How Taiwan has kept coronavirus infection rate low

Decisive action taken early, writes Andy Kang-i Chen.

Countries are scrambling to respond as the COVID-19 viral pandemic is sweeping the world over. Taiwan is only a short flight away from China, the origin of the outbreak. Intense people-to-people ties put the island in the front line of the epidemic crisis. Early assessments released by the Center for Systems Science and Engineering at Johns Hopkins University projected Thailand and Taiwan to have the highest risk of imported COVID-19.

However, Taiwan’s numbers are much lower than in neighbouring countries. It reported the first confirmed case on Jan. 21 and yet, it has had only 108 cases and one death as of March

19. Taiwan is still trying its utmost to refrain from a lockdown while more and more countries, including Canada, have taken drastic measures to try to stem the spread of the pandemic.

Why did Taiwan outperform many countries? Proactive measures since the beginning of the outbreak, transparent communication and early screenings helped.

In the past 60 years and more, Taiwan has overcome outbreaks of cholera, malaria, smallpox, tuberculosis and other communicable diseases, accumulating considerable experience and establishing an extensive disease prevention mechanism. Nevertheless, the SARS outbreak in 2003 cost the country 81 lives. The painful experience taught Taiwan the importance of a proactive approach.

Taiwan took tough action early. Monitoring and control systems for outbound and inbound travellers are in place, as is a comprehensive nationwide mechanism designed to follow the development of any outbreak. Taiwan’s Centers for Disease Control immediately ordered screenings of inbound flight passengers from Wuhan on Dec. 31, only two weeks after the first severe COVID-19 cases were reported in Wuhan on Dec. 17.

Taiwan’s government initiated by early January 2020 countermeasures such as requiring hospitals to test for and report cases. On Jan. 20, the Central Epidemic Command Center was set up to ensure co-ordinated efforts among ministries, public agencies, local governments and medical facilities and it has been holding a press conference almost every day to announce the latest policy and information on the epidemic, and to clarify rumours that are circulating on social media. On Jan. 26, only five days after it confirmed its first case, Taiwan banned arrivals from Wuhan, earlier than any other country.

As the outbreak has worsened around the world, Taiwan gradually expanded the scope of testing from those with suspected symptoms who had recently travelled to countries with coronavirus outbreaks or had contact with coronavirus patients to patients with severe flu-like symptoms. The expansion of screening has so far helped avert large scale community-wide outbreaks in the country. As of March 19, Taiwan has conducted 21,376 tests.

Taiwan’s Academic Sinica has rapidly developed antibodies in 19 days that can identify the protein that causes COVID-19, paving the way for a new test for the virus that can provide results within 15 minutes. If these antibodies can be successfully manufactured and validated, it will significantly improve screening efficiency.

As the seriousness of the outbreak became clear, a special budget plan worth $2.78 billion was approved by the legislature on March 13 to fund containment and control efforts, including border control, paid leave for caregivers and the sick and to help cushion the impact of the new coronavirus on its export-reliant economy, offering loans to hard-hit small businesses.

Taiwan has established a comprehensive national disease prevention mechanism, which includes digitized disease monitoring systems, stringent border quarantine measures, extensive community-based countermeasures, advanced medical preparedness, an abundant stock of preventive medical appliances and resources, concise guidelines and information for the reference of the general public, and annual disease prevention and control drills. In spite of this, Taiwan’s ability to share information with the members of the World Health Organization is limited because Taiwan is not a member of the WHO due to the objection of China, which considers it a Chinese province with no right to participate.

I believe that only by working together, leaving no one out, can we rapidly and adequately address the challenges of emerging infectious diseases which have been made all the more complex by the effects of globalization.

Andy Kang-i Chen is director general at the Taipei Economic and Cultural Office in Vancouver.