Taiwan has seen a spike in domestic COVID-19 cases since it began abandoning its “zero-COVID” strategy last month. On Thursday, the island reported over 90,000 local cases in one day for the first time since the pandemic began.

While the number of infections has increased exponentially over the past month, more than 99% of cases are considered mild or asymptomatic.

Taiwan’s Ministry of Health and Welfare said on May 19 that the virus had spread widely at the community level and that authorities expect the outbreak to peak towards the end of the month. The current outbreak is caused by the more transmissible Omicron variant.

In a statement, the ministry said Taiwan is moving toward coexistence with the virus and the government continues to strike a balance between risk management and maintaining health services. While authorities are relaxing some pandemic regulations, they are still urging high-risk individuals to get vaccinated. Taiwanese officials dubbed the new policy the “new Taiwan model.”

‘Constant changes’ in COVID-19 policy unleash chaos

In recent weeks, Taiwan has reduced the number of quarantine days for incoming visitors to seven. The island has also made several adjustments to isolation guidelines for those who have tested positive and their close contacts.

The changes in the COVID-19 policy have created a flurry of confusion and chaos, particularly for those who have tested positive.

On May 5, authorities revised their definition of confirmed COVID-19 infection to include people undergoing home isolation after testing positive with rapid tests. Those who tested positive with rapid tests would then have to schedule a medical consultation online with a doctor to officially announce their positive test result.

However, several people told DW that the official software used to arrange the medical sessions either crashed or didn’t show clinics or hospitals offering such services, leaving many frustrated. Patients said they had to leave home isolation and queue for more than an hour for PCR tests outside hospitals to officially report their cases to the government.

Yang, a marketer in her early 30s, was one of these patients.

“I ended up having to queue for a PCR test at a hospital to meet the criteria of a confirmed case,” she said, adding that some elderly citizens have given up on complying with the government’s COVID-19 reporting rules due to their ill health would have complexity.

“The constant change in guidelines and criteria has confused many COVID patients,” she said. “It feels like the government doesn’t have a really comprehensive plan and they’re always trying to keep up with changes in the outbreak.”

For Chen, the government’s ever-changing COVID-19 guidelines are increasing the stress for patients.

“Having tested positive, we have to research the quarantine criteria while trying to book appointments online for a PCR test… It’s a lot of stress for someone who is already ill,” she admitted.

Mei-Shang Ho, a research fellow at the Taiwan Institute of Biomedical Sciences at Academia Sinica, believes the confusion is caused by the government’s failure to clearly communicate its policy direction. “Unless the government tells the public clearly whether they want to stick to the zero-COVID policy or move towards coexistence with the virus, people will not know what rules to follow,” she said.

shortage of medical staff

Reports of hospitals experiencing shortages of medical staff have also surfaced in recent weeks. After the president of the Taiwan Union of Nurses Association announced that some frontline nurses would have to remain in hospitals to care for COVID-19 patients despite testing positive themselves, Health Minister Shih-Chung Chen announced on Wednesday known that the island is suffering from a shortage of medical staff. However, the health minister reassured the public that hospitals would regularly monitor the health of staff.

Chang, a registered nurse, said some furloughed nurses have been called back to work to support the influx of COVID-19 patients after medical staff became infected.

“As the workload for most medical workers continues to increase, I worry that the quality of medical care will suffer,” Chang said.

A victim of his own success

Chunhuei Chi, director of the Center for Global Health at Oregon State University and a former adviser to Taiwan’s National Health Insurance Administration, said Taiwan is “not ready to face an outbreak at this level.”

“A blind spot for countries that have long tracked zero-COVID is when they start moving away from politics,” he told DW.

Chi said Taiwan health officials should have anticipated the exponential increase in case numbers based on other countries’ experiences.

“Initially, in March, Taiwan still sent all mild and asymptomatic COVID-19 patients to government quarantine facilities, but if they had implemented the latest guidelines around that time, they could have eased the pressure on hospitals and quarantine facilities,” he said.

“Taiwan’s quarantine policy … basically changes every week or two,” he added.

According to Chi, Taiwan still relies on using tactics from the early stages of the pandemic to contain the outbreak.

“Because of the early success, Taiwan thought that all the experiences it had with SARS could be applied to the current outbreak. However, experiences from Western countries have shown that outbreaks caused by the Omicron variant will increase exponentially in a very short period of time,” he explained. “Therefore, their policies appear to have lagged behind the evolution of the outbreak.”

Chi said Taiwanese authorities wanted to avoid overburdening hospitals, but also didn’t want the outbreak “to drag on for too long.”

“Based on the experience in Europe and the United States, the outbreak curve only starts to flatten when at least 40 to 50 percent of the population has contracted the virus. So far, the number of confirmed cases in Taiwan is still too high, far from that target, so this is the dilemma facing the Taiwanese authorities,” he said.

Edited by: Sou-Jie van Brunnersum