How Taiwan Has Dealt with the Coronavirus Pandemic: Lessons for the United States

Written by T.Y. Wang and Ching-Hsin Yu.

Image credit: 200314-Z-XK819-0020 by New York National Guard/Flickr, license CC BY-ND 2.0

The number of novel coronavirus disease cases is skyrocketing across the globe.  In Italy, over 105,000 infections have been reported, while the death count has topped 12,000 – a staggering mortality number that more than triple that of China, where the pandemic originated. The number of confirmed cases is also frighteningly high in other European countries, such as Spain, Germany and France.  Across the U.S., the number of infected people is close to 190,000, with more than 4,000 deaths, making the U.S. the new coronavirus epicenter.  The worsening prospect of the pandemic has led to two dozen state governments to take drastic measures by ordering all residents to stay in their homes, restricting the movement of more than 200 million Americans.  As a result, schools are shut down, restaurants are closed, and the airlines have dramatically reduced their scheduled flights.  The American economy has grounded to a halt with a record 3.3 million Americans applying for unemployment benefits.

In contrast, several thousands of miles away, Taiwan has been able to keep the number of coronavirus infections relatively low. As of late March 2020, the island country has about 300 confirmed cases with merely five related deaths, despite its economic activity and proximity with the Chinese mainland. The policies exercised by the Taipei government, so far, have been able to keep the pandemic under control without imposing any drastic social changes. While winter breaks were extended by one or two weeks, Taiwanese schools are not closed. Businesses are still open, and government offices continue in operation. The daily lives of the public are not seriously disrupted. Taipei’s ability to contain the pandemic has been noted and praised by Western media. What lessons can the Trump administration take from Taiwan?

Taking it seriously and responding quickly: Taiwan is an international outcast and has been excluded from the World Health Organization (WHO) for decades due to diplomatic isolation imposed by China. Learning from the bitter lessons of the 2003 SARS outbreak — when the island country did not receive vital information from the WHO regarding the epidemic — the self-relying Taiwanese government has since continuously been monitoring the spread of infectious disease. This time, when China first reported cases of mysterious SARS-like pneumonia to the WHO, Taipei immediately adopted measures to self-guard the spread of the Coronavirus as early as December 31, 2019. The government first stepped up screening at border points and checked passengers on flights from Wuhan, China, prior to exiting the planes. As more confirmed cases were reported in China, a cabinet-level “Central Epidemic Command Center” (CECC) was activated in Taiwan on January 20, 2020, to coordinate government responses and information dissemination to the public. This was more than one month before U.S. Vice President Mike Pence was even tasked with leading efforts in combatting the spread of the disease. Unlike U.S. President Donald Trump, who constantly equated the deadly virus with a common flu and played down its threat, Taiwan President Tsai Ing-wen has since repeatedly warned the island citizens of the gravity of the infectious disease, including suspending her inauguration ceremony for the second term.

Strict enforcement of mitigation measures: It has been reported that South Korea conducted more than 10,000 tests daily. Meanwhile, Taiwan has only conducted about 30,000 tests so far for its 23-million citizens, a population size slightly larger than that of New York, or Florida. Taiwan’s strategy, instead, is to stop the deadly virus at its borders. In addition to stepping up screening at airports and harbours, all passengers now travelling from abroad are ordered to be self-quarantined for 14 days. These passengers are prohibited from taking public transportation. They are transported by a convoy of cabs contracted directly by the government from airports to their respective homes. During the quarantine period, they are required to take their temperature and are contacted by local officials twice a day, while their cell phone signals track their movements. Violators face hefty fines and even jail time. These measures, while initially considered invasive, can now be credited to benefiting the broader community, having substantially reduced the chances of human-to-human transmission of the deadly virus.

Effective government coordination: A year after the 2003 SARS outbreak, Taiwan established a National Health Command Center, which integrates all branches of different levels of government preparing for the possibility of another outbreak. The subsequent activation of the CECC in January 2020 has further provided a unified central command for coordinated responses. Several important measures were adopted as a result. In late January, the Taipei government integrated the databases of its national health with immigration systems, allowing it to track and isolate those who had been to Wuhan, and alerted medical providers to patients’ travel history. Medical supply availability also required government support, as scared citizens hoarded face masks, creating a shortage for the public as well as medical providers. To address these demands, the government directly contracted private companies for the production of surgical masks, enabling 60 new lines in operation to produce an expected 10 million masks each day. Furthermore, the Taiwanese government has created a digital platform to distribute surgical masks to healthcare providers and ration these masks to the public. Taiwan citizens can purchase these masks at local pharmacies, convenience stores, or online. These measures effectively calmed the panicked public and stabilised the situation. These coordinated responses by the Taiwanese government are a sharp contrast to Mr Trump’s reluctance to use the Defense Production Act, allowing him to take necessary actions and address the shortage of personal protective equipment in the U.S.

Voluntary civic participation: It would be wrong to assume that Taiwanese citizens are more likely to comply with government orders. Due to partisan politics, political gridlocks are prevalent in Taiwan, and public trust in the government is not particularly high. Yet, Taiwan’s adopted measures would not be effective without the cooperation of the public. Therefore, the CECC has held daily press conferences, which are presided over by medical professionals, to announce official measures and information on the epidemic, as well as to clarify misinformation circulating on social media. By keeping the public well-informed, the government has demonstrated reliable leadership. This consistent and truthful manner provides the Taipei government with the credibility and public confidence needed during a crisis. As a result, the hoarding of face masks has ceased, and voluntary civic obedience is common. Major festivities that would invite large gatherings have been cancelled under public pressure. Although the government has never issued a mandate of mask-wearing, the prevalent use of face masks shows the voluntary observance of social distancing.

Health experts have agreed that early actions in preventing the spread of the virus can effectively avoid implementing draconian measures, such as those in Wuhan, China, where a city of more than 11 million people have been on a state-imposed lockdown for over two months. Although these measures adopted by the Taiwanese government cannot eradicate the deadly virus, they have allowed the avoidance of radical social change.

The United States now has the worst coronavirus outbreak in the industrialised world, primarily due to the inaction and late action of the Trump administration. A Washington Post article reported that Mr Trump received repeated intelligence briefings about the rapid spread of the deadly virus as early as January. Still, he continued to ignore these warnings and played down the threat to the American public. Although he repeatedly boasts about imposing early travel restrictions from China, Mr Trump failed to take advantage of the time that might have given the country to prepare and respond. The result is wide-spread shortages of testing kits, surgical masks, gloves, gowns and ventilators. Despite desperate pleas of governors from multiple states hard-hit by the deadly virus, Mr Trump still will not fully deploy the Defense Production Act in a manner that would meet these needs. The White House, under his leadership, seems to have no national emergency plan in place to deal with this pandemic. Instead, Mr Trump indicated that he was hoping the United States would be reopened by Easter by relaxing nationwide social-distancing guidelines, which was only three weeks from the date he made the statement. ­Although he changed his mind a few days later, Mr Trump’s initial call to reopen the nation’s economy by Easter has alarmed medical experts as well as his staunch political allies. Mr Trump’s inconsistent stance creates confusion amongst the American people, including his questioning the need for ventilators, while simultaneously compelling General Motors to manufacture ventilators rapidly. This damages the American government’s credibility during a time of crisis.

The contrast between Taiwan and the United States illustrates that early actions and coordinated responses can drastically affect how the public adjusts during a public health emergency. However, speedy measures by the government depends on leadership. Observers pointed out that the Trump administration has collectively failed in taking the novel Coronavirus seriously from the start. Out of concern with his re-election bid, Mr Trump appears to have shifted the U.S. government’s position in the past week. However, he has yet to utilise the government’s authority fully. It is time for the Trump administration to learn from the Taiwanese government, who has led by example in its containment of the Coronavirus. A coordinated response from the federal government may save the United States from having a healthcare catastrophe.

T.Y. Wang is Professor and Chair of the Department of Politics and Government, Illinois State University, Normal, Illinois, U.S.A. His recent publications include The Taiwan Voter. Christopher Achen and T.Y. Wang (eds). (Ann Arbor: University of Michigan Press, 2017).

Ching-Hsin Yu is Research Fellow of National Chengchi University. His recent publications include Taiwan in 2019: US-China-Taiwan Relations and Domestic Dynamics. (Asian Survey, Vol. 60, Number 1, pp. 79–84). This article is part of special issue on the WHO and Taiwan.

Along with Taiwan Insight’s special issue on Taiwan and WHO, 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.

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