The whole of Taiwan will move into level 3 of its four-tier coronavirus alert system, after cases spread to more than half the island’s counties, infecting more than 1,300 people and killing two.
Health experts have expressed concern that Taiwan has been “a victim of its own success” and was caught short by the outbreak of the UK variant, with outdated preparations.
The Central Epidemic Command Center reported 267 new local cases on Wednesday, following 240 on Tuesday, and 333 on Monday.
The outbreak remains concentrated in the cities of Taipei and New Taipei, which went into level 3 at the weekend, but cases have been reported in eight other cities or counties, including 28 in Changhua, 16 in Taoyuan, and eight in the southern city of Kaohsiung. Tainan also reported its first two cases. There were 49 cases without an identified source, while 80 were linked to places in Wanhua, the centre of the northern outbreak.
Of those infected, 26 people were in hospital on ventilators, the CECC said.
Shih-chung Chen, the minister of health and welfare, announced that 400,000 new doses of the AstraZeneca vaccine were on the way from Europe, via the Covax scheme. Medical staff and frontline workers at quarantine hotels and testing stations will be prioritised for the doses once they have been released for use.
Taiwan’s vaccination rate is low. The government is yet to procure sufficient doses for the entire population, and take-up by the community has been low prior to this outbreak. In the past week, vaccinations have increased, and some of the 300,000 doses that were once feared to expire before they could be used are expected to be used within the week.
Taiwan has ordered 20m doses, including from Moderna, for its population of 24 million, but most are yet to arrive and have been affected by global shortages.
The low vaccination rate of about 1% is among concerns health experts have about Taiwan’s ability to contain the outbreak and return to a Covid-free life.
Prof Chunhuei Chi, the director of Oregon State University’s center for global health, said Taiwan was “a victim of its own success”. Having locally eliminated the virus in early 2020 it did not get prioritised vaccination orders and then failed to stay up to date with the changing science, such as the increased transmissibility and high asymptomatic rates of new variants like the UK one now spreading, he said.
“Taiwan is one of the few countries that never experienced a second, third, or fourth wave,” said Chi. “It basically resumed normal life so … most people including some government officials were lagging behind update knowledge.”
The government remains opposed to mass testing on the grounds that false positives could waste resources. Chi said Taiwan did not have the capacity for mass testing because it never needed it before, and establishing it could take weeks. Rapid testing stations were established in Wanhua – where Taipei’s cases are concentrated – in order to encourage patrons of the hostess bars at the centre of infections to come forward alongside the rest of the community. But there have been reports of stations hitting capacity and turning people away.
On Wednesday, the CECC said further stations would be set up in other hotspots, but continued to discourage people from getting tested unless they had symptoms and case connection.
“The virus is really vicious,” said Prof Chen Chien-jen from Academia Sinica genomics research centre, who was Taiwan’s health minister during the 2003 Sars outbreak, and sometimes consults current authorities. “Just one day [after we thought we’d controlled the Yilan outbreak], we found, oh my God, the Wanhua teahouse outbreak. Then the cases surged rapidly.”
Several of the experts the Guardian spoke to said the government was largely relying on the community to restrict their own movements voluntarily rather than impose lockdowns.
The level 3 alert does not establish lockdown measures, but mandates mask-wearing outside the home and limits gatherings to five indoors and 10 outdoors. Public venues, sporting venues, entertainment and recreation venues have been closed, but shops and restaurants remain open with enhanced social distancing and customer registration requirements. Level 4 would be triggered after 14 consecutive days of more than 100 cases, and 50% of unknown origin.
