Up until early May of this year, the island of Taiwan had long been regarded as one of the stellar standouts in the global fight against the Covid-19 pandemic. Though hit even earlier than the US or most of the rest of the world in the initial wave of infections spreading out from China, Taiwan used its hard-won experience in dealing with the 2003 SARS outbreak to swiftly contain and then virtually eradicate the novel coronavirus from its shores.
By early May, 2020, Taiwan had limited the initial surge to just 440 confirmed cases, and 7 deaths, for an initial case fatality rate (CFR) of 1.6% — which was actually quite favorable when compared to the initial CFR’s over the same period in most of the US and Europe. Then over the next 12 months, through strict quarantine measures and aggressive contact tracing (though not through extensive population-wide testing as a number of other nations attempted), Taiwan managed to record just 5 additional deaths out of 770 new cases for a CFR of less than 0.7% during this long intermezzo.
Unfortunately, success almost inevitably seems to breed hubris, and Taiwan’s quarantine protocols suffered a near catastrophic failure in April. As outlined by an article in Time, one of the hotels in Taipei used to house quarantined air crews broke protocol and allowed them to mix with non-quarantine guests in the same building, which was compounded by relaxing the quarantine requirement for non-vaccinated air crews from five days to three.
Among those guests were some attending an international conference of the Lions Club in Taipei, and one in particular (now known as “The Lion King”) became an asymptomatic superspreader when it was revealed he had visited one of the tea houses in the red-light district of Taipei and came in contact with over 100 hostesses and other patrons while infectious. .
As it turns out, this particular outbreak appears to be related to the original Alpha variant first identified in the UK, rather than the more recent Delta variant from India; but since Taiwan was still essentially virgin territory to any strain of the coronavirus, with less than 2% of the population vaccinated at this point, there was nothing already in place to prevent a staggering explosion in new cases.
Interesting side note here — it seems that because of their prior success in keeping Covid-19 at bay, the Taiwanese people weren’t all that interested in getting vaccinated, with only 40% indicating they would even consider doing so once the vaccines became available — which is why the government there made no real attempt to secure a supply beforehand. Hopefully attitudes are evolving.
By mid-May, it was already obvious that Taiwan was facing a far more serious outbreak than anything they had yet dealt with, and by the time they belatedly ramped up their moribund testing program toward the end of the month, they were already recording over 500 new cases and a dozen deaths per day.
Fortunately, Taiwan has not yet been worn down by the sort of Covid-fatigue evident in so many other societies (especially ours) that have had to bear the brunt of this pandemic, so in an amazingly short period of time, they managed to summon the collective will to reimpose the mask and social distancing mandates, and other measures necessary to defeat this second and far more serious outbreak.
New cases are now back down to barely a couple dozen per day now, and new deaths have tapered off to the low single digits; but since the beginning of May Taiwan has already recorded 14,300 new cases, and 766 new deaths. The really striking thing here is that the CFR for this particular outbreak stands at a shocking 5.36%, and will no doubt keep ticking up to the 5.5% or even higher level as additional deaths continue to trickle in.
This is nearly an order of magnitude higher than what we saw during the preceding intermezzo period, and still a 5-fold increase over the combined CFR prior to May, 2021. And while Taiwan seems to be something of an outlier at this point, it does demonstrate just how bad things can get if the wrong Covid variant gets loose in a population with little or no prior exposure.