Taiwan’s remarkably low number of coronavirus infections – less than 50 in total despite the island’s proximity to the outbreak area and extensive travel and commerce with China – has been credited to swift and effective action when the epidemic began, starting with a firm travel ban on China and the semi-autonomous territories of Hong Kong and Macau.
Deutsche Welle noted on Wednesday that experts initially predicted Taiwan would be one of the hardest-hit victims of the epidemic, but it achieved one of the lowest rates of coronavirus infection in the world.
Many factors placed Taiwan at high risk, including dense urban populations, a high number of travelers from China, the coronavirus outbreak erupting during the Lunar New Year holiday, and a large population of Taiwanese citizens living or working in China. Taiwan gets about 2.7 million visitors from China annually and has well over a million citizens either working in China or living there full-time, measured against a total Taiwanese population of 23 million.
Taiwan benefited from its National Health Command Center (NHCC), an agency established after the 2002-2003 SARS epidemic and explicitly intended to help contain future disease outbreaks.
Kyodo News explained how the NHCC helped Taiwan quickly determine the dangers posed by the coronavirus, facilitate communications between various government agencies, and implement effective countermeasures:
In a recent interview, Taiwan’s Vice President Chen Chien-jen, an epidemiologist by training and health minister during the SARS crisis, identified key elements of the program to include transparency, information sharing, staffing agencies with relevant experts, interagency cooperation and coordinating the efforts of government labs with hospitals and other medical facilities across the island.
Infrastructure developed by the NHCC enabled a remarkably quick response to initial reports from Wuhan, with Taiwanese health officials boarding flights from the region as early as Dec. 31 to check passengers for symptoms.
On Jan. 20, President Tsai Ing-wen announced that current Health Minister Chen Shih-chung would personally supervise operations and host daily press conferences to keep the public informed.
And as the seriousness of the outbreak became clear, the legislature passed a special bill allocating NT$60 billion (US$2 billion) to fund containment and control efforts, including border control, paid leave for caregivers and the sick, the manufacture of essential equipment like face masks, forming protocols for tracing sources of infection and reducing the risk of transmission in settings such as schools, hospitals and transportation systems.
Information management was an invaluable component of Taiwan’s response. Kyodo News noted that data from Taiwan’s health insurance and immigration agencies were integrated so doctors would have immediate access to the travel histories of their patients, helping them decide who needed coronavirus testing the most.
An analysis published by Stanford University last week credited “big data, transparency, and a central command” with helping Taiwan efficiently implement a list of 124 action items, beginning with border controls and the aforementioned integration of health and travel data. Taiwan began aggressively screening travelers for an as-yet-undefined form of pneumonia in late December, while the Chinese Communist Party was still trying to conceal the existence of the Wuhan coronavirus and punishing doctors who spoke out.
Some of those 124 action items implemented by Taiwan would be logistically or politically difficult to pull off in the United States. For example, Taiwanese who traveled to coronavirus outbreak regions were ordered into quarantine and tracked using their cell phones to ensure compliance. Hotlines were established so citizens could “report suspicious symptoms in themselves or others.” Taiwanese health officials were boarding airplanes and checking passengers for symptoms as early as December 31.
Taiwan quickly began stockpiling protective gear and setting up isolation rooms for coronavirus patients, creating a surge of resources before those resources were needed. It accomplished this with a high degree of cooperation between private entities, government officials, and rival political parties, which is rather different from the situation in the United States at present.
Dense urban populations are a problem during disease outbreaks, but Taiwan’s relatively small total population and modest landmass made control measures easier to implement than they would be in nations with many times its population and physical size. Taiwan is, for all intents and purposes, a well-managed city without a fractious, cumbersome, and distant national government to satisfy.
Taiwan’s hotly-contested presidential election was held on January 11, but even the pro-China candidates did little to interfere with early coronavirus containment procedures. This might have been a beneficial side effect of the Chinese Communist Party’s refusal to admit it had a serious epidemic on its hands in Wuhan; there was no Party line heckling Taiwan for its precautions for Taiwanese candidates aligned with Beijing to push, and incumbent President Tsai Ing-wen had already rebounded from a tough 2018 legislative election thanks to the Hong Kong protest movement and its critique of the Chinese government.
Ironically, China’s brutal insistence on keeping Taiwan out of the World Health Organization (WHO) might actually have helped Taiwan’s response to the coronavirus. China forced Taiwan out after President Tsai’s election in 2016 and has blocked every effort to regain even observer status at WHO’s annual policy meeting, insisting that Taiwan should not receive any considerations or honors that would be afforded to a full nation-state.
Kyodo News suggested this was perversely helpful to Taiwan, because its close allies in the United States and Japan forwarded the most vital information, while “being outside the official loop has required that island authorities be extra vigilant, with self-sufficiency a necessary objective.”
Taiwan’s Foreign Ministry nevertheless protested on Tuesday that China is “vile” and “evil” for continuing to block the island’s participation in WHO, slamming Beijing for providing incorrect information to WHO while presuming to act as Taiwan’s owner and manager. Foreign Ministry spokesman Joanne Ou stressed that Taiwan has relied on the U.S. and Japan to get the medical information it needs.
WHO responded by claiming that its representatives are collaborating with Taiwanese experts and have “received vital information from Taiwanese authorities.”
Beijing was, as always, callously uninterested in modifying its anti-Taiwan stance in the face of the epidemic unleashed upon the world by Chinese Communist Party incompetence and paranoia.
“The WHO is a special UN agency consisting of sovereign states. Taiwan’s participation in the activities of international organizations such as the WHO must be arranged properly through cross-strait consultations under the one-China principle,” said Chinese Foreign Ministry spokeswoman Hua Chunying.
The Taiwanese Foreign Ministry noted that China’s dogged insistence on forcing international agencies and corporations to treat Taiwan as a province ruled by Beijing is actively interfering with Taiwan’s exemplary coronavirus response and inconveniencing travelers, as with those who are blocked from traveling to Taiwan or have trouble obtaining visas because the nearly virus-free island is treated as just another city in China.
Taiwan also noted that China has been very slow to permit the evacuation of Taiwanese citizens from Wuhan even as other countries were allowed to do so. The first group of stranded Taiwanese was evacuated from Wuhan on Tuesday.
The Taiwanese government announced on Wednesday that it will lodge a protest with Johns Hopkins University in the United States because the university modified its coronavirus tracking map under pressure from Beijing to list Taiwan as part of China. The Johns Hopkins tracker now describes Taiwan as “Taipei and environs, China.”
On Thursday, Taiwan confirmed its latest case of coronavirus infection, bringing the total up to just 49 with one fatality.
The new patient was described as a woman in her 40s who returned to Taiwan on March 8 after traveling to the United Kingdom, Ireland, Belgium, and Turkey. She did not display any symptoms at the time of her return, but checked into a hospital two days later and tested positive for the Wuhan virus. Of Taiwan’s 49 confirmed infections, 26 contracted the virus locally while 23 were apparently infected while traveling abroad.