Although concerned over the impact of many citizens returning from Europe and the US while those nations cope with soaring COVID-19 infection rates, Taiwan has handled the pandemic with alacrity and seems to be successfully managing the process compared with many others, including European nations and the US.
Despite its proximity to China, by March 3, Taiwan had only 42 confirmed cases of COVID-19 and one death, while Japan had 287 cases and six deaths and South Korea had 4,812 cases and 28 deaths.
This is of considerable interest internationally because Taiwan is not only located near China, but is relatively densely populated and is an outstanding democracy that seeks to uphold the freedoms of its citizens.
As the coronavirus runs its course through nation after nation, foreign governments and health authorities would benefit from an examination of the case of Taiwan, as its government plans its next tactics.
Taiwan proficiently limited the original entry of the coronavirus from China, an achievement emphasized by former Department of Health director general Lee Ming-liang (李明亮).
Having learned lessons from the 2003 SARS outbreak, the government promptly adopted border controls and issued travel advisories tiered according to the outbreak level in each nation. Early testing was required and approvals were suspended for many visa categories.
Seeking to contain and control the virus, the government initiated a clear protocol for tracing those who had come into contact with infected people: identify, trace and follow up with those infected or suspected of being infected. This method has generally limited the spread of COVID-19 to an infected person’s family members, and slowed or limited any spread in communities.
Although Taiwan has a low number of medical personnel for the size of its population and a shortage of hospital beds for quarantined patients, the consequences of the shortfalls have been limited.
While Taiwanese officials should rightly be applauded for their astute, firm management, the nation’s populace should also be lauded, because the key in Taiwan has been the rapport between the government and the populace.
Despite some of the considerable financial inducements being offered in the UK and the US, cooperation cannot be bought. Governments that rely on fear to gain compliance might only end up inducing hysteria and paralysis.
Controlling the virus requires not only government planning, but also citizen responsiveness — and this is where Taiwan has shown national advantages in the face of potential disaster.
The first advantage stems, perhaps peculiarly, from Taiwan’s modern history, beginning with a terrible and unsettling period of Japanese colonialization (1895-1945) and continuing with a long period of martial law and the White Terror era of the Chinese Nationalist Party (KMT) authoritarian regime (1949-1987).
Taiwanese know about emergencies, dire circumstances and the threat of having civil society break down. They can adapt and react creatively — an immeasurable advantage that other nations might lack to a similar extent.
Second, being an island, Taiwan is surrounded by an effective physical frontier, reducing the chance that the virus could be reintroduced from an external source.
The nation has excellent border controls and can oversee the movement of foreigners through its airports and ports. This is in real contrast to European nations, whose multiple open borders frustrate attempts to control their physical and political frontiers.
Third, Taiwan has an economic structure that gives great importance to family-based businesses and small enterprises, which is a far less measurable advantage, but of fundamental importance.
These businesses form sound local communities, while robust communities foster a strong sense of civic responsibility. Burdens are shared within neighborhoods, without becoming a major cost to the central government.
Although agriculture provides only 2 percent of Taiwan’s GDP, comparable with developed Western nations, more rural areas of Taiwan are commonly places of workshops, fields and rice paddies, and small townships and villages, forming a virtual frontier where local populations become more dispersed and places rely more on self-help and family-provided food.
Fourth, Taiwan has an adaptable healthcare system in major cities, where general practitioners of both Western and Chinese medicine provide a broader range of services than can be found in the West.
In brief, relatively small medical clinics typically act as hospitals, in that they have beds to care for patients overnight and can provide X-ray and scanning in their facilities.
This relieves some of the pressure on overcrowded hospitals in large urban areas, which is a great advantage during the coronavirus pandemic.
These features of Taiwan take on great importance when compared with the situation in Italy. The epicenter of the outbreak in Italy is Lombardy and the north, which border other nations and are heavily congested with manufacturing.
The outbreak in the US is certainly bound to worsen, and this is not helped by the nation’s two extensive border areas, which are highly populated and almost uncontrollable, nor is it helped by Americans’ aggressive individualism, which could jeopardize attempts by the government to move, isolate or control the population.
Healthcare in the US does not begin to rival the community-based care in Taiwan. About 17 percent of the US’ GDP is spent on health services — compared with about 10 percent in the UK, 11 percent in Japan and Germany — but it fails to provide adequate medical care to millions of urban poor.
In the mind of US officials, caring for people’s welfare might get confused with fears of an economic recession — a perceived quandary that will dull reaction times and possibly trigger negative effects, especially in the tense relations between the central government and the individual states — as shown in the confusion sparked by US President Donald Trump’s public statements.
European nations have yet to show whether they are capable of managing the virus as efficiently as the democratic flexibility of Taiwan.
While China succeeded on many levels because authorities could enforce compliance, Taiwan appears to be managing the virus effectively by relying on the natural choices of its civilian population.
Although this has been helped by early and clear governmental direction and by fortunate physical and economic circumstances, these factors were probably of lesser importance than the flexibility and responsiveness of Taiwanese institutions, communities and families.
Ian Inkster is a professorial research associate at the Centre of Taiwan Studies, SOAS, University of London; a senior fellow in the Taiwan Studies Program, China Policy Institute, University of Nottingham; and the editor of the international journal History of Technology.
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