It should be danger signs for New Zealand that Taiwan, a country that's only vaccinated 1 percent of its population, is experiencing a spike in COVID-19 cases, a leading medical expert says.
After months of safety and no community transmission of COVID-19, Taiwan is battling a surge of locally acquired infections - recording more than 600 cases and 11 deaths on Wednesday.
New Zealand needs to take note of the Taiwan outbreak, Auckland University professor of medicine Des Gorman says - given the percentage of fully vaccinated New Zealanders is also in the single-digits (3.9 percent have had two doses, according to the Financial Times' COVID-19 vaccine tracker).
What happened in Taiwan?
Once hailed a COVID-19 success story, Taiwan is now under its most stringent lockdown measures since the pandemic began - with restaurant dining banned, fines for people not wearing face masks outside, and halt on wedding banquets and wakes.
"Those countries that did well through their isolation/lockdown approaches now have a real problem - and that's reintegration and rehabilitation of their economies and ways of life," Dr Gorman explains.
"In the case of Taiwan, they've got very good contact tracing and they've got very good border management but they didn't have the immunisation levels they needed."
Taiwan, with a population of more than 23 million, has reported a total of 6091 infections since the pandemic began, including 46 deaths - still relatively low compared to other countries (Iceland, for example, only has a population of about 357,000 but has recorded around 500 more cases than Taiwan).
COVID-19 started to circulate in Taiwan's community late last month - the original outbreak linked to an airport hotel and pilots at China Airlines - Taiwan's largest carrier.
Most of those infected in the current wave in Taiwan have had either no or mild symptoms, according to its government.
So where are Taiwan and New Zealand at with their vaccine rollouts?
Taiwan has ordered more than 20 million COVID-19 vaccines from AstraZeneca and Moderna but so far only just more than 700,000 of the AstraZeneca jab have arrived.
New Zealand has secured 10 million doses of the Pfizer vaccine. COVID-19 Response Minister Chris Hipkins told RNZ's Checkpoint this week there were about 300,000 doses on hand - in addition to the 562,149 jabs already administered.
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But Dr Gorman says New Zealand has a long way to go on COVID-19 vaccinations. He's "100 percent" confident the Government's goal of vaccinating as many people as possible by the end of 2021 won't be achieved.
He points to a recent report by Auditor-General John Ryan which found a "significant" scale-up of the vaccination effort is required to achieve the Government's goals. Ryan recommended the Ministry of Health be transparent around supply risks and the possible impact on the rollout schedule.
But it was revealed on Wednesday New Zealanders would have to wait an extra few weeks for their COVID-19 vaccine, as supply issues pushed the rollout back until the end of July. The Ministry of Health quietly updated its website last week to reflect the shift in the time frame.
"The Auditor-General, what did he ask for? He asked for transparency," Dr Gorman says. "What are we getting instead? Opaqueness."
But the Government insists there's no delay.
"We've got very firm undertakings from Pfizer… that they'll get us all our vaccines by the end of September," Hipkins told Magic Talk's Ryan Bridge on Wednesday.
"It's just a question of when we start getting those big deliveries in.
"Pfizer was pretty upfront with us; we could have the extra vaccines so that we could do the whole population. But we'll have to wait until July onwards - that July through to September period - for the big deliveries to be coming in."
Why is Taiwan's outbreak a warning sign?
The futures of both New Zealand and Taiwan will still rely heavily on managed isolation and quarantine, contact tracing, and testing, Dr Gorman says.
"The difference is the Taiwanese have a much more efficient way of managing an outbreak than we do - we should look at Taiwan and we should be very scared because it shows us just how vulnerable we are until we immunise our community.
"We're more vulnerable than Taiwan… not only are we not vaccinated but our border management remains quite porous. More worrying still is, our contact tracing is profoundly inadequate.
"I think we're literally a shag on a rock and just praying that we continue to be as lucky as we've been."
Earlier this month, Hipkins told Newshub New Zealand's contact tracing "continues to improve".
Nonetheless, epidemiologist Michael Baker, from the University of Otago, agrees Taiwan's experience has some key lessons for New Zealand.
"A big lesson for NZ is to continue to focus on managing its borders very effectively and to identify and close off areas of vulnerability," he told Newshub.
"This is still an area of vulnerability for NZ."
