Blood Sugar Hex Magic

                       

Yes, it's a punny title, but I won't change it. 

It felt like magic when I began losing weight without trying. Several months out from COVID recovery, I'd changed exactly one habit: I was drinking an average of two liters of water per day. Before COVID I had a small water bottle for going out; by the time I'd sipped it dry I could usually find a place ot refill it. Now, I could down that thing in three gulps, and was instead bringing a full liter everywhere I went. I'd have to refill that as well. I assumed that my wholesome new drinking habit was the driver of the weight loss. 

I had to have pants taken in and shirts re-tailored. I bought a belt. Even my shoes fit a little looser. From July to November, I lost a dress size. By January, it was a size and a half. As of now, it might be two.

I won't lie: it felt great. I didn't have any other issues or symptoms, so I just kept on assuming it was all that water. It's no secret that I'm -- what are we calling it these days? Curvy? -- and it was thrilling to be dropping pounds. Who wouldn't want that, especially with very little effort? 

Most cultures these days seem to be weight-conscious. People will say it's about health but it's really not. It's straight-up "NO FATTIES" judgmentalism. If you're fat and healthy that's still insufficient. If you're thin and sick, you should handle that, but it's ultimately better than being fat. There are people who will argue with the idea that this is totally fucked up, and that's fucked up too. 

Taiwan is no different. Taiwanese society's obsession with weight isn't even unique: you'll find pills and horrible diets and people -- mostly women -- taking on unhealthy habits and getting surgery in every other Asian country and many, if not most, places beyond. Although the country of my birth is somewhat fatter on average, all of these things exist there too. If you needed any evidence that none of it works, there it is: the United States has the juice cleanses, the disgusting powders, the gross teas and the weird contraptions too, and Americans aren't getting any thinner. 

The main difference I've found is that Taiwanese standards for being thin are far stricter: you have to be a stick to even fit into the clothing sizes available. Large-size stores exist, but they don't work for me as I'm too tall for the hemlines and the cuts don't take curves into account.

People (usually women) who are average or even slender have told me that they're regularly called fat. One told me a guy walked away because he believed he should be able to wrap his hands around her waist and have his fingers touch, which is some eating-disorder level bullshit.  I've heard far too many people commenting on weight as though it's a moral failing in an infuriatingly matter-of-fact way, and include people who are simply not fat in that definition (not that it would be any more acceptable if they didn't). 

If you're a foreign woman, it's unlikely that you'll meet these size standards. Even thin Western women I know have said they feel like giants here. Trust me, it's even harder when you're a Big Foreign Sasquatch. In addition to local messaging, there's a big community of misogynist Western dudes who have the "no fatties!" mindset. Fortunately, they mostly ignore expat women they deem overweight. They don't seem to realize they're handing us a gift.

It's to the point that seeing a doctor can be an exercise in stress, when medical professionals ought to focus on treatment. It felt like being cursed, or hexed: presenting for care, being told to lose weight and possibly receiving substandard care from a doctor who assumed weight loss was the only possible treatment, feeling like trash about it, and avoiding seeking further care. People say being overweight can lead to lower life expectancy, but I wonder if seeking medical treatment less often, and receiving insufficient treatment when one does, might lead to medical conditions spinning out of control that didn't need to be life-threatening in the first place.

Although I don't really want to speak Mandarin when there's a contraption that looks like a wine key stuck up my vagina, I quit one English-speaking OB-GYN and sought out another, because her only suggestion for treating my cystic ovaries was to lose weight. Of course, the cystic ovaries probably contribute to the weight in the first place. 

When I got COVID, I asked for Paxlovid as I was feeling weird in the general heart area, which is generally not considered to be a good thing. I have a family history of heart problems (though as far as I know, I'm fine), but that wasn't enough. The telemedicine doctor said it didn't qualify. So I said "oh, but I'm fat!" and got the drugs: having a likely predisposition to vascular issues was insufficient, but weight was. The doctor also said that heart problems were associated with obesity, and I didn't have it in me to reply my family members with heart issues were not fat, with no exceptions. 

I don't want to single out Taiwan, though. Fat people are treated like crap by society and medical professionals around the world. A doctor in the US whom I saw because I tested positive for tuberculosis exposure (I never developed the disease) exhorted me to lose weight, in college, when I wasn't fat. The main difference is that in the US people will talk about "fatties" (or "fat chicks", because this is mostly aimed at women) in derogatory ways to no-one in particular. In Taiwan they'll be more straightforward about it, but are more likely to say it to your face. 

In Taiwan, my tailor and one doctor congratulated me on my weight loss. Foreign friends said I should get checked out as my water consumption was atypical, others didn't see a concern: drinking that much of a calorie-free substance is a common weight-loss tactic!

Here's the truly unhealthy part: I didn't want this to be a problem. Of course no one does, but specifically I was quite happy to continue slimming down. A tiny voice in the back of my head kept prodding me -- you know they're right. Water or not, my rate of weight loss wasn't normal or healthy. And yet, as much work as I've done to simply love myself and focus on being a person rather than a number on a scale, I wanted to keep losing it. Going to the gym hadn't worked. Eating better never worked either. Why not take this gift being handed to me?

It gets worse: walking around in my slimmer body, I didn't just feel better about myself, I felt healthy. After all, losing weight is healthy, right? Slimmer people are healthier, no?

This was in fact extremely dangerous. I was not healthy. But when society tells you that dropping a size or two is good for you, it's extremely hard to break away and say no, something's wrong.

I visited the US recently, and it took an old college friend to really hammer it home: I needed to see a doctor. Excessive water consumption and unexplained weight loss were the most common symptoms of high blood sugar and diabetes. Even then, thinking back on years in Taiwan being matter-of-factly told I was fat, with insane diets and life-consuming exercise regimes suggested as a "cure", I secretly hoped that I would be able to "keep" the weight loss.

And yes, I did find the anti-fat messaging in Taiwan more damaging. That could just be me: it's easy to ignore Internet chuds in the US screeching about "fat chicks", usually with some assumption that said fat chicks would be single forever. Who cares? I'm not single!

It's harder to not let oneself be affected by a straight-up proclamation that you are fat and that is bad. The advertising affected me more too. It's harmful enough that the US has re-vamped all its weight-loss marketing as "wellness" or "health" (I'm sorry but nasty drinks and no food are not healthy, period). In Taiwan, well, you are fat and that is bad.

For someone who's worked hard to break free of mindsets like these, it really shows how deeply this societal messaging runs, and how damaging it can be. I came very close to not seeking care because I thought of weight loss as an unequivocal good! 

I should have known better. You know who else lost a lot of weight because she was sick? My mother, just before the cancer came back. She's no longer with us.

I did make an appointment with an endocrinologist after returning to Taiwan. You know what it took to do that? A friend treating my new body as a warning sign rather than something to be congratulated. I should not have needed that hard a push. I also massively cut down my sugar intake and reduced my carbohydrate intake, although it's hard to sustain that with no clear diagnosis. It was especially hard as my first week doing this was in Mexico, where the chocolate and the churros are delicious. 

You know what? Even then, I fretted about it the day before and morning of, simply because I wasn't in a good mental place to be told yet again that I am fat and that is bad, with the implied message that I'm a moral failure, or lazy, or a bad person because I am fat, which is what I suspect a lot of people truly believe. 

Nobody should have to feel that way when doing something as normal as going to the doctor. Everybody, in every country, should feel empowered to present for care without judgment. 

This story has no ending, as I'm still waiting for my blood sugar results. I can't imagine I'll be told I'm fine. 

There is one happy conclusion, however: unlike so many doctors before her, the endocrinologist didn't say a word about my weight. I told her I'd had COVID about six months ago, and the symptoms began immediately after. I'd had my blood sugar checked before I got sick, and there was no issue. She pointed out that there is some evidence that COVID can actually cause diabetes in rare cases, so I was right to be spooked. She asked me if I had a family history of diabetes, which I do.

She did not exhort me to exercise or eat less. That's a good thing. There is no overweight person in the world who is unaware of it, who hasn't already been told this, who doesn't know. It's never new information. It's not helpful. 

She did her job: ordered the necessary blood tests and told me how to fast and eat before each one. We'll discuss the results next week. 

I only wish every other doctor in my life had approached it that way.

If I had to offer any general advice, it would be the same for Taiwan as for the US: stop. Just stop. Leave people alone. You don't know their lives, you don't know their health, and the "I'm just concerned about your health" concern trolling is actively harmful -- but you knew that. Treat health issues as health issues in and of themselves, and don't tie moral rectitude or assumptions about health to weight. Every single thing you want to say, everyone already knows, and it does not help. Listen to Maintenance Phase and just...stop. 

How to get a booster shot in Taipei and across Taiwan (updated!)

If you get your booster at NTUH, this is the lovely building you get to see from the back as you exit

Update 1/7/2022: Boosters are now available for those who got their 2nd shot three months ago, down from five. Get your boosters!

Update #2: Here's where you can look for booster access anywhere in Taiwan (though the site seems somewhat overloaded at the moment)

Look, you guys. Omicron is coming. We're seeing small but concerning clusters: daily domestic cases are not zero, some of which are Omicron. And with Omicron, "not zero" should be enough to concern everyone.

You don't need me to tell you this. You also don't need me to point out the statistics: while 80% of people in Taiwan have received a first dose vaccine, we're not quite at 70% for 2nd dose. Although booster shots are available if you got your second dose five months ago, actual recipients are extremely low (about half a percent). Numbers of elderly getting 1st or 2nd doses does seem to have ticked up since the last time I checked, but I'm not loving all those numbers that are below the national average, among elderly residents.

Weekly breakdown of #COVIDVaccines doses administered in Taiwan. Something to be said about Taipei with the lowest rate for 1st doses among 12-17 year olds?

A small increase in 2nd doses for ppl 75+ overall. pic.twitter.com/8uxBb0h0v0

— cookiebandit (@cookiebandit) January 4, 2022

I'm not totally disheartened by these numbers, but I don't feel super confident either. Lower vaccination rates among the elderly is going to be a problem: even the CECC is saying so. To combat Omicron, more people need to get boosters, and they're not doing so. It's great that we've hit 80% for the first dose, but telling that this hasn't come with a corresponding relaxation of border controls. Remember when the government mulled relaxing border restrictions when full vaccination hit 60%? Well, it has. The border remains shut due to Omicron.

(Not that I'm screaming for relaxed border controls, I'm simply observing.) 

I could whine about this all day, but I hate feeling helpless, and whining does exactly that. 

When I learned one could get a booster after five (now three) months -- and then did the math and realized my five months had passed -- I had to turn to social media to figure out how to do so. I'm writing this now so that you don't have to ask around as I did.

Update: this CDC site will give you info for all of Taiwan, but it's somewhat slow at the moment. 

I used this site, sent by a friend -- it's a list of hospitals in Taipei offering booster shots. As I got my first two at National Taiwan University Hospital. You do have to choose a hospital, check "third dose" and see what appointments are available.

Now, the city government has a booking site, which you can access here. I haven't used it, but it appears you can check your status by entering your ID number. From there, I suppose it takes you where you need to go. 

Unfortunately, none of this is easy to do in English, but I checked and the automatic translations are, well, readable. I'm happy I don't need them, but you can figure out what you need with them.

If you were a self-payer like me, you're probably eligible for a booster now. If not, figure out when your three months are up now. If there are elderly people in your life who need help to get their dose, help them now. I've heard some are avoiding it because they're afraid their bodies can't "handle" the vaccine: let them know that in fact, older people seem to react less to the vaccine, but tend to have more complications from COVID. 

Then, go get your digital vaccine certificate, which can be done here. They seem to have worked out the formatting issues for foreigners.

I don't mean to sound alarmist but this is coming, and will probably hit Taiwan despite the country's overall stellar track record. Be ready for that, and get your booster if you can.

Taiwan’s COVID response: let’s stop assuming “imperfect” is the same as “terrible”

Just a warning: I wrote this after an extremely busy work week and after taking the anxiety meds that help me sleep. If that shows in the writing style or other weirdnesses, I’ll go back and improve on the post later.

“This is probably going to be my last year in Taiwan,” someone told me recently. This was partly for personal reasons, but partly because “I’m just not very happy with Taiwan’s COVID response.” Not enough vaccines, not rolling them out fast enough, the interminable quarantine — they simply weren’t impressed. 

“It’s really shocking how the government hasn’t made any effort to import more vaccines,” said another friend, though they admitted that view mostly came from their parents and the pan-blue news they watched. 

Still other friends are upset about the lack of information about what quarantine rules apply to foreigners — do we get subsidies? Do we qualify for the 7+7 program? Is it legal to charge foreign residents more than citizens for quarantine? There’s also a lack of consideration for foreign residents who want to reunite with family members, and extremely unclear guidelines regarding how to sign up for first or second shots.

I don’t agree with the negativity of most of these takes, but they’ve come from people I respect. They pushed me to think about the ways we all decide what evidence we choose to consider when forming an opinion, especially if you’re looking to justify what you’ve already decided you want to believe. Nobody is safe from confirmation bias.

My own perspective: Taiwan’s COVID response remains fantastic, and the evidence for this is simple. It’s one of the only COVID-free countries in the world. As far as I know, the only one with a comparable population and density. Despite considerable odds — Beijing’s attempts to block vaccines from reaching Taiwan, exclusion from the WHO and proximity and connectedness with China — Taiwan has crushed each COVID surge. What other country went from an extensive outbreak to zero COVID in 7 months, without (in my view) unduly impinging on guaranteed rights and freedoms. The vaccine rollout indeed began slowly, but it’s scaled up impressively since. I meet very few Taiwanese anti-vaxxers or anti-maskers: the vast majority of those jackasses seem to be foreign residents -- with some exceptions, of course.

(If you are one of those, I want nothing to do with you. I am not interested in your “opinion.”)

I empathize with the frustration, however. I support keeping the mandatory quarantine as long as experts deem it necessary, but the fact is, it’s made it impossible for us to visit family. At the same time, I’ve watched those family members travel while I am effectively stuck in Taiwan. I don’t miss leisure travel as much as I thought I would, but I do miss my family. I accepted that I’d miss Christmas 2020 and two weddings — the last family wedding before these two was my own 11 years ago, so they mattered to me — but I never imagined I’d have to give up Christmas 2021, too. 

Of any country to get stuck in, however, I am indeed grateful that it is Taiwan, with its zero domestic cases.

I watch friends and family in the US getting boosters, while my friends in Taiwan are still getting their second shots. I wonder how long it will be before I can get an mRNA booster, especially as both of my doses are AZ. I’m grateful that I was able to get the vaccine at all, but that booster? It’ll probably be awhile. Until then, international travel is indeed a bit more dangerous for me.

Even dismissing the exaggerations and truth-twisting of Taiwanese TV news (especially pan-blue news), it’s easy to see COVID-era Taiwan two ways: 

The half-empty glass: the delay in ordering vaccines caused the delays in receiving them. The quarantine is keeping Taiwan closed off while the rest of the world opens. The vaccines many of us were able to get aren’t the best, and aren’t necessarily going to make it easier to travel in the future. Guidelines have been vague and unclear, and foreign residents have been ignored entirely, treated as though we don’t exist. The government grew complacent in learning about the latest treatments and approaches because the country was COVID-free for so long, which led to higher mortality when an outbreak did occur. A surprising number of pilots (though still a tiny minority) didn’t follow the quarantine rules tailor-made for them. Businesses, especially those which typically served tourists, have closed. Taiwan is being left behind, and it’s starting to show.

The half-full glass: dude. We’re living in a COVID-free country. How many people can say that? How can you say a response that resulted in zero COVID isn’t working or isn’t impressive? This is despite having to fight just to be recognized on the international stage. Nobody has turned the wisdom of masking or vaccinating into a major political battle, even when they criticize the government. Taiwanese are masking and vaccinating and that’s more than you can say for a lot of belligerent ultracrepidarians in the US.

Perhaps the government could have jumped on orders faster, but the fact is that Beijing’s attempted (and somewhat successful) sabotage was real, and is not Taiwan’s fault. There have been outbreaks, and we’ve crushed them. There has been confusion and poor communication, and certainly missteps as well. What country can’t say that though? What government has handled the pandemic perfectly? What government has handled it better than Taiwan’s? The only real contender is New Zealand, and I’m not even sure that case is strong. We’ve all made sacrifices, and compared to what people in other countries have lived through, they’re mostly bearable (my heart goes out to anyone still waiting to bring a spouse to Taiwan with no timeline as to when it might be possible. That’s cruel.) 

My family in the US spent upwards of a year mostly locked indoors, away from others. I’m (de facto) being asked to wait about a year longer than I’d like to make that long-desired trip to see my family.

At the end of the day, however, we are living in a COVID-free country. What more do you really need in your glass?

To come to that more positive outlook, I pushed myself to think through the glass-half-empty view of Taiwan’s COVID response. Indeed, I found a lot to criticize: their views didn’t entirely lack logic or a point. Every day I don’t book a plane ticket to the US, that becomes clear. Every day I wonder when I’ll be able to get better protection than AZ for the Delta variant, I get it. 

The lesson: every country has made mistakes. Some more than others — the US’s strategy seemed to be ¯\_(ツ)_/¯, followed by a pretty decent effort, followed by a bunch of bellicose Dr. YouTube graduates who act like they’ve swallowed not-smart drugs ruining everything. No mistake Taiwan has made was worse than that of any other government, let alone so much worse that they deserve to be singled out for a poor response.

I’ve noticed a tendency of some — especially foreigners in Taiwan who’ve had a rough day — to assume every good strategy is simply obvious and doesn’t merit any praise for the Taiwanese COVID response, but every bad strategy is an indictment of the country.

That is, if it’s not absolutely perfect, they say it’s terrible. And they call it terrible with a level of dismissiveness and frankly condescension that they would most likely not aim at any other countries. COVID cases are surging in Europe, but do you see them going after that? No — Taiwan is a disaster to them because a few mistakes were made, but Europe? “Oh that’s worrisome”. That’s it. Oh, in Rotterdam they’re rioting against masks — that’s fine. But a pilot didn’t follow the rules in Taiwan? The problem must be the rules, not the individual pilot!

This leads to polarized viewpoints where Taiwan’s excellent-but-imperfect response is viewed as either unassailably amazing, or unforgivably terrible. 

The “unassailably amazing” people are in fact willing to be assailed, if you offer good evidence. 

The “anything less than a perfect response is a disaster!” people— a standard they would be unlikely to apply to any other country — are harder to reach. It’s hard to change someone’s mind if they want to dwell in negativity.

Fortunately, the middle ground is not devoid of people. There are also reasonable voices who posit that a generally excellent response was marred by a few missteps, but that the bad odds Taiwan has faced thanks to China merit quite a bit of grace towards Taiwan. Some of those missteps, however, do need to be addressed. 

This would best describe my viewpoint. But I had to come to it from an excessively positive one, genuinely consider the negative takes and incorporate what made sense while sloughing off everything that didn’t make sense when compared against the bigger picture (that is, the response of the rest of the world). 

If I can beg everyone reading this to one thing, it’s this: reconsider. Go through your baseline opinion on Taiwan’s COVID response and examine each of your assumptions, beliefs and areas of especially strong pride, anger or defensiveness. By all means, ignore the anti-science junk which is truly not worth your time.

Then, check them against your previous opinion. If this process causes your bright & sunny views to moderate a bit, then that’s a new level of nuance. It doesn’t mean your overall perspective is not a positive one.

If it causes you to question your previous negativity, great. 

If not, that’s your right, but we’re not going to agree. 

Perhaps consider that process for any opinion. Are you dumping on Taiwan because it doesn’t meet impossible standards of perfection that you wouldn’t apply to your home country? Stop, maybe. 

Are you looking at Taiwan through rose-colored glasses that you haven’t tried to remove? Your issue is the less severe one, but there might still be something to be learned here. 

Who should Taiwan open for?

For not quite two years now, Taiwan's borders have been closed to most people. In on-and-off policies, students, resident visa holders, foreign blue-collar labor, businesspeople and others have been permitted to enter...or not. Tourists have been firmly shut out. As the rest of the world (wisely or not) begins to re-open and "live with COVID", there's been debate about whether Taiwan should do the same. 

Some of this discussion has been quite reasonable: allowing students, family members of citizens and residents and people who have accepted jobs are all logical policies to support. Other points have been, shall we say, less trenchant -- for example, the push to let tourists back in. 

So, let me change the tone here and just lay it out. Yes, we should let family members -- especially spouses and children -- of both citizens and residents into Taiwan. Most spouses of citizens can now do so, but family members of non-citizen residents remain barred from entry. This is wrong. Quarantine and contact tracing have been fairly successful -- I see no reason not to let students and people with jobs waiting for them in as well. A special category of visa you can petition for if your situation gives you personal reasons to go to Taiwan can also be made available: for, example, unmarried partners, siblings and other family members.

Tourists, however? No. 

There was a recent article in The Guardian about this, but I don't want to focus on it. The discussion has been going on longer than that, and the attitude is widespread enough to merit a general response rather than a targeted breakdown. 

International tourism is a little over 4% of the economy. That's not nothing. I'm not saying the hotels, restaurants and tour businesses affected aren't important. But let's be honest -- it's a thin slice of what makes Taiwan hum. Even if Taiwan were more of a tourist-dependent place like, say, Bali, I'm not sure I'd be in favor of opening up. At such a small slice of what makes Taiwan go, however? Absolutely not.

Am I personally in favor of giving up a zero-COVID life and risking an outbreak in Taiwan so we can get that 4% or so humming again? No. Why should I? Why should anyone?

I'm sorry, hotels in Kenting, but I'm not  willing to give up the more or less normal life we can now have in Taiwan so that you can get more customers. I am certainly not willing to risk my health for it! I don't think many people are, nor should they be. Your business is simply not as important to me as normalcy in daily life in Taiwan and a near-zero chance of catching COVID -- for everyone who lives here. When vaccination rates rise that can change, but we're not there yet.

Perhaps think of strategies to entice domestic customers to take all that annual leave they're not spending on international travel to stay at your hotels during the week. 

Besides, re-opening for tourism would mean doing away with the quarantine. I suppose borders could be opened but the quarantine kept in place, which would certainly deter tourists but be tolerable to those with reasons to make the trip. However, we're still at the point where it's better to actively discourage non-essential travel, and framing it that way does the opposite. Perhaps in a few months, especially if quarantine capacity could be increased, that would be a conversation worth having. But by the time that happens, we'll also have higher vaccination rates anyway.

Honestly, I'm sick of the quarantine regulations too. We all are. I would very much like to go back to the US to see my family, some of whom I have not seen in person since 2018. My grandmother is 95 years old and I worry every day that things won't get better in time for me to see her again. It's just a sad financial fact that quarantine hotel rooms for my husband and I are simply not financially feasible after a genuinely rough summer. 

But the fact is that the quarantine has helped catch imported cases, and we still need it until vaccination rates are higher. Mandatory 2-week quarantines and international tourism are simply not compatible.

Besides, opening up for tourism would guarantee an outbreak -- for this reason, the entire premise of the argument is flawed. An outbreak wouldn't exactly cause tourists to pour in, would it? It would not only depress the exact sort of inbound travel that opening up would aim to bring in, it would depress domestic tourism too. We know this because that's exactly what happened during the May outbreak. I was in Tainan recently and the B&B owner admitted that from May until the "soft lockdown" ended, allowing indoor venues to re-open, they didn't have a single guest. Now, they have some -- we weren't the only people staying there. A fresh outbreak would mean none.

What's more, the risk such a move would bring would devastate a far greater chunk of the economy than the sliver fueled by international tourism. Business that rely on local custom -- restaurants, shops, cafes, smaller hotels catering mostly to local crowds, even cram schools as much as I dislike them -- all took a hit from the May outbreak. Many closed: the hotel I liked in Taichung which seemed to mostly attract young Taiwanese weekenders on mid-range budgets, the Konica shop I'd use to print out photos for relatives, more than one cafe I liked as well as several restaurants, gone. My own income was briefly torpedoed, as was my husband's, though fortunately at different points.

They didn't close, and we didn't have to dip into savings, because there weren't international tourists. That all happened because the domestic economy was affected. Risk that again for that tiny 4%, which probably wouldn't even reach 4%? No thanks.

I don't think the CECC is being particularly wishy-washy about this, either. It's true that they haven't set clear milestones for re-opening or changing quarantine rules. It's true that they won't state clearly what vaccination percentage will be considered "sufficient". But that makes sense to me: this is literally an evolving disaster, and it's evolving because people are not smart. They hear ignorant takes about vaccines and hesitate to protect themselves and others. They make obviously logically flawed arguments about "re-opening", which brings further outbreaks.

Oh yes, and they complain that "we can't find mayonnaise" -- or something -- when supply chains are disrupted around the world and there is indeed mayonnaise to be had. I have some in my fridge. It's available. I'm certainly not interested in risking my health and life because some guy whined to The Guardian that there isn't enough mayo. Come on.

The virus mutates, it becomes more infections, and all the milestones have to change. 

I don't call an evolving response to an evolving problem wishy-washiness or lack of clarity. I call that being flexible, which is exactly the right way to be. There is some strain, but the whole world is strained. By comparison, Taiwan is not a festering hellhole due to bad policies (though there have been some, I admit). It's stayed pretty good, due to (mostly) good policies.

So yes, by all means let's push the government to consider allowing home quarantine for the vaccinated at some point in the almost-predictable future. Let's push to allow people who should have the right to be here -- family, workers, students -- to be allowed in. Certainly, let's look at further relief as necessary for the worst-affected sectors. If you're able, take some time off during the week and go use those quiet tourist facilities while they're not crowded. Give the hoteliers and tour operators a bit of domestic custom. I'm looking at some trips I can take myself, now that life in Taiwan is closer to normal again.

But no, it is not time to re-open for international tourists. It's just not. 

Bad Facts on the Radio

I don't take much pleasure in completely tearing apart an episode of ICRT's Taiwan This Week, which I listen to most of the time (it depends on the guests). I was tipped off, however, that this week's episode turned into a vector for disinformation -- much of which I've already dealt with -- and felt like I had to give it a listen and say something.

Friends, it is dire. (This may not appear correctly with people on phones, you might also be able to get to Taiwan This Week by scrolling here or through your podcast app. The episode in question is Golf But No Swimming).

Bad enough that I'm surprised Gavin didn't intervene to correct some of those points.

I'm a little angry. Just so you know.

Let's deal with all of the bad takes and straight up misinformation as they come along.

"A mishmash or mismatch of science -- packed MRTs but you can't go to the beach"

Frankly, it's true that it probably is safer to go to the beach than be on a crowded MRT, but no, this is not bad science. You can't wear a mask the entire time you are at the beach (try going into the water with one -- weird, huh?) and the Delta variant is so highly contagious that this is a problem. Ralph is also correct when he responds by pointing out that beaches aren't highly regulated: you can't really stop all people from disobeying the rules at all beaches. 

The MRT, however, is an essential service. People still need it, so it makes sense that that would remain open, but beaches would be closed.

If matching up the science matters (and yes, it does), restaurants and cinemas are more dangerous than beaches as they're indoors, and one should still avoid them. However, relaxing the restrictions on restaurants as long as they follow certain protocols can help avoid a catastrophic series of restaurant closures and economic turmoil. That's not true for the beaches.

In other words, it's not a "mishmash", it's a series of decisions based on what is essential to either people's lives or the economy. In that light, you may not agree with every choice the government makes. I certainly don't, I say open up the outdoors where masks are possible (yes to hiking trails, tracks etc., probably no to beaches and playgrounds -- city parks are already mostly open, just not sheltered seating areas within them), but not cinemas or restaurants. Do allow outdoor dining. However, the government's choices have some kind of logic behind them. It's reasonable to disagree, but it is not random or inexplicable.


"They're saying China interfered but they're offering no proof of that. We know the real story here, and what will get us to that 60% level is the government's hope hope that the locally vaccines will be approved for use very quickly, and that's why they were slow in purchasing. They didn't want to get stuck spending a lot of money on foreign manufactured vaccines which are a lot more money than the locally-made product, so they didn't move quickly to buy, and other countries did sign contracts and were able to buy vaccines. We all know that's what happened."

Did TVBS hire an English-speaking talking head? Because this is what it sounds like.

First, the Taiwanese government was not slow to purchase vaccines -- the only data anyone's been able to show on this is when the contracts were signed, not when negotiations for those contracts began. And it seems to me from the timing of those contracts that the Taiwanese government started to attempt to buy foreign vaccines as soon as it was able. What's more, they bought millions of doses. So what are you even talking about?

They don't need to prove that China interfered, because China itself is providing plenty of proof. Every few days or weeks, depending on the news cycle, some CCP-approved drivel comes out about how Taiwan must buy BNT from a Shanghai Fosun, and that's why they can't buy from BNT directly. China openly says so! What more proof do you need that China is interfering in the purchase of that particular vaccine?

In fact, it's easy to prove this, as Fosun refuses to apply to the Taiwan FDA to distribute German-made vaccines, and yet keeps squealing about how it has the rights to the Taiwan market. They keep saying they want to sell to Taiwan, but won't take the government-mandated steps to actually apply to do so. And yet, they are willing to negotiate with pro-China Terry Gou.

What more proof do you need? Taiwan doesn't need to give it to you, because China already has.

By the way, from my knowledge of how these sorts of negotiations work -- which is more than you'd expect as I've worked with people at relevant pharmaceutical companies -- knowing that your negotiations had been interfered with and having hard evidence of that are two different things. It's not like the Taiwanese government would have access to a phone call between a Chinese state actor and a BNT executive aggressively incentivizing BNT not to sell to Taiwan. But, they'd know through various contacts and channels that that is, in fact, what took place. 

What on earth makes anyone think China wouldn't do that? Of course they would! They pull this crap on Taiwan all the time. So it's a bit disingenuous to just not believe the government when they say they had thought they'd reached an agreement with BNT, only to have it fall apart on BNT's side at the last minute, and it's fairly clear why that would happen.

To that end, there's also no proof that Taiwan pulled out of the negotiations because the doses were "too expensive" (it's possible the earlier negotiations via third party companies did, but it's unlikely a direct government-to-manufacturer negotiation would). There is plenty of circumstantial evidence that BNT was the one who scuppered the deal. 

And why would they do that? Why would you blame Taiwan for it?

For the other vaccines, Taiwan actually did order a huge amount, so it's clearly not about money. However, they seem to be receiving them slowly due to the global shortage. That's not Taiwan's fault.

This is true for every country except the US, which has enough to go around. It's just plain fake news to make it sound like the rest of the world is getting vaccinated while Taiwan is not. Most countries one might reasonably compare to Taiwan do indeed have higher vaccination rates, but those countries didn't have to deal with China blocking their access to vaccines. Even those countries, however, are struggling to get to even 50% of the population with at least one dose:

Friends of mine from Europe to Canada to Australia are talking about how they're still waiting their turn, or have only gotten one dose -- it's not that different from Taiwan.

Here is what we should all know: Taiwan did its best to purchase foreign vaccines, but the government made two accurate predictions: first, that there would be a global shortage. This is true. Second, that due to such a shortage and Chinese pressure, they would also need to develop a local vaccine to meet its goals. This is also true.

It's also not fair to make it sound like Taiwan needed those donations for financial reasons. They needed them because the foreign vaccines they did purchase -- millions of doses! -- were slow to be delivered, and an outbreak was making that situation critical. In the meantime, China and the KMT were using that gap between outbreak and vaccine delivery to pump as much fake news into Taiwan civic discourse as they could. It had nothing to do with money, so please don't imply that was the case. 

If anything, it was also a series of political moves aimed at showing China that the US and Japan do in fact take Taiwan seriously and will step in to assist this country.

There's nothing nefarious about it, unless you get your hot takes from pan-blue political talk shows.

"There's a public perception that [the Chinese vaccine] an inferior product...on the off-chance that it were to be approved because it's been proven safe and effective in other countries so there's a lack of a medical or scientific justification to prohibit it, by the time that happens it's sufficiently far enough into the future that other vaccines will be available to Taiwan."

This is actually fairly true: Taiwanese don't want the Chinese vaccine. But the fact is that even if it were proven "safe and effective", it doesn't matter as drugs made in China are banned in Taiwan. So that would require an entire law change. 

However, it's highly inconclusive that it is indeed safe and effective (to be fair, Ralph does not say it is proven). As I've written before, data on the Chinese vaccines are highly inconclusive.

 

"When you go back, you have to do a wicked quarantine. My understanding is it's every person per room. Even children in their young teens need to sit in their own room, I don't know how they're going to do that, without any human contact except someone in a face shield who delivers meals."

The fact that the quarantine is strictly enforced now is true, but the rest is false.

There was a big swirl of fake news about this in certain circles where people were screeching about how their children would be "taken from them" and forced to quarantine separately. It sure caused many clutchings of pearls. Brand-name pearls, too! 

From my post on the issue:

[The article and press release imply] that parents may have to pay for the quarantine of children over age 12, but it says nothing about them being quarantined separately. 

This is preposterous on its face. Think about it: do you honestly believe the Taiwanese government would require that 13-year-olds quarantine separately from their parents? Is there any evidence beyond one poorly-worded article that there were ever official rules stating this?

Because this is still getting traction, however, someone called 1922 and their answer was a very clear "obviously not". Children 18 and under can quarantine with parents (I don't know if they are required to, or if you'd be allowed to arrange a separate room for your 16-year-old who will probably be just fine without you. I don't think it matters.) 

 

Please stop spreading this. It is fake and, well, surprising that people still believe it.

"I think the government wants to avoid or limit the amount of discussion about why aren't there more vaccines available in Taiwan so they're imposing the quarantine requirement on people who are returning who are vaccinated. You can debate whether the science justifies or necessitates that, but it certainly will put a downward pressure on the take-up rate to do this...it's going to be one more factor people are going to consider and...will decide it's not worth the hassle. So you have fewer people walking around Taiwan talking about 'I went to Guam and you didn't, I got vaccinated and you didn't, so by imposing these restrictions, even if they might not be necessary, you reduce the number of people who are going to do it, and you maintain some fairness in Taiwan society....as ridiculous as all of this might sound."

This is only half-true. The government is not doing this to "limit discussion of why there aren't more vaccines in Taiwan", because literally everybody is talking about that. They couldn't limit it if they tried. 

Yes, the science does back it up: vaccinated people can still be carriers and we still don't know how well each vaccine works against the Delta variant. Families can infect each other at different times, especially if one is an asymptomatic carrier. 

But that the government wants to deter travel is true. Just not for the reasons Ralph is suggesting. Rather, travel is a huge vector for infection spread, so the government doesn't want you to do it. Frankly, it's good that it's working. It makes sense to deter people from traveling. That didn't stop the pearl-clutchers from crying about these unexpected return quarantine expenses because they chose to gamble on non-essential summer trips, however. 

Additionally, to travel one needs a PCR test, and most hospitals won't or can't turn away self-paid PCR requests. That means lines are long, as are wait times, and medical professionals are tired and overworked. A doctor friend of mine said just the other day that the staff at her hospital is sick and tired of privileged ABCs coming in demanding tests for non-essential travel, when people with more immediate needs require those tests as well. (If it makes you feel better, the hospital staff absolutely do ensure those with a true need get both the test and result quickly, and the Taiwanese with US passports hoping to fly out at their leisure are indeed expected to wait.) It's a strain on the system, and smart to deter this for public health reasons, not to quash discussion. 

Seriously, do you guys honestly think the Tsai administration is composed of monsters out for their own self-interest, ready to let Taiwan burn as long as they get their way? If so, I am sure you could both get spots on 中天's Youtube channel as talking heads. Right now you sound like you're perfect for the job.


"It's mind-boggling that Taiwan is scrambling to get this [vaccination effort] together."

I'm sorry, but I don't find it to be nearly as incompetent as Ross is making it sound. It's true that some older people are struggling with the technology, but ultimately, anecdotally, people I know are ensuring their parents get registered and vaccinated or are signing up themselves if they're in a priority group without nearly the same amount of confusion as in the early days of the US program. 

I remember my brother-in-law in the US pointing out that for his parents (my in-laws), it was a fairly straightforward process to sign up and go get vaccinated. He, however, had to wait months just to hear about whether he would be able to sign up, with absolutely no notification or clarification from the government. Now, of course, anyone can because the US is flush with vaccines, but that was what it was like in the early months. It's like people have selective amnesia about this. 

For me, I was one of the lucky self-payers, and got my first dose before the program was shut down. (That program, by the way, was a very smart way to ensure those vaccines got used back when people thought there was no rush and didn't want AZ). I was given an appointment for my 2nd dose. That was cancelled due to changing recommendations on when to get the 2nd dose, and a new appointment was texted to me soon after. I'll be going in on the 22nd, and NTUH arranged it all without a hitch. 

I'm sorry, but I just don't see the incompetence or the scramble. I wouldn't call the vaccine rollout perfect, but it's not the shambling mess they're making it out to be. 

"The Taiwan government perhaps rather passively and unknowingly, they just never figured this shit out. They just...quarantines and tracing and border controls were gonna solve this until the very end of COVID. They were always talking at a higher level: when this is over we're gonna open the borders, when this is over...they were always talking as if this was never gonna hit Taiwan. So they never prepared for it."

Oh, shut up man.

Most countries that did see a big outbreak would be thrilled if they'd been able to contain it the way Taiwan has. If they "never figured this shit out", then how did Taiwan crush the outbreak it did have faster and I would say more effectively than just about anywhere else (except, perhaps, New Zealand)?

Taiwan has also done a better job of contact tracing than the US, and Taiwan locks down when it has numbers that the US thinks are good enough to open back up with. If any given county had the number of daily cases Taiwan had at the peak of its outbreak, they'd celebrate and re-open everything -- in fact, many are doing just that.

And yet, people seem to think Taiwan's handling of the outbreak has been poor. It has not. It's unfortunate that it happened and no government is perfect, but we crushed it a lot faster than just about every other country.

I stole these graphs from a Facebook friend (you know who you are) who used the same Our World in Data site that I linked to above. As you can see, it's not even close. Yes, Taiwan had an outbreak. Yes, poor rule enforcement was part of it. The government made some mistakes. But, it's still not close. Does this look passive to you?

As my friend pointed out, the only hard choice is New Zealand. Would you want the lower overall case spike of New Zealand, or the months of security of zero cases in Taiwan? It's hard to say.

* * * 

I'm going to be honest, this is where I stopped listening, because there's only so many bad takes I can handle. I don't know if the rest of the program was filled with more bad analysis, and I don't care to know. 

All I can say is, do better next time. Some of the assertions in this episode are just a trashfire of stinky hot takes. Some are straight-up disinformation: literally fake news. That's not okay. 

And if you really dislike Taiwan so much that you want to make it look like it's a bumbling mess, governed by bellends, "passive" and "can't get its shit together", refusing to see the obvious fact of Chinese attacks on Taiwan over its outbreak and the vaccine issue, then maybe look at the data before you go on ICRT and bloviate like you run the KMT Twitter account or something.

The Taiwan CDC is not going to rip your children from you (obviously)

Because there are still people in the foreign community who believe information that is straight-up wrong regarding new CDC guidelines, I wanted to provide some clarity as a follow up to my last post.

Due to a poorly-worded Focus Taiwan article, a lot of people are asserting that the new quarantine restrictions will require children over age 12 to isolate separately. Some are wording this as "implementing the new rules on taking children from families" when entering the country. You know, to add the maximum amount of fearmongering to this particular bit of disinformation. 

The actual article says this: 

Arrivals from outside the seven high-risk countries will now be required to stay in a quarantine hotel or a government quarantine facility at their own expense for 14 days, and also get a PCR test, the CECC said in a press conference.

The PCR test for them will be free, but Health Minister Chen Shih-chung (陳時中) said the fee for a government quarantine center will be NT$2,000 (US$71.72) per night per person, though children aged 12 and under can stay either with their father or mother in a single room with no extra charge. 

This implies that parents may have to pay for the quarantine of children over age 12, but it says nothing about them being quarantined separately. 

It certainly doesn't imply that the heartless, child-hating CDC dramatically rips your children from your arms at the airport, whisking them to GOD KNOWS WHERE to be quarantined away from you for two entire weeks as you, the heartbroken parent, sob and rend your clothing helplessly as these agents of darkness violate your family. And, to pile offense upon offense, you will be required to pay for this, just as the families of executed political prisoners were charged for bullets in fascist regimes! 

This is preposterous on its face. Think about it: do you honestly believe the Taiwanese government would require that 13-year-olds quarantine separately from their parents? Is there any evidence beyond one poorly-worded article that there were ever official rules stating this?

(Yes, the article was based on a press release, but the press release doesn't say your children will be taken from you, either.)

Because this is still getting traction, however, someone called 1922 and their answer was a very clear "obviously not". Children 18 and under can quarantine with parents (I don't know if they are required to, or if you'd be allowed to arrange a separate room for your 16-year-old who will probably be just fine without you. I don't think it matters.) 

If you arrive from a "red list" country like the UK, you tell the appropriate CDC worker at the airport who is in your group and what they need -- so if your child has special needs, you will have the opportunity to point this out to the government as well -- and they will arrange the accommodation for you. If you arrive from any other country, you have to make the arrangements yourself. But again, nobody is going to tear your children from you. 

In fact, the rule that adults cannot quarantine together is not new either: they've been expected to isolate separately for months. And yet, people are still saying this rule is "new" and "unfair". It's neither.

In the past this separation could include a home quarantine (there were rules about what sort of housing arrangements were allowed). However, people skirted those rules, and in a few cases violations caused local COVID infections. That's why the only new rule is that all quarantines must be in hotels or government facilities, and arrivals from certain countries with a prevalence of the Delta variant must quarantine at government facilities. 

All anyone ever needed to do to confirm that these "family separation at the border" policies were complete and utter fake news was call 1922. They even speak English. 

So please, if you are still hearing accusations like this, shut it down. If you believe it, stop. If someone insists this is an "official" rule or regulation, inform them that they are not correct. If you are an admin in a social media group where accusations like this are proliferating, end it by warning people about disinformation. 

I am going to give the people spreading this information the benefit of the doubt that they are not intentionally trying to stir up trouble. They read an article that wasn't perfectly clear, made some very wrong conclusions and discussed their worries with others. That amplified their fears and echoed their wrong conclusions back at them, until "children under 12 can stay...at no extra charge" became "they are going to take our children from us at the airport!" 

It is possible to unintentionally spread fake news, or say things in the most incendiary way -- OUR CHILDREN! TORN FROM US! -- without realizing what one is doing. But now that you know, please stop. It amplifies the incorrect information and results in real actions which look bad for the foreign community, such as endlessly contacting the CDC to demand that they accommodate your return the way you would prefer. 

Yes, it is true that if you don't arrive from a "red list" country that you will have to pay for your own quarantine as home quarantine is no longer allowed. That makes sense given the rise of the Delta variant and the impossibility of perfect enforcement. Yes, this does mean that if you chose to travel, you're now likely on the hook if you want to return. However, I urge everyone to consider that in New Zealand, you don't get to choose your quarantine facility, but chances are you have to pay for it regardless. You also have to apply for a place: there's a reason why they have special categories for urgent or time-sensitive requests: not everyone gets a spot quickly. 

And not every country would allow you to return -- or allow you to leave: 

Australia maintains a near universal travel ban on all non-citizens coming to the country. And even Australian citizens living abroad don't have an easy time entering. They need to fight for a limited number of plane seats per week to get into the country and must serve a mandatory 14-day hotel quarantine upon arrival. Australians in countries deemed at high-risk for COVID-19 like India, are completely banned from returning home, and face potential prison time if they attempt to circumvent the ban. (In May, Australia launched some repatriation flights to bring select citizens home from India, such as those with medical conditions.)

Australia has also imposed an exit ban that bars most of its citizens from leaving the country. A rightwing think tank called Libertyworks challenged Australia's outbound ban in court, but a federal judge dismissed the case earlier this month.

Compared to that, can you honestly say that Taiwan doesn't sound eminently reasonable, allowing citizens and legal residents to travel and return? Although I would support fee waivers for people undertaking emergency travel, does the overarching policy for Taiwan truly sound unfair in comparison? 

From Focus Taiwan:

Each room will be equipped with internet accessibility, television and other amenities, including three meals per day per person, the CECC said.... 

When questioned why passengers from high-risk countries can enjoy free accommodation, but those from lower-risk countries have to pay for their accommodation, Chen said only that it was compulsory for people arriving from high-risk countries to stay in a government facility, and therefore they should not have to pay, while arrivals from other areas had the option to stay at quarantine hotels, which offer a lot of choice.

 

I completely understand the frustration or worry over facing a bill you weren't expecting upon return to Taiwan. Obviously some would be concerned about the logistics of such a stay. Of course, it will be difficult, and not everyone has the money. However, it's the right call for the good of the country even if it inconveniences you personally. 

For those who chose non-emergency travel during a pandemic, you took a gamble. You rolled the dice. That was your choice. You lost that bet. I understand it's annoying, but it was your bet to take. Please don't pretend that you have the right to take any gamble you want, without any of the risks. The CDC was never your insurance company against making a bad bet on the travel game right now. 

I have no problem with people venting their frustrations online. Affording the bill, managing children in a single room for two weeks, arranging pet care for the extra time away: these are all legitimate annoyances. 

However, that's not the same as spreading fake news. "They're going to take our children!" crosses a big fat red line.

Allow me to be harsh: a lot of people got used to Taiwan getting an A in pandemic prevention, and are now angry that it's getting perhaps a B, when the rest of the world got a D or F. Now, they think the Taiwanese government is somehow responsible for accommodating their personal travel choices. Some are spreading fear and straight-up fake news, because "I don't want to pay for quarantine thanks to travel I chose to take during a pandemic" is less captivating than "they're going to take our children!" 

Of course, given the way fake news spreads,  the "they're going to take our children!" angle had legs even after "we shouldn't have to pay for quarantine" and "they should let us quarantine at home" died out. It was more important to be outraged than to just call 1922 and ask.

It needs to stop. Now. It makes the foreign community look bad. It unfairly compares an annoying but eminently reasonable policy with the very real human rights violations that occur in other countries. This is not family separation at the US-Mexico border or asylum seekers to Australia being sent to Nauru or Christmas Island.

Frankly, it's embarrassing. Stop. 

An Open Thank You Letter to the Taiwan CDC

Something about this scene just makes me think of "home in Taiwan" even though my place looks nothing like this.

There have been a lot of complaints about the new quarantine regulations announced for returnees to Taiwan. Essentially, families cannot quarantine together -- one child per parent -- and home quarantine is no longer allowed. Government facilities are available for NT$2000/night (the hotel options are nicer, but more expensive). There have been reports of hotels quoting inflated rates, but that's an issue for law enforcement -- it's a scam, not government policy. The government facilities are plain, but livable. 

A lot of people are unhappy about this, especially those with children who were planning to travel this summer. 

The thing is, family quarantine hasn't been much of an option for awhile -- "one person per residence" has been the rule for months, although there were exceptions if you had your own rooms with bathrooms (how many families have one bathroom for every member?) and minors. 

I understand the frustration: I haven't seen my 95-year-old Grandma since 2018. I was always aiming for the holidays, but any chance of an earlier visit is now shattered. Not all travel is a choice: emergencies happen. And, of course, some people had already left to travel thinking that they could quarantine at home upon their return. This does make their lives more difficult, and I sympathize. It's tough, and we're all stressed. 

That said, most travel is a choice. I miss the country of my birth too -- well, some of the food and people in it anyway. But ultimately most travel plans are optional, and can be canceled. The convenience of people who chose to travel does not trump the good of the country.

The people who created these new rules are medical specialists with more expertise in how to contain something as scarily transmissible as the Delta variant. It's an inconvenience and a cost burden to quarantine away from home, but do people really believe they are better qualified to decide if home quarantine is safe in light of the Delta variant's spread than actual epidemiologists? 

I'm also a bit distraught that people are buying into the idea that Taiwan was late to acquire vaccines. As far as I'm aware, negotiations started as early as possible: the "lateness" was more due to what companies like Moderna and AZ could provide and when, which was influenced by a global vaccine shortage. And, of course, we all know how China created the BioNTech drama.

They -- mostly foreign residents, from my observation -- are  upset that life in Taiwan is not as normal as it has been for the past 16 months, and are turning on the government that gave them those months of normalcy because things have changed.

I do not care for this: when I feel the Taiwanese government is being unfair to foreign residents -- be they blue-collar workers or well-off expatriates -- I'll speak up. But I just don't think that's true here: the good of the country takes precedence over our own convenience.  The government is not perfect, but they are not being unfair.

Perhaps the government facilities should be free for all, but then again, why should they be? Most travel is a choice. 

A reimbursement program for true emergencies would be a kindness, but there is no reason why the government should pay for quarantine after travel one chose to do. Offering rooms with facilities for very young children would be smart; some kids need cribs, and not all families can afford the pricier hotel options. However, it would be reasonable to suggest this without writing entire "complaint" letters. 

In other words, the Delta variant does not care if you would prefer to quarantine together, or at home.

Although I am still distraught that the central government did not do enough to stop the racist treatment of foreign blue-collar workers, I think overall they've been working diligently since the beginning of 2020 to keep Taiwan as safe as possible.

As a result, I feel safer here than I would in the US (yes, still), and I notice that Taiwan is still continuing strict measures despite having fewer per capita cases than countries which are opening up (and probably shouldn't be). Yes, there was an outbreak because some people didn't follow the rules, but Taiwan contained it faster than just about any other country could. 

So rather than complain to the CDC, I wanted to thank them, while reminding them that blue-collar foreign workers still need to have their human rights protected more decisively. 

Of course everyone is free to voice their own opinion, and if you're one of the unhappy people, my "thank you" letter doesn't take away from your ability to write a complaint. I don't agree -- in fact I think it has the potential to cast the foreign community in a bad light as most of us are comparatively well-off, or at least have the resources to consider traveling at all. But it's still everyone's right to write whatever they want. I, personally, chose a "thanks". I can only hope others will do so, as well. 

Or, if you do have a suggestion, to write them a thank you for all those months of keeping you safe, and then add it in: better children's facilities. Emergency travel payment exemptions. Whatever you want. But complaining? I do not encourage that.

This is the letter I wrote. You can write your own here.

Hi,

First, I just wanted to thank the CDC for working hard to keep Taiwan safe. I know you are getting a lot of complaints right now, but I understand what you're doing and why it's necessary and I am grateful that the outbreak is being contained in Taiwan due to your hard work. I feel safer in Taiwan than I would in the country of my birth thanks to Taiwan's excellent response, even though times are hard now.

However, I do want to suggest that the central government should do more to stop the racism against Southeast Asian blue-collar workers. I've heard that Miaoli County hasn't actually stopped the restrictions, just relaxed them to let workers out for 45 minutes a day, and some companies are still locking them up like slaves or animals. It's not right. Since the CDC was able to revoke other local orders when they didn't comply with CDC regulations, I think you could do more to stop this. It is wrong and blatantly racist, and it really looks bad for Taiwan's human rights record. Clearly, you have the ability to stop it, so you should.

In fact, foreign blue-collar workers should be prioritized for vaccines, as their living and working conditions create danger of an outbreak, and they do mix with Taiwanese as well. I know this is politically difficult to do (probably a lot of Taiwanese would complain about them getting priority), but it's the right thing to do. At the very least, the blatant racism has got to be stopped. If local governments won't do it, the central government should take a stronger stand.

Thanks again for your hard work and for managing the pandemic well for over a year. Taiwan did a lot better than most other countries due to your efforts and they have not gone unnoticed.

I hope others will follow my lead and put the good of the country first. If this is our home -- not a playground where we get all our desires met -- we should act like it. 

Introducing Terry Gou, China's vaccine gamepiece

Are those claws real? Does it matter, if the purpose is the show?

I really didn't want to write about vaccines even one more time, but it feels somehow necessary. Sigh.

You've probably heard the news that Terry Gou -- Foxconn billionaire and guy who called Taiwan independence supporters "garbage" -- has applied to the Taiwan FDA to import 5 million doses of BNT. More accurately, a New Taipei-based biomedical firm is the official applicant, Gou's role is basically to write the check and talk to the press. Notably, Shanghai Fosun is not a part of this deal (perhaps there are some fees paid to waive distribution rights). 

Health Minister Chen Shih-chung has confirmed that the application is under review, but apparently the original authorization letter from BioNTech (BNT) does not seem to be included. From my understanding, that letter is essentially the proof that BNT is going to deliver what it says it will -- BNT doses imported straight from Germany.

I'll be quite interested to see how that story develops in the coming days. As it stands now, it seems clear that without that document, the planned purchase and distribution cannot go through. (If it doesn't, however, prepare to hear Gou scream about it and blame "the DPP" for the paper he doesn't have). 

One could say that Terry Gou might have been able to get around Shanghai Fosun by paying them off, and perhaps this is true. However, the government refusing to pay those fees was not the reason given for BNT's contract with the Taiwanese government falling through. Unless the Tsai government and Ministry of Health and Welfare (MOHW) are both telling some massive lies to the public, the reason was related to the use of the word "country" (and then "Taiwan") in the contract.

So, Shanghai Fosun -- whose owners certainly have close ties to the CCP -- is willing to step aside for Terry Gou, but not the Taiwanese government? Why?

Here's the best explanation I can provide: essentially, it's all politics on China's part, where they've set up a game that it will be very hard for Taiwan to win.

How does the game work?

First, China blocks the Taiwan government’s negotiations with BNT. Then China claims ”only” Shanghai Fosun has the right to sell BNT to Taiwan. Taiwan rejects this “offer” as Shanghai Fosun never applied for distribution approval in Taiwan. 

Then Terry Gou submits the application that Fosun couldn't be bothered to attempt. Terry says the vaccines will come straight from Germany — not through Shanghai Fosun.

Suddenly Shanghai Fosun’s inalienable “rights” to the Taiwan market no longer seem to matter. Which means they were never the reason why Taiwan's own negotiations were abruptly cut off even after a contract had been agreed upon.

This time, nobody in China, the media or the pan-blue camp claim Gou is “circumventing” Fosun or “trying to obtain independence through vaccines”, even though he is doing exactly what the Taiwanese government tried to do earlier (which, again, was completely acceptable).

China wants the DPP to look bad, so they won’t stand in the way of pro-China Terry Gou (remember just whom he called "garbage"!) obtaining these doses.

As there are some questions about this authorization letter, it is unclear to me if BNT has actually agreed to sell him the vaccines or not. There are also a few other lingering questions. If China is refusing to let Taiwan access vaccines because Taiwan insists on doing so without abrogating its sovereignty, how will China react if these BNT doses are approved in Taiwan without the Chinese government's involvement? (Remember, BNT is still not approved in China proper, only Hong Kong and Macau).

The MOHW will still have to go through quite a bit of documentation to obtain these 'donated' vaccines -- what name will they use for Taiwan? If their use of "Taiwan", "Republic of China" or "country" stops the deal dead, will China, the KMT and Gou scream "politics!" at the DPP? (Yes.) 

If the original authorization letter is required before this can go through, will Gou and the KMT still scream "politics"? (Yes.) 

It's also not clear to me if BNT is actually approved for use in Taiwan yet. If it isn't, that will have to happen. Approval for emergency use is possible, but in those cases typically the government itself assumes legal liability if any problems arise. If Gou donates the vaccines through this biomedical firm, how does the legal liability for that work? If that's the reason they are rejected, will these same parties scream "politics"? (Yes.) 

Therefore, if Gou doesn’t secure the vaccines, he can blame the DPP. This looks good for both the KMT and China.

If he does secure them, the government looks bad: incompetent, unable to get this done themselves, when the truth is China blocked their attempt to do exactly what Gou is doing now. The media will have a field day, and nobody will stop to think that these 5 million vaccines were specifically intended to embarrass the government. I say this without making a value judgment on whether we should or shouldn't import them (although I absolutely would refuse one, and I willingly took AZ). 

In either scenario, China wins. The KMT looks good. The current government looks bad. If this is a game, China is winning. Again, I say this with no value judgment on whether 5 million German-made BNT doses in Taiwan would be a good thing. Of course, if they came with no political strings, they would be. But they do come with political strings which are worth interrogating.

It also hands another victory to China: whether the vaccines actually get here or not, the CCP is sending a message. Cooperate with us. Call independence "garbage". Be pro-China. If you do, and are willing to play by our rules, we'll clear the path to life-saving vaccines for you. If you don't, then we'll put you in as many chokeholds as possible. So you'd better vote for the party we prefer, got it?

In other words, nice countr---er, province you got there, Taiwan. It'd be a shame if something happened to it.

Through it all, China pulls the levers. And perhaps this helps Gou with plans for a 2024 presidential run, a race the KMT could conceivably win despite their China stance being deeply unpopular.

So they are playing politics with vaccines, while accusing the DPP of exactly what they are doing. That's usually their strategy, to be honest. It's easy to see through once you know how it works.

(If I'm missing anything in this rundown of exactly what's going on, please feel free to comment in the spirit of sharing information. Troll comments, however, will not be accepted.)

I won't end with a fist-pump and reassurance that Taiwan will win this game. Right now, if this is Monopoly, China has too many properties. But there is some reason to hope. 

First, the government is responding with dignity, truly the only way that they can -- by not turning their noses up at these doses, and even taking Gou's calls to show they're not obstructing the process. From the Focus Taiwan link above:

In response, Health Minister Chen Shih-chung (陳時中) thanked Gou for his efforts to help Taiwan obtain vaccines during a daily press briefing, adding that the application was already under review.

Meanwhile, an official at the Ministry of Economic Affairs told CNA that Economics Minister Wang Mei-hua (王美花) had taken a call from Gou on Monday, to make sure he had the necessary information and contacts prior to completing the application.

The government, which initially expressed strong reservations about local governments and private enterprises attempting to procure COVID-19 vaccines, has lately softened its position, on the condition that it remains firmly in control of the process.

I'm no political strategist, but this is how I'd handle it. 

What I think they're really doing: the government knows this is a game, and they know vaccine procurement is no joke. They're aware Gou is highly unlikely to succeed. Better to just let him try and let the problem take care of itself, so the inevitable accusations of "blocking" him won't look credible -- because they won't be. 

Secondly, I don't claim to have data regarding how Taiwanese feel about these vaccines. However, from my students (everyday office workers -- generally just normal people, not political activists), there seems to be an understanding that this is indeed a game, and it was started not by the Tsai government, but China and the KMT. Many are filtering out news like this, choosing to only watch the 2pm CECC press conference because they're "sick of the rumors and bad reporting". Online it seems the world's gone haywire, but in the meatspace, there are still plenty of sensible people. The game hasn't turned everyone into a disinformation zombie. And China's "better vote for who we want or you'll suffer!" tactics have been backfiring since 2014.

I've also not heard anyone from this admittedly anecdotal group express any misgivings that Taiwan isn't good enough, can't manage this, or is somehow incompetent or unable to run itself as a country. Quite the opposite, in fact: they're staying home and talking about getting through this together as a country. That's good news.

Finally, this won't last forever. It can't. More vaccines will come; we'll get through this outbreak. Taiwan has proven itself a competent nation, as much as if not more so than any other developed democracy. China and the KMT are using this window of time between the outbreak occurring and vaccine availability to launch an attack, but this attack is time-limited. It will end. It's just unclear how much damage there will be.

Will Terry Gou actually procure these vaccines? Will they make it into Taiwanese arms? I honestly don't know, though I highly doubt it. It's almost irrelevant, however. To the orchestrators of this circus, the theater is all that matters.