Taiwan reports zero Covid cases for first time since outbreak in May

Taiwan has reported zero community cases of Covid-19 for the first time since its biggest outbreak began in May, killing more than 800 people.

“The local confirmed case today is zero, it was not easy,” the head of the Central Epidemic Command Centre, Chen Shih-chung, said on Wednesday.

“I believe everyone is happy about this zero, but it doesn’t mean that the Covid-19 is completely cleared in Taiwan. There is still a long way to go, but this zero means that the epidemic is relatively stable.”

The island’s ability to keep the pandemic out of the community was a global success story. Residents lived a largely normal life for most of 2020 and early 2021, albeit with closed borders.

But in May an outbreak of the Alpha strain, believed to have been introduced via airline crews, caught hold and spread across every county. The government enacted lockdown measures but was criticised early on for not going hard or early enough, and the population remained under level three restrictions (in a four-level system) for almost three months.

At the Alpha outbreak’s peak, Taiwan was reporting more than 500 cases a day. The outbreak also caused 818 of Taiwan’s total 830 recorded Covid-19 deaths, including one woman in her 70s reported on Wednesday.

Mr Chen said Wednesday’s announcement was “just the start of hope”, and authorities would observe the situation for a while before further relaxing restrictions.

The alert was dropped to level two on July 27th, but not all county governments have passed it on in totality, instead maintaining limited closures and restrictions. In some cities students have returned to school, restaurants have reopened for in-person dining, and sport and other entertainment is restarting.

Health experts and former senior government figures had expressed concern in the early weeks of the outbreak that Taiwan had grown complacent with its success and not kept up with recent science, including around the faster variants and new awareness of aerosolised spread.

It was also not conducting mass testing, instead relying on its trace and isolate procedure, which authorities said was initially overwhelmed. During the three-month outbreak, 2,548,825 tests were conducted.

Taiwan was also far behind in vaccinations compared with other countries, owing to a combination of insufficient orders, global supply issues, alleged Chinese interference in procurement and vaccine hesitancy in the population.

But the outbreak led to improvements in Taiwan’s responses. Testing and tracing capabilities were scaled up, and vaccine rollouts accelerated with the assistance of overseas donations and the development of Taiwan’s Medigen vaccine. More than 40 per cent of the population have had at least one dose, although only 3 per cent are fully vaccinated, according to Our World In Data.

This week, the government announced increased measures to avoid an outbreak of the Delta variant. In June, a handful of Delta cases in southern Taiwan were quickly contained but the island has not yet had to deal with rampant spread of the much more infectious strain.

WHAT IS TAIWAN's MEDIGEN VACCINE?

The MVC COVID-19 vaccine, designated MVC-COV1901 and also known as the Medigen COVID-19 vaccine, is a protein subunit COVID-19 vaccine developed by Medigen Vaccine Biologics Corporation in Taiwan, American company Dynavax Technologies and the U.S. National Institute of Health.

This vaccine is made by the recombinant S-2P spike protein adjuvanted with CpG 1018 supplied by Dynavax. Preliminary results from Phase I trials on 77 participants were published in June 2021, indicating what the authors described as "robust" immune system response elicited by the vaccine.

On 13 October 2020, Medigen Vaccine Biologics received Taiwan's government subsidies for the initiation of Phase 1 Clinical Trial in Taiwan starting early October. The Phase 1 Clinical Trial was held at National Taiwan University Hospital with 45 participants ranging the age of 20–50.

On 25 January 2021, Medigen Vaccine Biologics initiated Phase 2 Clinical Trial for its COVID-19 vaccine candidate MVC-COV1901 with the first participant being dosed. The Phase 2 Clinical Trial for the MVC COVID-19 vaccine was a randomized, double-blinded, and multi-center clinical trial, planned to enroll 3,700 participants of any age 20 above.

On 10 June 2021, Medigen Vaccine Biologics released its COVID-19 vaccine Phase 2 interim analysis results, which demonstrates good safety profile in participants. The Phase 2 Clinical Trial in the end included 3,800 participants with all participants receiving second dose by 28 April 2021. Medigen Vaccine Biologics announced that it will request Emergency Use Authorization (EUA) with the concluding of the Phase 2 Clinical Trial.

On 20 July 2021, Medigen Vaccine Biologics filed a Phase 3 Clinical Trial IND application with Paraguay's regulatory authority, which was later approved. The Phase 3 Clinical Trial, however, was different from regular Phase 3 Clinical Trial, which uses immune-bridging trial to compare the performance of MVC COVID-19 vaccine with the Oxford-AstraZeneca COVID-19 vaccine.

On July 19, 2021, MVC COVID-19 vaccine obtained Emergency Use Authorization (EUA) approval from the Taiwanese government after fulfilling EUA requirements set by Taiwanese authority.

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