Showing posts with label vaccines. Show all posts
Showing posts with label vaccines. Show all posts

Thursday, January 6, 2022

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.



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.

Sunday, November 21, 2021

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. 

Saturday, July 10, 2021

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.

Thursday, July 1, 2021

An Open Thank You Letter to the Taiwan CDC

Untitled

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. 

Tuesday, June 15, 2021

ONE WEIRD TRICK to stop INFLAMMATION OF CHINA TENSIONS that doctors don't want you to know!

 Untitled

If you need this explained to you like Richard Dawkins needs explanations of literature, China is the shark.


Two articles appeared recently over Taiwan's vaccine struggles amid a global shortage, one in Nikkei Asia and one in The Guardian. Both articles are fine, though they both get the same thing wrong (which I'll address later). They both cover how Taiwan's attempts to secure enough vaccines to beat the outbreak have turned into a political imbroglio.

However, the media narrative from both can be examined through the titles that editors chose for them, and that's what I'd like to look at. How does an article about Taiwan where the media outlet wishes to center Taiwan craft a headline, compared to an article about Taiwan where editors are stuck in the past and feel they must stick to tired cliches about the Taiwan-China relationship?

Both do the right thing by questioning China's narrative, or by putting it in parentheses, like this: 

China’s altruistic statements have been somewhat contradicted by its objections to the US and Japan donations, and by Taiwanese allegations (which China denies) that it actively blocked a deal Taiwan was working on with the German vaccine producer BioNTech.


This is great: it shows increased interest in and reporting on Taiwan by major international media, and it shows more willingness to look at the Taiwanese perspective or at least consider it through an international or local, rather than Chinese, lens. While international reporting on Taiwan is still tied to China, it's no longer guaranteed to follow the script that China puts forward. That's an improvement. 

However, I will come out and say that the Asia Nikkei piece is superior to the Guardian one. This is not a slight against Helen Davidson, and I'm not trying to pit her against Erin Hale. Rather, the issue is with the titles. 

Asia Nikkei:

Vaccines become political as Taiwan wakes up to COVID reality

President Tsai's approval rating drops as island struggles to procure doses


This isn't great news for Taiwan, but it is a good headline. It's neutral, and it centers Taiwan. China enters the narrative in the actual article, as it must (because it's the one doing the politicizing, with the help of the KMT and their various compradores) but the reader of this article is brought in through a focus on Taiwan.

Skimmers who just read the headlines will come away with that with a reasonably accurate view that something dodgy is going on with vaccine procurement in Taiwan, and might click to find out what those struggles are. Then they learn that the struggles are caused in part by a global shortage, but also Chinese interference.

Compare that to The Guardian: 

How Taiwan’s struggle for Covid vaccines is inflaming tensions with China

As island faces new outbreak and mistrust of Chinese jabs, Beijing objects to donations from US and Japan 


This headline sucks

I want to make it clear that headlines are almost always written by editors; writers rarely get a say in them. This is not a jab at Helen Davidson (it is a jab at her editor, but I don't know who that person is.)

It sucks because it totally bungles who is doing the inflaming of what. "Taiwan's struggle for coronavirus vaccines" is not inflaming tensions with China. China is inflaming tensions over Taiwan's vaccine struggle. This is an active choice on the part of the Chinese government, which does indeed have free will. 

All Taiwan is trying to do is get some damn vaccines. They don't want to play political games or "inflame" anything. And tensions aren't gout. They don't inflame on their own. Someone has to inflame them. That someone is China.

The subtitle isn't great either. It's not wrong per se, but the reader is invited to wonder "why would Taiwan distrust Chinese vaccines?" If they don't really know a lot about Taiwan/China issues, and the headline has not clarified that China is the inflamer (not the inflamee) they might preemptively conclude that Taiwan is being unreasonable, when it is not.

It also centers Beijing's reaction to the US and Japanese donations, rather than how these have affected the Taiwanese situation, even though the article is ostensibly about Taiwan. China starts out being centered, and the reader is then invited to keep centering China. 

The actual article is a lot better -- again, this isn't about Davidson's work -- but someone really ought to inflame tensions with the Guardian editors.

You may be curious what the two articles get wrong. It's relatively minor, but worth pointing out one last time. Both include some version of this narrative:

China said Fosun – the Shanghai-based manufacturer with exclusive regional production rights for Pfizer/BioNTech – had offered to supply Taiwan, but Taiwan had refused.

[Drew] Thompson said there were scientific and transparency concerns about China’s vaccines, which made it unsurprising and potentially sensible for Taiwan to reject an offer of Chinese-developed vaccines. But if the Fosun offer is legitimate, refusing it is “entirely political”.


Clearly, Thompson doesn't actually know that Fosun never made a legitimate offer. To distribute your drug in Taiwan, you need to apply through the Taiwan FDA. It is possible to do this, though as Terry Gou is finding out, you can't just leave out important documents. 

Fosun never applied. So it never offered those vaccines to Taiwan in any capacity that Taiwan could officially accept. How can Taiwan reject an offer it never actually received? 

I explore this process in more detail here, by the way.

Hale's article also commits this error, and includes discussion of vaccines actually manufactured in China, not Germany. I can't quote it because I've hit the paywall on Asia Nikkei (I read the article days ago), but it leaves out the fact that Chinese-made drugs are banned in Taiwan, by law. To accept drugs made in China would require changing the law. That's not going to happen. The German-made doses are a gray area, but Fosun would still need to apply. To date, it has not done so. 

A minor point, but one I wish the international media would get this point right.

I'm also really starting to wonder about this Thompson fellow in the Guardian article, however. He says: 
 

 

“Pfizer and BioNTech have a huge incentive to ensure that the Fosun product is equivalent, so I would think there is no concern,” he said. “There’s no reason not to take it.”

 

But he himself provides a very good reason just a few paragraphs up:

 

If Taiwan accepted Chinese vaccines it would be the political “kiss of death for the DPP [Taiwan’s ruling party]”, Thompson said. “It’s quite likely China would take some sort of gratuitous swipe … see it as a capitulation or recognition of Beijing’s superiority.”

Right -- how is that not a good reason not to take this "offer"? Why is Thompson spinning this as somehow Taiwan's fault?

This is not entirely political: it's also about public health and safety.

China does indeed have every reason to try to harm Taiwan, including tampering with vaccines. And of course, the main reason Fosun never applied is probably because it would require a level of submission that national governments require, not regional ones. Fosun can't just treat Taiwan like Hong Kong and Macau, but to apply, it would essentially have to admit that Taiwan is a place not controlled by China


So instead it uses its doses as media fodder, because it knows they're never going to make it to Taiwan. The China-proffered solution to a problem China created is (perhaps literally) a poison chalice.

Why Thompson is implying that this is mostly political on the Taiwanese side despite laying out exactly why it's actually a political move on the Chinese side is beyond me. How is China deliberately inflaming tensions somehow politicking on the part of Taiwan?

There is one more thing both articles fail to clarify. Both are correct that Tsai's popularity has fallen, however, both fail to contextualize this: the general reader might be left with the impression that Tsai's drop in approval is especially concerning. In fact, at about the same time in their administrations (mid-2nd term) both Chen Shui-bian and Ma Ying-jeou had lower popularity ratings than Tsai. Chen dropped to about 18% I believe, and Ma hit an astounding 9%: the latter was so awful that students occupied the legislature. And they managed to be that unpopular without a pandemic (and with Ma not being constantly attacked by the CCP). 

Taiwanese voters have high expectations and tend to be critical. Properly contextualized, Tsai's 40% is actually pretty impressive. I won't say it's great, but frankly, it's better than one might expect, and surprisingly so. The typical international reader, however, won't realize that from reading these pieces.

A lot of people who think they are knowledgeable about Taiwan and China don't seem to want you to know how to stop this kind of inflammation. A lot of them have PhDs, so it's fair to say that there is indeed one weird trick to stop inflammation of China tensions that doctors don't want you to know. 

It's simple to pinpoint, but difficult to execute. If you want to stop inflammation, the best thing you can do is look for the source. If your feet swell up because you're not wearing supportive shoes, the answer isn't to elevate your feet with an icepack. That will help, but the shoes will just cause inflammation again tomorrow.

The trick is to do something about your shoes.

Ahem. China is the shoes. 

Wednesday, June 2, 2021

Introducing Terry Gou, China's vaccine gamepiece

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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.

Friday, May 28, 2021

A Taxonomy of Lies about Taiwan's Vaccine Situation

Untitled

Razor blades in candy were always an urban legend, but I wouldn't take China's candy


Trust me, nobody wants to talk about a different topic more than me, but as long as disinformation is permeating discussions about vaccine access in Taiwan, it's important to make sure reasonable clarifications are available in English. 


I want to start by saying that I understand there is a lot of fear and anxiety right now. There's an outbreak in Taiwan that, while not growing exponentially, is still growing. It is probably controllable over a period of months, but that still means several months of worry, doubt, admonitions to stay home, and yes, some deaths. Hospitals are strained. There's a global vaccine shortage in most countries, while the US is flush with doses, and other countries have struggled to obtain them. 

That's a worrying situation to be in, and I don't want to diminish it even as I repeat my message to not freak out

It also presents a window: a time when Taiwan is trying to manage its outbreak while attempting to obtain vaccines which are in short supply globally. Eventually, Taiwan will get this under control and vaccines will be available, but we're looking at a timeline of months. That gives malicious actors plenty of time to disseminate disinformation, and for those lies to fester. And some unsavory political elements are trying to use that window to sow distrust in the Taiwanese government -- specifically Tsai and the DPP -- while calling for cooperation on the surface. These same elements turn and point fingers at the Tsai government for "playing politics". 

Anxious people may believe things that give them an outlet for their stress, so I'm not writing this to belittle anyone. It's pretty normal human behavior, and not all believers in disinformation are ill-intentioned. I do believe people are glomming on to this "we want BNT" storyline because it represents a type of hope. They want vaccines and these seem available. They're not, but that doesn't mean those who misplace their hope in these vaccines are bad, or wrong, and I don't intend to imply otherwise.

Rather, I just want to create a clear record in English to prevent further misdirection.


Let's take a look at each of these false claims about Taiwan's vaccine situation in turn, and then hopefully leave the topic behind for good. 


The national government is unfairly blocking local governments from obtaining vaccines on their own

The story here is that the CECC said earlier in May that cities and municipalities could procure vaccines on their own if they wished, and people are complaining that the CECC is "now" insisting that only the national government can procure vaccines.

This is genuinely confusing, so I don't blame anyone who perhaps skimmed this news believes that this is  a course reversal or about-face meant to take power away from local governments. 

The key point, however, is that the vaccines these local governments could potentially buy, and the distributors that sell them, still need to have been approved by the central government before the purchases can take place, and the batches themselves also need to be tested. This is usually done by the central government, and then after given the all-clear, a municipality could theoretically purchase these drugs on their own.

The central government noted, however, that the procurement procedures were complex and cumbersome, and would probably be challenging for a city to pull off on their own. Imagine if, say, Nantou City approached BioNTech, which rebuffed the Taiwanese government, or called up Moderna, which sold doses to Taiwan which are coming late due to a global shortage. What leverage does Nantou City have that Taiwan doesn't? Why would those companies sell to Nantou, not Taiwan? Do they have the resources to get through the procedure in the first place?

However unlikely, in theory, I suppose it could be done. 

The issue here is that the local governments trying to "buy their own doses" now aren't talking about buying approved batches from approved distributors. They're talking about the Shanghai Fosun doses, and Shanghai Fosun has not applied for approval to distribute their product in Taiwan. Therefore, they're not approved, and municipal governments cannot buy from them.

Hence, the government is clarifying that locally-procured doses and the brokers who sell them still have to go through the same Taiwan FDA approval process as everyone else. 

This limitation also applies to Terry Gou, who says he wants to purchase ten million vaccine doses. If he can do that through an approved channel and get those doses to the government for the required batch testing, then fine. It'd prove that the government could just throw around cold, hard cash -- but fine. 

However, if he thinks he can just buy whatever from any channel he likes and get those doses in Taiwanese arms without the usual approval process, he's dreaming.

By the way, there's an update to the Terry Gou story: the game continues. It turns out manufacturers don't want to sell to these various non-government-affiliated parties.

If these municipalities truly wanted to approach approved channels to purchase more vaccines on their own, I'd be very interested to hear the whether the CECC's answer might change given recent political hassles. It would actually make sense to centralize one's vaccine strategy given the current crisis to ensure the fairest possible distribution, but I hope the CECC would make that clear.


Tsai and the DPP are trying to keep out foreign vaccines to 'protect' the market for the Taiwanese-made vaccine 

This is obviously untrue. In fact, I'll go ahead and say it's a blatant lie. 

If it were true, why has Taiwan spent the better part of a year trying to negotiate for every foreign vaccine they can get their hands on, from AstraZeneca to Moderna to BioNTech -- millions of doses in all?

If uptake on these doses has been slow, it's because there's a global vaccine shortage and massive inequities in availability (the US, for example, clearly has plenty), and ordered shipments are taking longer to fulfill. Plus, it is absolutely plausible that China has been blocking Taiwan's attempts to secure vaccines. Taiwan only implied this before; now they've come right out and said it's the case. It has nothing to do with trying to 'protect' a local product. 

If the government were trying to 'protect' the market to ensure the domestically-produced Taiwan vaccine has enough takers, first, that would entail endangering lives and a full-blown COVID health system breakdown to possibly make money later on.

The Taiwanese government isn't perfect, but I highly doubt they'd do that -- you'd have to think of them as monsters. They're imperfect, but they're not monsters. (China, on the other hand, absolutely would do that to Taiwan and the CCP is indeed run by monstrous people). 

This "insider trading on the local vaccine" accusation likely arises from the extremely confusing story of Tungyang 東洋, a Taiwanese pharmaceutical company, which had been in talks with BioNTech and possibly, Shanghai Fosun as well (though I'm unclear on this). but pulled out for unclear reasons. Some say the amount of product offered for the price made for a poor business decision. It has been reported that at that time, the drug wasn't far enough along in clinical trials for the company to feel confident in the deal, whereas others say Tungyang dithered too long. Still others say that the government wasn't adequately supporting them (one would expect the government to commit to purchasing those doses from Tungyang, once approved). 

I don't know what happened, but it seems clear that if the Taiwanese government turned its back on these BioNTech doses to protect their own profits from local vaccine sales, then they wouldn't have tried so hard to procure millions of other foreign vaccines. Whatever is going on here, it isn't that.

In fact, it sure sounds like the sort of thing people who stand to make a lot of money on the Shanghai Fosun doses would say to divert attention from their own activities. (I can't prove that, however.)



But China can't block Taiwan's access to vaccines!

Yes, they can. 

I'll talk more below about how people came to believe that the only way Taiwan can access BioNTech vaccines must be through Shanghai Fosun, the Chinese company that claims it has rights to "Greater China". 

But first, Taiwan has every right to seek another distribution channel from the manufacturer, which can accept or reject this. Taiwan has now directly stated that China intervened in Taiwan's own negotiation with BioNTech, which again, it had every right to engage in.

This wouldn't even be close to the first time China has pressured an international organization or company to change how it deals with Taiwan, from excluding Taiwan from the WHO, trying to block international aid to Taiwan after major disasters, to pressuring airlines and IELTS and other English proficiency exams to call Taiwan "Taiwan, China".

The vaccine issue is no different.

If you think China can't do the exact same thing to a vaccine distribution contract, please think again.


Shanghai Fosun has the "right" to claim distribution for BioNTech in Taiwan, and the government is trying to circumvent them

This has a veneer of truth, but is ultimately false. 

Drugs available in Taiwan need to be approved by the Taiwan FDA, and are often batch-tested as well (this is certainly the case with coronavirus vaccines). Brokers and agents -- who may have the right to produce the same drug, or sell an already-produced drug from the original manufacturer -- also require approval. 

Fosun doesn't have this approval in Taiwan itself, so its "rights" don't exist here -- it can't just barge into the market at will. It still needs that TFDA approval.

For many drugs, multiple avenues of purchase are approved in Taiwan. If you're on any long-term medication, you might have noticed that the packaging and even 'look' of the drug changes, despite the actual drug being the same. For example, my main anxiety medication is lorazepam. It's usually branded as "Silence" -- small, white pills in bubble sheets. Then my hospital changed distributors and I still got lorazepam, but they were larger, yellow pills dosed out into sealed plastic packets (I don't remember the name, but it had changed). Now they're back to the familiar Silence. Once, I was given Ativan: tiny blue pills in gold foil sheets that are half as strong, and was told I can take two. Ativan is lorazepam in a smaller dose. Why? The hospital changed suppliers, but it's all the same drug.

It's very common, and a highly competitive business.

Approval, however, remains crucial. Even if the drug is not fake, if it's sold through an unauthorized channel, the government considers it to be "counterfeit". It doesn't matter if that distributor has an agreement with a manufacturer whose drug is approved in your country; the distributor also requires approval. Any pre-approval agreements are contingent on that process being completed.

What does this mean for Shanghai Fosun? That they may have "secured the rights for Greater China" including Taiwan from BioNTech, but there is absolutely no law or regulation stopping Taiwan from seeking out an alternative method of acquisition. BioNTech could always refuse, but they always have the right to authorize another distributor that is not Fosun.

It's not even that rare, and it sure doesn't seem to be a problem for Fosun or the CCP if the buyer is pro-China billionaire Terry Gou, who once called independence supporters "garbage".

That's why they talked to Taiwan in the first place, before backing out -- after pressuring Taiwan to remove the word "country" from the contract -- under what I can only assume was some sort of pressure or (ahem) aggressive incentivization. 

In fact, what Fosun has are the rights to sell a drug called "Fubitai", which is BioNTech's drug with a Chinese name. As far as BioNTech is concerned, it has no official Chinese name for its drug, that's a name Fosun is authorized to use. Taiwan has every right to seek out the same drug, not branded as "Fubitai". Another distributor for this drug is Pfizer, and Pfizer has no agreement with Shanghai Fosun. Although BioNTech might object -- meaning perhaps the contract would be rejected or there would be a fee -- there is no law prohibiting Pfizer and Taiwan from working together. 

Even Tungyang,  the Taiwanese company which tried to secure BioNTech rights but ultimately didn't (a long convoluted story that could be its own post), was not doing anything wrong by ultimately not working with Fosun. They might have made other mistakes, but talking to BioNTech was not one of them. Companies do it all the time. The only real issue here is that the government's messaging could have been clearer.

And this isn't even getting into the timeline of when Taiwan was or wasn't specified in the "Greater China" contract with Shanghai Fosun. I'm quite aware there's a story here and have my sources, but it's become increasingly clear that it doesn't matter. 


Taiwan "rejected" Fosun's offer of vaccines

Imagine if I applied to do a PhD at Harvard, but before I could even send in my application and proposal, the Dean of my preferred school called me up to tell me personally that she intended to reject me. 

That sounds like the sort of nightmare I'd have, but in the waking world it would be preposterous.

Well, so is this myth. 

The cold hard fact is that Fosun never applied to distribute those vaccines in Taiwan. I offered one possible reason why in my last post: basically, it would require a level of submission commensurate with approval by a national government. So by making such a submission, Fosun would in essence be admitting it is dealing with a national-level government. In other words, that Taiwan is a country. 

People have been complaining that Tungyang (mentioned above) didn't seem to think this was a problem, and that the approval should be fairly easy. However, Tungyang is a Taiwanese company that would be quite familiar with the approval process and regulations. Shanghai Fosun has never applied for such approval because Chinese drugs are banned in Taiwan. In fact, I'm not sure any Chinese drug company has gone through this process in Taiwan. 

Therefore, there's probably another reason Fosun hasn't applied: these doses are said to have been produced in Germany, so in theory, a Chinese company could apply to distribute them in Taiwan. However, Fosun has said they intend to start domestic production of "Fubitai" soon. As they would be Chinese-made, Fosun would not be able to sell them here. They'd be going through all that work for a one-time shipment of vaccines. 

So what is the incentive for Fosun to go through that process for a one-off sale?

Far more likely that it was a political ploy all along to attack the Taiwanese government in the window they have open to them -- when Taiwan is facing a crisis, and vaccine uptake has been slow.

That said, I would actually understand why the government wouldn't want to deal with Fosun. They seem dodgy at best -- complaining about not having rights they never applied for -- and I wouldn't want to deal with them either. It's likely Tungyang got spooked by them too. This might be the reason why the government now insists it will only talk to manufacturers directly: perhaps it got burned in these previous negotiations.

That doesn't mean, however, that Fosun was "pre-emptively" rejected.

I don't really know the full story behind why Tungyang's deal with BioNTech fell through, but it doesn't really matter. Perhaps the government could have supported Tungyang more. Perhaps it seemed wise in the moment to decide against the deal, as the vaccine hadn't been through all clinical trials. The government's own messaging on this could be a lot clearer.

Regardless, the company kicking up a fuss now is Fosun. And yet, they don't seem to be any closer to actually applying for distribution approval. 


You can just buy vaccines at Costco in the US, so why not do that?


This one is the funniest, but fortunately doesn't seem to be widely believed. And yet, there's always someone.

KMT Chair Johnny Chiang recently tweeted out a picture of a vaccination center available at Costco in the US, and KMT city councilor (and person who perhaps needs an intervention) Wang Hong-wei 王鴻薇 posted that if vaccines were so easy to get in the US that you could just buy them at Costco, shouldn't Chen Shih-chung just head to the US and buy out the stock?

I hope that I don't need to post a lengthy explanation of why you cannot, in fact, just go buy vaccine doses in bulk at Costco, right next to the Einstein's Bagels, tubs of oregano and massive graduation cakes.

Perhaps Wang is really that ignorant, but it's more likely that she's smart enough to know how ridiculous she sounds, but doesn't think her constituents are smart enough to see it.

I don't want to put every preposterous statement by every KMTer on the party as a whole. Wang is one city councilor. However, that's hard to do that when it's not just the grunts but the caucus whip saying Chen Shih-chung should be "executed" -- a method of governance the KMT is intimately familiar with, though you'd think they would have figured out was wrong by now. It's even harder when KMTers below him echo that sentiment.

However, with the KMT calling for cooperation with the government while continuing to undermine them at all levels, I have to wonder whether they're truly striving for cooperation or they're just a bunch of backstabbing Mean Girls.



It is possible for Shanghai Fosun to distribute their doses of German-made BioNTech in Taiwan quickly, but the government is blocking them

No.

It's not even clear these particular doses could make it to Taiwan. The approval process takes months, as you can see by the lengths of time some of these contract dramas have played out. At the latest, the doses in question expire by September. There's a very good chance they'd be expired by the time they were even shipped. Plus, it seems odd that Shanghai Fosun would just have all those doses sitting in a warehouse, knowing full well they can't sell them to Taiwan without going through the proper channels. There's a fair chance what they have is the option to buy the doses, not the drugs themselves. I can't prove that, however.

And by then, Taiwan would have other options available, including AZ, Moderna and the domestic vaccine.

Changing that timeline to get the doses here quickly would require changing the law to allow Chinese drugs into the Taiwanese market, and I know very few people who aren't deep blue unificationist extremists who think that's a good idea.

In any case, the main point here is that Fosun never applied to distribute its doses in Taiwanbut is complaining that it can't distribute its doses in Taiwan! The only way around this if Fosun continues its obstinacy is for Taiwan to just...pretend it doesn't have laws and allow Fosun to operate here the way it can in Hong Kong and Macau. 

Essentially, you can have these doses but the price is your sovereignty.

In other words, if you want those German doses of BioNTech, then pressure Fosun to submit the necessary data, samples and paperwork. 

They're the ones holding it up. But even then, it's a daydream to think these doses could possibly make it to Taiwan in time.

Chen Shih-chung is not being transparent about Taiwan's attempts to obtain vaccines

It's true that sometimes the information from the CECC on what vaccines are coming, where they're coming from and when seems unclear. By June, by July, some are coming, we're awaiting the next shipment, they're on order. It would be reassuring to hear something more concrete. The disparity between the number of shipments actually received and what Taiwan says it's ordered seem huge.

However, this doesn't appear to me to be a lack of "transparency". Again, there is a global vaccine shortage. Many countries likely have similar issues: millions of doses on order, but shipments coming frustratingly late. 

I don't have as much of a window into this world as I do into pharmaceutical approval processes (which I know a surprising amount about despite not working in the field, because I've listened to dozens of presentations on just this issue). I would imagine, however, that there are a lot of harried phone calls, negotiations and favors, wheedling and requesting, cases being made, and back-and-forth in order to ensure that at least some of what's on order is received in a timeframe that can ensure the government seems to have the issue under control. 

It's very hard to put this sort of constant negotiation into palatable words for the public. Nobody really wants to see how sausages are made. Information is great, and we need as much as possible. Said in just the wrong way, however, too much information provides fodder for the KMT to call you weak, bureaucratic, slow or ineffective. They're probably just trying to maintain public trust by not raising a fuss (and everyone's blood pressure) about the actual mechanics of vaccine procurement in a time of crisis and shortage. 

One thing I do think they could do better isn't so much transparency, but messaging. The Tsai government still has one key weakness: they don't announce their victories clearly enough. This feels very cultural to me, in a particularly Taiwanese (and perhaps Japanese) way. The KMT seems to have no issue announcing successes regarding things they haven't even done all that well! Clearer messaging on how hard they are working to get all of this to happen without showing the whole sausage might help, but it has to be done carefully.

Chen Shih-chung is not trying hard enough to obtain vaccines (and is satisfied with 'second-rate' ones)

See above. Pay attention to the actual numbers involved when the CECC talks about what it's been trying to order, and how they waited quite some time to go from "implying" that China blocked their access to BioNTech to outright stating it. 

It's quite clear that this is a monumental, difficult and frustrating task. AZ came first because that's what we could get, not because Chen thinks Taiwanese don't deserve the best vaccines. The shipments are slow, again, because of a global vaccine shortage and access inequities. 

I'm not even sure Chen sleeps at this point. That's how hard he is clearly working.

The outbreak is in part due to the Tsai government being 'complacent' about vaccination drives

This is completely backwards. 

The government procured the vaccines it could, and tried to get them out to frontline workers and other priority groups. It was the lack of local transmission at the time that stymied the drive, not complacency. (The area where they made the big mistake was the shortened flight staff quarantine and not ensuring adequate security at quarantine hotels.) 

People didn't want the shots because they didn't think they needed them. 

So, rather than be complacent about that, the government opened it up to just about everyone. It's true that many people who could have simply signed up for a self-paid shot didn't because they didn't realize that nobody was going to follow up on their "reason", but at the time, it made sense to create a small barrier to ensure there wasn't a stampede for vaccines, to ensure that doses would still be available for the priority groups should they change their mind. 

Once it became clear that the local outbreak was a real problem, the government immediately changed course, and now those vaccines have been given to priority candidates. 

That is not government complacency. It's the government trying to include normal human behavior into their vaccination strategy.


A new study on Sinopharm offers evidence that it's more effective than previously thought, therefore it definitely is (and thus we should consider allowing it into Taiwan)

I don't want to spend a lot of time on this, but as the most reprehensible unificationists in the KMT are trying to use the "let the German BNT doses in!" talk as a gateway to calling for Sinopharm (and other Chinese drugs) to be allowed into Taiwan. This would essentially mean changing the law. 

Not that unificationists and malicious CCP actors see it that way. Having helped create Taiwan's vaccine problem -- and make it seem like more of a failure than it really is in the media -- they offer a "solution": use our Shanghai Fosun/BioNTech vaccines, and here are some Sinopharm ones too! Just issue a "permit". Forget that you have your own FDA and approval process. Forget that Chinese drugs are banned by law in Taiwan. Let us treat you like Hong Kong and Macau! 

It's a poison apple: take it, and watch your citizens' willingness to get vaccinated plummet and pay for it with your sovereignty. Or refuse it, and we continue to attack you for not doing "enough" to procure vaccines.

At around the same time this attack started up, a study came out showing Sinopharm may be more effective than previously thought. However, it is unclear how much protection it provides against severe symptomatic cases or how well it works for older patients. At the same time, the Seychelles, which has the most vaccinated population in the world (it helps that it's a small population), is seeing a fresh outbreak. About 60% of vaccinated individuals in Seychelles received Sinopharm; the rest received AstraZeneca. Although most cases were among the unvaccinated or those who'd only received their first dose, it's still troubling that vaccinating most of a country's citizens with Sinopharm does not appear to be enough to reach herd immunity. 

Generously, I would call this data inconclusive. That one study is fantastic. It's one study. I'd like to see some replication, especially given the situation in the Seychelles.

Now, I actually want Sinopharm to work. In so many countries, it's the only option, or one of the only ones. China, Thailand, Seychelles, half of all available doses in Hong Kong: Sinopharm. With WHO emergency approval, the number of people who will receive Sinopharm will only rise. Those people deserve to be safely vaccinated as much as anyone else. I do hope the doses they have received are effective, as any human would.

That said, I accepted AZ but would refuse Sinopharm. I personally do not trust any drugs from China, nor the government under which they are produced. 

I also do not think the law should be changed or temporarily suspended to allow Chinese vaccines (or any drugs) into Taiwan. I honestly do believe the CCP is evil enough to tamper with the supply, because China is an existential threat to Taiwan. It is in their best interest for Taiwan to suffer. 

As such, I don't even really think the Shanghai Fosun doses should be let into Taiwan. But certainly, whatever data might say about Sinopharm, Taiwan should never, ever trust the CCP or any drugs it attempts to bring into Taiwan.

I don't know the percentage of Taiwanese who'd be willing to take the Fosun-brokered BioNTech doses made in Germany if they could. There's no data. But we do know that willingness to take Chinese vaccines is very low: less than 2%. All those Chinese business executives claiming "Taiwan compatriots" want Chinese vaccines -- and not clarifying the doses in question -- are deliberately dodging this clear fact. 

In fact, if the Taiwanese government were to allow Fosun's German doses in, they'd probably have to ensure they remain separate from any supply where patients don't get to choose which vaccine they receive, as it may impact willingness to make an appointment at all. If the allowed Chinese-made vaccines in, that would cause even more of a problem. Afraid they'd be injected with a Chinese-made vaccine against their will, registrations might well plummet. If they went ahead with the procurements anyway, they'd have to be very clear about messaging: that you'll only get these shots if you specifically sign up for them

It's smart for the government to refuse to play this game.

Yes, this is political. But the threat is real, and unique to Taiwan.