TAIPEI, Taiwan — It is at lunchtime that Nancy Chen misses her father the most. For 30 years, she ate every day with her parents at their apartment. Her father, despite being partially impaired by a stroke, would buy her a box lunch with cod. If she were 15 minutes late, he would worry and ask if she was working too hard.
But Taiwan was caught off guard when the virus came. The health system couldn’t handle the number of COVID tests needed and doctors lacked the right medications. The death toll rose quickly from just 12 to more than 800.
Chen’s father, who died in June, was one of the victims.
“We never thought it would explode in Taiwan like this,” Chen’s husband, Jason Ding, said in an interview at their home in New Taipei City.
They are among 12 bereaved families that are seeking an apology and 60 million new Taiwan dollars ($2 million) in compensation from the government, saying it was underprepared — despite it being a year and a half into the pandemic — leading to unnecessary deaths and suffering.
Lawyers for the families submitted their case Thursday to the Ministry of Health and Welfare and the Executive Yuan, Taiwan’s Cabinet. One of the lawyers, Chen Hsueh-hua, said the families want a public reckoning because they believe their government failed them.
The Taiwan Centers for Disease Control, which is under the Health Ministry, did not immediately respond to questions.
Taiwan’s experience shows how quickly the virus can destabilize health care systems even when the caseload is relatively low. To date, the island of 24 million people has had 16,465 cases and 848 deaths. Yet, the loss for each family cuts as deeply as anywhere else.
Relatives of victims elsewhere are also seeking answers. A raft of lawsuits have been filed in France over shortages of masks and test kits early in the outbreak. The British government has agreed to hold a public inquiry into its handling of the pandemic, partly in response to threats of legal action.
The Taiwanese case is backed by Yaung Chih-liang, a former health minister from Taiwan’s main opposition party, the Nationalists, who have repeatedly attacked the government’s handling of the pandemic.
At the height of the outbreak, Chen couldn’t get an ambulance for her mother, who tested positive on May 23 and had been feverish. They waited four days for an ambulance.
“It was always busy, you couldn’t even connect,” said Chen, whose parents’ neighborhood was one of the hardest-hit areas. “It was really terrifying, it was constantly busy.”
Her father, who had been hospitalized after a second stroke a day before her mother started showing symptoms, tested negative for the coronavirus twice. About a week later, his third test was positive.
Chen asked if the hospital had any COVID-19 drugs. The hospital said no, aside from remdesivir, but the doctor worried it would interact with the stroke medication. The hospital didn’t have any antibody drugs, which are used to prevent mild cases from becoming severe, though it may have been too late for her father by then.
“They really didn’t prepare at all. If you look abroad, these things had already happened,” Ding said.
Taiwan did not have any COVID-19 antibody drugs when the outbreak exploded in May, doctors and families said. Only on June 11 did the Taiwan Centers for Disease Control announce they had purchased 1,000 doses of antibody treatments. Chen’s father died three days later.
Taiwan had a limited stock of remdesivir, an anti-viral drug from Gilead, which has demonstrated mixed results
“There wasn’t enough, you could only get it if you applied for it from the central government,” said Su Yi-Fong, a pulmonary doctor at a Taipei hospital near one of the hotspots in the outbreak.
Further, it wasn’t covered by the island’s national health insurance scheme, making it affordable only for a small percent of the population.
Su said they only had treatments such as steroids. “If they needed oxygen, we would give them oxygen, and if they really weren’t OK, then we would have to intubate them,” he said. “That’s all we could do.”
Chen’s mother was given tocilizumab, an arthritis drug, which a doctor had suggested as a last resort.
The families in the lawsuit wonder if their relatives would have lived if they had been given the antibody drugs early on, before they had deteriorated.
Chien-Chang Lee, a clinical professor of emergency medicine at National Taiwan University, believes that antibody treatments would not have made a huge difference in the number of deaths given a culture of being cautious in prescribing medications.
Due to Taiwan’s previous success, many doctors did not have any experience in treating COVID-19 patients and may not have known when to best use the medicine, he added.
As hospitals and morgues were overwhelmed with patients, many people could not carry out their family members’ last wishes.
Adams Chi, who is one of the members of the group seeking compensation, viewed his mother’s final moments through a cellphone screen, outside the room where she was isolated.
After her death, he found he had no choice but to cremate her body. His mother had wanted to be buried next to his father, not cremated, because she was afraid of fire. But the morgue would not store her body while burial arrangements were made, because it did not want to keep COVID-19 victims with the other bodies.
Before dawn on a Tuesday in June, as workers waited to cremate his mother, he shouted to warn of the incoming flames.
“Before the fire comes, you have to tell your loved one, ‘The fire is coming, go! Run!’ And then they won’t be hurt,” Chi said. “Then, the soul won’t be affected.”