An American in Taiwan’s Perspective on Taiwan’s COVID-19 Success

This article is by Grace Faerber (馮思思), a Research Assistant at Academia Sinicia, a second-year Master’s student at the Hopkins-Nanjing Center, a Visiting Student studying Political Science at National Taiwan University, and a Publications Intern at the American Chamber of Commerce in Taipei. More of her works can be read on her LinkedIn at linkedin.com/in/gracefaerber and on Twitter @grace_faerber. Originally published by CommonWealth Magazine. Used with permission.

Former US president Trump’s Health and Human Services Secretary Alex Azar visited Taiwan in August 2020 and applauded its COVID-19 pandemic response, calling it “among the most successful in the world.” While the virus was spiraling out of control all over the globe, life in Taiwan was relatively normal, with schools open and night markets packed – much to the astonishment of the rest of the world, as Taiwan, China’s close neighbor, was expected to suffer from the second-highest number of cases internationally. Taiwan reported under 1000 cases and less than 10 deaths throughout all of 2020. Taiwan was seen as a COVID-19-free haven – the major reason why I, as a U.S. National Security Initiative Boren Fellow, was granted a fellowship to study in Taiwan when travel abroad to nearly every other country was not permitted by the U.S. Government in early 2021.

(Source: Pei-Yin Hsieh)

However, in May 2021, an outbreak in COVID-19 cases struck Taiwan. Following imported cases from China Airlines pilots, the COVID-19 alert level was raised, resulting in increased pandemic restrictions. A Level 3 alert was introduced nationwide on May 19th, requiring face masks to be worn at all times outdoors, banning indoor gatherings of 5 or more people and outdoor gatherings of 10 or more, and stipulating the closure of most businesses and public venues. The steady increase in case counts and initial difficulties tracing cases reinforced the introduction of more stringent policies. Schools and workplaces moved online, restaurants shuttered their doors, and most people stayed at home for nearly three months.

Things began to look up for Taiwan in July 2021, when daily cases fell below 30 and the nationwide COVID-19 alert was lowered to Level 2. On August 25th, Taiwan reported zero local COVID-19 cases for the first time in three months. The outbreak has now been declared “under control” by CECC Minister Chen Shih-chung (陳時中) and pandemic restrictions and border controls have been eased. Restaurants are open for indoor dining, schools and colleges are opening for in-person learning in the fall, and life’s back to a relative normality.

After just over three months Taiwan’s only COVID-19 outbreak was squashed. How did Taiwan do it?

Taiwan’s pandemic success: evaluating Taiwan’s political leadership, coordinated governing authority, public trust, and civic participation

Effective political leadership, a coordinated governing authority, and high degrees of public trust and civic participation are the four most important components of a successful pandemic response. How did each of these components contribute to Taiwan’s COVID-19 success story?

Taiwan’s effective leadership and coordinated governing authority are major factors in its success over COVID-19. The “Taiwan governing model” includes an efficient command system, collaborative ministries, and effective policy communication. Under the president’s leadership, a joint-command system cooperates to carry out a series of coordinated governmental actions to control COVID-19, including pandemic evaluation, decision-making, issuing commands and executing pandemic policy. Taiwan’s Special Act for Prevention, Relief and Revitalization Measures for Severe Pneumonia with Novel Pathogens (Special Act or COVID-19 Special Act), introduced on 25 February 2020 grants the Central Epidemic Command Center (CECC) open-ended authority to take “all necessary measures” to address the pandemic.

(Source: CommonWealth Magazine)

After the COVID-19 outbreak was first reported, Taiwan – which had been hit hard by the SARS epidemic in 2003 – quickly implemented virus screenings, closed its borders to residents of Wuhan, and activated a command center (the CECC) to coordinate its pandemic response. Taiwan was one of the first countries to enforce border controls to contain the COVID-19 outbreak, banning visitors from Wuhan on January 23rd, 2020, then all of China on February 6th followed by other affected areas in the rest of the world.

The government has coordinated comprehensive and diligent contact tracing to suppress the COVID-19 outbreak, starting with integrating immigration records with the National Health Insurance (NHI) database to identify COVID-19 victims, perform digital tracing for those in quarantine and isolation, and pick out individuals who had been in close proximity to confirmed patients. Personal data and immigration records are collected, processed, and shared across governmental agencies through database integration, the use of surveillance cameras, vehicle license plate recognition, and phone tracking. Data is used to conduct contact-tracing and monitor mobility in order to surveil compliance with quarantine orders and other pandemic control measures.

(Source: Chien-Ying Chiu)

As a means of deterrence, the CECC discloses to the public COVID-19 patients’ daily routes and detailed information on individuals quarantined because of “unnecessary” travel to worst-affected countries – some individuals have also been deprived eligibility for quarantine subsidies for breaking pandemic regulations. In cases in both Taiwan’s rural and urban communities, the government has encouraged citizens to report “black sheep” who defy COVID-19 protocols to the police.

Although Taiwan was suffering from low levels of public trust in government when President Tsai Ing-Wen entered office in 2016, her administration, through a series of measures, increased public trust and governmental transparency, very likely contributing to high levels of compliance with COVID-19 protocols. The CECC, under the Ministry of Health and Welfare, serves as the face of the government: holding daily public briefings, communicating calmly and efficiently with the public, and earning the trust and support of Taiwanese society.  Great efforts are made by the CECC to stream all public forums and include online participation in government, which contextualizes pandemic control policy, allowing citizens to engage with officials and discuss the real-life effects of various measures.

(Source: Chien-Tong Wang)

In terms of civic engagement, participatory collective action is also central to Taiwan’s success in coordinating a consensual and transparent COVID-19 response strategy. Foreign Affairs described Taiwan’s COVID-19 success as the result of “a fusion of technology, activism, and civic participation,” calling Taiwanese society “one of the world’s most vibrant political cultures” and applauding its use of “civic technology” to fight the virus. Digital Minister Audrey Tang has also played a large role in Taiwan’s transparent digital governing model. The Diplomat commented that her model of “digital democracy” enhances trust between civil society and government, paying massive dividends for Taiwan’s fight against the COVID-19 pandemic.

The Taiwanese government employed both formal and informal channels for engaging with the public and worked with civic technology groups to facilitate two-way communication between the CECC and citizens. The CECC coordinated with Line Taiwan and HTC Corporation’s healthcare unit DeepQ to create a LINE Bot system, called Disease Containment Expert, to monitor the health of people in quarantine and allow them to report their status via text message. On the LINE app, the public also receives information concerning disease prevention, news about daily imported and domestic COVID-19 cases, changes in pandemic control policy, mask availability, and more.

Public trust and engagement have been high in Taiwan amid the pandemic because COVID-19 control measures and policies highlight mutual respect and cooperation between the government and the citizenry. The government encourages a range of civil society and private sector actors to contribute to the pandemic strategy and build on official policy. Adding in effective leadership and a coordinated governmental response, Taiwan has been able to act against the spread of COVID-19 without paralyzing economic activity. Businesses and events have not been compulsorily closed or banned – many businesses have been willing to adopt their own stringent control measures or close voluntarily.

Reflecting on Taiwan’s pre-established capability to balance public safety and democracy

Taiwan’s success in pandemic control has demonstrated its efficient leadership and coordinated governing capacity, as well as its ability to depend on the public’s trust, engagement, and cooperation with pandemic policy and protocol. Yet, many intrinsic factors also align in Taiwan’s favor for its ability to effectively govern public health.

First, having somewhat recently experienced authoritarian rule and martial law, Taiwan’s history helps reveal its society’s heightened awareness of the costs of surveillance and other authoritarian measures. Taiwan strives to maintain a high degree of democratic governance and rule of law, which in part explains why the government has been reluctant to resort to statism and issue a strict national lockdown.

(Source: Pei-Yin Hsieh)

Second, experience with a major infectious disease outbreak like SARS provided the government with the opportunity to adopt legal, political, and legislative measures to prepare for the next pandemic. Although SARS only resulted in 37 deaths in Taiwan, the pandemic nonetheless forced the government to make changes to the nation’s crisis communication framework, command structure, public health preparation measures, and use of digital technology. The Legislative Yuan overhauled the Communicable Disease Control Act (CDC Act) in 2004, creating a standardized procedure to coordinate central and local governments during a pandemic response and empowering the CECC to impose compulsory measures and fine lawbreakers. Such compulsory measures were later upheld by the Constitutional Court in 2011.

Also after the SARS pandemic, Taiwan stockpiled Personal Protective Equipment (PPE) such as masks in preparation for the next pandemic; when COVID-19 broke out, masks were readily available for Taiwan to distribute domestically and internationally. Mask compliance was high and not muddled by political debate – something I experienced firsthand in the United States. These measures provided Taiwan with a critical head-start and undoubtedly contributed to the normalcy Taiwan has enjoyed throughout most of the global COVID-19 pandemic.

(Source: CommonWealth Magazine)

Finally, a ‘rally-round-the-flag’ effect manifested in the Taiwanese government’s high approval rating in combating the virus. In a study conducted in Summer 2020 by the Asia Journal for Public Opinion Research, 68% of Taiwanese people surveyed said they are willing to trade their civil liberties and privacy for public safety. The public’s high level of trust in the government also contributed to their willingness to sacrifice civil liberties in exchange for security.

As an American who has lived in Taiwan for 6 months now and witnessed some of the highs and lows of its fight against COVID-19, I continue to be astonished and impressed by the drive and resilience of Taiwan’s government and people. Particularly in comparison with the United States’ ongoing struggles containing the virus, enforcing mask and protocol compliance, and encouraging vaccination, I for one have never felt pessimistic about Taiwan’s capacity to fight COVID-19. I hope other Americans look to Taiwan’s vitality as an example, and take some cues from the strength and unity of this archipelago’s government and society as I have.