An unprecedented pandemic of the century has ravaged the world for a year and a half since December 2019. It seems that China, Japan, and Korea, all in North-east Asia, will face a new round of challenges. The unstable pandemic situation has caused disputes between the Japanese sports and healthcare sectors on whether the Tokyo Olympics, already postponed for a year, should take place or not. Shenzhen and Guangzhou, the economic engine and the most open cities in China, have confirmed infected cases, some asymptomatic, on a daily basis.

After the World Health Assembly, the World Health Organization (WHO) has decided to speed up its reviews on different vaccines to include them in the COVID-19 Vaccines Global Access (COVAX). On the other hand, the UK, the U.S., India, and Brazil have more confirmed cases despite vaccinations after their governments have eased the anti-pandemic lockdown restrictions. There are also new outbreak points in the areas surrounding Hong Kong, which have naturally alerted and caused concern for the citizens.

The biggest difference between SARS in 2003 and what we have now is not their infection and death rate. Since 2020, many variants have appeared in western Europe, Africa, South Asia, South America, etc. The WHO has recently officially named these variants using letters from the Greek alphabet to eliminate the stigmatization of places where those variants were first identified, and make it easier for the society to pass on the related information. The widespread of the mutated virus indicated its adaptability, especially against temperature and humidity, is much higher than SARS back then. Therefore, the changes in latitude, longitude, and seasons are not sufficient to hinder its reproduction.

The complex combination of time and space changes means the tactics used to control the infected rate could not yield immediate and significant effects like lower the death rate. SARS in 2003 was lethal, but it could not survive beyond summer or outside the sub-tropical region. It cannot recirculate within the global human society year after year, unlike the virus we have now. COVID is highly transmittable and adaptable. The more international, open urban economy with service industry as core, the harder it is to control the pandemic. Therefore the international economic, trade and financial centers such as London, New York, Hong Kong, and Tokyo have a much higher risk of being disturbed by the pandemic than those inward-looking cities. For London and New York, it isn’t that they do not do anything to prevent imported cases. They simply cannot. Therefore a large-scale vaccination would be the definite choice for the people living in these two cosmopolitan cities.

Taiwan, with the strength of a small island and the determination of 23 million people, has successfully fought off the pandemic for nearly a year and a half. One of the reasons is Taiwan is not densely populated apart from Taipei and New Taipei cities. The subtropical maritime climate also provides a better environmental factor. Secondly, Taiwan’s fishing and farming industries are very well developed, so it has adequate supplies of rice, poultry, fruit, and vegetable for its population. Also, it does not depend on foreign labor so heavily like Hong Kong and Singapore. Therefore Taiwan has been able to more strictly control its sea, air transportation, and the traffics of people and goods for a very long time. With no fault of its own, it is inevitable to lose its defense after holding out for so long. People being tired from fighting the pandemic is understandable. Besides, an occasional local outbreak caused by an imported case has already happened in Singapore, Beijing, and more recently Guangzhou, Shenzhen, etc.

Whether in terms of the cost or the technology, it is impossible to be absolutely water-tight only by applying testing and quarantine tactics. The most effective option seems to be vaccinating people according to designated groups, such as medical staff, the elderly, and carers. The UK has, after Israel, already vaccinated most adult population. Biden has also set a target to complete vaccinating 70% of the U.S. population by Jul. 4, Independence Day. The vaccination rate of Mainland China is not as high as that of the UK and the U.S., but the number of vaccines used has reached 700 million, which shows a positive attitude of the government and the people.

Taiwan is in an embarrassing situation because it cannot bypass Beijing and join the WHO, an organization under the United Nations. The German pharma company cannot ignore Fosun to supply Taiwan with mRNA vaccines due to business terms. Japan could support Taiwan to a limited extent as its vaccines were from the UK. However, the U.S. regulator does not recommend the vaccines because there is a risk of causing thrombus. Hong Kong has the intention to order, but it is almost certainly it would not be shipped. Amid the difficulties, Taipei could only order the mRNA vaccines from the U.S. Pfizer directly. The U.S. pharmaceutical industry, especially with vaccine development, is the leader in its field. There are also Moderna mRNA and vaccines of other production principles to choose from.

Taking Taiwan’s strategic position in the Indo-Pacific region and the subtle and sensitive China-U.S. relations into consideration, the U.S. relaxing its vaccine export regulations for Taiwan has not only rescued Taiwan from its desperate need but can also influence who the people will support and against. Furthermore, Taiwanese, including the blue camp voters, lack interest in China vaccines. So the Chinese Kuomintang, the blue camp county mayors, and the Taiwan Affairs Office across the Strait could put little pressure on Tsai Ing-wen’s government on vaccination issues.

(Dr. Hui Ching, Research Director of Hong Kong Zhi Ming Institute.)

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