A small island with little to no recognition internationally, overshadowed by the lurking behemoth of China, has managed to do something very few other countries have managed. It has managed to keep the death toll of its citizens down, whilst not completely shutting down its economy. That country is Taiwan and as of 27th April it had registered just 429 cases of Covid 19 and 6 deaths. Just how has this little island nation managed to do something that larger and more prosperous countries have not?
The Taiwanese government first heard about seven people who had been admitted into intensive care with ‘severe pneumonia’ in December of last year in China from members of the Wuhan Institute of Virology. The government learned that six of the seven had been working at the same seafood market where it is believed by some that the virus originated. Upon learning this the Taiwanese government started inspecting flights from Wuhan, and found that there might be evidence of human-to-human transmission of the novel coronavirus, the government informed the WHO but were unfortunately ignored. That did not deter them however, and when the first case of coronavirus was detected in Taiwan, in January, the government was prepared.
On 24th January, the government announced a temporary ban on the export of face masks and by March had begun producing 10 million masks per day, to go alongside a 14 day quarantine on all inbound travellers from the 101 countries acknowledged to be infected. The government also introduced testing at airports in a strategic manner. Arrivals were tested on the plane before departing and received medical questionnaires on their phones asking them about symptoms whilst waiting at the gate.
This data collection enabled the government to deal with a potential disaster in a much more rapid and effective manner, through enabling them to divide people into two categories: those who were most at risk and those who weren’t. This enabled those who were tested positive for Covid-19 to be informed to self-isolate before being seen by a healthcare visitor, whilst the government used GPS data to check whether those self-isolating were following the regulations, and to warn any who weren’t. From there any who had tested positive who developed symptoms were immediately hospitalised. It helped that the government was only testing those that were considered to be of high risk.
Of course, the use of data would have been all for naught had the Taiwanese government not also implemented sensible solutions in their hospitals. First they reduced the work group sizes within medical facilities which helped reduce the risk of a community spread within the hospital from emerging, through reducing work units by as much as two-thirds. Resulting in fewer staff members being responsible for fewer patients, allowing for greater control over the spread of infection whilst keeping treatment standards intact. The government also announced that separate entrances and exits were being established for in and out patients alongside A&E patients to prevent the spread of the virus through regular traffic. Visitors had to pass through a temperature checkpoint and show their ID before being allowed to enter.
The government was also prepared for a potential second spike in infection rates through assembling nearly 1,000 negative pressure isolation rooms and through ensuring that other rooms can be easily reconfigured to meet demand.
Taiwan has faced a small economic slowdown, but schools and shopping malls have remained open allowing for social and economic life to remain relatively normal.
All of this would not have been possible without the lessons the Taiwanese learned from the SARS outbreak in 2003. Taiwan struggled to contain the virus in 2003, and consequently the government set up the Central Epidemic COmmand Centre (CECC) which has been so instrumental in shaping the aforementioned responses the government has implemented. The CECC has the ability to work across government departments and has shown an ability to be highly efficient in dealing with epidemics such as swine-flu and the dengue fever. It can be brought out when needed and then stored away when its work is done.
Taiwan has been able to effectively keep the spread of the virus down, due to an effective system of data collection, testing and subsequent preventive measures. It used its experience of SARS to shape its response to this current pandemic and it has largely succeeded so far in keeping the death toll low. Naturally some of the methods that they have implemented such as the data collection strategy might be frowned upon in the West, but in times of emergency needs must. And the need has never been greater.