This is an interesting personal insight from Taiwan from the beginning of the COVID-19 pandemic. To put this in perspective, Taiwan has a population of just under 24 million, only slightly less than Australia’s 25 million; At the time of writing, Taiwan has 432 recorded COVID-19 cases1, while Australia has 6,7992; Taiwan has had 6 deaths1, while Australia has had 942. Our Taiwan correspondent reports:
Chinese people in Taiwan are very health conscious and make heavy use of their national health insurance system which works in combination with a variety of independent health suppliers in both local clinics and hospitals. Many people go directly to hospital to see a specialist if they have a medical problem. There is not the filtering/rationing process applied by GPs in other countries like Australia or the United Kingdom. They pay a small contribution for a consultation/treatment and any prescribed medications. There is also a network of state-funded local health-care centres which, for example, supply annual flu vaccinations and which were used to distribute face masks at one point during the COVID-19 emergency, to take a bit of the pressure off private sector pharmacies.
Wearing face masks to reduce the spread of the regular flu during the winter months, especially on public transport, is common, both to prevent passing on infection and also, people rightly or wrongly believe, to reduce the risk of catching something from others. In general people do not smoke much, not so many are overweight but the incidence of cancer is higher than elsewhere. There are plenty of retired people who regularly go walking in the mountains but many take very little exercise.
People are attuned to be on the alert for threats to their health. In recent years these have included adulterated cooking oil gathered from the kitchen floor, adulterated imported olive oil, recycled meat and relabelling of out-of-date products. There is a tendency to try patent remedies for certain ailments. Fatty Western style convenience food is very popular.
Information flows very freely. Nothing stays a secret for very long under intense if inexpert media scrutiny and wall-to-wall TV talk shows. Media opinion is polarised between the ruling Democratic Progressive Party and opposition Kuomintang Party. Current leadership under Tsai Ying-wen is credited with winning big in the recent Presidential Election and standing up to political pressure from mainland People’s Republic of China (PRC) to commit to eventual unification, and to reject formally any prospect of independence. The government is expected to protect the population from harm and to act quickly and effectively in the face of any threat.
Some people resent the damage that Tsai’s robust defence of Taiwan’s current way of life has done to the economy due to PRC economic sanctions, but they are also very conscious of PRC’s interference in, and pressure on Hong Kong. They are similarly aware of the past concealment of previous health crises in the PRC, most recently with the Severe Acute Respiratory Syndrome (SARS) in 20033,4.
Relevance to COVID-19
The rapid decision to impose restrictions on Chinese visitors from Wuhan and later other Chinese cities was welcomed. Taiwan followed up rapidly with restrictions on arrivals from other jurisdictions, such as those from Hong Kong and Singapore, where cases of COVID-19 had been reported. Also welcomed enthusiastically was the identification of those suspected of having COVID-19, the compulsory self-isolation at home of those with suspected symptoms, and the isolation of arrivals in government provided facilities. Self-isolation of those detected on arrival or subsequently, and their monitoring using government-supplied mobile phones was also embraced. Tracing of contacts of those suspected of having COVID-19 was pursued energetically. The use of face masks on public transport, in shops and markets became almost universal but was complicated by government grandstanding in announcing a ban on exports of facemasks; this immediately led to shortages in the shops, followed by a rationing system involving masses of queueing, then a downplaying of the need for healthy people to wear masks. This in turn was followed by a re-emphasis on the importance of everyone wearing masks to reduce infection, once the supply of masks had been increased ten-fold. There was also a pronounced shortage of hand-sanitiser until supplies were eventually increased. The capacity of Taiwan to react rapidly to new circumstances, with highly qualified medical specialists, relevant civil servants and a burgeoning biotech industry were all part of the response mix. It may also have helped that the Vice-President of Taiwan is an epidemiologist5. The patronage of those cinemas, restaurants etc. which did stay open, dropped considerably
The sense of responsibility towards fellow citizens in Taiwan is strong, and there was fairly strong support for the lead given by the government, despite their missteps, and a willingness to inform on those flouting the announced rules. There was also a degree of pride that Taiwan has apparently coped better than many Western countries; this reinforced the continuation of appropriate behaviour. It would however have been very difficult to enforce a complete lockdown in strongly family-oriented Taiwan. It was also noticeable that young people were more reluctant to cut down on social interaction with their peers.