As protests against strict COVID-19 controls have spread through China in recent weeks, and the problem of how its government can respond has reared its head, one idea probably won’t occur to those high up, but that doesn’t mean it’s a bad one. That is: What if … China asked Taiwan for advice?
The situation in China now is that, after more than 20 cities scrapped various COVID-19 requirements, including negative Covid tests on public transport and infected residents with special needs being sent to centralized quarantine, the central government has announced incremental loosening measures of its own. In an announcement on Wednesday, China’s National Health Commission (NHC) said that negative COVID-19 tests shown via a smartphone app would no longer be required except in places such as nurseries, elderly care facilities and schools. The scale of lockdowns where cases are known will also be reduced from whole neighborhoods and districts to single floors or buildings. Additionally, people testing positive for the virus will be allowed to isolate at home.
However, key stumbling blocks still exist to any broader move away from the zero-COVID policy which the country has previously pursued. Just 65.8% of people over 80 are fully vaccinated, according to NHC officials at a press conference held two weeks ago. China’s healthcare system is also relatively unprepared for a sudden shift in policy, which could mean caring for many more people sick with the virus — “with only 3.6 ICU beds for every 100,000 citizens, compared with 25.8 and 33.9 in the U.S. and Germany, respectively,” for example. And rather than importing other countries’, China has waited on approving its own mRNA vaccine, which “would reduce the chances of widespread serious infections that could overwhelm hospitals.” Politically, there are issues too. As The Financial Times’ Europe-China correspondent recently noted, there are still those in China — particularly elderly people in rural areas who have not experienced COVID cases — who support Zero COVID policy. And of course, most notably, the government has boldly invested its reputation in the strategy.
Not all of these issues translate to Taiwan — it has for a long time had a very high ratio of ICU beds to citizens, for instance (29.8 per 100 000 population in 2015) — but a number of them do. Like China, Taiwan also pursued zero-COVID for a long period with, for instance, masks mandated in indoor and outdoor public spaces, QR tracker codes installed at the entrances to public buildings, and strict quarantines applied to international arrivals and those testing positive for the virus. Like China, this meant low levels of immunity through exposure when the virus began to spread fast through omicron. Like China now, an outbreak in April saw Taiwan’s government switch to attempting to prevent severe COVID and “living with the virus.” Like China, at that stage, a large number of its elderly population was not fully vaccinated (as of March 29, 22.9% of people 75 years and older were completely unvaccinated), and the issue was (and remains) politicized.
Across this (non-exhaustive) list of similarities, an exchange of information between two neighboring countries would obviously be a reasonable step, were it not for the tensions between them. It could focus on headline policy or background administrative decisions — health and policy experts would decide — but regardless of the details, it would be worth a go — surely? Even if Taiwan’s 14,548 COVID-19 deaths since 2020 (as of December 7), from a population of almost 24 million, is no longer touted as miraculous, it is still a lower death rate than many countries (particularly those with equivalent reporting systems). What’s more, lessons can come from failures as much as successes.
Instead, while Taiwan’s foreign minister, Joseph Wu, has just been asked for his advice to China, an interview with The Guardian is about the closest anyone will get to an idea that would cost very little and possibly save people’s lives.