How is Taiwan Facing the Coronavirus?

Written by Josie-Marie Perkuhn.

Image credit: 總統視導「陸軍第33化學兵群防疫整備」by 總統府/Flickr, license CC BY 2.0

The sheer scope of the Coronavirus (2019-nCov) has taken the world’s breath away: the numbers of infected mainlanders have increased dramatically. According to a WHO Report, since January 23^rd—when the first infected women arrived in Taoyuan International Airport—the number of confirmed cases in Taiwan has reached 23. Taiwan-based COVID-tracking webpage also reports 24 deaths, which is corroborated by ifeng News. Additionally, Taiwan’s health minister Chen Shih-Chung (陳時中), along with confirming the first fatality, has stated that a violation of reporting will be fined up to NT 150,00. As of writing, it is unclear how the deceased taxi driver became infected since he spent no time outside the island.

Given this, Taiwan’s problems go beyond the purely medical. The medical concern is to prevent any further infection. However, the political involvement of the cross-straits relations, and the international institutional setting, proves challenging. Taiwanese citizens remaining in the mainland are one matter of concern, as is the question of how to improve Taiwan’s political situation during the latest epidemic outbreak.

The Coronavirus—2019 n-CoV (Guanzhuang bingdu 冠狀病毒), also known as Wuhan Pneumonia (Wuhan Feiyan 武漢肺炎)—allegedly originated in December 2019 at a living animal food market in the city of Wuhan. Although caution is advised in such postulations, the scientific community tentatively suggest that contagious animals, such as bats, could be held responsible (although this hasn’t been fully confirmed yet.) The virus is named after its molecular appearance, as protein spikes in its constitution resemble a corona (Latin: crown). There are many types of Coronaviruses, which either affect the respiratory or gastrointestinal system. Comparable to the previous outbreak of SARS in 2002 or MERS in Saudi-Arabia in 2012, the 2019-nCoV is a respiratory virus. The symptoms are similar to influenza: fever, cough and shortness of breath. However, if untreated, it might lead to pneumonia, kidney failure and death. To be sure whether a patient is infected or not, only the pricy PCR (Polymerase Chain Reaction) testing procedure will identify the viruses ‘genetic fingerprint.’

In Taiwan, the first confirmed case of the novel Coronavirus was reported on January 21^st. A middle-aged woman, who previously lived in Wuhan, returned home showing symptoms: fever, coughing and a sore throat. Airport officials quarantined her at the Centre for Disease Control (CDC). The CDC is in close contact with Taoyuan International Airport and Taoyuan hospital. The latter is an essential pillar for infection control procedure. Taoyuan hospital is close to the airport and is the first responder to such cases. As of now, Taiwan’s regular infection control protocol is effective. The comparable few cases that reach Taiwan are quarantined under the supervision of the CDC and the Central Epidemic Command Centre (CECC), as a physician working at the Taoyuan hospital confirmed.

The outbreak of 2019 –nCov has allowed opportunities for improvements to Taiwan’s medical system. For example, the health insurance cards’ various technologies and utilities are about to be renewed. Dr. Tsai (蔡紫君)— a politically active medical doctor working in Taoyuan— has also suggested a better method for infection control, through improving net-based communication between communities and medical institutions. Although there are a few technological issues, physician Tsai is positive for prompt implementation.

In Taiwan, besides the personal identification card (ID card), everyone possesses a national health insurance card (NHI). The card holds background information on pharmaceutical drugs and health history. The distribution of medical masks is linked to the NHI card. Each holder can afford two masks per week. The most crucial improvement, as explained by Dr Tsai, is that as early as this month, information on travel history will be included on the NHI card for pandemic prevention.

Given the overall entanglement of cross-straits relations, Taiwan’s government is well aware of the political situation caused by the Coronavirus. President Tsai held many press conferences concerning the question of how to protect Taiwanese citizens on the island and those remaining in the mainland. During a visit to the CEEC, she called for “prevention and management of the disease.” As a precaution, most flights have been suspended, and entry spots have restricted access, such as maritime passages via Kinmen, Matsu or Penghu Island. President Tsai also assured that “as long as the two sides fully communicate and cooperate, I do believe that we will be able to take good care of our people”. However, controversy arose when on February 3^rd evacuees arrived. Three of the 247 people on the charter flight had not been on the priority list, which Taiwan provided to China, and one was tested positive, becoming the 11^th patient in Taiwan to be diagnosed. This left the impression that cross-straits communication channels are not as good as proclaimed. Since the outbreak, in the last month, the mainland shared information 30 times with Taiwan.

Furthermore, data from the Taiwan Affairs Office (TAO) listed 979 Taiwanese still waiting for evacuation from Wuhan. Most are about to be evacuated by civil aviation channels. While Taiwan’s authorities in charge are working effectively on improvements to protect their citizens within and outside of the island, physicians criticise the opaque information provided by the mainland institutions about delivery and transportation of returning residents to Taiwan.

Recently, the Chinese physician Li Wenliang (李文亮), who discovered the new epidemic potential, passed away. His efforts to warn about dangers in its early stages have been marginalised, if not outright hindered, by mainland authorities. This trajectory alarmingly reminded the Taiwanese community of the glaring insufficiencies associated with the previous SARS crisis. This Created, once again, trust issues in Beijing’s compliance with internationally agreed-upon norms for pandemic prevention control.

Reflecting these trust concerns, physicians are anxious that Beijing is in control of important databases and might misuse such power for propaganda. This concern regards the inclusion of formerly referred to ‘Greater China’, i.e. Hong Kong, Macao and Taiwan, to PRC datasets and thus subsuming Taiwan into their ideological framework. However, data sovereignty and data security are not the only concern to Tsai’s newly re-elected government; a fundamental issue is seeking for WHA membership. As of writing, Taiwan is not an official member of the World Health Organisation, and also not an official member at the World Health Assembly. Although Taiwan used to partake as an observer, this status was withdrawn. Asia News reports that since Tsai Ing-wen’s first election in early 2017, the WHO allegedly gave in to Beijing’s pressure and stopped inviting Taiwan to WHA, accusing president Tsai of seeking the island’s formal independence from the mainland by claiming membership status. This controversy traces back to the question of whether Taiwan accepts the one-China principle or not. Hence, Beijing—being a member of the WTO— hinders Taiwan in becoming a full member, or even an observer, to the WHO.

When in late January the official report improperly placed the self-ruled island under the category “Taiwan, China,” Taiwan’s authorities complained. On January 23^rd, as Laurence Chung reported for the South China Morning Post, by excluding Taiwan’s representatives to the medical emergency meeting held in Geneva on Wednesday, January 22^nd, Taiwan might suffer more than others, due to incorrect mapping of infected patients. Nevertheless, how to refer to Taiwan in terms of WHO reporting remains an issue. After the first patient arrived in Taiwan, the WHO listed this case under China, Taipei Municipality, neglecting the self-claimed statehood of the Republic of China. Later that week, WHO changed its reporting chart and subsumed all confirmed cases under the China label with a note elaborating that the number includes confirmed cases of Hong Kong SAR, Macao SAR and Taipei. In February, the report also listed infection numbers by country and by region. Only after Taiwan vehemently criticised being subsumed, the official declaration in the report changed the current status to “Taipei and environs,” which is still not in favour of Taiwan’s claims.

Although cross-straits cooperation in this current situation seems quite acceptable, Tsai’s supporters might expect her to use this window to strengthen Taiwan’s self-isolation and claim for sovereignty. Chinatimes.com seeks for a period of “Cross-Strait-Love” in this time of the corona outbreak. The title refers to the Spanish book Love in the Times of Cholera by Gabriel Garcia Marquez (1985) and supports using the political opportunity of the Coronavirus to improve Taiwan’s position concerning the international arena. The political argument laid out is that Taiwan is not just motivated to prevent the Coronavirus from spreading; rather, Tsai’s government only follows the polls, because “more than 90 per cent of the polled supported the complete terminations of cross-straits transportations if the epidemic further spreads”, as argued later in the article. Yet, if not handled well, Taiwan’s future position might not only benefit from a harsher course.

Josie-Marie Perkuhn is an academic researcher at the Political Science Department of Kiel University. She studied Political Science and Chinese Studies in Heidelberg, Shanghai and Chengdu. Her PhD research on the PRC and International Relations brought her 2014/2015 to Tsinghua University, Beijing, and as Taiwan Fellow 2017 to the National Chengchi University (NCCU) in Taipei. This article is part of a special issue on Covid-19.

Along with Taiwan Insight’s special issue on Covid-19, we also introduce a timely special issue of the International Journal of Taiwan Studies (IJTS) on “Taiwan, Public Diplomacy, and WHA”. Taiwan’s exclusion from the WHO and the WHA is now a major cause for concern. To understand the reasons, consequences and possible remedies for Taiwan’s exclusion, one has to adopt a multi-disciplinary perspective. In this IJTS’s special issue, we have brought together political scientists, IR specialists, communication scholars, and health experts. For more details, please visit here.