Taipei Mayor Ko Wen-je (柯文哲) last week sketched a chart showing projected numbers of SARS-CoV-2 infections in an attempt to explain his preferred pandemic-prevention strategy.
The chart was in fact straight from the pages of a public health textbook, first shown by the Central Epidemic Command Center two years ago at the start of the COVID-19 pandemic. It has since formed the basis of the government’s pandemic prevention plans. It was also used by Kaohsiung Mayor Chen Chi-mai (陳其邁) to illustrate his city’s approach to the pandemic.
Whether to pursue a policy of “zero COVID-19” or live with the virus is a question that China is dealing with. It has become an ideological struggle between supporters of Chinese President Xi Jinping (習近平) and his rivals in the run-up to the Chinese Communist Party’s 20th National Party Congress later this year.
However, the pandemic prevention measures pursued in Taiwan over the past two years have never been about achieving zero cases at all costs. They have been largely aimed at keeping the virus under control and moving toward a form of herd immunity, which is essentially a scientific way of saying “living with the virus.”
At the start of the pandemic, Taiwan was faced with a virulent disease that produces severe symptoms. There was no vaccine, a lack of medical supplies, an insufficient supply of surgical masks and sanitizing products, and limited numbers of hospital beds. During this time, the country was still trying to figure out the virus’ transmission path.
The objective in the pandemic response back then was to prevent an explosion in the number of severe cases from collapsing the health system, which would make us lose control of the virus.
For this reason, it was thought proportionate to try to reduce the speed of virus transmission, even if this goal came at a relatively high social cost, so that the medical system would have the capacity to cope with severe cases. It would buy time until a vaccine was developed and distributed, and allow for hope that the virus might mutate into a weaker strain that would cause less severe symptoms.
With these conditions in place, the country could then hope to achieve some form of herd immunity.
Today, Taiwan has adequate vaccine coverage. The Omicron variant of the SARS-CoV-2 is more easily transmitted, but it largely produces no or less severe symptoms. The medical system is fairly stable.
The question therefore becomes whether Taiwan needs to maintain the social costs of pandemic restrictions to control the virus. The country has reached the point where people can once more discuss how best to further refine our allocation of resources and our control measures. In public administration, policy support measures are the goals and means of coordination in key areas to achieve the overall strategy and objectives.
Therefore, in the process of fighting the pandemic, these measures have to take into account the circumstances at any given point in time, including the capacity of the medical system, the corresponding social costs and the policy tools at hand to meet objectives and prioritize resource allocation.
As part of the policy discussion, the government needs to explain the entire policy framework and connections in a structured way, and to provide key data in a timely manner, such as the number of hospitalized patients that fully recover. The public needs to understand what the government is trying to achieve in its overall strategy, and how the results demonstrate success.
In this way, it can fend off critics who clamor for attention, and guide the nation out of the pandemic in the final stretch.
Shih Chia-liang is an adjunct assistant professor at National Chengchi University’s Department of Public Administration.
Translated by Paul Cooper
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