When Taiwan closed its borders at midnight on March 20, the country had just seen its cases of coronavirus double from 54 to 108 over the course of one week. Only 81 miles of water separated the country from mainland China, and travelers had been returning from Chinese New Year celebrations, many from Hubei province, capital city: Wuhan. The country was poised for disaster … and yet today, as infection and death rates continue to soar in the US, Taiwan has held the line at 440 infections and six fatalities. How did they do it? I spoke with Dr. Ian Clarke, a cultural anthropologist who was, and still is, living in Taoyuan, in northwestern Taiwan to find out.
Cathren Housley (Motif): Looking at the world numbers, it’s astonishing what Taiwan has done. Did you have to impose lock downs and shut down businesses as they did in Italy, the US, the UK and so many other places?
Ian Clarke: No, we didn’t. The reason that Taiwan has avoided a lock down is that the virus was never allowed to establish a foothold here. Everyone coming from a virus hot spot was quarantined. Initially this was just Wuhan, then quickly all of China, then later the rest of the world. This was compulsory and enforced. When cases appeared in the community, they were quarantined. ALL their contacts were traced and where possible tested, and ALL were quarantined. This isn’t voluntary – if quarantined, your location is monitored using your mobile phone, and if you try to leave your home, the police will swoop down on you, slap you with a hefty fine and forcibly take you back again. Anyone who’d had any contact with you would be told to socially isolate and report any symptoms.
It was shocking to see other countries, particularly US and Europe, do virtually nothing. On the media we could watch millions of people in China under strict lock down and see disturbing pictures from Wuhan hospitals – while everyone seemed to go on as normal in much of the rest of the world. In Taiwan, I think everyone realized this was serious. We’d had some experience with epidemics before, but even still, it was obvious from the news how serious the situation was.
CH: How was the government able to act so quickly?
IC: The preparations for a pandemic were in place at the government level in Taiwan even before the outbreak started, and this was largely because of the SARS outbreak of 2003. I’m sure this experience helped the government response; I’m not sure about how much it influenced ordinary people’s attitudes, though. There really wasn’t that much laying low here that I could see. One could feel a change around the end of March/beginning of April, but there really wasn’t a lot of community spread going on at this time. In retrospect, it was probably under control by then, but at the time, of course, this is virtually impossible to know because of the ease with which the virus spreads, and the huge number of asymptomatic and only mildly symptomatic people who were infected.
CH: How much of a part do you think masks played in stopping the spread?
IC: I have no idea if mask wearing helps. It should stop infected people from passing it on so easily, but there seems some debate on how effective this is. Of course, lots of people wear masks in Taiwan anyway. Long before the pandemic people wore them because they were sick, or didn’t want to get sick … so masks are not unusual or stigmatized in any way. I’m sure the normality of mask wearing has helped mute any opposition to compulsory mask wearing. It isn’t asking people to do something strange or bizarre or unheard of.
CH: We’ve had a lot of panic buying in the US. Did that happen in Taiwan?
IC: There was a little panic buying around the end of March/start of April. There were three or four days when the supermarkets all seemed to be out of toilet paper (why would anybody in a panic buy toilet paper?), and all the tinned tuna disappeared from the shelves except for the tuna in brine (no one was that desperate). The instant noodle aisle looked very depleted, though not sold out. By the next week everything was back to normal. There were no reports of people fighting over anything that I can remember.
CH: It seems like the people in Taiwan were far more accepting of restrictions than we were in the US. Is that because the people have more trust in the government?
IC: A lot of the response in Taiwan is coming from the people and their demand to be kept safe; it is not being imposed from above by the government. It certainly isn’t because Taiwanese follow rules blindly. Rules in Taiwan are routinely ignored unless enforced. People are, by and large, following what rules there are because they are reasonable and safe. You also have to remember that because Taiwan hasn’t been locked down, the population isn’t under as much economic pressure. If they were locked down and needed the money, they might well protest to go back to work. But there would be a strong expectation that the government would act to solve the economic problem while keeping the lock down. This is usually the case with a crisis in Taiwan. The government must do something, and if they don’t, they’ll be punished at the ballot box.
CH: What I find remarkable is the people actually understand what is reasonable and safe, how to protect themselves.
IC: The government gives out a lot of information, about both the current situation and advice for citizens. They hold daily press conferences with the command center and the minister of health, Chen Shi-chung. He has become a celebrity in Taiwan for the way he coordinated the response. Of course, that’s because it worked. If it hadn’t worked, everyone would hate him personally. Taiwanese politics is very personal, and result driven.
CH: So, how is life for the people now? We are still traumatized by the changes in our culture here in the US.
IC: In Taiwan, all businesses are still open, and many are quite crowded. For two or three weeks in April, after a few incidents of infection, there was a very subdued atmosphere. People weren’t going out as much and everything seemed much quieter. But now things are going back to almost normal. The government is even talking about relaxing some of the restrictions. You have to wear masks on public transport, of course. I believe all schools are also doing temperature checks, but this isn’t because it’s required; it’s because parents are demanding it. Most people voluntarily wear masks on the street and in shops, as do most of the staff. Again, I don’t believe it’s required now.
CH: When do you think that Taiwan is likely to open its borders again to foreign nationals?
IC: I have no idea. No time soon, I would say. As of May 4, things are still under control. Only Taiwanese and permanent residents can enter the country. When the virus spread completely subsides in other countries, I would say they may open things up, but that’s going to be a long time. No one here is publicly clambering for borders to be reopened.
Anybody who suggested it would probably be criticized from all sides.
CH: Do you have any advice to share with those of us who may unfortunately still have the worst of it ahead? A lot of people here are afraid of what is going to happen, with some states easing restrictions even as the numbers are still climbing.
IC: People should do whatever they can. This means social distancing and wearing masks. I hate wearing masks. I’m not convinced it works, but it might help stop the spread, and that’s good enough for me. If you have a mask, wear it. The government needs to take effective action as well and find every case through testing, trace every contact and isolate them immediately. This is a herculean task, but every developed country has the capacity to do this if there is the political will. Taiwan has done this, though the small number of cases means this hasn’t taken a massive effort. South Korea has done this, and it has taken a massive effort, but they did it. China has done this, with the aid of its vast and pervasive systems of social control, which probably isn’t a good model to follow. But seriously, in the US, literally trillions of dollars are being spent on economic stimulus. Apply this to virus prevention and maybe you wouldn’t need to spend so much to save the economy.