines meant that the first doses didn’t start rolling out until late March. Bad press for AstraZeneca Plc’s offering, coupled with the low case count, meant that even frontline medical workers were dragging their feet. The slow uptake allowed the government to start offering shots to anyone who wanted them, but even then interest was low.
With this outbreak raising alarm, Taiwanese have changed their tune. Streets were empty over the weekend as dutiful citizens stayed home as requested, while the surge in demand for vaccines prompted the government to once again limit doses to high-risk and medical staff.
Now if pilots can refrain from bar-hopping and older citizens can get with the program, Taiwan might just be able beat this thing.
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.