During the pandemic, Taiwan went about business as usual. Schools were open, concerts were playing, theaters were packed. Restaurants were bustling, the economy was booming, and expatriates and overseas Taiwanese flooded into the island. Taiwan was among a group of fortunate countries, including Australia, New Zealand, Vietnam, and Singapore, whose citizens went about business as usual as tight borders, strict quarantine rules, and excellent contract tracing kept the virus at bay.
That enviable routine came to an end in mid-May 2021 when an outbreak of COVID-19 transmission upended everyday life. Yet, COVID-19 cases have fallen significantly in recent days. New cases per day have fallen from 535 on May 17 to an average of fewer than 20 in the past seven days. On July 26, Taiwan reported a new low of 10 cases of community transmission.
How did Taiwan suppress this wave of COVID-19 transmission, even as Australia, Vietnam, and Singapore are struggling with an uptick of the virus?
First, Taiwan doubled down on longstanding strategies of masking, quarantine measures, and contact tracing. Long before this wave, as early as April 2020, Taiwan had already instituted mask mandates on public transportation. The government extended the mask mandate to everybody on the island and required its citizens to wear a mask outside their home.
Moreover, Taiwan extended its quarantine facilities for those entering the country from abroad to domestic COVID-19 patients. Many local governments began providing options for anyone testing positive to quarantine in a government-provided hotel or facility. The provision of quarantine facilities significantly reduced transmission of the virus within the family, thus reducing the number of cases in the community.
Democratic Taiwan, in its attempt to maintain civil liberties, eschewed the more invasive phone-based surveillance technology used by countries in the region. Instead, contact tracers leveraged the records of Taiwanese businesses who encouraged their patrons to leave their contacts either by writing them down on a piece of paper or scanning a business-provided QR code from an app from their phones. While these records were imperfect, they still managed to reduce transmission rates in conjunction with universal masking and enhanced quarantine measures while maintaining a high level of civil liberties.
Second, the Taiwanese government was willing to listen to critics and change its policies in fighting the pandemic. Taiwan emphasizes surface and droplet-based transmission of COVID-19 over the global consensus that the virus could be transmitted through aerosols in poorly ventilated indoor spaces. Taiwanese authorities were reluctant to ban indoor dining in the early days of the outbreak, as they felt that measures such as social distancing and plexiglass installation would prevent transmission. However, after growing intervention from its diaspora and local expatriates who urged the government to restrict indoor activities, many local governments eventually banned indoor dining and restricting indoor activities. Incidentally, the mayor of the southern port city of Kaohsiung led the way in limiting indoor dining. His early move became critical in preventing any spread of the virus in Kaohsiung from Taipei and New Taipei City, which had substantial community transmission. Some local governments have continued to ban indoor dining partly for fear of criticism from voters, even though such a ban was lifted recently by the central government as cases fell. Finally, the ruling DPP government supported the high-profile purchase of BioNTech vaccines from Germany via a mainland Chinese company by a former presidential hopeful in the rival Chinese Nationalist Party (KMT) after segments of the Taiwanese population expressed interest in obtaining those vaccines.
Third, the Taiwanese people actively sought accountability from politicians in fighting the pandemic. Fighting diseases became a marker for good governance in Taiwan’s modern history, beginning from the colonial period, where Japanese medical officers sought to eradicate infectious diseases to benefit the colonizers, to the more recent period, where Taiwanese health experts criticized politicians for being too slow and unprepared in dealing with the outbreak of the SARS virus in 2003.
In today’s context, the mayor of Taiwan, Ko Wen-je, has been chastised by media personalities, politicians, and voters for his relatively poor performance in fighting the outbreak. They criticized Ko for not taking contact tracing and testing seriously enough to contain localized outbreaks at markets, for failing to establish a proper vaccine distribution system, and pushing the blame for the persistent community transmission on the ground to anyone but himself. Elected as a populist, the physician-turned-mayor saw his approval numbers for pandemic control falling almost 7 percentage points from June to July 2021, the most significant fall among all mayors. Ongoing criticism has spurred Ko to accept the help of medical experts from the CDC reluctantly. They have sought to improve anti-pandemic efforts on the ground with the assistance of the vice mayor of Taipei.
Fourth, Taiwan’s media played an understated role in fighting the pandemic. Taiwan’s free-wheeling media, which traces its origins to the democratization of the media landscape in the 1990s, competed to provide the latest information on fighting COVID-19 around the clock. Despite some outlets promoting vaccine hesitancy through emphasizing alleged cases of deaths associated with WHO-approved vaccines, most television stations have modeled good behaviors in their broadcasts. Almost all variety shows and news programs have moved online or insisted that all guests and hosts wear masks and socially distance. These measures reflected the seriousness of the Taiwanese media in fighting the pandemic and modeling appropriate behaviors for their viewers, irrespective of their political leanings.
Fifth, Taiwan reaped the goodwill it sowed in the early days of pandemics. Taiwan donated more than 51 million face masks to countries worldwide last year. Recipient countries, in return, have gifted Taiwan precious vaccines during this outbreak, which the country struggled to obtain due to geopolitical reasons. Japan has given Taiwan more than 3.3 million doses of AstraZeneca vaccines, and the United States has delivered 2.5 million doses of Moderna vaccines to Taiwan in the last two months. Lithuania, Slovenia, and Czechia have also pledged tens of thousands of vaccines to Taiwan. With the vaccines it purchased from COVAX and the United States, Taiwan has inoculated 28 percent of its population with one dose of vaccine, a considerable leap from the 1 percent of the population before the most recent outbreak.
Taiwan’s success may not last, given the virulent Delta variant may breach Taiwan’s borders as it did in Australia, Vietnam, Singapore, and elsewhere. But its experiences, both near and far, should put the country in good stead in dealing with future outbreaks. Global health experts should consider how Taiwan has successfully fought COVID-19 as a democracy, particularly in its incremental improvements on testing, tracing, and isolation without significantly compromising fundamental freedoms and civil liberties.
Despite criticism from the opposition party, the government’s willingness to share its homegrown vaccine, developed with the assistance of the U.S. National Institutes of Health, has revealed Taiwan’s desire to be a responsible member of the global health community. Taiwan’s generosity in sharing masks, resources, and expertise reveals the urgency for Taiwan to be given an observer status in the World Health Assembly. Taiwan can help, and the international health community should facilitate such assistance in order to end the global pandemic.