Sweden and Taiwan Are Showing the World a Sustainable Way to Fearlessly Live with the Coronavirus4
HSVG misson P.O. Box 206, Hagatna, GU 96932, USA
(01/17/2022)Did G20 learn lessons from the Delta? When the world welcomed 2022, many people were actually calling the new year “pandemic year 3.” If we have had it enough and do not want “pandemic year 4,” year 5 or year 6, let’s encourage Indonesian government step forward with its Group of 20 (G20) presidency to call for an international campaign helping people around the globe fearlessly live with the coronavirus and adopt the new normal as soon as possible. Quite a number of public health experts had advised before COVID vaccines became available that the human society was inevitably going to live with the coronavirus for a while and only sustainable measures would help everybody get through the pandemic. Unfortunately, most governments , with certain high-profile scientists and celebrities, put so much faith in lockdowns and looked forward to seeing COVID vaccines would work perfectly like a silver bullet even though, at that time, almost every vaccine developer was apparently targeting at lowering the numbers of severe patients and death victims instead of guaranteeing no infections after getting vaccinated. The Delta variant’s attack last summer was a wake-up call. Many countries, after enjoying reopening and sort of returning to normal brought by successful vaccine rollouts, experienced the Delta variant of the coronavirus caused a new wave of case surge, made hospitals overwhelmed again, and, sadly, took many people’s lives. It was the time that people started being familiar with a term called “breakthrough infections.” For example, Singapore surprisingly reported 28,901 new infections and 40 deaths in September 2021 after the vaccination rate was beyond 80%. Their COVID death number was zero in September 2020 when there was no CIVID vaccine at all. The epidemiological investigation and laboratory results concluded the changed situation was mainly caused by the Delta variant. Singapore was not the only place having a bad September last year. As of 31 August 2021, 80.43% of the residents 12 years and older were fully vaccinated, but Guam, an US island territory in the Pacific reported 47 COVID-related fatalities in September 2021. The figure was higher than the death number of 39 reported in September 2020 when no vaccine was available at that time. With almost the same land size, Guam is home of less than 200 thousand residents and Singapore has a population of 5.7 million. It means the highly-contagious Delta variant was influencing everywhere, no matter a busy and crowded city or a relaxed and rural place. In addition, obviously, vaccines alone are not suppressing the coronavirus. Europe’s experience reminded that nobody should drop his/her guard even thought the population reached a high vaccination rate. European Union has been leading its member states to keep precautions and try reopening in a gradual way. The continent has maintained a basically downward curve of infections as well as hospitalizations and deaths since its successful vaccine rollouts in association with well-managed medical capacity, even though the Delta variant did make a noticeable, but not really harmful, spike. However, it seemed that most parts of the world did not learn lessons from the Delta and implement proper measures when the Omicron came. The World Health Organization did not wait for sufficient morbidity and fatality data to be collected. Its warning message on the Omicron variant released late November last year triggered many countries’ panicked decisions of tightening COVID restrictions. It’s sad that South Africa’s variant identification efforts, which should have been appreciated, made its people punished by the almost worldwide travel ban. The wait wasn’t even long. Before last Christmas, at least three scientific researches caught the media’s attention and proved the Omicron variant may be much more contagious but it’s mostly causing mild cases. However, the chaos has hurt people. For example, Guam, which finally saw a little bit tourism recovery last November, immediately suffered from more than 5000 travel booking cancellations right after the Omicron panic widely spread. More variants will definitely come and we definitely do not want more chaos. While the Omicron has shown the new variants in the future are very likely to be less lethal and the COVID vaccines are actually promisingly reducing severe cases, plus the antiviral medicines are available, the whole world really needs a leadership that urges every jurisdiction to guide people fearlessly living with the virus by using more appropriate strategies to respond to every emerging variant. Let’s try to recall whether the system was encouraging people to get tested during the flu season to try to contain flu viruses. Were we worried so much when we experienced flu-like symptoms or got diagnosed as having flu? Wasn’t the goal of flu control to avoid severe complications and save people’s lives? The best tools helping us achieve the goal are always personal hygiene and flu vaccines although so-called “breakthrough infections” did happen to flu vaccines as well. COVID is not flu, but flu control experience could apply to COVID response, especially to the current situation of “pandemic year 3,” a year that G20 presidency returns to Asia, where people totally have no issue with wearing a mask and helped prove this measure could effectively prevent COVID spread. Indonesian government needs to work with its G20 partners and make history.(Published in The Jakarta Post on January 11, 2022) http://www.hsvg.org/hot_414422.html Did G20 learn lessons from Delta variant? 2022-01-17 2023-01-17
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(May 22, 2020)

Sweden and Taiwan Are Showing the World a Sustainable Way to Fearlessly Live with the Coronavirus


An article on the website of science journal Nature mentioned that 22 scientists wrote to the Swedish daily Dagens Nyheter in April criticizing Sweden's no-lockdown response to COVID-19. Our evidence-based analysis actually shows that lockdown is not a one-size-fits-all measure and Sweden is truly showing the world a sustainable way for everybody to fearlessly live with the virus, which is an inevitable situation we all need to face and accept for a while.

The biggest myth about lockdowns is that they are the only solution when an epidemic worsens. In fact, a lockdown is a measure to cordon off a seriously-affected area so that people in other areas are protected. When SARS hit Taiwan 17 years ago, the health authority locked down a hospital, where a serious nosocomial infection occurred, to protect the community. When Wuhan became a miserable epicenter of China in January, Chinese government issued a lockdown order to prevent the coronavirus from further spreading to other cities and provinces.

Italian officials misunderstood the lockdown measure. Italy was the first country in Europe to enforce a lockdown order, starting from the north and then spreading nationwide. However, unfortunately, Italy also became the first country in the world to have death toll that surpassed China's on March 19.

The lockdown measure was also misunderstood in New York State of the United States. While California and Washington States, on the West Coast, were piling confirmed cases in February, New Yorkers seemed to think they had nothing to do with the virus at all. The Wall Street Journal reported that hospitals in New York did not well plan coordination until the death toll topped 1200. New York Governor Andrew Cuomo issued a “stay home” order on March 20 and enforced strict measures, but, unfortunately, New York became the US state that reported the greatest number of deaths from COVID-19.

Belgium seemed to rush into a lockdown as well, but forgot to take care of the high-risk elderly. The BBC reported on May 2 that, out of Belgium's 7,703 deaths, 53% have been in care homes. Belgian Officials told BBC that poor preparation left care home staff lacking personal protective equipment (PPE) and that allowed the virus to spread quickly.

An analysis done by Prof. Isaac Ben-Israel, an Israeli top scientist, has shown that the novel coronavirus would run its full course of epidemic no matter if there is a lockdown or any similar restrictions in place. One price of chaotic restrictions – which the whole world must pay for - is the collapse of supply-chains. This has sadly led to many frontline medical personnel having to fight the coronavirus without personal protective equipment (PPE).

We think that a “flu-like epidemic control” better describes Sweden's COVID-19 response strategy. Although COVID-19 is not flu, the coronavirus appears to be highly contagious and has a transmission pattern similar to a flu pandemic, with so many countries worldwide reporting confirmed cases. The most relevant and sustainable measures for most countries are therefore flu control protocols.

In the end of January, Germany’s first two cases contracted the virus from a colleague who flew in from Shanghai to join the company’s workshop. Soon after, two other colleagues, who had not had contact with the Chinese visitor, tested positive for the coronavirus. This cluster has preliminarily showed the virus could be easily transmitted from human to human - very similar to an influenza virus. At the same time, those German patients’ very mild flu-like symptoms were noticed.

Singapore and Japan offered significant evidence of a larger scale in February. As of February 29, Singapore had reported 93 cases, including five clusters and quite a number of patients whose source of infection could not be traced. It was showing that the coronavirus could easily spread within a community, just like what an influenza virus can do.

By February, Japan had confirmed more than 250 cases - excluding the cruise line’s cases. Most of those infected had flu-like symptoms only, while six older patients died of pneumonia. So, in Japan, the virus was also showing a flu-like epidemic, which usually brings senior people a higher risk for developing severe illness and causing fatality.

Therefore, the frighteningly high death toll number in China and Italy could be the result of a medical system collapse caused by too many patients rushing to hospitals, which is the scenario usually observed during a flu pandemic.

Unfortunately, most people seem too nervous to notice the virus' “flu-like epidemic pattern”, so they rushed into lockdowns and emotionally criticized that countries without strict restrictions are risking people's lives. If the world's leading countries, or international organizations, stepped forward in March to coordinate a global force to battle the pandemic with measures derived from flu control protocols, the whole story would be different now.

Taiwan's success story offers an example of effective control protocols that combines an existing flu-like disease surveillance system, previous SARS control experience, and no strict lockdowns. The surveillance system asks clinics and hospitals to cooperate by reporting patients with flu-like symptoms for virus testing and early treatments. Taiwan also asks infected people and their contacts must undergo a home or facility quarantine, as well as reminds healthy people to practice good hygiene all the time to flatten the epidemic curve, but has never seriously disrupted people's daily routines. For example, many people in Taipei still commute by train every day.

As of May 12, Taiwan, with a population of 23 million citizens, had reported 6 deaths from COVID-19 and less than 500 confirmed cases, while New York State, having its 19 million residents under strict lockdowns, has reported more than 27,000 deaths.

In addition, Taiwanese have been promptly wearing a mask since the middle of January even though experts could not agree on whether it helped at that time. Taiwanese government also coordinated mask manufacturers to increase production capacity to meet people’s demands of purchasing masks. In contrast, most of western countries did not add wearing a mask to their COVID-19 control guidelines until April.

The only thing that Sweden needs to worry about is the high number of deaths form COVID-19 at nursing homes. If nearby hospitals have spare capacity, it would be better to move nursing home residents to hospitals, and thoroughly clean and sanitize affected nursing homes.

Sweden also needs to learn that Taiwan's experience has proved wearing a mask can be an effective extra precaution, especially for countries trying to avoid stricter restrictions. People do not need a surgical mask. Cloth masks work well, too. The more Swedes wear a mask, the more effective Sweden's COVID-19 control measures will appear to the world.