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‘Prevention fatigue’ driving sudden COVID surge in Taiwan: Expert | Coronavirus pandemic News



Taipei, Taiwan – After 18 months of successfully keeping COVID-19 at bay, Taiwan is now facing a surge in cases after an outbreak was discovered in mid-May.

From just 1,200 cases and a handful of deaths among the island’s population of 23 million, the number of confirmed cases had reached more than 11,000 by Tuesday and the death toll had risen to 308.

The self-ruled island was widely praised last year for its effective response to COVID-19, which included strict border controls and contact tracing. Now, as they grapple with life under lockdown for the first time, many in Taiwan are wondering what went wrong.

Six months ago, Al Jazeera interviewed Chen Chien-jen, Taiwan’s former vice president and health minister who made his name during the SARS [Severe Acute Respiratory Syndrome] outbreak nearly 20 years ago, about why Taiwan had been so successful in fighting COVID-19.

This week, we spoke to the epidemiologist again – over Zoom – about the island’s sudden change in fortunes.

Chen says the outbreak is partly the result of “prevention fatigue” as people let down their guard.

Hospitals, which were supposed to have dedicated COVID-19 and isolation wards, had also begun using them for other patients and the health system was unprepared for the sudden surge in coronavirus cases, which have been traced back to a group of airline pilots, he said.

For Chen, the first two weeks of the outbreak “were a disaster”.

Taiwan is under COVID-19 alert level 3 until at least June 28 after a sudden cluster of cases emerged linked to quarantines for airline pilots [Ritchie B Tongo/EPA]

The interview has been edited for length and clarity.

The COVID-19 situation in Taiwan has suddenly become very serious. What do you think went wrong?

Dating back to April, we started to have this British variant B117 imported from other countries and as you know B117 is a highly infectious virus. The second important characteristic is it causes a lot of asymptotic and mild cases.

It started from China Airlines and Novotel employees, then transmitted to New Taipei City and the Lions Clubs, and then transmitted to Yilan and it finally got to Wanhua’s adult entertainment venues, the so-called “tea houses”.

On May 15, before our Central Epidemic Command Centre (CECC) announced the Level 3 (semi-lockdown) alert, President Tsai Ing-wen called a meeting and invited me. (I said) thousands and thousands of people will be infected this time.

How do you think the current epidemic procedures are going?

In the first week of May 15, every day we had around 500 to 600 people infected and my former boss asked me is that good enough, I said I cannot say if that’s the peak. But fortunately for the first seven days it’s 500-600 cases, and the second week is 400 to 500, and then 300 to 400. Now it’s 200 to 300.

That means the epidemic curve has been levelled off through the efforts of Level 3 alert.

So I think it’s a good sign, but (the numbers are) also a bad sign. The disease has become endemic, which means the virus in Taiwan has community transmission and it is very, very difficult to eradicate the virus at all now.

Last February, I had some suspicions and unfortunately, my suspicion was right that COVID-19 is mutating, and it’s becoming flu-like.

The only way Taiwan can have very good containment in this second phase of the pandemic is the increased herd immunity through a nationwide immunisation program and urge the CECC to try to get the vaccine as soon as possible.

What do you think about Taiwan’s response to COVID-19 six months later?

I think that for the prevention of the pandemic, there are two ways to do it scientifically. The first one is the interruption of the virus transmission. That’s what we were doing in 2020 and it seemed to be very successful.

But there is prevention fatigue, people get tired of it and they somewhat loosen their awareness.  So before November 2020, Taiwan played very good first half of the game, but in the second half we ran short (because) of the vaccine.

I have to confess in the very first two weeks (of the recent outbreak) was really a disaster. Too many people got an infection and too many people rushed out to be tested and community stations were not ready at all and not even the hospitals.

Originally, we asked every hospital to have a designated ward or isolation room for COVID-19 patients, but since there were no COVID-19 cases, all the hospitals thought they didn’t need it so they filled in a lot of patients in the designated isolation rooms.

The situation is quite similar to any country with this surge of patients but fortunately, I would say, after two weeks, the community-based screenings stations were set up and then there were more and more isolation rooms available.

If COVID-19 has become more like the flu, what does that mean for Taiwan?

I would like to share first how we combatted influenza going back to the 2009 H1N1 pandemic.

We did three things: one is very good contact tracing and also home quarantining of infected people. For infected people, when they had very severe symptoms they got a rapid test and immediately and they would get antiviral, the so-called Tamiflu. They didn’t have to do any kind of home quarantine as their viral load went down and they recovered.

At that time, we developed Taiwan’s first domestic flu vaccine and then we used the international and domestic one to immunise people. If COVID-19 is going to become more and more flu-like, in the future, we need a very good and very sensitive specific rapid diagnosis test and a so-called antiviral for really infected people like influenza.

The outbreak has left Taiwan vulnerable because so few people have been vaccinated for the disease, It is now stepping up the programme and Japan and the US are sending doses [Sam Yeh/AFP]

Taiwan is struggling now to get enough vaccines. Why?

As you know, we have an ordered 20 million doses of the vaccine: from COVAX around five million, Moderna five million and AstraZeneca 10 million. The (domestic vaccines) Medigen, as well as United Biomedical, are in phase 2 clinical trials. If their safety and efficacy are good, they might get emergency-use authorisation.

But as you know, although we already have the purchase order with COVAX, the delivery is somewhat delayed and somewhat inadequate. At least we got the 1.25 million (AstraZeneca) donation from Japan and 0.75 million doses of Moderna from the United States. We hope that in June we can vaccinate three million people, and if it goes smoothly with the international vaccine and domestic efforts, we hope in July there will be another six million vaccines available, and in August another six million available.

By the end of August, I hope we may immunise at least 15 million people in Taiwan with (at least) one dose and at that point the epidemic might be contained much better.  With some hope and if that’s the case then we are going to return to a new normal life.

What will solve the current crisis?

The only thing we can do is immunisation. We try to get everybody to have resistance to it, and more importantly, the immunisation has to be implemented as soon as possible and on as large a scale as possible. This isn’t only for Taiwan, this is for the rest of the world.

There is a kind of competition in time with virus. If (the) coronavirus is going to keep mutating like influenza virus, then someday, somehow there will be a new variant which the current vaccine cannot prevent it in humans at all.

What do you think of the theory COVID-19 may have been leaked from a lab?

According to recent report there is a piece of human genome in the COVID-19 virus, and it is really weird. It seems to be genetically modified or inserted by some of the lab and that’s the reason why US President Joe Biden has asked their experts to try to look into it.

Another reason people have their suspicions is when the WHO delegation went to the Wuhan lab, they didn’t get very much information from their visit at all. If there really are human genes in the virus, then we have to figure out how it could be integrated into the virus gene. This is very strong evidence to indicate that in some lab some (researchers) did a laboratory experiment.

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‘Suddenly, she’s gone’: Mud and death in COVID-hit Indonesia | Coronavirus pandemic News




Jakarta/Kudus, Indonesia – It should have been a time of celebration for Puji Apriani’s family – she was pregnant with her second child, and just weeks away from giving birth.

But instead of welcoming a new life, her family is now in mourning.

“I miss her. She was healthy, her pregnancy was normal. And suddenly, she’s gone,” her younger sister Ery Jurniastuti said.

The family lives in Kudus, Central Java – one of the worst affected areas by Indonesia’s recent surge in COVID-19 cases.

“She felt out of breath, and she was coughing. She felt contractions in her stomach, too,” Ery said.

Home to almost 900,000 people, Kudus has recorded a 7,594 percent increase in cases since the beginning of this year.

Following a steep rise in cases this month, overwhelmed hospitals have been forced to turn patients away.

After being rejected by two hospitals, Puji was finally admitted, and her oxygen levels increased slightly.

But it was too late. Her condition deteriorated and she died in hospital.

“She died first, then they checked the heart of the baby. The baby is still inside, they didn’t take it out. It died there.”


Puji Apriani was pregnant and only a few weeks away from giving birth when she caught COVID-19. Now, instead of celebrating a new arrival, her family are morning the death of both Puji and her baby [Jamaah/Al Jazeera]

Doctors vs Delta

At the Loekmono Hadi General Hospital in Kudus, Dr Abdul Aziz Achyar said he was “surprised” by the ferocity of the surge, which has pushed bed occupancy rates in hospitals to more than 90 percent.

“During Ramadan, it was so quiet. We only had 18 patients. But then, when it started … I myself was also hospitalised,” he told Al Jazeera.

One hundred fifty-three of his colleagues also contracted the virus, and two of them died.

Indonesia’s capacity to track variants is limited, but doctors believe the current outbreak in Kudus is driven in part by the spread of the Delta variant, which was first detected in India.

“We sent cases from health centre [for genome sequencing]… from 72 samples, 62 were the new variant,” Dr Abdul said.

At Aisyiyah Kudus Hospital, Dr Najib Budhiwardoyo said his hospital is completely at capacity.

“We are full of COVID patients. This second wave started after Eid,” he said.

“All hospitals in Kudus are experiencing this problem … oxygen scarcity. We have to be selective; we can only use oxygen for patients with very low saturation.”

Swamp turned cemetery

It is not just the hospitals in Java that are close to capacity, but cemeteries too.

In the Indonesian capital, the designated COVID-19 burial sites, such as Pondok Rangon Cemetery, that were opened in the early months of the pandemic are already full.

Cemetery workers told Al Jazeera they are struggling to keep up with their workload.

“Before COVID, I used to dig 10 graves each day. But yesterday, we dug 46 graves. The day before, it was 51,” Darsiman, a gravedigger of 20 years, said.

“We are very tired. We work from morning until night.”

Darsiman, a gravedigger of 20 years, waits for Wahyudin to finish writing on a wooden headstone [Jessica Washington/Al Jazeera]

In Rorotan, North Jakarta, a new burial site for those who have died from COVID-19 opened just weeks ago – and already, more than 800 people have been buried there.

As the death toll continues to rise, finding room for the dead in this densely packed city is becoming a challenge.

The land at Rorotan used to be an empty swamp – the families of the deceased have to trek through the mud, to pay respects to their loved ones.

“This is a new cemetery … the other locations are full. There are just so many COVID cases, so they have to bring them here,” Darsiman said.

“It’s been raining so it’s muddy. It’s very sad to see funerals here, even the ambulances get stuck trying to come in.”

Headstone writer Wahyudin said his workload has increased because of the pandemic – and working at the cemetery takes an emotional toll.

“I feel so sad seeing this many burials. Seeing those families cry, I think about my own family,” he said.

“Before COVID, I also made headstones but it’s busier now. So many people have died.”

Moments to rest are scarce – just as workers lower a plastic-wrapped coffin into the ground, more ambulances arrive, with more dead to bury.


‘India should be our lesson’

This week, Indonesia surpassed two million confirmed cases of coronavirus – and more than 55,000 confirmed deaths.

Dr Nadia Siti, the head of Infectious Diseases at the Ministry of Health, said the rise in cases is not surprising.

“We know that if there is a holiday or event, there is an increasing number of people moving and travelling from other cities,” she said.

The cemetery at Rorotan has been built on what was once a swamp in northern Jakarta [Fakhrur Roz/Al Jazeera]
The cemetery at Rorotan has only been open for a few weeks and more than 800 people have already been buried there [Jessica Washington/Al Jazeera]

“The government had restrictions on mudik, which is the tradition of Muslims to visit their hometown [during Eid Al Fitr]. Still, there are four to six million people who travelled.”

The situation in Kudus and capital are of particular concern to the Ministry of Health, where bed occupation rates are high and hospital workers are already overwhelmed by the crisis.

“In Jakarta, the bed occupation rate is almost 80 to 90 percent. We instruct hospitals to convert their beds into COVID-19 services, so they can be available for patients,” she said.

“The last strategy is to establish field hospitals with the coordination of the army or police.”

Long before the pandemic, Indonesia had a shortage of medical professionals – and there are concerns about how its stretched healthcare system will cope when infections are expected to peak in July.

“With the existing doctors, paramedics and nurses, it might not be enough. We might need an experienced doctor to supervise five or 10 new ones, who don’t have experience in taking care of patients,” Dr Nadia said.

“We do hope we won’t face the same situation like India. What happened in India should be our lesson.”

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Former Philippine president Benigno Aquino dies at age of 61 | Obituaries News




Aquino was the country’s 15th president from 2010 to 2016, and was succeeded by current president , Rodrigo Duterte.

Former Philippine President Benigno Aquino III died early on Thursday, after a prolonged illness, according to several news reports.

Aquino, 61, served as the country’s 15th president from 2010 to 2016, and was succeeded in office by the incumbent, Rodrigo Duterte.

According to ABS-CBN News, he was hospitalised last Thursday.

But he has been undergoing dialysis for at least five months and had recently undergone a heart operation.

It was during Aquino’s administration that Manila took on China and filed a case before the Court of Arbitration at The Hague over the South China Sea dispute.

The Philippines later won that landmark case a month after Aquino left office in 2016.

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The scrappy Hong Kong tabloid that refused to bow to Beijing | Freedom of the Press News




Hong Kong, China – The last edition of the Apple Daily, the small scrappy Hong Kong tabloid that emerged as a champion of democracy and outspoken critic of China, has rolled off the presses, four days after the newspaper celebrated its 26th anniversary.

The paper had been raided by police twice during the past 10 months on suspicion of violating the National Security Law that was imposed by Beijing almost a year ago. Since the first raid last August, founder Jimmy Lai, 73, has been in jail awaiting trial under the law.

Last week’s raid saw five top executives, including its chief editor, arrested for alleged security offences as 500 police officers swooped in on Apple’s headquarters, with another staffer – the head editorial writer – apprehended on Wednesday morning.

The final nail in the coffin, however, was Hong Kong authorities’ freeze on the bank accounts of the media group that owns the paper. The move made it impossible for the paper to pay its staff and vendors, even as readers snapped up copies to show their support.

The decision was based on “employee safety and manpower considerations”, Apple Daily said as it announced its closure on Wednesday.
“Here we say goodbye. Take care of yourselves.”

Staff members of Apple Daily and its publisher Next Digital clap out the final edition of a paper that began publishing in 1995 and became a thorn in Beijing’s side [Tyrone Siu/Reuters]

Hong Kong was returned to Chinese rule in 1997 under the “one country, two systems” framework meant to guarantee rights and liberties absent in the mainland. For most of the past 20 years, the territory has remained a bastion of press freedom in a country where media is muzzled.

“The demise of Apple Daily negates ‘one country, two systems’ and sets the stage for ‘one country, one system,’” said Willy Lam, a longtime commentator on Chinese politics and a veteran newspaper editor.

Bold, brash

Founded just two years before the handover, Apple Daily was at once a gamble and a leap of faith.

“The paper wanted to have some impact not just on Hong Kong but also to support the liberalisation of China,” Lam told Al Jazeera. “But as China has become less open to Western values, the paper has focused on defending Hong Kong values and holding Beijing to account.”

In its inaugural editorial, Apple Daily said it aimed to be a paper for the Hong Kong people.

Lai, its founder and funder, a devout Catholic who had made a fortune in the fashion business, named the paper after the forbidden fruit in the Garden of Eden in the Old Testament. Its rhyming couplet jingle – “An Apple a day, no liars can hold sway” – caught the attention of Hong Kong readers used to more staid offerings.

It was loud. It was bold, It was flashy.

The paper grabbed attention when it splashed a surreptitiously shot photo of Deng Xiaoping – China’s then-paramount leader died in February at the age of 92 – on his deathbed on the front page.

Brashness was its selling point.

Its reporters frequently skewered public officials and needled the comfortable.

“It speaks truth to power and finds a way to do profitably,” said Lokman Tsui, assistant professor of journalism at the Chinese University of Hong Kong.

Jimmy Lai, standing by one of the printing presses in 2009, created a hugely popular paper that supported democracy, was unafraid to speak truth to power and critical of the Communist Party in Beijing [File: Alex Hofford/EPA]
Apple Daily’s founder and funder, Jimmy Lai, was arrested in August under the national security law and the paper’s headquarters raided. He has now been jailed [File: Tyrone Siu/Reuters]

The paper catered to high brow and low. Colourful spreads of scantily-clad female models appeared in the same section of the paper as erudite columns featuring quotes in Latin and Classical Chinese. With a couple of exceptions, its ranks of columnists were the who’s who of the territory’s pro-democracy circle.

Giving people what they want

Launched at the dawn of the internet age, the daily was quick to adapt to the digital world. Its website pioneered animated news – a mix of stills, short clips and clever graphics with narration dripping with sour sarcasm. Its lifestyle channel on YouTube built a fervent following.

A decade in, the paper’s circulation peaked at 500,000 in a city of approximately six million people with a dozen dailies.

Apple Daily’s brand of advocacy journalism would soon make the paper a thorn in the side of the Chinese Communist Party. But to Lai, a rags-to-riches maverick millionaire now named Public Enemy No. 1 by Beijing, it was all about giving his customers what they would buy, even down to protest poster inserts.

In the summer of 2019, amid popular opposition to legislation that would send Hong Kong residents for trial in mainland China, the paper shorthanded “extradition to China” into the homophonic colloquial Cantonese expression of seeing someone to the grave. The expression immediately caught on and became a rallying cry in the protest movement.

“At times, we might have gone overboard but everything we did fell within the bounds of the law,” said Robert Chan, 45, who has covered mainland China for the paper for the past three years.

That is until the passage of the security law, which punishes what the authorities deem subversion, sedition, collusion with foreign forces and secession with possible life sentences.

Prosecutors have used Lai’s frequent meetings with US officials in recent years, from the then-vice president on down, as “evidence” of his alleged “collusion with foreign powers”.

Staff from Apple Daily and its publisher Next Digital work on the final edition of their newspaper on June 23. In its first-ever editorial, the paper said it wanted to be a publication of the Hong Kong people. It printed a million copies of its final edition [Tyrone Siu/Reuters]

Early last month, rumours started to circulate that Beijing wanted to see the paper be shuttered in time for the Communist Party’s centenary celebrations on July 1.

Technology reporter for a decade, Alex Tang, 37, said like most of his colleagues he had become conditioned to taking unsubstantiated gossip with a grain of salt – until the second raid and the company asset freeze.

During the past few days, some of the 800 reporters at the paper were frustrated by the lack of a definitive answer on the last publishing date and severance.

“Management said they’d hang on till the bitter end, and they’ve kept their word,” said Tang. “The company has done its best.”

Apple Daily will live on as a website on the self-governing island of Taiwan, where it ceased paper publication last month.

But in Hong Kong, China news reporter Chan said he will mourn the loss of far more than his livelihood.

“With the paper gone, so would the values it represents: pursuit of freedom and democracy,” he said.

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