How China undermines Taiwan’s national anti-COVID success with local-government actors

Taiwan managed to keep the lid on COVID by being smarter than most other countries, more wary perhaps, by being closer to the original source of the virus, and most importantly by avoiding mass testing, using technologies that were questionable for use for even for well-known disease agents.

During early days of the outbreak, in 2020, Taiwan’s Ministry of Health and Welfare’s Central Epidemic Control Center (CECC) decided to implement border controls, put people into a 14 day quarantine upon arrival in the country, test people in specific situations, such as quarantine exit, suspected symptoms, or contact history, but most importantly, not on a random, or mass/general basis.

The science of avoiding mass testing was explained by a professor at Department of Applied Physics at Tunghai University, as early as March, 2020.

“If universal screening for COVID-19 were implemented, people who tested positive, but who are not sick, would vastly overwhelm resources available for people who actually need them.”

There were no unusual numbers of COVID-19 cases, increased numbers of hospitalisations, nor excess deaths between the time of the CECC decision, and the attempt to undermine the no-mass-screening policy by the KMT (Chinese Nationalist Party) five months later.

When the KMT attempted to undermine the CECC in August 2020, by introducing “general screening,” – tests on the general public, regardless of contact history, or suspicious symptoms, at city and county level, Minister of Health and Welfare, and commander of the CECC, Chen Shi-chung, managed to rein-in the hotheaded municipal authorities under the national umbrella.

“Local governments must follow the instructions of the national health authorities,” Chen said.

“General screening will produce both false-positive and false-negative results, and that this will create an unaffordable burden on society,” the health minister warned.

“If 250,000 people were to be tested, it would produce 12,475 false-positive results.

These more than 12,000 people would not only exceed the 3,000 specialist beds available in negative pressure, and general isolation wards; they would create overcrowding in hospitals, which are a high-risk area for infection and would overwhelm medical resources.”

A full eight months later, in April 2021, a cluster of COVID-19 positive tests involving occupants and workers at a hotel at Taoyuan Airport housing pilots and flight crew led to contact tracing and inevitable positive results. The reputation of airplane pilots as an occupation became mud, and the victims of the mudslinging were pilots and flight-crew who worked under a constant regime of disinfection, testing, quarantine, then back to work.

When a cluster of positives was traced to a “Tea Parlor” in Wanhua District – a red light district that must not be named, because sex work is illegal in Taiwan, the shit really hit the moral fan.

That’s when Taipei City Mayor Ko Wen-je, a respected surgeon, before he walked into the political arena, stepped in and ordered rapid-screening reagent tests starting in Wanhua District. The rapid-screening sites, using antigen tests, that promise to return a result within 15 minutes, quickly expanded to other areas of the city, then nationwide via municipal government-level authorities over the next few days.

People flocked to the tests because it’s “free”

On the first day of testing 11% of tests turned positive for COVID-19.

Other municipalities quickly followed the Taipei City experiment, rolling out rapid testing centers using antigen tests.

The Central Epidemic Command Center (CECC) stressed that only individuals who have come into contact with confirmed cases or are experiencing suspected symptoms of the coronavirus should undergo testing, and advised those who have not come in contact with known COVID cases, and do not have a high fever or noticeable symptoms to not get tested.

But the test was free to the public, and that made it more popular than a buy-one-get-one-free deal from Starbucks: people lined up around the block to get a free test.

The Unreliability of Rapid Tests

“Remember that positive predictive value (PPV) varies with disease prevalence when interpreting results from diagnostic tests,” the US Food and Drug Administration (FDA) warns.

• For example, a test with 98% specificity would have a PPV of just over 80% in a population with 10% prevalence, meaning 20 out of 100 positive results would be false positives.
• The same test would only have a PPV of approximately 30% in a population with 1% prevalence, meaning 70 out of 100 positive results would be false positives.  This means that, in a population with 1% prevalence, only 30% of individuals with positive test results actually have the disease.
• At 0.1% prevalence, the PPV would only be 4%, meaning that 96 out of 100 positive results would be false positives.
• Health care providers should take the local prevalence into consideration when interpreting diagnostic test results.

Under such guidelines, the likelihood of getting false positive results grows proportionally the further away you get from the hotspot district in Taipei City.

The CECC invalidated a decision by the (KMT) Kinmen County Government that required all travelers to the island county to present a negative COVID-19 test certificate, or be subjected to a rapid screening test upon arrival, Taiwan’s Central News Agency reported, Monday, May 23.

Another two island counties – Penghu and Lienchiang have also raised similar proposals.

The CECC’s over-ruling of the Kinmen County Government’s testing plan, came just 6 days after the CECC had to quash the county’s application for permission to import vaccines from China.

Blood and serum products can not be legally imported from China into Taiwan by law, the CECC pointed out.

Recommended reading: Taiwan’s problem isn’t vaccines — it’s China (or: Reuters Sucks Again)

Taipei Mayor: No time to discuss science

When Taipei City Councillor Liang Wen-jie (梁文傑) questioned the good mayor about the issue of false negative, and false positive results of antigen tests, Saturday, May 23, but Ko dismissed his question by telling him that “this is not the time to discuss science.”

Ke said that he agrees that quick screening is not as accurate as PCR, but it still has 95% accuracy, and that “we need to make quick decisions,” and “policy adjustments in accordance with expert opinions.”

Liang pointed out that out of 1,168 people tested by the rapid screening tests during a purported outbreak at Chaoyang University of Technology in Taichung City, 29 people were tested as positive for COVID-19. After the panic created by this figure, all 29 were found to be negative after subsequent PCR tests returned the next day, the councillor pointed out.

The same was true of rapid tests carried out on the Matsu Islands (Lienchiang County), where all three positive results returned, turned negative when tested with PCR.

China Can Help

The most insidious aspect of this break with the “central authority” that managed to keep the lid on the virus, is the response by the KMT, CCP, and CUPP.

Red elements of the Kuomintang, the pro-unificationist Chinese Unification Promotion Party, and the Chinese Communist Party all obviously see the situation as an opportunity to turn the People’s Republic of China from a threat to Taiwan, into Taiwan’s Savior.

Former Chinese Nationalist Party (KMT) chairperson, Hung Hsiu-chu (洪秀柱) expressed her willingness to come to the rescue by helping to procure vaccines from China.

Hung said that vaccines are the ultimate solution to the new coronavirus.

“When people’s lives are endangered in emergency, vaccine procurement is the top priority,” Hong said.

“Any method that can eliminate the threat to people’s lives should be carried out in such a special circumstance.”

Hong promised that as “a member of this nation,” she can do what she can do, and do her best to do her part to communicate with the “other side” [of the nation] to strive to get the Chinese vaccines.

That’s a lot of doing being promised.

Chinese ultranationalist “White Wolf,” Chang An-lo ( 張安樂), in true gangster form, threatened to hound Minister of Health and Welfare, and commander of the CECC, Chen Shi-chung until the Democratic Progressive Party (DPP) government accepts the Sinopharm vaccine. The Bamboo Union gang-master promised to follow the Minister of Health and Welfare like a shadow, every day, saying “we will never give up until we get a vaccine.”

Zhang claimed that only the Communist Party of China loves Taiwan and cares for the health of the Taiwanese people.

President Calls for Unity Against CCP’s Cognitive Warfare

President Tsai Ing-wen called on citizens to work together against cognitive warfare, Sunday May 23, using the social media app Line.

Tsai wrote that Taiwan’s epidemic alert has escalated recently and epidemic prevention work is facing challenges. The President said that Epidemic prevention requires everybody to work together. “Democracy and freedom are not easy to come by, and cognitive warfare must not be allowed to break or split Taiwanese society.”

The day previous to the President’s call, a message appeared in the comment section during a live broadcast on YouTube, saying that the President had been diagnosed with COVID-19, but a public announcement hadn’t been made yet. The text contained simplified Chinese characters, as used in the PRC, and were traced to an overseas IP address.

President Tsai assured citizens that she was healthy, and working as usual, that that the claim was false information, and obvious cognitive warfare.

Wolf Warrior Diplomats don Fleecy Cloaks

The Taiwan Affairs Office of the State Council of China “is willing to quickly make arrangements for the majority of Taiwan compatriots to have the Chinese vaccines available as soon as possible,” the office’ spokesperson Zhu Fenglian said, on the evening of Monday, May 24.

Zhu said that in response to the current “raging epidemic,” in Taiwan, the Taiwan Affairs Office has repeatedly emphasized its willingness to do its utmost to assist Taiwan compatriots in strengthening the prevention and control of the epidemic, and defeat it as soon as possible.

“Facing the increasingly severe epidemic situation on the island and the constant pressure of epidemic prevention by the majority of Taiwan compatriots, some groups and people on the island continue to call for the purchase of mainland vaccines,” Zhu said, in a comment that was enabled by people like the KMT’s Hung Hsiu-chu, and the Kinmen County Government.

Taiwan’s Mainland Affairs Council responded that the Mainland has never provided us with information about mainland vaccines through existing cross-strait channels, but whenever the epidemic in Taiwan is heating up, it criticizes our government for obstructing the import of Mainland-based vaccines. This kind of obvious united front division operation is very clear in Taiwanese society, and the international community also clearly recognizes it. The other side knows what obstacles Taiwan is facing to obtain vaccines, and everyone knows it.

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